# How Statistics Turned a Harmless Nurse Into a Vicious Killer

Let’s do a thought experiment. Suppose you have 2 million coins at hand and a machine that will flip them all at the same time. After twenty flips, you evaluate and you come across one particular coin that showed heads twenty times in a row. Suspicious? Alarming? Is there something wrong with this coin? Let’s dig deeper. How likely is it that a coin shows heads twenty times in a row? Luckily, that’s not so hard to compute. For each flip there’s a 0.5 probability that the coin shows heads and the chance of seeing this twenty times in a row is just 0.5^20 = 0.000001 (rounded). So the odds of this happening are incredibly low. Indeed we stumbled across a very suspicious coin. Deep down I always knew there was something up with this coin. He just had this “crazy flip”, you know what I mean? Guilty as charged and end of story.

Not quite, you say? You are right. After all, we flipped 2 million coins. If the odds of twenty heads in a row are 0.000001, we should expect 0.000001 * 2,000,000 = 2 coins to show this unlikely string. It would be much more surprising not to find this string among the large number of trials. Suddenly, the coin with the supposedly “crazy flip” doesn’t seem so guilty anymore.

What’s the point of all this? Recently, I came across the case of Lucia De Berk, a dutch nurse who was accused of murdering patients in 2003. Over the course of one year, seven of her patients had died and a “sharp” medical expert concluded that there was only a 1 in 342 million chance of this happening. This number and some other pieces of “evidence” (among them, her “odd” diary entries and her “obsession” with Tarot cards) led the court in The Hague to conclude that she must be guilty as charged, end of story.

Not quite, you say? You are right. In 2010 came the not guilty verdict. Turns out (funny story), she never commited any murder, she was just a harmless nurse that was transformed into vicious killer by faulty statistics. Let’s go back to the thought experiment for a moment, imperfect for this case though it may be. Imagine that each coin represents a nurse and each flip a month of duty. It is estimated that there are around 300,000 hospitals worldwide, so we are talking about a lot of nurses/coins doing a lot of work/flips. Should we become suspicious when seeing a string of several deaths for a particular nurse? No, of course not. By pure chance, this will occur. It would be much more surprising not to find a nurse with a “suspicious” string of deaths among this large number of nurses. Focusing in on one nurse only blurs the big picture.

And, leaving statistics behind, the case also goes to show that you can always find something “odd” about a person if you want to. Faced with new information, even if not reliable, you interpret the present and past behavior in a “new light”. The “odd” diary entries, the “obsession” with Tarot cards … weren’t the signs always there?

Be careful to judge. Benjamin Franklin once said he should consider himself lucky if he’s right 50 % of the time. And that’s a genius talking, so I don’t even want to know my stats …