Chapter 2: Monkey's Typewriter
Introduction
My name is Adam Green. I am an independent investigative journalist specialising in medical scandals. Over the past 20 years I've worked for CNN, Reuters, the BBC and The Guardian, covering a variety of stories, from the happy to the sad to the downright bizarre.
But nothing compares to the story of St Dumbarton's Hospital. This is the story of Dunbarton Magical.
Chapter Two - Monkey’s Typewriter
Public Health England’s Statistics and Data Research office sits on the Southbank of the River Thames, just past The Shard. The office itself has an odd design. A gutted 19th-century building that has largely been refurbished inside to serve the needs of its current occupiers. It is a prime example of government design favouring function over all else.
John’s office was on the fourth floor, and although its windows overlooked the Thames, the internal redesign that had clearly taken place in the 90s, meant that, although daylight crept through, no meaningful view of the Thames could truly be seen. The internal facade had been poorly aligned with the exterior windows either by the designer or the builder.
John was not one to mind though. If he wanted to see the Thames he would step outside and smoke, a frequent occurrence that had caused this anglo-germanic man’s fingers and teeth to take on the characteristic yellow discolouration of a nicotine addict.
John had run a statistical analysis unit for Public Health England for nearly a decade, building models to better understand demand, spot potential disease outbreaks and generally inform government policy. The team he led consumed near real-time data from NHS trusts up and down the country, gathering statistics on deaths, injuries, diagnoses, procedures and operations performed by the various health services.
Despite a master's degree in statistics from the Free University in Berlin, John’s work mostly consisted of video calls, meetings and emails to various senior people, informing them of the latest trends, or discussing the abstract of otherwise very detailed data.
The team itself mostly led on analysis. At 3:19PM John would receive an email from one of his team. “Error in data reporting from St. Dunbarton’s NHS trust”. The email detailed a suspected glitch in the system used by data managers at the various trusts that may be leading it to register zero deaths for the past 3 days.
Scrolling through a list of individuals with access to the reporting system and bringing up the contact info for the data manager at Dunbarton, John calls.
“Hi, yes, this is John Galbraith from Public Health England Statistics, I’m just calling about some numbers you’ve submitted to IRIS”
John pauses as he listens to the person on the other end.
“Uhh yeah I just wanted to confirm your death numbers for the past three days”
John pauses again, writing on a piece of paper, his desk covered in notes taken from various scraps of paper.
“Okay, and you’ve confirmed with recordkeeping that they’ve had no death certificates for the past three days?”
John waits for the response to the challenge and makes a note.
“Okay, thank you, yes, thank you, goodbye”. Putting the handset back in its cradle he steps out of the office to the huddle of desks in the larger office space outside.
“Yulia, can you go through the statistics for St Dunbarton’s trust for the past year, and do a time series analysis, see if there’s been a drop in diagnoses, or admissions, I don’t know, anything out of the ordinary ''.
John steps back into the office, pulling together the death statistics for the trust, emailing the chief policy analyst at the Department for Health and Social Care, the health liaison at No. 10, and the health team at the National Audit Office.
****
John is the most interesting boring person I ever met. We met three years ago at a health conference sponsored in part by the Wellcome trust.
6 months earlier I had run an expose detailing the mis-treatment of elderly patients at a number of facilities run by a private care provider contracted by several trusts. I was not popular among the attendees.
Like most industries, public or private, health trust management is something of a club. People know each other, they’re friends, they leave one job managing one and enter a job somewhere else working for another. I understand why. It’s a difficult job requiring very specific skills and experiences.
When you’re asked to delegate responsibility especially in something like healthcare, you need to know its someone you can trust. You’re putting your career in their hands. Clubs breed trust, informal or formal, they create codes that their members know and understand. And, as with many clubs, an attack on one is an attack on all.
I was sat at a table for an evening dinner, something I believe I had been invited to prior to the story and they couldn’t remove me from without it appearing blatantly retaliatory. The table - however - was clearly a collection of rejects. “We have to have them, but we don’t have to entertain them” table. John, like me, was something of an outcast.
I suspect - although he never confirmed it to me - that his unit was not popular amongst management across these trusts. John didn’t care for sloppy data or incomplete statistics. I suspect his abrasiveness and perhaps unrealistic expectations for good reporting didn’t win him many friends.
Still, we got talking. John was born in West Berlin to a Scottish Father and German mother, a fact he alludes to by using Scottish colloquialisms with an otherwise mixed English-German accent. Despite having - for me at least - one of the least interesting jobs imaginable, he seemed to love it.
“Aye, the numbers tell you so much”
I remember him saying to me as we stepped outside from the sycophantic atmosphere so that he could smoke. We sat on a bench, overlooking a park opposite the venue. I sipped on a beer as he told me with such passion about how he thought with better data, more frequent data, they’d be able to predict disease outbreaks before they happened, diagnose population-wide pathologies, and generally be more in tune with the needs of a trust.
One of my many responsibilities working as health correspondent has been covering health startups - something that’s been on the rise since the dawn of silicon valley. For all of their faith, I have to admit I’ve found the progress to be very slow or non-existent.
Eventually, you get tired of sitting, listening to someone who could just as well be in college, telling you that within three years the data they’re collecting could end cancer.
But with John it was different, with John - I believed it.
John races sidecar motorbikes as a passenger. When I texted him the day after my meeting with Dr Kirupakaran he told me he was just down the road in a Preston for a race meet.
Stepping out of my grey Prius which had now surely irrecoverably sunk into the boggy swamp that was the field they were racing in, John came up in full motorbike race suit, tied around his waist.
“Ahh Adam! Come, my trailer is down here, can I get you a drink?” He said, and despite being shorter than me, placed his arm round leading me as I felt the squelch of my trainers in the field and the soft soak of moisture run into them.
“I’m good, I’m gonna drive back tonight, but wow, you race these?”
Our conversation continued for a good hour before I got to what I wanted. I don’t like to rush my sources. I often work with people who are grieving or feel aggrieved and a journalist simply pumping them for information is hardly what they want - so even when I meet with people like John, people with no skin in the game, I like to give them the time of day they’re giving me.
“How’d this Dunbarton stuff get out John?” I asked, looking across at him as we sat in two folding chairs outside his van, watching other bikes do practice laps around the dirt track, the overcast day still warm enough to enjoy in a t-shirt.
“How’d it get out? Adam, come on.” the statistician smiled at me, his big yellow toothed grin looking at me. “The only member of the press I know is you, and you didn’t get this scoop did you?”
He pauses looking down at the coffee mug he’s repurposed into a whiskey mug.
“This has DHSC spin-doctors all over it” He laughs a little “Probably trying to distract from another cut, or some other unpalatable piece of policy they’re trying to ram through”.
He takes a sip, as I listen, knowing that John has something of a flair for delivery.
“Look, I work with numbers. These numbers aren’t interesting. You’ve heard that saying, about a million monkeys at a million typewriters? Well, the monkeys are the doctors and nurses, and the typewriters are the hospitals - eventually, they have a few days without a death. Rare, but not impossible. It’s nothing, just a fluke of statistics”
I laugh a little, as I look out over the track
“Go home Adam, you’ve got a beautiful wife and daughter there. Up here, you’re just chasing ghosts”
Under the dusk sky I waded back to the Prius, which through a statistical fluke of its own had managed not to completely sink into the boggy earth underneath, and pulled it back out onto the main road heading back to my hotel.
I thought about what John had said to me on the drive back and found myself agreeing with him. It was simply chance-at-play. Nothing more.
