Abstract
I loved many aspects of this book, from the opening sentence of the Foreword ‘Many people died to make this book possible.’ to its closing definition for the layman: ‘Vomit’. It deals with 14 murder cases from around the world in which insulin-induced hypoglycaemia was thought to be implicated as a cause of death, and the evidence for this (or lack of it).
The cases are discussed independently of each other, which on the down side leads to considerable repetition, and the combination of two authors produces at times a curious juxtaposition of written styles. Overall, the book falls into a no-man's land in between textbook and populist writing, although this does not detract from its interest.
Perhaps the most fascinating aspect of the book is the chasm it reveals between analytical (and at times clinical) interpretation and legal opinion and interpretation. As someone who has spent many hours in Court trying to explain concepts of analytical variability (these days, I use a cake-baking analogy), I totally sympathize with Professor Marks, who found himself described by an Appeal Court Judge as ‘A slightly unusual and not particularly impressive witness’.
Only towards its end does the book introduce a disturbing note: the concept of analytical interference in immunoassays, particularly in the acutely ill subject. This of course throws doubt over the reliability of any analytical evidence produced in these or related cases.
Almost 50 years ago, George Orwell commented on our fascination for murders: ‘The editors of Sunday newspapers had grasped that people don't really mind whether their murders are up-to-date and when there was no new murder on hand they'd hash up an old one.’; and the ‘crime’ sections of public libraries are still among the most popular. This book will undoubtedly find a place there, and I can recommend it particularly to those whose work at times extends into forensic problems: a nice present for anyone involved in toxicology!