Costel’s Reviews > Unnatural Causes: The Life and Many Deaths of Britain's Top Forensic Pathologist > Status Update

The heart is an organ one can hold neatly in the palm of one's hand. So small but so steady, a little fist, clenching and unclenching seventy times a minute, day and night, year after year, 30 billion times over a lifespan. A faithful friend. Until it stops.

People find it hard to believe that, in mass disasters, visual identification is unreliable, especially so when death has been traumatic or the body has been immersed in water.

Only moderate force is required to penetrate major organs like the heart or the liver, and so even perpetrators with little strength can kill by stabbing.

One of us was always just about to leave for work. And if we were both home there were a thousand topics which required our attention: the children and their schoolwork, difficulties at work, the house repairs... I wondered how I was supposed to fit love into all this?

I really do understand that it is hard, very hard, to recognise the finality of death. To understand that the son who was thinking and feeling and animated yesterday is not so today. To comprehend that yesterday he would have been in agony when I inserted my knife but today he cannot feel it at all.

Most people misunderstand death. They see it as an instant event. You think that one moment your daughter was alive. And the next... gone. But death just isn't like that. Humans only switch off completely, in one moment, like lights, if they're vaporized in a nuclear explosion. In all other circumstances, death is a process.

Nowadays we know about SUDEP - sudden unexpected death in epilepsy. We know it is something that can happen without warning to those who suffer from epilepsy, usually in the night and not necessarily after a seizure.

The old lady had almost certainly given in to that strange counter-intuitive urge that can arise in those who are dying of cold. They take off their clothes. Survivors have described feeling very hot as their temperature dropped and really thinking that stripping off was a completely sensible thing to do. This is a common response to hypothermia.

If the body’s core temperature falls below approximately 32°C then heart rate and blood pressure fall and there is a dulling of consciousness. If the body’s temperature falls below about 26°C then death must almost certainly follow, although there is a famous case of someone who reportedly recovered, albeit mutilated by frostbite, from a body temperature of 18°C.

The law recognised that there could be a “disturbance of a mother’s mind which can result from giving birth”, something which today we call postnatal depression, or its even more serious sister, puerperal psychosis.