Trust me, I’m your doctor

LITHOGRAPH: ILLUSTRATED POLICE NEWS 19.11.1892, BRITISH LIBRARY

Dr. Harold Shipman—England’s “Dr. Death”—was sentenced to life in prison last January after he was found guilty of murdering 15 of his elderly patients by administering lethal doses of morphine. In June, a public inquiry opened to examine evidence of more than 400 other cases in which Dr. Shipman is suspected of murder. Depending on the outcome of the inquiry, Dr. Shipman might prove to be Britain’s—and the world’s—most prolific serial killer.

Serial murderers are not new to the medical profession in England or the United States. Many theories claim that Jack the Ripper, the notorious killer who mutilated London’s prostitutes in 1888, was a doctor or other member of the medical profession. “Arguably, medicine has thrown up more serial killers than all other professions put together,” stated an article in the December 2000 issue of BMJ, a British medical journal (1).

One of Dr. Shipman’s predecessors (and Jack the Ripper’s contemporaries) was Dr. Thomas Neill Cream, a physician with a homicidal hatred of women, especially lower-class women and prostitutes. Cream claimed at least seven victims in Canada, Chicago, and London, where Scotland Yard finally captured and charged him with multiple counts of murder in 1891.

Dr. Cream’s favored method of killing his victims was with strychnine tablets; he told his prostitute victims that the pills would prevent sexually transmitted diseases. Poisons were sold over-the-counter during the 1800s. If a doctor or other medical practitioner asked for strychnine or arsenic, the pharmacist wouldn’t hesitate to fulfill the request.Strychnine poisoning is a horrific way to die: Victims succumb to wracking convulsions while they gasp for oxygen as their throat swells shut. “The first symptoms are feelings of apprehension and terror followed by muscle stiffness, twitching of the face, and finally titanic convulsions,” writes Angus McLaren in A Prescription for Murder (2). “The body relaxes, and then the spasms strike again. You have a sense of being suffocated. Indeed, death is actually caused by anoxia—lack of oxygen due to contraction of the lungs. . . . Death occurs in one to two hours, the face fixed in a macabre grin.”

A handsome, debonair gentleman, Thomas Neill Cream graduated from medical school at McGill University in Montreal in 1876 and immediately set his sights on London. The United Kingdom boasted some of the finest medical institutions in the world at this time, such as the Royal College of Physicians and the Royal College of Surgeons. England also was in great need of doctors: The Industrial Revolution had created not only technological advances, but also poverty that manifested itself in filthy, disease-ridden slums that throttled large cities such as London, Manchester, and Glasgow.

Even though professional opportunities awaited Cream abroad, he was detained in Canada. On his way out of town, he was confronted by an angry, gun-toting mob led by the father of a young woman named Flora Brooks, who Cream had seduced and then discarded. Flora had been gravely ill, and while being examined by her family doctor, she admitted to having had an abortion performed by Cream. Holding him at gunpoint, Mr. Brooks forced Cream to return and marry his daughter. The morning after the wedding, Flora woke up to find that Cream had fled to London, leaving a note promising he would keep in touch.

In England, Cream studied at St. Thomas’ Hospital in South London, where Thomas Lister and Florence Nightingale had worked. Cream enjoyed life in London and all of its temptations—from dancing and drinking in music halls and vaudeville theaters to romancing both society women and prostitutes working the Waterloo Bridge. And even though he had paid no heed to matrimonial commitments, Cream found himself a bachelor once again after his wife mysteriously died in 1877. Flora once again became seriously ill shortly after her wedding. When her doctor asked her if she had taken any medications for her illness, she mentioned taking some pills her husband had sent her.

Now freed from his marriage, Cream pursued his medical studies in Edinburgh and opened a practice in the center of town. But it wasn’t long before another mysterious death occurred. In 1879, a young pregnant woman was found dead from chloroform poisoning in a shed behind Cream’s office. He eventually avoided murder charges, but his reputation was ruined in Edinburgh. Cream decided to move to Chicago.

Shortly after his arrival in Chicago, Cream passed the state board of health examination and set up his practice not far from the city’s red-light district. Police quickly suspected him of performing abortions, which was strictly against the moral code of the 1880s but certainly not unheard of for doctors who wanted to make some fast money. Unfortunately, many women fell victim to abortionists who were butchers rather than doctors. Many bled to death from botched jobs or contracted diseases from contaminated instruments. Cream, who at this time was thought to be addicted to cocaine and morphine, narrowly escaped murder charges when two prostitutes died after receiving abortions from him. One simply bled to death, but the other was given “antipregnancy pills” later discovered to be strychnine. Police were suspicious of Cream, but they could not positively link him with the murders.

Ironically, Cream’s downfall in Chicago occurred after he poisoned a man. Around the time that he killed the two prostitutes, Cream had been marketing an elixir for epilepsy. One of his patients, Daniel Stott, swore by the medication and would regularly send his wife to Cream’s office for the pills. Cream began an affair with the wife, and when Stott eventually became suspicious, he added a little strychnine to Stott’s medication. Cream was eventually found guilty of murder and sentenced to Joliet (Illinois) State Penitentiary for life.

Cream ended up serving only 10 years of his life sentence. He was set free in 1891 after he bribed Illinois politicians to grant him a pardon. After his release, he set sail for a return to London. He was soon prowling around his old haunts, such as Waterloo Bridge, and living in South London near St. Thomas’ Hospital. He posed as a resident doctor from the hospital, signing his name “Thomas Neill, MD”. Cream also returned to some of his old habits—he was soon ingesting large amounts of morphine, and he was soon killing.

Two young prostitutes soon fell victim to his false promises of health; postmortem examinations uncovered lethal doses of strychnine in both women’s stomachs. Neither the Metropolitan Police nor Scotland Yard paid much attention—prostitution thrived in Victorian England, and the “working girls” rarely solicited either concern or sympathy from the London public.

One prostitute proved too wise for Cream, although it still did not end his killing spree. After approaching a young prostitute in Piccadilly named Lou Harvey, Cream convinced her to meet him later that evening for dinner and theater. Before they parted at the Charing Cross Embankment near the Thames River, “Dr. Neill” gave her some pills to take care of her pale complexion caused by the London air. By this time, the streetwise Ms. Harvey was suspicious of Cream, and she tossed the pills into the Thames once he was out of sight. However, she showed up at the appointed place and time later that evening to meet Cream, although he never appeared. He assumed she was already dead.

It was only after two more prostitutes were found dead from strychnine poisoning that Scotland Yard took notice. But what ultimately gave Cream away was his arrogance. Cream had befriended a former New York City detective named John Haynes, who was living in London trying to get a position in Scotland Yard. By this time, all of London was buzzing with news about the prostitutes’ murders. Because Haynes was a former detective, he was naturally engrossed in the cases; and he was surprised to hear how much his new friend Dr. Neill (Cream) knew about the details of the murders. After the men had supper one night, Cream actually took Haynes on a tour of the murder sites and talked at length about each of the victims, including Lou Harvey. When Haynes asked Cream how he knew so much about the murders, Cream claimed he had just been following the cases closely in the newspapers. But so had Haynes, and he didn’t recall any mention in the papers of a victim named Lou Harvey.

Haynes immediately contacted a friend at Scotland Yard, Inspector Patrick McIntyre, who had been trying to get him a detective position. Following Haynes’ account, authorities soon discovered that Cream had forged passport paperwork claiming he was Thomas Neill. Soon police were trailing Cream around the clock, in addition to trying to solve the mystery of Lou Harvey.Many prostitutes gave police accounts of being approached by someone fitting Cream’s description (the prostitutes were eager to cooperate with authorities by this time—they were still haunted by Jack the Ripper’s murders in 1888). With mounting evidence against him, Cream was arrested on June 3, 1892.

Throughout his incarceration and during the beginning of his inquest, Cream maintained that he was an innocent man. He betrayed no emotion and remained composed with a stoic expression on his face, according to many historical accounts. It was not until the bailiff introduced Lou Harvey to the courtroom that Cream appeared startled. After Ms. Harvey gave testimony of her encounter with “the doctor” and his pills, Cream was found guilty of murdering four women. He was sentenced to death by hanging.

Public hangings had ceased in 1868; prisoners were now executed within prison walls. On November 16, 1892, crowds gathered outside the execution site, loudly clamoring for Cream’s death. One Canadian newspaper wrote, “Probably no criminal was ever executed in London who had a less pitying mob awaiting his execution.”

According to legends and stories, right before the trapdoor released Cream to his death, he supposedly shouted, “I am Jack” and then was cut off as his neck snapped in the noose. This, of course, refers to Cream admitting he was Jack the Ripper, although this is impossible because he was serving his jail sentence in Illinois when Jack was preying on the streetwalkers of London. Nevertheless, like Dr. Harold Shipman many years later, Dr. Thomas Neill Cream used his medical training to poison and kill rather than to heal.

References

1. Kinnel, H. G. Serial homicide by doctors: Shipman in perspective. BMJ, Dec. 23, 2000, 321, 1594.
2. McLaren, A. A Prescription for Murder: The Victorian Serial Killings of Dr. Thomas Neill Cream; University of Chicago Press: Chicago, 1995.