'Why I was hounded out of hospital'

As the Bristol heart inquiry revives charges of "closed club" practices in the NHS, Margaret-Jane Evans, a former paediatric pathologist, tells how some medics have become public hate figures.

I finally decided to leave my job in the wake of the Alder Hey report earlier this year.

Without consent

Professor van Velzen removed organs from thousands of dead children at Alder Hey Hospital

Bristol Royal Infirmary removed up to 180 hearts from dead children

I'd agonised for a year and a half over whether I was actually benefiting people by what I did or whether I should do something else.

The main reasons were the growing hostility of the press toward paediatric pathologists, and how that affected my relationship with parents.

Professor van Velzen was called a monster, and a number of families conferred that type of personality onto all of us.

Suspended and vilified: Professor van Velzen

I wanted to be a pathologist who could sit down with parents who had good trust in me, so I could explain the post-mortem findings to them and they could meet the person who had examined their child.

But it was clear that all that trust was being eroded. They didn't want to meet me - they were afraid, a fear that hadn't been there before.

I had a father who said he wanted my children to die in tragic circumstances, that he wanted their hearts on his mantelpiece.

Villain of the piece

People were very verbally abusive about what I did - they made out that it was an abnormal thing to do.

The backlash

Fewer post-mortems performed

Pathologists get hate mail

Their children have been taunted

Then there were the jibes: 'Do you have organs in your shed?' My children were told in the playground that their mother was probably an organ-snatcher and she chopped up dead babies.

But pathologists aren't butchers. It's an investigation of the dead for the living.

If you're grieving because of a loss of a child, paediatric pathologists can say why the child died, and whether or not it's going to occur again in that family.

Paternalism to patient power

Some parents I worked with refused to have autopsies done, and would therefore never find out what was wrong within the family if they'd lost the baby during pregnancy.

"I felt that the job was being compromised"

Then there were the parents who, because the government said they could take charge, were telling us which specimens we could take.

I felt that the job was being compromised by what parents were allowing us to do.

I can understand how awful it must have been to discover that organs had been kept. But some good came from it - for instance, mortalities in child cardiac surgery fell in part because these organs had been kept and surgeons had been able to study them.

Yet the press judged 1950s and '60s practice by what we now know.

The climate when these things were done was very different to what it is now. Doctors were paternalistic; they tended to protect people by not discussing in detail what was happening.

'Life-changing moment'

I remember the day I realised I wanted to spend my career in this speciality.

In the corner of the mortuary was a Moses basket with a child in it - this death, to me, was very out of place

I was a medical student in Cardiff, and I went to see a post-mortem. There, in the corner of the mortuary, was a Moses basket with a child who was about one-year-old and immaculately dressed.

It was one of those life-changing moments. This death, to me, was something that was very out of place. Even as a medical student, you have this sense that life goes on; that babies are born, grow up, and die as old people.

I found myself thinking about how a family might come to terms with the death of a child that never reached its first birthday.

It occurred to me that it would help to know why the child died. I felt that this was what I wanted to do - to explain why these things happen.

I'm not an odd person for wanting to do pathology, any more than I'm an odd person to be going into general practice now.

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