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The Imagined Confession - Examining the Green Note

Updated: Oct 9, 2023


The Green Note at the Trial


To describe the media coverage of the Lucy Letby trial as sensationalist would not be an understatement. But in this long-running case where there was nothing that the media could represent as a ‘smoking gun’ and where so much of the evidence was circumstantial there is one item that seems to stand out as something of an exception. Letby was first arrested on 3rd July 2018, and during a house search a green Post-it note was found among the pages of her diary. This is the so-called ‘confession’, containing such things as ‘I am evil’, ‘I did this’, ‘I killed them on purpose’, ‘I am a horrible evil person’, and the like. As far as many members of the public are concerned, especially those who paid no great attention to the trial as it progressed and who know most about the case from the media coverage of the verdicts and sentencing, the note constitutes one of the single most damning piece of evidence against her.


It was introduced in evidence right at the beginning of the trial by the prosecution barrister in his opening statement.


Highlighting a yellow [sic] Post-it note shown on TV screens to the jury, Mr Johnson focused on some of the words written by Letby. He said: "She wrote, 'I don't deserve to live. I killed them on purpose because I'm not good enough'. 'I am a horrible evil person' and in capital letters, 'I AM EVIL I DID THIS'."

(Report in Liverpool Echo 13/10/2022)


Difficulties of Interpretation


The defence case in response was essentially that the note had no important evidential status in respect of guilt or innocence, and betrayed nothing other than the defendant’s anguished state of mind at the time it was written. However, the note has certain characteristics that make an immediate judgement of it as a statement of guilt hard to ward off, and this is doubly true as far as the general public is concerned.


The green note is difficult to interpret for two principal but related reasons. First, it is not a coherent, narrative document but comprises a series of fragments with no immediately or transparently clear sense of organisation. Secondly, the fragments do not all have the same level of ‘visibility’: some parts stand out because of their position on the page, the size of the writing and because they are written in upper case. These highly visible fragments seem to rise above the rest of the writing and stand as figures against a ground. The remainder of the note is then understood only in so far as it repeats the motifs established by the ‘headline’ words and phrases.


In this way the most salient features of the note then become its ‘content’: what the note is ‘about’. The lack of organisation can be interpreted as expressive of a deep disturbance, of violent emotion, of passion outside the normal spectrum, and the more visible fragments then betray the nature of this: ‘Hate’, ‘Evil’, ‘I did this’, ‘killed’, and so on. This reading culminates in a summative judgement of the note as a whole: it is a confession of a deranged and evil mass-murderer pushed to the edge of madness and suicide by her own actions. This is the general tenor of reaction that may be seen in much of the mainstream media and it does not take much imagination to see how a similar reading of the note may have shaped the reaction of the jury.


Anyone seeing the note for the first time, especially if it is only a brief examination, will be likely to see it in the way that has just been outlined. And indeed exactly this reaction was fostered by the prosecution when the note was presented right at the outset in its opening statement, carefully quoting the fragments that served its purpose and in so doing allowing the jury to fall into a reading of the note that is consistent with that which was to become dominant in the media. The note works best at conveying this meaning when it is not scrutinised closely and this was exactly what happened at the trial.


Rereading the Note


An alternative reading of the note does not immediately reveal crucial data that nobody else has seen. Several commentators have tried to undermine its status as a ‘confession’ and maintained that it is little more than the anguished emotional outpourings of a woman under immense pressure; this was essentially the defence line in the trial. This is difficult to sustain convincingly, however, if the note is not examined in detail in all its parts. Once all the fragments of the note are made equally ‘visible’ and given their proper weight in making sense of it as a whole, the idea that the note was some kind of ‘confession’ becomes much more clearly without any secure foundation.


As a set of scribbled fragments the note is not easy to read, so the first step is to produce a transcription that is as accurate as possible. Secondly, some idea of the way the note was written and the way the different parts fit together can help make sense of its overall significance. Thirdly, the meaning of some of the more obscure fragments can be clarified by seeing the thematic links with other parts.


Transcription of the Note


The diagrammatic transcription below is an approximate representation of the position on the page of each of the fragments. It is intended solely as a reference aid for assisting with a reading of the original note. The colour coding is to highlight what appear to be the different parts of the text and to enable the parts that belong together to be more clearly visible. The justification for this delineation is given in the commentary below.





Commentary on the Fragments


The following notes provide the rationale for the transcription of the written text and for the colour coding depicting its structure.


There are no words

I cant breathe I can’t focus

overwhelming fear / panic

I haven’t done anything wrong

Police Investigation

Slander Discrimination Victimisation

All getting too much

Taking over my life

I feel very alone + scared

what does the future hold

How can I get through it ?

How will things ever be like they used to

- they won’t


It appears that these were the first words written on the note. They start at the top left and reach about three-quarters of the way down the page. The first letter of the first word (‘T’) is repeatedly written and there are signs of the pen not writing properly on the first two strokes. But the emphatic nature of the correction is suggestive of the heightened emotional state evident in the words themselves. The final two words in the middle of the page, where there is no reason why they should not have been placed on the left, suggest an ending of this train of thought.


I am an awful

person – I pay

everyday for that


I’ll never have

children or

marry I’ll

never know what

[it’s] like to

have a family


It is quite possible, though not certain, that this was the next thing written on the note since it occupies the space left by the words on the left of the page. The break suggests two separate thoughts, but the content suggests the continuation of a single train of thought. From the copy of the note available the ‘it’s’ is not totally discernible, but the context suggests this is what is intended.


Hate myself

so much for

what this has


This brief fragment is most likely separate from the one above, since the first two words are in larger writing and shifted to the left compared with the previous line. However, the theme seems to be a continuation and they could plausibly be grouped together. The conclusion is hidden by the large overwritten circling of ‘HATE’, but the context suggests a word or phrase along the lines of ‘done’.


HATE


This is the most heavily emphasised fragment of the note. It appears as though it may be an overwriting of something else, but this is unclear. This should be thought of as part of the same thematic stream as the fragment above it. This is most obviously because of the repetition of the word ‘hate’, which appears nowhere else on the note. This is important because it indicates that the ‘hate’ that is so clearly marked by this is a self-hatred, not hatred for anything or anyone else.


I don’t deserve to live


The positioning of this about three quarters down the left side suggests that it stands alone. It is not clearly aligned with either of the two lines to the right.


killing me


These two words follow two lines below ‘I don’t deserve to live’. They were clearly written after the lines immediately above and below and appear to stand alone. It should be noted that ‘killing me softly’ is a motif that features elsewhere on other handwritten notes.


I killed them on

purpose because I’m not good enough to

care for them + I am a horrible evil

person


The fact that this starts halfway across the page suggests that ‘I don’t deserve to live’ had already been written. This suggests a break between this fragment and the one that ends ‘they won’t’, immediately above it.


The ‘to’ has other text either on top of or beneath it, but from the existing copy it is not possible to be clearer about this.


NOT GOOD ENOUGH


This is the title of the note. The cramped spacing at the top indicates that it was added after the words immediately below it were written. The whole point of a title is to signal a unity of what falls below it; it is a summary indication of the dominant tone of the note as it stood in the view of the writer at the point the words were written. The colour coding picks out the thematic unity of the title with the ‘I killed them on purpose’ fragment and suggests that the title could well have been written as part of the same train of thought, indicating that the overall theme of the note at that point was one of inadequacy, of simply not being good enough. This is consistent with the indications of self-hatred that the layout suggests had already been written. The self-hatred emerges because the writer feels she is simply not good enough and she has brought all this on herself and her family.


world is better off without me


The layout is indicative of this phrase standing as a single fragment.


I don’t deserve Mum + Dad +

Tom + Matt


It is difficult to determine whether the fact that ‘Tom + Matt’ is written directly below ‘Mum + Dad’ is because these four people were grouped together in the writer’s mind or because ‘world is better off without me’ was already written. For reasons given below, the former is perhaps more likely, though the question is probably not of any great significance.


Kill myself right now

forget

everything

everyone


These words were clearly a late addition, squeezed in between the existing fragments. They are indicative of suicidal thoughts and for that reason may perhaps have been written together with ‘world is better off without me’. (Because of the positioning of ‘I killed them on purpose’ it is possible that the other manifestly suicidal fragment (‘I don’t deserve to live’) came earlier, though this is not certain.)


NO HOPE

DESPAIR

PANIC

FEAR

LOST

I DID THIS

WHY ME

I AM EVIL

I DID THIS


The positioning of these words suggests they are a late addition to the note, perhaps almost the last things written on it. The fact that they are in upper case is indicative of the emotional state in which they are written. It should be noted that ‘I AM EVIL’ and ‘I DID THIS’ are not quite aligned. ‘I DID THIS’ is a repetition of a phrase already written a few lines directly above and should not be seen as part of the same phrase as ‘I AM EVIL’, which may even have been written afterwards. Conjoining the two phrases into one readily lends itself to a misleading reading of them as a single thought along the lines of ‘I am evil [because] I did this [specific action].


The scattered words in upper case summarise the pervasive feelings of inadequacy, self-blame, self-hatred, being responsible for letting people down, and consequently being a ‘horrible evil person’. The suicidal thoughts are consonant with this general mood of the note considered as a whole.


The Green Note at the Trial


Given the prominence of the note in the media coverage of the trial and the sensational way in which it was represented it may surprise many to learn that in fact very little time at the trial was devoted to it. It did not feature at all significantly in the prosecution case and emerged only briefly in cross examination. The prosecution did not argue at length that that this was a ‘confession’ and in fact its ‘confessional’ status was never more than lightly (and very obliquely) touched on in court.


However, the fact that the note was subject to so little attention at the trial paradoxically may well have worked against the defendant because what was important about it was the first impression gained from a cursory glance. From the point of view of the prosecution nothing more than this was needed from it.


The three occasions where the note featured most prominently were on 13th October 2022 in the prosecution opening statement, on 27th April 2023, when summaries of the police interviews concerning the note were read out in court, and on 9th June in the final section of Lucy Letby’s cross examination.


The prosecution barrister’s approach to the note was to deal with it right at the start of the trial and once in cross-examination eight months later.


Reports of the way the note featured at the conclusion of the prosecution’s opening statement are worth quoting at greater length. According to the Liverpool Echo (13/10/2022) the prosecution barrister referred to a number of Post-it notes:

Mr Johnson said: "In her writings, she expressed frustration at the fact that she was not being allowed back on to the neo-natal unit and wrote, 'I haven't done anything wrong and they have no evidence, so why have I had to hide away?' And notes also expressed concern for the long-term effects of what she feared was being alleged against her and there are also many protestations of innocence.

"But I want to show you one note in particular."

Highlighting a yellow [sic] Post-it note shown on TV screens to the jury, Mr Johnson focused on some of the words written by Letby. He said: "She wrote, 'I don't deserve to live. I killed them on purpose because I'm not good enough'. 'I am a horrible evil person' and in capital letters, 'I AM EVIL I DID THIS'."

Mr Johnson added: "Well, ladies and gentlemen, that in a nutshell is your task in this case. Whether or not she did these dreadful things is the decision you will have to make when you have heard all the evidence."


The prosecution here merely quotes the words from the note, makes no substantive argument in relation to them and simply concludes that it will be the task of the jury to decide on their truth value. It was never explicitly argued that the words ‘I did this’ amounted to a confession, although of course this is implicit in the prosecution position.


According to the live report of the Chester Standard (9/6/2023) the note was again raised by the prosecution in cross examination of Letby as follows:


The 'I AM EVIL I DID THIS' handwritten note by Letby is shown to the court.

Letby is asked about the notes.


NJ: "You had done nothing wrong?"


LL: "No."


NJ: "Why did you think you would not marry and have a family?"


LL: "Because I was in the position that I was in and didn't think it would end."


NJ: "You had a good job working in the patient safety department at the Countess of Chester."


The summary report in the same newspaper later that day reports the exchange differently:


She wrote: “I am an awful person…. I AM EVIL I DID THIS.”


Mr Johnson said: “You felt [emphasis added] like this because you knew you had killed and grievously injured these children.”


“No,” said Letby.


Mr Johnson said: “That’s the truth, isn’t it? You are a murderer.”


“No,” said Letby.


Mr Johnson said: “You have murdered many children.”


Letby said: “I have never murdered a child or harmed any of them.”


Another report of the same exchange puts it in these words:

Mr Johnson says she felt [emphasis added] the way she did and was writing the notes she was because 'you knew you had killed and grievously injured these children...you have murdered these children' 'I have never murdered a child or harmed any of them', she says (BBC live report: https://twitter.com/MrDanDonoghue/status/1667131618056650752)


It is noticeable that in drawing conclusions from the words on the note the prosecution did not focus on the literal meaning of the words but (according to two of the independent reports quoted here) on the feelings that motivated them. The inference the prosecution wished the jury to draw was not from the words to the supposed deeds, but from the words to the supposed feelings that Letby had when she wrote the note. The prosecution case was that the feelings arose because of the murderous actions of the defendant.


This tortuous form of argument and inference suggests that the prosecution knew that there were no grounds on which it would be possible to sustain a case that the note constituted a straightforwardly confessional document. From the short amount of time devoted to it over the trial period of 10 months it is clear that the note was never central to the evidence against Lucy Letby and in particular never had the status that one might expect from reading the newspaper headlines that reported it. For the mainstream media it was a confession; but for the prosecution this was never the case.


Lucy Letby’s Evidence


The line taken by the defence in relation to the note is quite straightforward, as may be seen from the following accounts.


It is reported (https://tattle.life/wiki/lucy-letby-case/#defence-opening-statement) that in his opening statement on 13th October the defence barrister set out the defence position as follows.


Mr Myers refers back to the note shown to the court just before the break.


He said it is a note written in anguish and despair.


She was "going through a grievance procedure" with the NHS at the time, the court hears, and knew what was being said about her before her arrest.


The allegations were "destructive", the court hears.


The note is headed 'not good enough'. The defence notes it does not say 'guilty'.


The note adds: "I will never have children or marry".


Another part of the note says "I haven't done anything wrong".


Mr Myers: "We say people can pour feelings on to paper.


"This [paper] represents the anguished state of mind Letby felt when accused of killing children she had cared for.


"We say this paper represents 'anguish' and not 'guilt'.


Similarly from the Chester Standard on the same day:


Ben Myers KC, defending Letby, referred to the note in the afternoon session.


He said: “This is the anguished outpouring of a young woman in fear and despair when she realises the enormity of what’s being said about her, in the moment to herself.”


In short the note has no evidential status other than betraying the extreme emotional pressure that Letby was experiencing at the time.


Both under questioning in court and in the interview with the police that was read out in a summary form in court, Letby gives an account of the significance of this note. While it would be perfectly possible to summarise what she says it is preferable to let her speak in her own words. Readers may wish to evaluate for themselves the degree of match between what should now be visible in the note itself and what the writer of the note says about it.


The following details are taken from the live reporting of the Chester Standard (2/5/2023).


Mr Myers asks about notes.


Letby says, about her notes, "it's something I have done my whole life".


She adds she has "difficulties" throwing things away, and that includes notes.


Mr Myers asks about one of the notes she had written. Letby says she does not have a precise date of when she had written it - between July 2016 and July 2018. The note is headlined 'Not good enough'.


Letby says she had written "I haven't done anything wrong" because she hadn't done anything wrong.


She said in the "worst case scenario", the police would get involved.


Re: 'slander and discrimination', she says that was how she felt the trust was towards her in regard to the allegations.


re: 'I am an awful person...', Letby said at the time she did feel an awful person as she was worried she had made any mistakes.


She said she was being taken away from the job she loved for things she had not done.


She adds, at the time, she could not see a future for herself, in relation to 'I'll never children or marry'.


She says "my whole situation felt hopeless, at times".


Re: 'HATE' and 'Hate myself for what this has' - "At the time, I did hate myself".


She says she was made to feel incompetent in some way.


She says her mental health at the time of writing this note was "poor".


She says it was "difficult", with the "isolation I felt", and this lasted "two years".


Re: 'I killed them on purpose because I am not good enough to care for them, I am a horrible evil person'. Asked what she means by that note, Letby responds: "I [felt as though I] hadn't been good enough and in some way I had failed [in my duties, my competencies]...that was insinuated to me."


Re: 'I AM EVIL I DID THIS' - "I felt at the time if I had done something wrong, I must have been an awful person..." Letby says she feared she may have been "incompetent" and because of that, she had "harmed those babies".


She adds she could not understand "why this happened to me".


She says, looking back, she was "really struggling" at the time of writing the note.


A summary of the police interview that had been conducted nearly five years previously after her arrest in 2018 was presented to the court in April 2023. The fact that there is a significant consistency between what she said to her barrister and what had been said to police comes as no great surprise. But its consistency with the content of the note, taken as a whole, should be noted.


There is a detailed report of what was read out in court in the Liverpool Echo (27/4/2023):

On Thursday, jurors were read more excerpts from police interviews with the defendant following her arrest. Asked about the Post-it note - found inside a diary at her home in Chester after her arrest in 2018 - she told detectives: "I just wrote it because everything had got on top of me.

"It was when I'd not long found out I'd been removed from the unit and they were telling me my practice might be wrong, that I needed to read all my competencies - my practice might not have been good enough.

"So I felt like people were blaming my practice, that I might have hurt them without knowing through my practice, and that made me feel guilty and I just felt really isolated. I was blaming myself but not because I'd done something (but) because of the way people were making me feel.

"But like I'd only ever done my best for those babies and then people were trying to say that my practice wasn't good, that I'd done something. I just couldn't cope and I just did not want to be here any more.

"I just felt it was, it was all just spiralling out of control, I just didn't know how to feel about it or what was going to happen or what to do."

The detective asked: "What people were they?" Letby replied: "The Trust and the staff on the unit."

The detective said: "Did you ever make any mistakes?" "No," replied Letby.

Letby appeared strained at times in the dock as she listened to the interviews being read out. She wiped away tears with a tissue as the court heard her explanation as to why she had written: "I'll never have children or marry, I'll never know what it's like to have a family."

The detective asked: "What did you mean by that Lucy?"

Letby replied: "Just that I'd never meet anybody and therefore I'd never have a family. Because nobody would want to.

"If you say to somebody you had to be redeployed then people make assumptions, don't they, and if my practice had caused these problems then I wouldn't deserve to have children myself."

The detective said: "Purely because you had been redeployed off one unit?" Letby said: "Yeah, because at the time it was huge."

The detective said: "Where you say 'kill myself right now', is that something you were considering?"

"Yes," said Letby. The detective said: "And why was that?"

Letby said: "Cos I just felt so isolated and alone." The detective asked: "In your own mind had you done anything wrong at all?"

Letby said: "No, not intentionally, but I was worried that they would find that my practice hadn't been good..." The detective said: "What made you think they might find something that was wrong or that you shouldn't have done?"

Letby said: "It was more that I was worried they'd already gone to the lengths of redeploying me and moved me from the unit and banning contact, I didn't know how it was gonna go. I didn't think they'd find that I'd been incompetent but I was worried that they might try and assume that I had been just because I was there for all of these babies."

She said she had met with the head of nursing in July and was told "there had been a lot more deaths and that I'd been linked as somebody that was there for a lot of them".

Letby said: "They also said that there was some other people that had flagged as being on shift for a lot of them and that myself and these other people are gonna have to be going and redoing our competencies."

Asked why she wrote "slander, discrimination and victimisation" on the note, she replied: "Cos I felt that the trust and the team were trying to imply that it, it was something I'd done."

She added: "I'd lost everything and obviously mum and dad were down in Hereford... and I thought we were a good team regardless of who was my friends, we were a good nursing team on the unit and I'd just lost that. We were like a little family."

The detective asked: "How would you describe the thing (the note) as a whole?"

Letby said: "It was just a way of me getting my feelings out on to paper, it just helps me process it a bit more. I felt if my practice hadn't been right then I had killed them and that was why I wasn't good enough."

The detective said: "In what way do you think your practice might have been the reason why these babies have died?"

Letby said: "I didn't know, I thought maybe I'd missed something, maybe I hadn't acted quickly enough."

The detective went on: "And you felt evil?" Letby replied: "Other people would perceive me as being evil, yes, if I had missed something."

Asked why she wrote 'I don't deserve mum and dad', she said: "I felt so guilty that they have to go through this, that I wasn't good enough for them or any of them and it was all just becoming a big mess and I'd just be better off out of it for everybody."

Letby said she was the first person in the family to go to university and move away from home. She said her parents, John and Susan, were "disappointed" and "really, really upset" at her removal from the unit in July 2016.

She said they were close and she would speak to them "every day". Following the collapse of a baby on the unit she would speak to her mother, she said.

Letby said: "I wouldn't talk to her about it in the level of detail I would with a colleague. I suppose I just saw it was a safe way of me sort of offloading how I felt to someone I trusted."


The Note in its Context


It is not clear exactly when the green note was written. In a police interview Lucy Letby says: ‘It was when I'd not long found out I'd been removed from the unit’ and in his opening statement her defence barrister says that she was going through a grievance procedure against the NHS at the time. This was begun in September 2016 and concluded in her favour by December 2016, so the most likely period for the origin of the note is the last three months of 2016. This was before the police investigation, which started in May 2017; at the time of the note a police investigation was a ‘worst case scenario’, according to her testimony in court.


The dominant theme of Letby’s account of the note concerned the overwhelming feelings she was experiencing when she wrote it. She was filled with anxiety both about the process of investigation, distressed about being moved away from the unit where she loved working and even racked by the possibility that she might in fact have had some responsibility for the deaths.


It is clear from everything we know of her professional practice prior to the catastrophe that began in 2015 Lucy Letby was regarded as an able and highly committed nurse. Precisely because of this conscientiousness her testimony shows her being caught between two streams of thought: that she had no knowledge of doing anything wrong in the care of her patients coupled with a fear that she might unknowingly be responsible for their deaths. This is the consistent theme of what she says about the note, underwritten by fear of the consequences of what people were saying about her competence in relation to the deaths. But there is a further aspect to this that is not reflected in these statements, but which can shed further light on the note.


We know from publicly available details of the timeline of events that from very early on Lucy became associated in the minds of some of her senior colleagues as someone who was somehow connected with the deaths. These suspicions emerged from a single cluster of events in June 2015, when four neonates collapsed unexpectedly and three of them died all within a two-week period. Dr Stephen Breary testified to this at the trial: ‘The court heard that an "association" with Letby and her presence at a number of collapses up to that point were noted.’ (https://news.sky.com/story/lucy-letby-trial-nurse-tried-to-murder-baby-a-day-after-doctor-asked-for-her-to-be-removed-from-duties-court-hears-12833853)


Breary shared his concerns with his colleague Dr Ravi Jayaram, and said that there was nothing to link the deaths ‘other than one nurse’. (The Times, 19/8/2023). This means that from as early as June 2015, the month the first deaths occurred, and on the basis of nothing more than Breary’s hunch Lucy Letby was a figure of suspicion in the minds of senior medical staff. But in the words of the redacted section of the Royal College of Paediatrics and Child Health independent review ‘this was a subjective view with no other evidence or reports of clinical concerns about the nurse beyond this simple correlation’.


At this stage it is not clear whether Breary considered the association he had noted between the deaths and Letby’s presence was much more than a coincidence, but, as is now well known, suspicions about the role of Lucy Letby in the deaths of the babies began to accumulate. Leaving aside whether or not these suspicions were well-founded the natural expectation would be that even if Letby were somehow responsible this would at least initially be thought to be for a ‘medical’ reason to do with her competence, rather than as a purposeful and criminal action. Only when the second superseded the first would there be grounds for calling in the police.


But at some point those initial suspicions took on the form that she might indeed be deliberately harming those in her care. When this happened is not clear. The Times (19/8/2023) reports that in a meeting with the neonatal unit’s ward manager on 16 May 2016, a senior doctor, Jim McCormack (a consultant obstetrician and gynaecologist), said: ‘You are harbouring a murderer’. By the following month lobbying from the consultants had resulted in the executive directors of the hospital discussing whether the police should be called. It was at the end of that month that Lucy Letby was removed from the unit ‘without explanation nor any formal investigative process having been established’ (Royal College of Paediatrics and Child Health report) having already (and with no clear explanation) been moved from night to day shifts.


By September 2016 Letby, around the time of the note, had been subjected to rumours and allegations about her putative links to the deaths of babies, but with no clear statement about what might be behind this, whether there was a question about her competence or whether there were other, more sinister, allegations. In the grievance that she commenced in that same month the Times (19/8/2023) reports that: ‘She said she felt she had been singled out, moved away from the job she loved, and the hospital trust had not been honest about doctors’ allegations against her.’ This clearly suggests that while on the face of it her removal from the unit was to do with competence, she suspected that what was being said behind the scenes amounted to much more than that. And in this respect she was quite correct.


To magnify the bad feeling of the doctors towards Lucy Letby, not only were they convinced she was a murderer, but they were being reprimanded by the executives for suggesting it. At the point where she wrote the note Lucy Letby was isolated, fearful and panicked, emotionally overwhelmed by a maelstrom of overt and covert accusation, not knowing fully what was going on behind the scenes, clearly aware from what she was picking up that she was being accused of something that could lead to a police investigation. The note is a fragmented collection of emotions of panic and fear at what was happening, about the unfairness of what was being said about her, accusatory thoughts, both her own and those of others, about her own possible role in what had come about, and suicidal thoughts in the face of a situation that seemed to have no good outcome.


Undoubtedly, a significant number of infant deaths occurred during Lucy Letby's shifts. For a dedicated nurse like her, it is only natural to grapple with a profound sense of guilt, questioning whether her practice fell short or if heightened skills and vigilance could have saved some lives. In an ideal scenario, surrounded by a team of trusting and supportive colleagues, Lucy's emotional outpourings on a gloomy day might have culminated in less severe self-doubt, perhaps "I feel guilty that I wasn’t more skilled to save them."


However, Lucy's workplace did not offer unwavering support. For months, a group of doctors on the ward had entrenched themselves in the belief that she was a murderer. While no one may have said this to her face, they were working with her for some months with this mindset and the pervasive essence of their unwavering conviction - that she was a truly wicked individual intentionally causing harm - undoubtedly permeated her psyche. As a result, her inner demons of self-doubt were amplified to the next level, reaching their zenith with the expressions: "I killed them on purpose because I'm not good enough to care for them + I am a horrible evil person”, "I am evil", and "I did this.”


Without the benefit of contextual knowledge, merely encountering headlines proclaiming, "I killed them on purpose" (often with the media omitting the remainder of the sentence), it is only natural to question why an innocent person would write this. However, a deeper understanding emerges as we delve into the context. Whilst we do not know the precise psychological reality on the ward, one can imagine that Lucy's guilt, stemming from her belief that with greater skill she could have saved more lives had incubated within a toxic environment where superiors looked at her each day with the conviction that she was the embodiment of evil. In this light, her writings take on a different dimension, revealing such extreme self-condemnation that it borders on self-flagellation.


It is easy to see why at her trial the prosecution did little more than wave the green note under the nose of the jury to take advantage of its immediate effect, rather than making a serious and detailed attempt to argue the case that this note constituted a confession. Just as this notion played no part at the trial, the clarification of the content of the note and the context in which it is written should make it abundantly clear to all that the very idea of a confession is little more than the fantasy of a superficial and hysterical mass media.



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Twenty years ago, Kathleen Folbigg here in Australia was jailed for life because her diaries were treated just like Lucy’s post-it notes were, in a case also littered by statistical errors and medical mischief. Kathleen was therefore wrongfully convicted of killing four children, but was pardoned and freed earlier this year after an Inquiry where experts from around the world gave evidence about what the diary entries really meant. The same diary experts could be useful for Lucy. The 2023 Folbigg Inquiry also had conclusive genetic findings pointing towards innocence, so that Folbigg had to be freed. I was involved in a minor way in the Folbigg case, which involved two decades of academic articles and books about the case…


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Mary Smyth
Mary Smyth
15 de out. de 2023

An altered pattern of behaviour/thinking can occur if you learn that it doesn't matter what you say or do, everything you say and do will be misinterpreted in a negative manner. "Learned Helplessness" follows.


You will stop trying to defend yourself. What's the point? You become stressed and depressed. You cannot exert any control over anything whatsoever. You start to question your previously held beliefs about yourself and the world you live in. Now, even if an opportunity arose to help you in your situation, you wouldn't recognise it. Everything looks bleak.


When I read the comments Lucy wrote, I'm just so thankful she didn't kill herself. Her deep distress is so evident. Maybe she was just insightful enough …

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Mary Smyth
Mary Smyth
14 de out. de 2023

Certain antidepressant medications induce suicidal ideation.

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Mary Smyth
Mary Smyth
13 de out. de 2023

From memory, I think "Tom and Matt" are her cats and so yes, grouped with Mom and Dad because that's her whole family. I should say "were" her cats because they've been rehomed - as a cat lover myself that stabs me in the heart, same for Lucy too I would imagine.

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Mary Smyth
Mary Smyth
16 de out. de 2023
Respondendo a

Oh, thanks Ali. I do apologise for any confusion. Sorry to Tom and Matt and Whisky and Smudge too.

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Very good assessment of how the note might have been laid out originally and helpful to print the different sections in colours. There are two places where I think there might be an alternative . I can see why you put the word 'forget' where you did, but I was wondering if there was a possiblity it could have been part of the section coloured red (so 'Police Investigation, forget slander discrimination, victimisation ...) - two possible meanings from this too, either that the police were ignoring the slander etc against her (by the consultants) or that she is emphasising police investigation as some kind of last straw AFTER having suffered slander, discrimination etc. My second thought i…

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Respondendo a

Suggested amendments always welcome, but I don’t think either of these work.


At the time when the note was (most likely) written the police investigation did not exist and was in fact some months away. As Lucy herself says about it: ‘in the “worst case scenario” the police would get involved’. Secondly, ‘Kill myself right now forget everything everyone’ only makes sense if all the parts are included in that single thought. If you take away ‘forget’ then ‘everything’ and ‘everyone’ have no meaning. Thirdly, look at the alignment of the first two phrases and also the style of the script of the four phrases. They are subtly different and separate from the surrounding writing. They are squeezed …


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