FAIRFAX

FROM PAGE 1 Professor Byard says the process took about 10 days, with his team identifying those killed using dental records and tattoos because the wet, acidic storage method had rendered DNA identification impossible.

“ There have only been a couple of instances in my professional life where I have had nightmares about cases— and with this one, I had nightmares for probably three or four nights,” he says.

“ I dreamt that the bodies were in the back of a ute and they were coming alive.” But although new to the job, he still returned to work the next week.“ I think I was too shell-shocked to quit.” Now, when the job gets to him, he leans on his colleagues.

“ If you have a terrible case, you call them in to look at it, and then you chat over a coffee afterwards. They know what it is like. Your colleagues have all been through it.

“ We see terrible things year after year, but everybody expects us just to keep going. There is not much support.”

A film was made in 2011, dramatising the Snowtown case, but Professor Byard says he could not comment on whether his work was portrayed accurately on screen.

“ I refuse to watch it because they did not get Sean Connery to play me.”

NCIS

Professor Byard says shows like NCIS have come close to capturing some of the realities of the work, but they usually fail to show how convoluted and often imprecise it can be.“ What they are doing is compressing months or years of investigation into 60 minutes.

“ Then you will have pathologists interviewing suspects and doing blood analysis and all sorts of things.

“ Or they will be prognosticating about the time of death:‘ Oh, it is clearly two seconds past midnight,’ and my response to that is always,‘ Yes, plus or minus a week.’”

Professor Byard has also been involved in research into the causes of SIDS, a landmark for the power( and necessity) of evidence-based medicine.

He was one of the expert witnesses who testified in the retrial of Sally Clark in the UK in the final court of criminal appeal.

Sally Clark in 2003, after her release from prison.

She had been convicted in 1999 of killing her two children based on flawed expert evidence given by paediatrician Professor Roy Meadow, who, with bogus statistical reasoning, had estimated that the probability of two cot deaths in an affluent non-smoking family, such as the Clarks, was around one in 73 million.

Professor Meadow went on to tell the jury that a double cot death— the argument made by the defence— would be expected to occur once every hundred years. They convicted her of murder.

“ My opinion was that the cases had been investigated in a very idiosyncratic manner, and that significant information had not been looked at. And clearly, infection was involved in the babies’ deaths,” Professor Byard says.

“ And I thought there was very much the chance of reasonable doubt, and the judge agreed with my assessment.”

Ms Clark never recovered from what she went through. She died in 2007 from acute alcohol intoxication.

Expert witness?

Professor Byard’ s long experience explaining complex medical concepts to lay juries has made him a proponent of the inquisitorial judicial system found in Europe.

The adversarial system underpinning the legal process in Australia— where two opposing counsels’ expert witnesses describe conflicting technical information— asks too much of non-expert juries, he says. He also notes that expert witnesses do

SA authorities collect evidence during the Snowtown investigation in 1999.

not really have to prove they are experts to give evidence, which is a further burden on non-specialist juries.

Pioneer work on SIDS

Professor Byard’ s involvement in the Clark case was a result of his work on the links between babies sleeping on their fronts and SIDS.

The first evidence that prone sleeping could kill babies emerged through the epidemiological investigations of the Adelaide paediatrician Dr Susan Beal.

From the early 1970s to the mid-1980s she visited more than 500 families who had lost children to cot death in an attempt to identify the common factors.

In 1988 she was able to definitively show that the rate of death was highest among babies who slept face-down.

“ I worked with her in Adelaide and then with others on the information she put together,” Professor Byard says.

“ Then with Fiona Stanley, I co-chaired a scientific review meeting in Canberra in 1991. It was the first meeting in any country to address this issue.”

Today the work of Dr Beal and her colleagues is celebrated as a landmark in evidence-based medicine, overturning 50 years of routine medical advice that had been popularised by US paediatrician Dr Benjamin Spock, who believed sleeping face-down would reduce the risk of babies choking to death.

Babies saved worldwide

To get a sense of its significance, in 2005, a meta-analysis was published estimating that between the 1950s and the early 1990s, more than 60,000 infant deaths worldwide“ were attributable to harmful health advice— that is, advice favouring prone sleeping”.

A decade later, Professor Byard was part of a team that discovered a link between neuropeptide‘ substance P’ and SIDS.

“ SIDS babies had a significantly lower level of substance P in areas that controlled the response to low oxygen, and also in areas that controlled head and neck movement,” he tells Australian Doctor.

“ For decades, we have been saying, why do they not just lift their heads up in their pillows? And the answer is, some

of them cannot because they have this chemical defect.”

But what about the scientific developments in his own specialty during his career? He immediately says CT scanning.

“ A colleague of mine in Sweden had a stab wound case, and the knife was still in the body when he did the CT,” he says.

“ And what the knife had done was it had come in from the left side and pushed all the organs over to the right.

“ But when he pulled the knife out and went to do the standard autopsy— and in standard autopsies, we do layer dissections and work out exactly where things are— all the organs had moved back.

“ For all the world, it looked as if the stab wound had come from the front.

“ So the traditional standard autopsy was wrong; the CT was right.

‘ We see terrible things year after year, but everybody expects us just to keep going.’

“ With CT, we can sometimes identify a cause of death without having to do the autopsy, which is good for the families.”

Cultural revolution

But Professor Byard says the second revolution in pathology was simply cultural: he and his colleagues had learnt to be humble.

“ If you read transcripts of some of the English pathologists from the mid-part of last century, they were just pontificating about all sorts of things.

“ Now, I think we are happy to realise that we do not have all the answers.”

His worst case was the murder of Jasmeen Kaur in 2021, who was kidnapped and buried alive by her ex-boyfriend Tarikjot Singh.

Singh kidnapped the 21-year-old nurse from her Adelaide workplace, bound her with tape and cable ties, and took her out to the Flinders Ranges to kill her after she broke up with him.

Professor Byard says the cruelty of the killing angered and pained him.

“ She was in that boot for five hours. This outraged me,” he told The Advertiser.

“ Then to die like that— buried alive— one of the worst ways to die.”

It was the first time in his career he went to watch a sentencing.

Later that year, he wrote about PTSD in forensic pathologists and the right to mourn.

In it, he called for“ recognition that years of intimate exposure to violence PAGE 6