It was a Friday afternoon – June 13th, 1986. Dr David Ross returned to his home in Templepatrick, Co Antrim, from the Maze Prison where he worked as chief medical officer.
In the midst of Northern Ireland’s Troubles, the doctor had to drive different routes home because, as an employee of Her Majesty’s Prison Maze or “Long Kesh” – home to republican paramilitary prisoners of the IRA and INLA waging a war against the British Crown – he was considered a target.
Once home, he slept for an hour as he often did, had a cup of tea, planted flowers in his garden with his wife and took his Labrador dog for a walk. At about 6.20pm, he went to the garage next to his bungalow in the Co Antrim countryside and attempted to take his life.
A later inquest found that Dr Ross suffered from "recurrent depressive illness" and was taking anti-depressants and anti-anxiety medication prescribed by his doctor and a psychiatrist
Gladys, his wife of almost 30 years, found him. The 57-year-old doctor was taken to the Royal Victoria Hospital in Belfast. He died four hours later on an operating table. A later inquest found that Dr Ross suffered from "recurrent depressive illness" and was taking anti-depressants and anti-anxiety medication prescribed by his doctor and a psychiatrist. Belfast coroner James Elliott concluded that the doctor's wounds were "consistent with self-infliction".
Forty years before doctors were on the frontline of a killer pandemic, Dr Ross was on a very different frontline. In 1981, as a prison doctor in charge of the medical treatment of prisoners, he oversaw the care of republican prisoners who had made the decision to starve themselves to death to secure political status at the prison that treated them as criminals. It was a protest that was followed closely around the world.
The hunger strike of 1981 was the culmination of a battle waged inside the prison for five years, resulting in the deaths of 10 prisoners. Dr Ross has been called “the 11th victim of the hunger strike”.
From the mid-1970s, doctors treating IRA prisoners in British prisons found themselves in new territory. Following the death of IRA hunger striker Michael Gaughan in 1974 from the effects of force-feeding in an English prison, international medical guidelines declared force-feeding unethical, though it had not been in practice in Northern Ireland's prisons. Britain signed up to 1975 guidelines, respecting the right of prisoners to refuse medical treatment, if mentally competent.
This gave prisoners control over their bodies without the fear of being force-fed, handing power over to the hunger striker. Doctors overseeing their care were relegated to the role of bedside bystander.
As that daily observer, Dr Ross tracked the health of the prisoners as seven men deteriorated from starvation in the first hunger strike in 1980 followed by 23 men during a second strike in 1981. He took detailed notes on their weight and condition as their bodies shed pounds day after day.
"He was a very, very quiet individual – quiet spoken – but a very dedicated doctor," says Tom Murtagh, a deputy governor and head of security of the Maze during the Troubles.
“His responsibility was the care of all the prisoners in the Maze. He was known to take that duty very seriously. Prisoners were his patients and that was the way he saw them.”
Dr Ross could do nothing to prevent the strikers' starvation, but he took every effort to ease the suffering caused by their self-imposed hunger after they were moved to the prison hospital
Although Dr Ross could do nothing to prevent their starvation, he took every effort to ease the suffering caused by their self-imposed hunger after they were moved to the prison hospital, usually after 21 days.
He had sheepskins and soft mats brought in for prisoners to lie on to ease their bed sores caused by depleted flesh and protruding bones from lying in bed for long periods. When they were weakened by hunger, he had the patients turned over now and then to ease their pain. He had good relations with the prisoners and was on first name terms with them.
“To my mind, he was decent and kind. He may have had an ulterior motive but that would be unfair,” says former IRA man Tommy McKearney, who was on the first hunger strike that ended in December 1980 after 53 days.
He remembers Dr Ross ensuring he was warm after being moved to hospital, an environment that contrasted with the harsher treatment experienced in the prison.
“The one thing I do remember him saying was at the time there was very little contemporary medical evidence on hunger striking because it was a very rare thing to happen.”
When prisoners had trouble keeping normal tap water down, Dr Ross prescribed mineral water. Officers were sent to a local shop to buy supplies until a bulk delivery arrived within days.
“There was a lorry arrived in and it was completely filled with bottles of spring water,” recalls Dessie Waterworth, a prison officer at the Maze during the Troubles.
He recalls a room in the prison hospital “bunged” with bottles of water. As for Dr Ross, he remembers him as “a wee quiet man that done his job, bothered nobody”. Prisoners liked when he was on duty, he says, because – unlike other doctors at the Maze – he had “a sympathetic ear”.
Another doctor at the Maze, Dr Emerson, was despised by the prisoners. Nicknamed “Mengele” after the notorious Nazi concentration camp doctor, he was involved in the forced washings during the blanket protest that predated the hunger strikes. Former IRA hunger striker Laurence McKeown says this doctor justified the washings on spurious grounds, claiming the prisoners had head lice from examinations of up to 20 feet away as they were “dragged up a wing naked to him.” Prisoners were regularly subjected to beatings by prison guards during the forced washings.
When it became clear that hunger strikers were days from death, Dr Ross allowed their families to move into the prison hospital. Tom Murtagh says Dr Ross made arrangements for the families in the hospital and ensured that they were looked after by the hospital staff.
But while helpful to the families, Dr Ross would not sugar-coat what the prisoners were going through. Murtagh says that he explained “in great detail” to the prisoners and their families the effect of starvation on the body’s vital organs, which the leaders of the hunger strike did not like because “they felt he was undermining them”.
“Although he was very quiet, he was also very straightforward in telling people what he thought and that sometimes made him unpopular,” says Murtagh.
You couldn't get him to go home, and if there was any change in the condition of an individual he would get out of his bed in the middle of the night and travel back to the prison to make sure that they were all right and to look after them
“He was completely committed to try and care for those prisoners on hunger strike, to the extent you couldn’t get him to go home, and if there was any change in the condition of an individual he would get out of his bed in the middle of the night and travel back to the prison to make sure that they were all right and to look after them. That’s the type of individual that he was. He seemed to worry all the time about them.”
Dr Ross visited the hunger strikers every day, sitting on their beds and speaking with them for hours as he tried to “talk some sense to them,” said one former colleague.
The late Brendan “The Dark” Hughes, the IRA leader of the first hunger strike, remembered Dr Ross sitting on his bed and talking at length about fishing, the mountains, rivers and streams. He liked him; a man who would “bring in spring water because he believed it to be much richer and would help the prisoners, [he] was not a ruthless man,” he told Boston College’s oral history archive.
Perhaps this view was coloured by the key role Dr Ross played in the end of the first hunger strike, saving the hunger strikers closest to death during the first strike on December 18th, 1980.
Sean McKenna had only hours to live and Dr Ross had urged Hughes to intervene and save him. Hughes had promised McKenna that he would not let him die. As Hughes saw McKenna being wheeled out on a stretcher to the prison hospital, he shouted after Dr Ross: “Feed him.”
Dr Ross was described as being “excited” that the hunger strike had ended. He gave the prisoners injections of glucose into the little flesh on their bodies at that point to save them.
Other IRA prisoners held a less flattering view of Dr Ross, seeing him as another agent of the wider British establishment they were battling in their protest.
Bobby Sands, the leader of the second IRA hunger strike, had a very different view of Dr Ross to Hughes. Sands died in May 1981 after 66 days without food, the first of 10 men to die in the second hunger strike that lasted from March to October 1981.
In a diary kept for the first 17 days of his hunger strike, Sands called him “little friendly Dr Ross” but thought there was more to his cordial nature: “Dr Ross, although friendly, is in my opinion an examiner of minds.”
Hughes later said that Sands thought of him a “mind manipulator” and “mind wrestler”.
Other hunger strikers shared this view. In July 1981, two months after Sands’s death, Paddy Quinn – the 11th man to join the hunger strike – had gone more than 30 days without food when he received a visit from Dr Ross. Quinn was severely ill at the time and could not keep water down.
He says: 'Your kidneys aren't being washed out, because the water won't go through the kidneys, and eventually the poison is going to go to the brain, and you will go out like a light'
He recalls Dr Ross “just kept talking and talking and talking” about fishing and a trip to Italy. Then, at the end of the conversation, he explained what was happening to Quinn’s body, likening his starvation to brick after brick in a tall brick chimney being chipped away before collapsing.
“He says: ‘That is what is happening to you. You are going to fall if you don’t keep this water down.’ He says: ‘Your kidneys aren’t being washed out, because the water won’t go through the kidneys, and eventually the poison is going to go to the brain, and you will go out like a light.’”
The next day, Dr Ross returned and again “talked away about things” before turning to another analogy to impress upon Quinn what the starvation was doing to his body.
“At the end of the conversation he started to use the example of a train coming along steadily until it reached a hill and then it started going slower and slower and slower until it reached the top of the hill and then once it goes over the hill it crashes down the other side. He says: ‘That is what is going to happen to you if you don’t keep this water down,’” Quinn says.
Like Sands, Quinn thought the doctor was playing mind games.
“I remember saying to myself: ‘This man is definitely at it. He is definitely trying to get to me here. He is trying to get to me psychologically,’” he says.
That evening, Quinn remembers talking to “a big tasty pie the size of the plate” left by the guards in his cell, telling the pie: “If I eat you, I will let the lads in the blocks down.”
But he was determined to act on the doctor’s advice and he forced a glass of water down, watching a bump appear in the belly of his emaciated body. After drinking the water, he fell asleep. When he awoke the bump was gone and he had not been sick. The water had passed.
The next day, Dr Ross visited again and Quinn told him: “I have good news for you, doctor”. He told him that a glass of water had stayed down.
“He says back to me: ‘Oh no Patrick, that is not good news. That is further deterioration.’ I remember looking at him and saying to myself: ‘There is no praise in this fucker at all,’” he says.
A small, balding man with pale skin, Dr Ross wore a white doctor's coat in the prison hospital, wearing tweed coming and going to work, 'a bit like a country man who likes to go out and about'
Quinn’s hunger strike lasted 47 days. At the end of July 1981, his mother intervened and called for medical help to save her son’s life, the first hunger striker to be taken off the protest by their family. It marked the beginning of the end of the hunger strike.
McKeown, another IRA hunger striker who went 70 days without food – the longest of any surviving hunger striker – recalls daily visits from Dr Ross. The doctor knew McKeown was from Randalstown in Co Antrim, a short distance from where Dr Ross lived. The doctor regularly talked about helping out at weekends on the family farm where he was born and reared.
“It was a bit of social conversation,” says McKeown. “He was always fairly friendly.”
Before his job at the Maze, Dr Ross treated very different patients. A Presbyterian from the townland of Cabragh outside Ballymena – a Unionist heartland and Ian Paisley country – he spent most of his career, prior to becoming a prison doctor, working as a GP in the Co Antrim village of Ballyclare. He was known locally as Davey Ross.
He left his younger brother, Samuel, to run the family farm and he went to medical school at Queen’s University, a short distance away in Belfast. He graduated with a degree in medicine, surgery and obstetrics in July 1952.
Four years later he married Gladys Irwin, an only daughter from across the Border in Manorhamilton, Co Leitrim, at Knock Methodist Church in Belfast. They had two children, Rosemary and Ian, who later both emigrated from Northern Ireland.
A small, balding man with pale skin – described as “wiry” and “nearly frail” by McKeown – Dr Ross wore a white doctor’s coat in the prison hospital. Waterworth remembers him wearing tweed coming and going to work, “a bit like a country man who likes to go out and about”.
Former colleagues at the prison say Dr Ross bore the experience of the hunger strikes heavily. They believe he was deeply affected by that period 40 years ago.
Frank Smith, a chief hospital officer, told former deputy governor Tom Murtagh for his book, The Maze Prison, A Hidden Story of Chaos, Anarchy and Politics, that Dr Ross “hardly ever left the prison (day or night) throughout the months of the hunger strike”.
Murtagh describes in the book the “palpable” stress felt by Dr Ross and all the hospital officer in the hours leading up to Sands’s inevitable death in the early hours of May 5th.
One incident during the hunger strikes involving Raymond McCreesh, the third hunger striker to die, is said to have particularly affected Dr Ross, though he was not directly involved. McCreesh’s family have vehemently disputed the prison’s account of what happened.
Prison hospital staff reported that McCreesh on May 16th – the 56th day of his hunger strike – “in a confused and disorientated state of mind” told a prison hospital officer that he would “like a drink of milk,” according to public records released a decade ago. Such a request, if granted, was significant as it would have marked the end of his hunger strike.
When another of the hospital’s doctors, Dr Emerson, asked McCreesh “do you want us to save your life?” he replied: “Yes’ in a strong voice.”
The doctor then phoned the hunger striker’s family. The records state that hospital staff overheard McCreesh’s family members reminding the hunger striker where he was and his mother telling him: “Now, Raymond, you are going back on your word”. The prison record went on to say that he was told to remember where he was, not to get confused and not to listen to anyone but his family. He remained on hunger strike.
McCreesh died five days later. His family have long denied this account and described the statements attributed to them in the public records as “untrue, inaccurate and falsified” adding that “agents of the State had abused the extremely vulnerable condition of a dying man for political and propaganda purposes”.
Overall, the hunger strikes were a traumatising event for Dr Ross and his medical team.
Murtagh quotes an unnamed hospital officer in his book: “When you are caring for these guys, getting to know them and their families and watching their grief, you are only human and you have your feelings. It had an impact on all of us. I know Dr Ross, who never seemed to leave the hospital, was badly affected.”
The former deputy governor remembers how hospital staff developed close relationships with the hunger strikers, “even some of the IRA prisoners who had notorious reputations”.
Anyone who did open up a bit to what was actually happening – regardless of what was happening politically – got to know the hunger strikers in the hospital as individuals and people
McKeown confirms that these kinds of bonds developed. He remembers one medical officer, a born-again Christian, who was “very taken” by Kieran Doherty, the eighth hunger striker to die, and the IRA man’s absolute conviction in the hunger strike and seeing it through to his death after 73 days, the longest fast of the hunger strike.
“He told me: ‘As a Christian, I have to admit I don’t have that level of belief,’” says McKeown.
“Anyone who did open up a bit to what was actually happening – regardless of what was happening politically – got to know the hunger strikers in the hospital as individuals and people.”
McKeown remembers one prison hospital officer, Paul Lennon, argued for the prison to stop leaving the meals in the hospital cells, as was the policy, as it affected the hunger strikers because they had a heightened sense of smell as their eyesight deteriorated in the later stages of their starvation.
“Paul would say: ‘Laurence couldn’t eat that even if he wanted to – I think it is cruel to leave it there because of the smell of it.’ The doctor, to his credit said: ‘Take it out,’” says McKeown. (His co-edited book “Nor Meekly Serve My Time: The H-Block Struggle 1976-1981” has been republished in a 40th anniversary edition by Beyond The Pale Books.)
While some hospital officers were “detached and hostile”, others were “attentive and helpful”.
“You would have to be very hard-hearted for it not to have an impact on you. If you are in charge of the hospital, as Dr Ross was then, it would obviously have a bigger impact,” he says.
Dr Ross’s history of depression appears to predate his time at the Maze and his own suicide by many years. The inquest report into his death, released to The Irish Times by the Public Record Office of Northern Ireland with heavy redactions, seems to suggest that he first attended his psychiatrist in the early 1970s but visited him again one year after the hunger strikes.
Years after the hunger strike – not long before Dr Ross’s death – McKeown recalls a meeting with him where he was unusually stressed and acting “out of character” when McKeown as IRA “O/C” “officer commanding” of a block at the Maze reported a fairly routine concern of the prisoners relating to the prison conditions.
“He got really agitated and said that it has nothing to do with him. He said to the medical officers: ‘Take him out of here,’ which was totally unheard of,” he said.
The evidence given by Dr Ross’s wife Gladys at the inquest into his death – 35 years ago on Monday – suggests no forewarning of his suicide. She told the inquest they had returned from a holiday in the United States on May 6th, 1986 – a day after the fifth anniversary of Bobby Sands’s death.
On the day of his suicide, Dr Ross had told her he had bought daisy killer for the garden and that the weather might be suitable the following week to put it on the lawn. He was “happy and full of plans” for the summer in the garden such as building a green house and planting trees. At social occasions, he was “cheerful, outgoing and chatty” and that he had been “sleeping well, eating well and was full of interest”.
A hospital officer at the Maze told the inquest that Dr Ross seemed “his normal efficient busy self” that Friday and “at no time did he give me the impression he was under stress or preoccupied”. He said the doctor’s job was “very responsible” and that he coped with it “in a most efficient manner”.
Another hospital officer said that the doctor appeared to be in “normal form” that morning, though he found him “to be a little quieter than usual, as if he had something on his mind”.
Dr Ross’s cousin, Ian, a solicitor, attended the inquest and questioned the police, asking an RUC constable whether it was possible that Dr Ross’s death could have been an accident. He agrees now, in an interview with The Irish Times, that it was “not very likely”.
The mid-1980s was a stressful period for staff at the Maze, as they faced intense pressure from the prisoners they policed. Some were turned to act as agents for the paramilitary groups
Among the media reports the day after the doctor’s death was the Belfast Telegraph’s which noted: “The RUC say they do not suspect a crime.”
Former Maze prison officer Dessie Waterworth summarised the reaction within the prison: “Holy f*ck – what did he do that for?”
At the time, there had been a spate of suicides amongst prison staff and as many as 30 across the prison service killed themselves over the years. The mid-1980s was a stressful period for staff at the Maze as there was intimidation and serious assaults on prison staff as they faced intense pressure from the prisoners they policed with some being turned to act as agents for the paramilitary groups.
Waterworth says Dr Ross’s suicide was different from those of other prison officers.
“I could not understand it and the staff in the hospital could not understand it. He was a contradiction to every suicide in the Maze or the prison service,” he says. “There was no reason or logic for it. There was no serious problem. He wasn’t up to his eyes in debt. He wasn’t out chasing other women. He wasn’t on the drink. He was a good Christian man.”
Ian Ross remembers the death of his cousin coming as “a complete shock” to the family. Ian’s wife Edmae said the reaction of his family was “absolute horror”.
She described Dr Ross as “a gentle and quiet man, a thoughtful person”.
“I am quite sure that he looked on his prisoners as patients rather than criminals. He was a lovely person and deserves to be spoken about. He had a very trying time there,” she says.
She counts Dr Ross’s death alongside those of the hunger strikers: “Ten died and David was the 11th”.
Dr Ross just couldn't take it. He couldn't stand seeing these people every day and not being able to do anything. He tried to persuade them. He did everything he could
McKeown doesn’t agree that Dr Ross was the “11th victim of the hunger strike”. He and others say that the 11th victim was former IRA man Pat McGeown, who was taken off hunger strike after 42 days and never fully regained his health afterwards. He died 15 years later.
The doctor was remembered by his colleagues after his death. Dr Hernán Reyes, now retired, visited the Maze in the years after the hunger strikes in his role as medical co-ordinator of the Red Cross examining health issues in the detention of political prisoners. He heard a lot about Dr Ross from another doctor at the prison.
That Belfast doctor told him that Dr Ross suffered from depression as a result of seeing his patients – all young men – slowly die. According to Dr Reyes, the other doctor tried to talk Dr Ross out of his depression, explaining to him that he did nothing wrong. It did not help.
“Dr Ross just couldn’t take it. He couldn’t stand seeing these people every day and not being able to do anything. He tried to persuade them. He did everything he could,” he says.
“The other doctors were also affected but not to the point that Dr Ross was.”
Another doctor recalled Dr Ross and the psychological scars he bore from the hunger strike when he spoke to a 2009 historical study on medical care during the Troubles called Candles in the Dark: “It never left him and he often recounted how he felt at that time and what he had gone through.” The doctor said Dr Ross also often recalled what the families and what each individual hunger striker had gone through.
Looking back on the role played by Dr Ross, former hunger striker McKeown can understand the impact on the prison doctor and the sense of “helplessness and powerlessness” he felt.
Dr Ross was trying to keep his patients alive and to look after them and they were trying to kill themselves. His job was to try and save their lives but they were committed to taking their own lives
“There is not so much they can do for you. They just treat you. It is a strange situation for people to be involved in a medical profession to be trained to treat people. In this case, you cannot treat people, you can just observe the deterioration and then see them die,” he says.
The Maze’s former head of security shares the same view as the former IRA man.
Murtagh says Dr Ross had considerable difficulty in accepting the role he was playing as the doctor “shepherding” the hunger strikers to painful deaths, an act that challenged the “do no harm” pledge of his Hippocratic oath sworn as a doctor to preserve life.
“I do know Dr Ross was badly affected by it. It was a conflict in him: he was trying to keep his patients alive and to look after them and they were trying to kill themselves. His job was to try and save their lives but they were committed to taking their own lives,” he says.
Birmingham-based neurologist Dr David Nicholls, who has studied the effect of starvation on hunger strikers and has taken a strong interest in Dr Ross, says the doctor found himself on the "frontline of a war of nutrition" where he was "getting it from all sides" – prisoners, next of kin, the government, politicians – while he was trying to focus on the care of the prisoners.
“You have got the ethical dilemma of putting your patient as the first concern: is that patient making valid decisions or are they under duress or pressure from outside? That would have caused just unbelievable, crippling strain for a doctor,” he says.
The duty of the doctor was to make their lives as comfortable as possible while they proceeded to starve themselves to death. It was a very difficult situation
When Paddy Quinn heard that Dr Ross had died by suicide years after his hunger strike, he started to reflect again on those conversations he had with the doctor in his cell.
“He seemed to be a nervous type of person. He just seemed to have to talk all the time and I formed the opinion that this man shouldn’t have been anywhere near the hunger strikers,” he says.
Dr Ross’s sensitive nature meant the toll felt by the 1981 hunger strikes was particularly great.
“We know that he took a lot of these things to heart because he cared about his patients,” says Murtagh of his former colleague.
“The duty of the doctor was to make their lives as comfortable as possible while they proceeded to starve themselves to death. It was a very difficult situation.”
Murtagh feels Dr Ross’s “exceptional” role in the hunger strikes, which has been relegated to a footnote or passing reference in histories of the period, has never been properly recognised.
“We all thought that he was such a nice guy and a very, very good doctor,” he says.