The surgeon who cruelly betrayed his patients’ trust | Barbara Ellen

Breast surgeon Ian Paterson has been convicted of 17 counts of “wounding with intent” and three counts of “unlawful wounding” and is now bailed, awaiting sentencing.

Many women have come forward to claim compensation, which sounds richly deserved. For years, Paterson performed hundreds of unnecessary or inadequate surgeries, for mainly female patients at the Heart of England NHS Foundation in Birmingham and private clinics run by Spire Healthcare.

As the case unfolded, there was a recurring theme of Paterson’s charming bedside manner, but also of his arrogance-cum-“God complex”, which was allowed to go unchecked, despite many concerns and complaints. Sometimes, Paterson would perform unnecessary disfiguring operations. At other times, his signature “cleavage-sparing mastectomy” procedure left patients in greater danger of developing secondary cancers.

Reading this, one feels sickened for the patients. There’s a nightmarish feel, almost reminiscent of the 1988 David Cronenberg film Dead Ringers, in which an insane surgeon performed gruesome gynaecological operations. Paterson’s patients were at their most vulnerable and in such a specifically female way. For women, breasts are not just another body part but can be bound up in maternal and sexual identity. Paterson’s patients trusted him, not only with their bodies and lives, but also with their identity and he violated them in the cruellest possible way.

Paterson has also undermined general trust in surgeons, not least with this recurring theme of arrogance and “God complex”. These are all too familiar complaints when it comes to surgeons. However, is it always a case of the surgeon being arrogant or could it sometimes be about the solid confidence that you need to do the job? My partner is a surgeon and, from what I’ve gleaned from him and other surgeons, a high level of confidence, in their decisions, in their ability, is crucial. They’re cutting people’s bodies open; they need to be in charge, to make the tough calls. The last thing anyone wants is an unconfident, self-doubting surgeon.

This doesn’t mean that surgeons think they know it all. Far from it. Good surgeons not only welcome second opinions, they continue to train, learn new techniques, question and push themselves, like the driven type-A personalities so many of them seem to be. It sounds as though Paterson had stopped all that, if he ever started, instead letting himself slide into a state of self–serving toxicity and, from the sounds of it, lucrative complacency.

In someone like Paterson, the “God complex” would emanate not from innate belief, but the self-conviction that, ultimately, their wrongful behaviour is justified. Certain details spring out: the endless operating, the fact that Paterson kept himself apart from colleagues. Not only is performing unnecessary operations simply not done, able surgeons are much more likely to confer over diagnoses, to want to share knowledge and expertise. When someone shies away from doing this, it suggests not so much arrogance as a fear of exposure or a mask for incompetence.

None of this excuses how Paterson was allowed to continue mutilating patients or placing them in danger, unhindered, for so long. The culture of secrecy and protection around high-ranking medical professionals must be stamped out. Moreover, I’m sure that some surgeons are just arrogant sods who bully patients. No one is defending that, however good they may be at their jobs.

However, this case shouldn’t lead to people automatically distrusting or fearing confident surgeons. While Paterson’s actions are the stuff of nightmares, they also feed straight into a paranoid, 1950s-style narrative of haughty surgeons badgering patients into doing as they’re told. In truth, whatever Paterson was (incompetent? greedy? psychotic?), his crimes clearly demonstrate that he wasn’t on the normal surgeon spectrum, not even at the arrogant end. What Paterson did was criminal and pathological.

The surgeon who cruelly betrayed his patients’ trust | Barbara Ellen

Marks & Spencer asbestos situation: "I truly feel so angry and betrayed"

Former Marks and Spencer workers Janice Allen with her husband Stuart at house in Harrow. Photograph: Graham Turner for the Guardian

Janice Allen sits in the conservatory in her cosy semi-detached home in Harrow, husband Stuart alongside her, explaining how their lives have been devastated soon after she was diagnosed with the deadly cancer mesothelioma, caused by being exposed to asbestos when she worked at Marks &amp Spencer up to 36 many years in the past.

Her lawyer, Harminder Bains of Leigh Day, who took on the legal declare in which M&ampS have admitted breaching their duty of care to Allen, is warning that a lot of far more hard-working, as yet oblivious members of the public could comprise a “third phase” of people stricken by publicity to asbestos. Bains says that inadequate security procedures, in breach of the stringent law on asbestos-handing and removal, indicates the public need to have been exposed. Very first of all, industrial and development workers handled asbestos when it was deemed an invaluable fire-proof material until finally its dangers had been recognised in the 1970s, ahead of maintenance staff have been exposed in these buildings.

“Before this occurred,” Allen says, “I had never ever heard of mesothelioma, I barely knew about asbestos. I never would have dreamed that I would be affected by it. It has been devastating.”

She and Stuart met when they the two worked at M&ampS he was 18, she 19, his supervisor on the men’s shirts part of the flagship Oxford Street retailer in London near Marble Arch. They recall operating hard, currently being created to truly feel element of an M&ampS loved ones, that the firm cared. Thursdays were late-evening buying and spend day, and they would usually go to the pub, the Marlborough Head, soon after function. Janice, now 53, worked for 9 many years, 1988-87, at Marble Arch then M&ampS in Uxbridge till they had their first kid, Matthew, now 26, then their daughter, Louise, now 24. Stuart stayed at M&ampS for 22 many years, operating his way up to turning out to be a business analyst, until he left in 2001.

“Marks &amp Spencer engender this total loyalty they had welfare for personnel, hairdressing, when they celebrated 100 many years as a organization [in 1984] we had been all given books on the background,” Janice says. “Now I feel so angry and betrayed. To know that behind the scenes it is so cynical they did not even care for the health and security of their personal staff – it is past phrases. I was only 18 when I joined, I thought I had a secure job, and now each and every day I want I could turn the clock back and had never ever, ever gone to operate for them.”

After the youngsters went to school, Janice herself worked in colleges, latterly as a increased level educating assistant for secondary school young children with specific educational requirements, a work she loved. She and Stuart had been hunting forward to a minor much more comfort, and holidays, in the forthcoming many years, but the end of their ideas came right after Janice woke up one particular morning in the summer time of 2012 with agonising ache in her ribs. It was, she says, “like a shard of glass going via my muscle”.

The soreness eased for a number of months, right up until in March 2013 the agony returned. She went by way of a series of tests and X-rays, till in April 2013 she was diagnosed with mesothelioma. It is a cancer in the outer lining of the lung, induced from cells forming close to asbestos, probably just a single deadly fibre, which can have been inhaled decades ahead of.

“It has been devastating, the shock of the diagnosis,” Janice says. “It was disbelief, at how this could occur, and to realise it is not curable, though it is treatable – I am getting to hang on to that. My initial reactions had been to go totally into depression and excessive anxiousness. With no the help of Macmillan nurses and the hospital, I would be getting terrible problems functioning typically now.”

She did not believe for some time about suing M&ampS, but by means of her stepmother, she heard about Marks &amp Spencer getting been prosecuted, for illegally unsafe managing of asbestos at the Reading shop, for which the firm was fined £1m in 2011, and sued by former personnel, in situations which settled rather than reached a judgment.

Bains, an asbestos professional, applied for a court order that M&ampS disclose paperwork relating to the Marble Arch and Uxbridge retailers the place Janice Allen worked, including surveys of the shops which would present the prevalence of asbestos. M&ampS did not disclose the paperwork. But in April M&ampS formally admitted in court that it: “In breach of duty, exposed [Janice Allen] to asbestos fibres, during the program of her employment with them.” The company declined to comment on its breach of duty to Allen, but stressed it took area in the 1970s and 80s.

In a statement the firm explained: “We are confident that we now have the most rigorous policy we can have in area and that M&ampS shops are risk-free for our personnel and our buyers.”

That admission does raise the alarming probability that in the past, numerous other people, in areas as public as M&ampS’s massive shops, could have contracted the deadly condition previously related with unfortunate industrial and maintenance employees.

“I hope my case will deliver some focus on to this,” Allen says. “When we understood how significantly asbestos there was, the degree of risk we had been exposed to, we felt so angry. Throughout our time, nobody ever mentioned anything at all about it.”

Marks & Spencer asbestos situation: "I truly feel so angry and betrayed"