Books: Did He Save Lives? A Surgeon’s Story

One ordinary evening in February 2010 an experienced consultant colorectal surgeon saw his last patient of the day, a 66-year old retired builder who had developed abdominal pain shortly following an elective knee replacement. Three years later on a cold November day David Sellu was sentenced to prison for 2 and a half years for unlawfully killing John Hughes.

Did He Save Lives? charts the events between these two dates that would lead to the conviction of a surgeon with a previously unblemished record of gross negligence manslaughter. Sellu’s methodical, sparse yet descriptive prose depicting the day-to-day of prison life belies the quiet horror of a life stripped of freedom, autonomy, and dignity.

Born in a rural village in Sierra Leone to illiterate farmers it was not in Sellu’s destiny to become an eminent surgeon in England. Two things changed that. The first was moving to the capital to be raised by his aunt, and the second was winning a scholarship to study medicine in Manchester. After years of surgical training and marrying his wife Catherine, a staff nurse at Hammersmith Hospital, Sellu had it all: four successful children, one of whom was reading medicine at his alma mater, a happy marriage, and a thriving NHS and private practice.

John Hughes, a private inpatient, was seen by Sellu late one Thursday evening. Hughes was 5 days post-total knee replacement but had developed abdominal pain. Sellu’s plan included antibiotics, bloods, and an urgent CT scan. At home later that evening Sellu called the hospital several times to enquire about available anaesthetists. Shockingly, unlike NHS hospitals, many private hospitals do not have 24-hour anaesthetic cover. Sellu also called the residential medical officer to enquire about the results of the tests and to advise on antibiotics. The RMO reassured Sellu that the bloods were normal and the antibiotics prescribed. The bloods were never done and the antibiotics were never issued — Sellu was later blamed for both these failures. The following morning, Sellu called radiology to chase the CT scan but it was not done until later that afternoon and showed a perforation of the large bowel. Sellu would later be held responsible for the delay in the scan. Sellu tried to book the patient for theatre but the earliest he could secure both a theatre and an anaesthetist was 7.00 pm that evening. Unfortunately, the anaesthetist got delayed on another case. On a Friday evening with no 24-hour anaesthetic cover Sellu tried in vain to find another anaesthetist. Hughes was eventually operated on 3 hours later than planned and passed away 2 days later in the intensive care unit. The coroner later referred Sellu to the police, believing he had committed a crime, and Sellu was subsequently convicted of that crime — gross negligence manslaughter.

How could this happen? How could a surgeon who acted in accordance with what a body of his peers would have done at that time, with no access to an emergency anaesthetist, with no power to arrange a CT scan any earlier — be held culpable for systemic failures? How can a jury who openly expressed their confusion about exactly what issue they were deliberating on be allowed to determine the fate of a man? How can a judge be allowed to use a report commissioned by the hospital whose agenda was to exonerate itself at whatever cost instead of using the original case notes?

The conviction and incarceration of David Sellu is one of the biggest miscarriages of justice in British history; it is also a stark reminder of our own vulnerability — as clinicians whose decisions can be scrutinised in a vacuum devoid of the systemic context, for some as persons of colour who do not fit the establishment image, as law-abiding citizens who find ourselves on the wrong side of the law. Sellu’s story is also a testament to the power of perseverance, determination, and faith — faith in family, justice, and the future. Sellu wryly observes, ‘Prison taught me that whatever obstacles man can invent, man can circumvent.’

Sellu’s determination to maintain his sanity and sense of hope has taught me that, whatever circumstances befall a person, they can overcome them.

• © British Journal of General Practice 2020