David Payne on Raoul Moat and Desert Island Discs

David Payne The sorry saga of fugitive gunman Raoul Moat has no doubt triggered countless watercooler conversations about the extent to which he was “mad, bad, or just plain evil.” A colleague described him as less of a threat than the media painted him on the grounds that all of the people he killed or maimed were known to him. He wasn’t a Geordie equivalent of Cumbrian killer Derrick Bird. He made an (apparently unheeded) plea from prison to see a psychiatrist.

Moat turned the gun on himself after shooting ex-girlfriend Samantha Stobbart, hew new boyfriend Chris Brown, and PC David Rathbone. The thought of him on the run in the Northumbrian countryside reminded me of the Alan Bates character in that wonderful 1961 film Whistle Down the Wind, mistaken for Jesus by the three children who discovered him in their father’s barn.

In that drama, the adult viewers see in Bates a hardened and violent criminal, but one capable of a kind of tenderness when the children descend on the barn to see who they think is the Son of God. But that story is set in more innocent times, before the days of Max Clifford-type publicists and Facebook hate campaigns. A remake of the film nowadays would no doubt cut to website headlines such as “He’s better off dead – Mum,” as Moat’s own mother is alleged to have said.

Had Moat survived, might he have ended up in Broadmoor? This thought crossed my mind while listening to psychiatrist Gwen Adshead, a medical psychotherapist at the high security hospital, on Desert Island Discs. (The programme was due to go out shortly after Derrick Bird’s killing spree but was postponed.) I thought about it again hours later, when I saw headlines about Yorkshire Ripper Peter Sutcliffe, one of Broadmoor’s 250 male patients, “never being released from prison.” Don’t the headline writers ever get it? He’s currently a patient, not a prisoner.

But back to Dr Adshead, Kirsty Young’s castaway. You can download this fascinating programme as a podcast, and I recommend that you do, particularly if, like my fellow BMJ blogger Anna Mead Robson, you’re considering a career in psychiatry. Why wouldn’t everybody want to be one, wonders the humane and compassionate Dr Adshead, a 50-year-old divorcee and mother of two, who sings in a church choir and had to retake her second year of medical school because she spent too much time dancing to Ian Dury and The Weather Girls. She’s currently writing a book about the nature of evil.

Her current post, she says, offers an opportunity to combine medicine with criminology, jurisprudence, theology and poetry. She loves the moment when she asks a patient: “How did we come to be meeting here today” and told a fascinated Kirsty Young of the moment when a patient is asked “When you killed so-and-so….”

Raoul Moat aged three
The therapeutic relationship is personable, not personal, she explains, where strict boundaries apply, but motherhood has confirmed in her own mind that the men she treats (most of whom come from violent and dysfunctional background) once had hope and showed promise, as the picture of a blonde, blued-eyed Moat aged three, suggests. 

Because humans are dynamic, some can and do re-enter society, but clinical risk factors are like the numbers on a bicyle lock, she adds. If the right four numbers lock into place, a released prisoner, despatched to a lonely hostel where drink is available, can easily re-offend.

For me Dr Adshead’s most powerful comment was about happiness and our expectation of it, almost as a right. “We expect too much happiness. We’re not prepared for the slings and arrows of outrageous fortune.”

If you know anyone who joined the Facebook pages hailing Raoul Moat a legend or a monster, or the one hoping Sam Stobbart “dies a horrible death,” send them the Desert Islands disc link. They may see things differently after listening.

By the way, here’s Dr Adshead’s Desert Island discs:

The Rolling Stones — Gimmie Shelter
The Prelude to Bach’s Cello Suite No.1 in G Major
Ian Dury — Hit Me With Your Rhythm Stick
The Weather Girls — It’s Raining Men
Kiri Te Kanawa with the Orchestra of L’Opera in Paris conducted by Lorin Maazel — That Ungrateful Man Betrayed Me from Mozart’s Don Giovanni
James Taylor — Shower the People
When Mary to the Temple Went – The choirs of St Peter’s in Caversham & St John’s in Mortimer

The Lacrimosa – MozartRequiem

David Payne is bmj.com and doc2doc editor.