Lucy Letby ~ What Could Have Been Going On In Her Mind?

This case has certainly gripped the profession of nursing, casting a dark cloud of shock, mistrust, and disgust – as opposed to the caring and trusted profession it was thought to be. At least in Britain it has caused a profound public reaction. It appears there will be a public enquiry, and changes to the system as a result. 

The media covering the trial, and all the grisly details, has been widespread enough to make every other country re-examine the role of a nurse, and bring pause to the concept of nurses being in  positions of ultimate trust. 

There is much speculation, and a real possibility it will result in putting CTV cameras on the minute by minute conduct of every single nurse. It is almost beyond belief this could be on the horizon for all health care workers. 

If the profession is so untrustworthy it requires constant monitoring, it most certainly can no longer be called a self regulated profession, as they used to claim it was. Perhaps those days are over.

Yet being treated with suspicion is no way to have to work. Even if they did rely on cameras, how could they determine if there was air or saline in a syringe? They would have to develop preloaded syringes for all medications, including normal saline, which is used to flush the IV’s and saline locks. 

In addition to the preloaded syringes, they would need to have a sealed colour coded tape over the cap, to break open just prior to accessing the IV, so if there were any untoward reactions, the CTV footage could be looked at, to determine what was in the syringe, and if it had been tampered with. 

They would also probably need to hire technicians on every ward to access, and trouble shoot monitors, to include the IV pumps, ventilators, incubators, and all other equipment. They would have to make it clear to all staff to avoid using their body to shield what they are doing. They would have to somehow learn to make all tasks visible to the camera. 

The job is stressful enough. This would just add another layer of difficulty, for those working in a task oriented fast paced environment, where people can and do make innocent mistakes.

Instead of insulin being in bottles, they would have to put insulin into preloaded syringes as well. This would be quite difficult, as there are often sliding scale doses, where different short acting and long acting insulin combinations are used, depending on the patient’s blood sugar. The dosages vary a fair bit, and are usually checked against the doctor’s orders by two nurses. One nurse draws up the insulin, and the other watches carefully, and then both nurses sign the medication record. 

They would have to create a method to make sure IV bags could not be tampered with. Traditionally most of them simply have access through a rubber stopper on the bag. You wipe it with a swab, and put whatever medication is required into the bag. Or more often, the medication is added to a mini bag which is piggy backed and allowed to run through, instead of putting the medication into the main bag. After it is finished, the main IV resumes. So all mini bags would also have to be tamper proof.

For the most part, if a nurse chose to add something surreptitiously to an IV bag, she could. But in the millions of nurses over the years, and millions of IV bags, how many times would someone do such a thing? I suppose there have been a few cases of murderous health care workers. Each one has a unique abnormal psychology and history. 

But poisoning newborns, and tampering with IV lines in a NICU is an isolated occurrence, and perhaps Lucy Letby is the only one who has ever been convicted of doing such a thing. You would no more consider doing such a thing, than you would put antifreeze in someone’s coffee at work. It’s just not even conceivable for most normal people. 

Perhaps more than anything, this case ends up shedding light on hospital cover ups, and the corporate image as a priority over and above the patient safety, in particular the protection of the most vulnerable patients. The attempted cover up is almost as bad as the murders, and in some ways, it is even more deranged.

Her image was that of the quintessential nurse. She had no history of being a mean girl, of torturing animals, or even being rebellious. It would seem she was the perfect adorable child, who had morphed into a sweet caring nurse. She was the proverbial poster child for the role. 

However behind the facade, she was cunning, devious, and craved attention. She did not really care about the infants she was assigned to. In fact she intentionally harmed them in order to draw attention to herself, and mostly in order to have power, dominance and control. She also wanted to attract a doctor who she had a crush on.

She used her role to get what she wanted, perhaps even more so, to get what was otherwise out of her reach. If she was used to getting what she wanted no matter what, she then decided to up the ante. 

But surely things go much deeper than what meets the eye. I am not a psychologist, only speculating. And some of the speculation is based on knowing what it is like to be trapped in a domineering facade, with no plausible escape route.

By the grace of God I did finally escape it, and although I did work as an RN for many years, the profession was not my choice of a career. I was never given credit for having achieved the designation anyway. I escaped it but not unscathed. In fact I am still paying the price for escaping it, on a daily basis. The punishment is ongoing. Setting a boundary should not become a lifelong battle.

When people in a professional role abuse power, it is absolutely appalling. I was forced into the role of being a “nice obedient nurse.” Few professions have more than 90% females with blanket expectations of being sweet, obedient, caring, subservient, and willing to follow orders. The profession was chosen for me so that I would not be able to excel academically. It was a toxic male dominant way of limiting my potential. 

I did excel in the nursing courses, but there was a ceiling, a limit, and a job description to adhere to. For me, it was demeaning. It was always associated with the use of force, a pack of lies, and all credit went to the teacher. 

We can be somewhat assured that many nurses do not fit the sweet, obedient, nice nurse persona. Nursing services are a commodity, and like any other service, should not have so many syrupy expectations attached to it. Yes nurses should be ethical and caring. However, teachers and anyone else in a professional role should also be professional, ethical and caring. 

When people conspire to lock themselves into a deceptive plot, they are not inclined to let go of it. I cannot take responsibility for someone else’s conduct and lies. All I can do is stick to the truth, which is provable and incontrovertible.

The teachers claims about me are false. He should have been held accountable at the onset. It is steeped in deception, betrayal, and blatant brazen lies. His conduct and collusion, is not my fault, and nor is it my fault for telling the truth about my own life.

I graduated early, because I had accelerated through school. My parents were both alive, but were unable to take care of us. As a result, I was targeted by a religious fundamentalist lying high school teacher, who forced me into nursing.

He then took credit for the fact I was a nurse, was very proud of it, and also made outrageous claims about having adopted me, when I was never up for adoption. In fact I was never under his jurisdiction at any point in my life.

He was a total stranger to me, and at the time I was very afraid of him. He was authoritative and domineering to the extreme. He was a bully. Most of the kids in the school were afraid of him.

He decided to paint me as the proverbial bad girl, even though I passed with honours on a regular basis. He was bound and determined to be the pseudo-rescuer. I was simply trying to get through school. There was no princess syndrome whatsoever, but suddenly there was an irreconcilable facade governing my life. 

I wanted to go to University with a focus on studying  literature and history. I had an interest in design, and artistic endeavours. I also had an offer of a scholarship into an English program. But all of it was shattered by a teacher who abused power, and took command over the direction of my life. I knew the state had to pay for my schooling until I turned eighteen, so I did have a plan in place at a very early age as to how I would get a post secondary education. 

When I turned eighteen, I was already two years into a nursing program. The teacher did aggressively try to force me to sign adoption papers, but I flatly refused. I still could not get rid of the guy, because he had infiltrated my family. When I refuted his lies, I was bullied, gaslit, condemned and forced into submission. It went on for years.

The teacher robbed me of who I am for a period of time. He tried to snuff out my family history. He stole my identity, my dreams, aspirations and choices in life. He took away my right to freedom of association, because I had no choice but to associate with him, when I could not even stand him.

He lied about me to everyone. In fact, there was never a single time I was around that man when he did not constantly lie through his teeth. It was a never ending batch of lies. The ultimate con. If I said anything, there was a threat of punishment, blame, and rejection. 

He took credit for my academic abilities, when I had been identified as being academically gifted in the first grade. I did not even know him as a teacher until I was a teenager. When I was in first grade, he was seventeen or eighteen years old, and living in another community. He was not even on my radar in any way, shape of form. He came to teach in the community I grew up in when I was already in high school. 

He attacked and damaged all of my family relationships. He used me as a fund raising mascot for his cult religion. Because it was obvious I could manage to get a post secondary education, he used it as an opportunity to not only rob me of my academic potential and choices, but also to take credit for what I did accomplish. I was like something he found at a garage sale. 

He set out to limit, take credit for, obtain financial gain, shame, accuse, and get a lifelong benefits and multiple perks for doing so. There was no way he was going to let go of the goose that laid his golden egg.

All this because he was a narcissistic predator in a public school, and was allowed to get away with it. He was a man in his twenties who was totally obsessed with a teenage student, yet no one protected me from his supreme aggression, dominance and deception. 

This particular teacher, was a recent graduate when he came to teach at our school. He was immature and inexperienced. Yet he had a profound god complex. He seemed to think he could operate outside all boundaries, simply because he was in the role of a teacher. In addition, he was a tough guy. He used all kinds of intimidation tactics to include yelling, making threats, and prolonged staring. He was a punisher, accuser, and guilt tripper. He was an emotional sadist. 

Above all, he seemed to think his religious beliefs made him the all encompassing authority. He himself was a deity to be treated with the utmost respect and obedience. He crafted the role, and never let go of it.

Why should anyone in a public school care what his extremist religious views are? Yet he acted like he was wearing the crown of righteousness, which made him the king, with authority over his subjects, and if he chose a specific target, so be it. This was his domain, and no one could challenge him, least of all me. 

Although my story is very different, in some ways the polar opposite from Lucy Letby, and the way I reacted was very different, I can kind of see how she was trapped. Only she was trapped in a gilded cage, and I was trapped in another kind of cage.

I had no desire to harm patients, or anyone else for that matter. But there are elements of her pathology that I can kind of understand. I was not doted on by any means, and was not an only child. But I do understand what it is to be trapped, and robbed of an identity. I can relate to how difficult it is to be forced to conform to a certain image, and the expectations of others. 

If there is a domination over our independent choices and our free will, it is soul-destroying. Our soul consists of our mind, will and emotions. If we are dominated into submission, there is both anger and guilt. We are supposed to feel gratitude, yet we feel oppressed and angry instead. So there is guilt for not having involuntary gratitude. There is a debt bondage that can never be repaid, or forgotten about. The sad fact is that some people will use others in every conceivable way, to advance their own agenda.

The reason I believe she may have been robbed of her authentic self, is because she was too perfect. Could it be because she felt she had no choice but to be perfect? Was every breath she took aided by a golden fan waving over her, to help the air flow, because in reality, she was being suffocated?

Being the object of constant attention and adoration, could rob a child of key developmental milestones when it comes to autonomy and identity. It would also instil a belief in her that her life mattered, far more than anyone else’s life mattered. 

I can understand how rebellious rage, and a sense of entitlement might rise out of a longstanding good girl subservience role, because it is a trap, and is a profoundly psychologically damaging place to be. You are in a prison of sorts, yet no one can see it, and no one is experiencing it but you. 

If one is forced to live a lie, or a facade denying the true self, there is a very powerful condemnation, entrapment, cognitive dissonance, and dichotomy of the soul. It ends up being turned inward with no conceivable escape route. 

I do understand the intrinsic agony of living in a false world, and trying to constantly please people, without being given the opportunity to be who you are, flaws and all. 

From what does meet the eye, I am speculating Lucy Letby may have been dominated and overshadowed by her parents. Without a doubt, her parents would not have intended to harm her psychologically and emotionally. But they did have a role. There is nowhere else to look. 

In hindsight, I feel much gratitude toward my own mother, because in spite of her many flaws, she did have genuine love toward me, and created an attachment that was never abandoned or completely severed. She gave us a lot of freedom when we were small, and simply warned us about dangers, like abandoned wells on the farm, and bears in the blueberry patch on the back quarter. 

I am not suggesting being an only child is an issue, but rather being an only child who is excessively doted on, in conjunction with portraying an image of perfection, or being conditioned to be a people pleaser, instead of figuring out her own needs first – could cause big problems.

To become a giving person is a good thing. But it is not a good thing, if you have to give yourself away in the process. If so, you are a sacrificial lamb, a mascot, a prop, or a scapegoat. Even if you are put on a pedestal, it’s just a greater distance to fall. 

They could not have known what kinds of reactions she might have, with regards to the lifelong childish dependency, doting, and constant attention she received from them as an only child. Following the childhood, she faced the struggles involved in becoming an independent and autonomous adult. It was at that juncture where she ran into serious problems. 

The image of her room with teddy bears, fairy lights, and Disney movie type posters, does show that in many ways she was still very immature. She might have been locked into a fantasy world of escapism, but still managed to give the appearance of being normal, simply because she had learned to be a good actress along the way. 

Most abnormal psychology develops in the formative years. Therefore her early childhood will be scrutinized. If she had come from a troubled background of poverty and addiction, there would be an immediate blaming of the parents.

In such cases, the judgement is swift and all encompassing. Things like “well what do you expect?” and “she didn’t stand a chance”. Truthfully though, we all stand a chance. Countless people overcome difficult childhoods without becoming serial killers. 

But when a wayward person comes from an upstanding middle class home, looking into the nitty gritty nuances of dysfunctional family dynamics, does not have as many people who are even willing to study it. In fact sometimes the polar opposites between too little, and too much advantage, can be equally as debilitating to a child’s development. 

If people are expected to evaluate what appears to be normal, yet might not be – they risk being jarred out of their own denial, and might be forced to examine their own lives. So they avoid the analysis altogether. 

Dysfunction in families, like so many other things, has no respecter of persons. Denial and dysfunction can happen within any family, rich or poor, addicted, lazy or workaholic, with secrecy and deception, cheating, favouritism, and a false image projected to the outside world. It can be narcissistic, or negligent – there is no shortage of pitfalls. 

The fact she committed the crimes in her early twenties, points to what is already known. The adolescent brain is not considered to be fully developed until the early to mid twenties. In her case, as an only child who was doted on, the transition would have been more tangled and difficult.

As all the reporters and experts are pointing out, she was always considered to be a “good girl”. She showed no signs of being anything but a sweet darling who was studious, quiet, obedient, and aspired to be a nurse.

The question is, was that her true self? Surely with domineering parents who she described as “suffocating at times” one would think she would have rebelled at some point. Also if she truly did have psychopathy, it would have shown as having an obvious conduct disorder in her childhood.

Usually a young person in such an environment will do things the parent does not want or expect them to do, by the time they are fourteen or fifteen years old. They might dye their hair purple, experiment with drugs, get tattoos, find a rebel boyfriend, or run away from home. They might sneak out at night, go to parties, or skip classes. 

As much as they drive the parents crazy, those are simply examples of the child exercising some personal autonomy, and free will, even though they may not be making the best choices in doing so.

I am not suggesting disobedience to parents, serious rebellion, and very high risk behaviours are a good thing, but rather expected, if the child has been carefully crafted into an image of perfection.

Some kids are naturally very sensible, and don’t get into much trouble. It is more likely to become a problem if they are dominated into submission, or denied the right to take any risks, or make mistakes. They need a certain amount of freedom. Too much advantage can be a real disadvantage. Doting on and spoiling children rotten, does have a dark side.

It sounds like Lucy Letby did none of the above mentioned rebellious activities. She may have felt at some level, that she was a carefully constructed extension of her parent’s image. She may have been so ingrained with what was expected of her, she learned to put on the perfect act. Obedient, submissive, soft spoken, people pleasing, and sweet. She may have felt like a possession, or an object, yet she could not voice how she felt without feeling guilty. 

Inwardly she may have felt like she was dying inside. Her true self was being suffocated and snuffed out. She could not grow up and break free. Her parents could not let go, and she could not extricate herself from the bonds of sweetness. Kind of like a fly gets stuck on one of those home made sticky fly traps. 

As pure speculation, I am wondering if what Lucy Letby was doing at work was a way of acting out indirectly against parental control. Her projection of familial destruction onto her patients and their families, may have been a deep rooted psychological attack on her own family dynamic.

If Lucy Letby felt objectified as a child, and forced into a facade to suit parental ideals, she may have also projected the destruction of her own false self onto the babies, as a form of extreme aggressive regression. She was suffocated, therefore she would suffocate them. She knew her parents would be devastated if they lost her, so she took children away from their parents, and revelled in their grief.

With each attack, she was attacking the good girl image – the false self, the perfect family. She was attacking the powerless, the vulnerable, and those who had no say. She may have been acting out some of her own childhood psychology, and the rage within her directly onto them. How else does one explain the sadistic nature of those attacks?

She may have regretted her own birth, and in a warped way, thought she was saving them from a life of fabrication, and an existential nothingness. 

As a child develops, they gradually learn to stand on their own two feet. The mishaps, mistakes, failures, rebellions, and battles they go through, are all part of developing a strong sense of self.

They are separate from their parents. They are who they are, and they must be allowed to be who they are. They have an identity, and if they cannot get comfortable with, and maintain their identity, it is going to cause them a great deal of harm. 

The fact Lucy’s father went to workplace meetings with her, and defended her like a dominant papa bear, is quite telling. There is no way he should have been going to workplace meetings with his adult daughter.

There are many reasons for this. The obvious one is that she needed to take responsibility for her own life, and her own conduct, not have her daddy there to railroad those who were trying to address it.

The other factor is one of confidentiality for the patients, other staff, and the health authority. Outsiders are not allowed to be part of the dialogue as a rule. So why was he allowed to participate in the meetings?

Not only did he participate, but the hospital administration sided with him against the doctors. He succeeded in getting a letter of apology, and nearly got her reinstated without consequences. They also looked at other alternatives, like sending her for her Master’s degree, or relocating her. Clearly her father had a great deal of influence.

But such influence is likely the very thing that caused her so much damage. The interference, the power, the control, the dominance, the rescuer, the getting away with things – may be part of what got her into hot water in the first place. It also prevented her from reaching full maturity.

When she was finally convicted, her mother was extremely distressed, and cried out something like “I did it, take me instead.” This too shows the parents did not see or allow their daughter to be her own person. She was an extension of them. Which means, she too was a product of narcissistic traits, because narcissistic parents view their children as being extensions of themselves.

I am not suggesting the parents are to blame. When adults commit crimes, they are the ones who did the crimes, and they must be the ones who are held responsible for what they did.

Ultimately, Lucy Letby did destroy the ties that bound her so tightly to her parents. Without a doubt they will still support her, and do all they can to arrange appeals etc. But she did succeed in shattering the good girl image, the false self, entrapped in a world of Disney land cotton candy, stuffed animals, and fairy lights.

She contrived an elaborate way to break free. She destroyed others, as she was in the process of breaking out of the mold she had been forced into. She could not cut her own umbilical cord. Her life was an illusion. She shattered the illusion in the worst imaginable way.

I believe the key takeaways in this should be to gain a better understanding of young people who are transitioning into roles involving a lot of responsibility. The level of maturity, and the degree of parental involvement should be taken into consideration.

Health authorities need to be able to see the deeper implications of a father attending workplace meetings with an adult daughter who is in a professional role. Obviously if she needs him there to defend her, she should not be looking after defenceless neonates, or given the trust one would give to a mature adult.

All parents, and all adults, especially those who are in a position to abuse trust, like what happened in my own life, need to realize children are not pawns or mascots to improve their image, or get them what they want. 

Children are not extensions of another person. They are not to be dominated into absolute submission. They need the freedom to become their own person. They need to integrate who they are, with how they feel, and what makes sense to them.

Otherwise there is a risk there will be a splitting of self, as there so clearly was with Lucy Letby. On the one hand she was superior, spoiled and grandiose. On the other hand she was bereft, adrift, full of self loathing, and morose.

At some level she must have wanted to be caught, to put an end to it all. She was clever and cunning, yet she left all the evidence, including confessional type notes at her residence for the police to find.

When she was taken off night shift, it was a clear indicator to any intelligent person, that there were serious suspicions developing. Yet she continued the attacks with a brazen disregard for the consequences.

In my opinion a significant part of what developed with Lucy Letby, was a profound act of rebellion. Rebellion against the perfect child image, rebellion against her false self, rebellion against the hierarchy and power structure she saw within the hospital setting, and perhaps even rebellion against God for the very fact families are allowed to exist.

As I contemplated it more, I do not see her as pure evil, and don’t really believe anyone is pure evil, because as long as a person is alive, there is hope for them to repent and see the light. She could not possibly have come to the point in her early twenties to have enough insight, to figure out what was plaguing her. She was used to putting on an act, so she kept on acting.

When we are in our early twenties, we have the energy and resilience to carry out a facade, to seek distractions, to deal with high levels of internal dichotomy, and bounce around a fair bit. But it wears on a person, and eventually there is a breakdown of some sort.

If she would have taken a different path, she may have hit the brick wall sooner. She may have found a way to get out from under it all. Who knows? One thing for certain, is she will have much time to reflect, and hopefully develop true remorse for the victims and their families.

If she does come to such a place, it will be overwhelming for her. There are so many tragedies surrounding this case, it is beyond our capacity as humans to ever fully understand it. How one sweet little girl could turn into an emotional powder keg, is beyond our wildest imaginations.

It seems Lucy to a large extent was a product of her upbringing, a family dynamic that tried to conform to some kind of image, yet it somehow became warped into something truly horrific.

Does this mean her parents are to blame? No it does not. They did nothing intentional to cause Lucy harm. They too will have an astronomical amount of soul searching to do. They have gone through a terrible ordeal, as such an outcome is every parent’s worst nightmare.

If they would have had four children, chances are the others would have been fine. It was a unique dynamic involving certain predispositions, that would have led to her profoundly aberrant psychology.

Most kids who are under the thumb of domineering parents, will rebel and act out long before it gets to the point it did with Lucy Letby. It was a combination of circumstances, like in the model of the Swiss cheese, as a construct developed to avoid such a catastrophe from happening again. 

It would probably be a good idea for the British health authority to take an expanded view of this model, and apply it to abnormal psychology, to help prevent it from infiltrating the system, and causing harm to patients:

“James Reason proposed the image of “Swiss cheese” to explain the occurrence of system failures, such as medical mishaps [1–5]. According to this metaphor, in a complex system, hazards are prevented from causing human losses by a series of barriers. Each barrier has unintended weaknesses, or holes – hence the similarity with Swiss cheese. These weaknesses are inconstant – i.e., the holes open and close at random.”

In my opinion those were random acts of violence. The system itself should bear the burden, since they are the only ones who can create the necessary changes, to prevent those holes from lining up again.

She went from a gilded cage to another type of cage, one which she will truly never escape. There is nothing but grief for the families whose babies she so cruelly attacked. In some aspects, this remains a case with no end in sight. 

If Lucy Letby’s mother truly did have an extremely difficult birth placing them both in peril, as has been described in various news reports, why didn’t Lucy have any neurological deficits as a result? Just think about the deficits and long term harm she caused when she attacked, and attempted to murder children. At least one of them is severely disabled for life. Who knows the level of cognitive impact, or learning disabilities it may have caused to the others? 

If a labour and delivery is so difficult that the child experiences prolonged hypoxia, there will be cerebral palsy, or other lifelong deficits affecting learning, coordination etc. Lucy Letby suffered no such damages. She had no problems learning, or with concentration, or other academic achievements.

It leads me to believe the description of the difficult birth experience could have been exaggerated by her mother, in order to guilt trip her into lifelong gratitude. Even in cases of near misses, close calls and very difficult births, if the outcome is positive, usually the parents breathe a huge sigh of relief, and carry on normal lives. The difficult birth story sounds like it had elements of hyperbole, and long suffering for her poor mother, who may have sought lifelong sympathy for herself. 

Millions of women have difficult births. Why would the difficult birth be used as an excuse to molly coddle and watch over her for life, when she was totally competent and just fine? What did living alone when she was in her twenties, and working full time have to do with her difficult birth? It sounds like they used it as an excuse to control her. 

Letby made claims to have felt much guilt, and was watched over closely, at least in part, because her mother had a very difficult birth, and they “almost lost her”. That is highly manipulative and absurd. It is not a fair to place such a guilt trip, or preoccupation with morbidity, onto any child. 

For those who do become ensnared in the abnormal psychology of another person, especially narcissism and psychopathy, it becomes a life sentence. It is much worse of they have the power to manipulate others.

They inflict such monumental damage, there is no turning back. Oftentimes, they will not stop the destructive behaviours and attitudes, unless they are caught. They condemn their victims to a hellish cycle of abuse. 

In the case of Lucy Letby, it is not the fault of the nurses, and should not become the burden of the working nurse. The system needs to step up and take responsibility, especially when it comes to protecting children. 

Copyright Valerie J. Hayes and Quiet West (2023). Unauthorized use and/or duplication of this material without express and written permission from this blog’s author/owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Valerie J. Hayes and Quiet West with appropriate and specific direction to the original content.