George Floyd, Excited Delirium and the Medicalization of Police Violence

>>> AS WE JUST HEARD, BLACK VICTIMS IN THE UNITED STATES ARE LESS LIKELY TO BE BELIEVED, AND SADLY, THIS RACISM PREVAILS ACROSS THE LAW ENFORCEMENT SYSTEM.

SO, AISHA BELISO-DE JESUS' NEW BOOK "EXCITED DLEER YUM" EXPLORES THE MEDICAL TERM THAT HAS LONG BEEN USED AS A SCAPEGOAT FOR POLICE MISCONDUCT, LIKE IN THE GEORGE FLOYD CASE, WHOSE MURDER BY POLICE FOUR YEARS AGO THIS WEEKEND SPARKED OUTRAGE.

THE AUTHOR AND ACADEMIC SPEAKS TO MICHEL MARTIN ABOUT HOW LEGISLATORS ARE NOW DEALING WITH THIS INVENTED DISEASE.

>> PROFESSOR, THANK YOU SO MUCH FOR JOINING US.

>> THANK YOU FOR HAVING ME.

>> YOU'VE WRITTEN A NEW BOOK ABOUT "EXCITED DELIRIUM."

I WOULD SAY, I THINK MOST OF US WHO FOLLOW THE NEWS ONLY HEARD ABOUT THIS TERM IN CONNECTION WITH THE DEATH OF GEORGE FLOYD.

SO -- SO WHAT IS EXCITED DELIRIUM, AND WHO COINED THIS TERM?

>> I THINK IT WAS, YOU KNOW, ACTUALLY QUITE STARTLING TO ME TO HAVE BEEN DOING RESEARCH ON POLICING, WITH POLICE OFFICERS SINCE 2013, AND, YOU KNOW, HAD NEVER HEARD OF THE TERM UNTIL AFTER GEORGE FLOYD'S DEATH.

SO, EXCITED DELIRIUM IS WHAT MANY WOULD CONSIDER NOW TO BE A MISAPPROPRIATED DIAGNOSIS.

IT WAS COINED WHILE STUDYING COCAINE AND AFRO-CUBANS IN THE 1980s AND '90s, AND THE TERM ACTUALLY STARTED AS COCAINE AGITATED DELIRIUM, AND IT SWITCHED TO EXCITED DELIRIUM SYNDROME IN THE '90s WHEN THEY TRIED TO OPEN UP THE TERM AND MAKE IT MORE APPLICABLE TO -- BEYOND COCAINE USAGE.

BASICALL BASICALLY, WHAT THE TERM ARGUES IS THAT WITH JUST A SMALL AMOUNT OF COCAINE USAGE, PEOPLE BECOME AGGRESSIVE, EXCITED, SWEATING, AGITATED, AND ARE DESCRIBED AS SUDDENLY DYING.

AND IN THIS CASE, POLICE OFFICERS WHO ARE CALLED TO THE SCENE ARE SEEN AS SORT OF INNOCENT BYSTANDERS OF, OR JUST HAPPENED TO WITNESS EXCITED DELIRIUM.

IT'S BEEN DESCRIBED AS SIMILAR TO SIDS, OR SUDDEN INFANT DEATH SYNDROME IN THE SENSE THAT YOU CAN'T ACTUALLY AUTOPSY.

THERE'S NO WAY TO DIAGNOSE EXCITED DELIRIUM, EXCEPT BY WHAT IS TOLD, WHAT PEOPLE DID ON THE SCENE.

AND SO, IN MANY CASES THIS IS THE POLICE WHO DESCRIBE HOW PEOPLE ARE BEHAVING.

AND, OF COURSE, EXCITED DELIRIUM SYNDROME HAS SORT OF GONE UNDER THE RADAR, IN MANY WAYS, BECAUSE IT'S BEEN USED BY MET CALL EXAMINERS, AND SO, CHARLES WETLEY, HE ACTUALLY USED IT AS A RACIAL ARGUMENT.

HE MADE THE ARGUMENT THAT BLACK PEOPLE IN PARTICULAR HAD A SPECIAL GENETIC FLAW TO SPONTANEOUSLY DIE ON SMALL DOSES OF COCAINE.

>> OKAY.

SO -- SO, AGAIN, I THINK THAT'S WHERE A LOT OF -- THOSE OF US WHO LIVE IN THE GENERAL PUBLIC HEARD ABOUT THIS TERM, BECAUSE IT WAS, IN FACT, CITED IN DEREK CHAUVIN'S LEGAL DEFENSE.

THIS, OF COURSE, IS ONE OF THE FOUR OFFICERS, HE WAS THE ONE MOST HEAVILY IMPLICATED IN THE DEATH OF GEORGE FLOYD.

DURING HIS TRIAL, A MINNEAPOLIS POLICE OFFICER WHO TRAINED OTHERS IN MEDICAL CARE TESTIFIED THAT RECOGNIZING SIGNS OF EXCITED DELIRIUM IS PART OF THE TRAINING FOR NEW OFFICERS, BUT YOU'RE REPORTING INDICATES THAT THIS IS MADE UP.

THIS IS -- THIS DOESN'T EVEN EXIST.

SO, TELL MEL HOW YOU CAME TO THAT CONCLUSION.

>> I THINK IT'S IMPORTANT TO NOTE THAT SIMILAR TO GEORGE FLOYD, THE MAJORITY IN ALMOST ALL OF THE PEOPLE WHO HAVE BEEN LABELED EXCITED DELIRIUM SYNDROME, ARE ACTUALLY KILLED DURING POLICE INTERACTIONS, RIGHT?

THEY ALMOST ALWAYS INVOLVE SOME TYPE OF POLICE USE OF FORCE.

FORCE SUCH AS HOG TYING PEOPLE, APPLYING KNEELING ON PEOPLE'S BODIES, AS WE SAW WITH GEORGE FLOYD, TASING PEOPLE, INJECTING THEM WITH SEDATIVES, AS WE SAW WITH ELIJAH McCLAIN, RIGHT, AND SO, FORCEFUL RESTRAINT IS ACTUALLY KEY TO EXCITED DELIRIUM SYNDROME, HOWEVER, THE SYNDROME HAS BEEN USED, AND WHAT I ARGUE IN THE BOOK, AND ALSO, I THINK, WHAT MANY PEOPLE HAVE COME TO REALIZE, IS THAT IT IS AN EXCUSE, OR, A COVERUP, A MEDICALIZATION OF POLICE VIOLENCE.

SO, IT'S REALLY CRUCIAL TO THINK ABOUT THE RELATIONSHIP BETWEEN THE USE OF FORCEFUL RESTRAINTS, RIGHT, AND THE WAYS THAT THESE DEATHS ARE THEN LABELED AFTER THE FACT.

>> EXCITED DELIRIUM HAS BEEN LISTED AS A FACTOR IN AUTOPSY REPORTS, COURT RECORDS, OR OTHER SOURCES IN AT LEAST 276 DEATHS THAT FOLLOWED TASER USE SINCE THE YEAR 2000.

THIS IS FROM A REPORT IN REUTERS IN 2017.

SO, WHEN TASERS GOT INTRODUCED, THIS BECAME ONE OF THE SORT OF THE ARGUMENTS.

AND, SO, THIS -- LET'S GO BACK TO CHARLES WETLEY, IT STARTED WITH HIM.

WHAT DID YOU FIND OUT ABOUT HIS BACKGROUND AND WHY YOU FEEL LIKE THIS IS RELEVANT TO OUR UNDERSTANDING OF THIS?

>> SO, WHEN I STARTED DELVING INTO THE HISTORY OF EXCITED DELIRIUM SYNDROME, I BECAME EXTREMELY ENGROSSED IN HOW CHARLES WETLEY CAME TO DEFINE THE SYNDROME.

THE FIRST PRECEDENT THAT HE USED WAS THE IDEA THAT SOMEHOW BLACK PEOPLE HAVE A SPECIAL SORT OF GENETIC FLAW THAT CREATES THEM TO GO CRAZY, RIGHT?

AND THAT'S, LIKE, THE TERM THAT'S BEING USED.

AND HE CITES LITERATURE, ACTUALLY, FROM JIM CROW SEGREGATION DOCTORS, WHO WERE ARGUING FOR THE CRIMINALIZATION OF COCAINE IN THE EARLY 1900s, TO JUSTIFY THE ABUSE AND THE LYNCHING OF BLACK MEN IN THE SOUTH.

SO, THE FIRST SORT OF PRECEDENT THAT HE USES IS THIS -- IS T THIS -- IS THIS MEDICAL DOCTOR, THIS NEW YORK TIMES ARTICLE BY DR. EDWARD WILLIAMS, WHO DESCRIBES AND WARNS THAT SO-CALLED NEGRO COCAINE FIENDS ARE RUNNING AROUND IN THE SOUTH.

HE STARTS THIS IN THE 1980s WHEN 12 BLACK WOMEN ARE FOUND TO BE BRUTALLY RAPED AND STRANGLED TO DEATH IN MIAMI.

AND WETLEY SAYS THAT HE NOTICES A PATTERN OF THESE BLACK WOMEN'S DEATHS, WHICH HE ARGUES IS A -- NOT DUE TO MURDER, ACTUALLY, BUT HE CLAIMS DUE TO, QUOTE, SEX AND COCAINE DEATHS, SO, HE CALLS THEM A SPONTANEOUS REACTION TO SMALL AMOUNTS OF COCAINE.

AND HE ACTUALLY DESCRIBES BLACK PEOPLE AS THE BLACK SPECIES, IN HIS MEDICAL WRITINGS.

AND HE LABELS THESE 12 WOMEN'S DEATHS AS -- AS SEX AND COCAINE DEATHS, AS ACCIDENTS.

WHAT HAPPENS IS, A BLACK GIRL BY THE NAME OF ANTOINETTE BURNS, WAS FOUND RAPED AND MURDERED, WITHOUT COCAINE IN HER SYSTEM.

AND THIS CAUSES POLICE AND THE MEDICAL EXAMINER'S OFFICE, ACTUALLY CHARLES WETLEY'S BOSS AT THE TIME, JOSEPH-DAY VICE, TO REINVESTIGATE, AND IT FINDS THAT THE WOMEN WHO HAD ALL BEEN LABELED BY WETLEY SEX AND C COCAINE DEATHS, WERE ACTUALLY MURDERED AND ASPHYXIATED SO, THIS CAUSES A STIR IN MIAMI, BECAUSE THEY REALIZED THAT THEY LIKELY HAD A SERIAL KILLER THAT WAS MURDERING AND TARGETING BLACK WOMEN.

>> BUT SOMEHOW, THIS DID NOT TERMINATE THIS IDEA OF EXCITED DELIRIUM.

WHY DO YOU THINK THAT IT'S TAKEN SO LONG FOR PEOPLE TO QUESTION THIS DIAGNOSIS?

>> WE THINK OF MEDICALIZATION OF POLICE VIOLENCE, WE THINK ABOUT HOW SOMETHING GETS LABELED A MEDICAL TERM IN THE FIRST PLACE, RIGHT?

SO, MEDICAL EXAMINERS WERE USING THE TERM, AND WERE LABELLING THESE DEATHS ACCIDENTS, OR UNCLASSIFIED, AND SO, FOR MANY YEARS, A LOT OF THE EXCITED DELIRIUM DEATHS, OR LABELED EXCITED DELIRIUM, WERE ACTUALLY NOT GIVEN ANY ANSWERS, AND BECAUSE THEIR DEATHS WERE LABELED ACCIDENTS, BECAUSE THESE DEATHS WERE UNCLASSIFIED, NOT ONLY WAS NO ONE HELD ACCOUNTABLE, BUT IT JUST LOOKED LIKE A MEDICAL INCIDENT, RIGHT?

AND WE SAW THAT WITH GEORGE FLOYD'S DEATH, WHEN INITIALLY, THE POLICE PLACED ON THEIR WEBSITE A NOTICE SAYING THAT A MAN DIES IN MEDICAL DISTRESS, REEGT?

AND HAD IT NOT BEEN FOR DARNELLA FRAZIER WHO ACTUALLY POSTED THE BYSTANDER VIDEO THAT SHOWED DEREK CHAUVIN, YOU KNOW, KNEELING ON GEORGE FLOYD'S NECK, THE WORLD BOULWOULD NOT HAVE KN THAT THIS WAS NOT ANOTHER CASE OF A SO-CALLED MEDICAL DISTRESS.

AND I THINK BECAUSE IT'S GONE, YOU KNOW, SORT OF UNDER THE RADAR FOR SO MANY YEARS, BECAUSE IN MANY WAYS, IT'S KIND OF -- IT CAN BE SEEN AS A SORT OF PERFECT COVERUP FOR POLICE VIOLENCE, AND WHAT IT ALSO REVEALS TO US IS HOW MEDICAL EXAMINERS, AND ALSO, YOU KNOW, PARAMEDICS, RIGHT, PARTICIPATE IN -- IN POLICE VIOLENCE IN WAYS THAT WE REALLY CAN'T UNCOVER UNTIL WE START TO REALLY UNDERSTAND HOW THESE STRUCTURES WORK.

>> A 2021 STUDY PUBLISHED IN THE VIRGINIA LAW REVIEW FOUND THAT OF 166 REPORTED DEATHS IN POLICE CUSTODY FROM POSSIBLE EXCITED DELIRIUM, BLACK PEOPLE MADE UP 43.3% OF CASES, AND BLACK AND LATINO PEOPLE TOGETHER MADE UP AT LEAST 56%, AND FOR PEOPLE, YOU KNOW, AREN'T AWARE THAT IS FAR BEYOND, YOU KNOW, THE PRESENCE OF BLACK AND LATINO PEOPLE IN THE POPULATION ON THE WHOLE.

SO, WHAT DO YOU MAKE OF THOSE NUMBERS?

WHAT DO YOU THINK THAT SAYS?

>> WELL, I THINK THE OTHER SORT OF REASON WHY EXCITED DELIRIUM HAS SORT OF OPERATED UNDER THE RADAR FOR A LOT OF PEOPLE IS BECAUSE IT DOES ALLOW US TO SORT OF JUSTIFY AND BLAME THE VICTIMS FOR POLICE VIOLENCE.

THERE'S ALREADY A LONG HISTORY OF RACIALIZING, RIGHT, AND MEDICALIZING BLACK AND BROWN PEOPLE IN THE UNITED STATES, AND UNIT LOSING UTILIZING THESE SORT OF TERMS, THESE FEARS, RIGHT, OF DANGEROUS BLACK AND LATINO MEN THAT ARE GOING TO SORT OF, YOU KNOW, CAUSE HAVOC AND BE THREATENING.

AS AN EASY SORT OF SCAPEGOAT TO THEN COVER UP THIS KIND OF VIOLENCE.

AND I THINK THAT THESE IDEAS ARE THEN ENTRENCHED IN MEDICAL DIAGNOSIS.

AND THIS ACTUALLY GOES BACK TO A LONGER HISTORY, EVEN FROM SLAVERY, RIGHT, SO, FOR INSTANCE, IN SLAVERY, THERE WAS, YOU KNOW, A HOST OF MEDICAL TERMS THAT SIMILARLY RACIALIZED, RIGHT, BLACK PEOPLE, AS DANGEROUS OR THREATENING OR VIO VIOLENT, RIGHT?

WE SAW IT, YOU KNOW, DR. SAMUEL CARTWRIGHT IN ARGUING FOR THE IDEA THAT RUNAWAY SLAVES HAVE A MENTAL ILLNESS, THAT WERE SORT OF CRAZY AND UNHINGED, A KIND OF MANIA.

AND HE ADVOCATED FOR AMPUTATING TOES.

AND I THINK IT IS CRUCIAL TO RECOGNIZE THAT WHEN WETLEY'S PRECEDENT IS THE LYNCHING NARRATIVES FROM THE SOUTH, THAT ARGUE THAT BLACK MEN NEEDED TO BE SUBDUED BY MORE HEAVILY ARMING POLICE OFFICERS, THAT THERE'S A SORT OF LONG HISTORY CONNECTING THESE LINKS BETWEEN MEDICAL DOCTORS AND POLICE VIOLENCE.

>> SO, THIS -- THE DATA THAT WE JUST CITED, THIS STUDY, WAS INCLUDED IN A PHYSICIAN'S FOR HUMAN RIGHTS REPORT THAT CONCLUDED THE TERM EXCITED DELIRIUM CAN'T BE DISENTANGLED FROM ITS RACIST AND UNSCIENTIFIC ORIGINS, I'M QUOTING HERE, AND IT PROVED THAT EXCITED DELIRIUM IS NOT A VALID DIE KNOW SIS.

>> THAT'S RIGHT.

>> AND SO, NOW THAT, THROUGH YOUR WORK, THROUGH WORK OF OTHER RESEARCHERS, THIS KIND OF HISTORY HAS BEEN SORT OF SURFACED, WHERE ARE WE NOW?

IS THERE A WILLINGNESS, IS THERE A WILL, TO LOOK AT THIS IN A NEW LIGHT?

>> SO, I THINK THERE IS.

YOU KNOW, ACROSS THE COUNTRY, ESPECIALLY SINCE GEORGE FLOYD'S MURDER, WE SEE THE, YOU KNOW, REEXAMINATION OF THE TERM, AND RECENTLY, THERE HAS BEEN INCREASED PRESSURE TO NOT ONLY ACKNOWLEDGE THAT EXCITED DELIRIUM IS NOT AN ACTUAL MEDICAL DIAGNOSIS, BUT ALSO, TO E LLIMINATE THE USE OF THE TERM AND ALSO BAN ITS USE IN TRAINING DOCUMENTS.

AND SO, JUST RECENTLY, OCTOBER 2023, CALIFORNIA BECAME THE FIRST STATE TO BAN ITS USE AS A CAUSE OF DEATH.

AND THEN, WE ALSO SEE COLORADO, RECENTLY, I THINK JUST LAST MONTH, STRUCK DOWN EXCITED DELIRIUM FROM ALL LAW ENFORCEMENT TRAINING DOCUMENTS.

AND THEN WE HAVE OTHER MOVEMENTS GOING ON, FLORIDA, IN NEW YORK, AND SO ON.

AND SO, I THINK THERE IS -- THERE IS A RECOGNITION, RIGHT, THAT -- THAT THE DIAGNOSIS ITSELF IS FABRICATED.

AND, YOU KNOW, IT'S IMPORTANT TO REMEMBER THAT THIS DIAGNOSIS WAS ACTUALLY NEVER TRULY RECOGNIZED.

SO, IT WAS NOT CLASSIFIED IN THE DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL HEALTH DISORDERS OR EVEN IN THE INTERNATIONAL CLASSIFICATION OF DISEASES.

IT WAS NEVER RECOGNIZED BY THE AMERICAN MEDICAL ASSOCIATION, THE AMERICAN PSYCHIATRIC ASSOCIATION, OR EVEN THE WORLD HEALTH ORGANIZATION.

AND IT'S REALLY -- UP UNTIL JUST LAST YEAR, IT WAS ONLY RECOGNIZED BY THE NATIONAL ASSOCIATION OF MEDICAL EXAMINERS, WHICH ALLOWED FOR IT TO BE USED AS A CAUSE OF DEATH, AND SO, IT'S REALLY IMPORTANT TO UNDERSTAND THAT EVEN THAT ASSOCIATION FINALLY REJECTED EXCITED DELIRIUM SYNDROME.

AND SO, IN THE WAKE OF GEORGE FLOYD'S DEATH, AND, YOU KNOW, THE PROTESTS THAT, I THINK, YOU KNOW, REALLY CALLED TO ATTENTION A KIND OF HISTORIC RECKONING IN THE WORLD, WE SEE THIS IMPORTANT THINGS HAPPENING, BUT THERE'S STILL A LOT OF WORK TO BE DONE.

ESPECIALLY THE MEDICALIZATION OF POLICE VIOLENCE DOES CONTINUE, EVEN WITHOUT THE USE OF THE TERM.

>> AND WHY DO YOU SAY THAT?

>> SO, IN 2023, YOU MIGHT RECALL THE DEATH OF KEENAN ANDERSON, WHO WAS TASED MULTIPLE TIMES, RIGHT, AND ACTUALLY WHILE THE POLICE DETAINED HIM, HE YELLED TO PEOPLE, SAID, THEY'RE GOING TO GEORGE FLOYD ME.

AND HOWEVER, ANDERSON'S DEATH WAS DESCRIBED BY THE CORONER AS HEART FAILURE AND COCAINE, WHICH, IN ESSENCE, IS EXCITED DELIRIUM WITHOUT THE TERM, RIGHT?

AND THEN, JUST THIS PAST APRIL, WE CAN SEE FRANK TYSON WAS ALSO AS ASPHYXIATED, SIMILAR TO GEORGE FLOYD'S DEATH, AND TYSON'S FAMILY MEMBERS AND ATTORNEYS HAVE DESCRIBED HIM AS SORT OF A GEORGE FLOYD 2.0.

HE WAS SUBDUED, HANDCUFFED, AND COMPLAINING OF BEING ABLE TO BREATHE.

SO, I THINK IT'S REALLY IMPORTANT THAT WE HAVE ONGOING AWARENESS AROUND NOT JUST THE TERM, WHICH I THINK IS APPALLING AND POINTS TO THE RACIST HISTORY, BUT ALSO THE ONGOING WAYS IN WHICH THIS HAPPENS.

>> IS THERE ANYTHING THAT GIVES YOU HOPE THAT THE KIND OF CYCLE OF MISINFORMATION, MADE-UP JUNK SCIENCE, AND KIND OF RACIALIZED, YOU KNOW, VIOLENCE IN POLICING, CAN BE INTERVENED IN?

IS THERE ANYTHING THAT GIVES YOU HOPE THAT THIS CAN CHANGE?

>> I DO HAVE HOPE, AND I THINK, YOU KNOW, AFTER GEORGE FLOYD'S DEATH, WE SAW PEOPLE FROM ACROSS THE WORLD, REALLY, I MEAN, IN THE UNITED STATES, ESPECIALLY, BUT MILLIONS OF PEOPLE TOOK TO THE STREETS TO REALLY ACKNOWLEDGE THE VIOLENCE THAT OUR SOCIETY HAS ENDANGERED.

THERE HAS BEEN A SIGNIFICANT SHIFT, RIGHT?

BEFORE GEORGE FLOYD'S DEATH, PEOPLE COULDN'T EVEN IMAGINE THE POSSIBILITY OF, YOU KNOW, REDISTRIBUTING RESOURCES FROM THE POLICE TOWARDS, YOU KNOW, OTHER KINDS OF PROGRAMS, EDUCATIONAL PROGRAMS, MENTAL HEALTH PROGRAMS, RIGHT?

AND THAT HAPPENED, RIGHT?

WE SAW A MOVEMENT OF PEOPLE REALLY DEMANDING, CALLING TOWARDS A SHIFT IN OUR SOCIETY, AND WE SAW RESOURCES BEING DIVERTED, AND I THINK WE HAVE TO REMEMBER GEORGE FLOYD'S DEATH, AND REMEMBER WHAT -- WHAT THAT CALL TO -- TO CHANGE OUR SOCIETY REALLY DID.

IT'S NOT GOING TO HAPPEN IN ONE SWIFT MOVE, BUT I THINK SLOWLY BRINGING THESE TO OUR ATTENTION AND CREATING NEW INSTITUTIONS, OR SHIFTING OUR INSTITUTIONS TOWARDS HEALING AND CARING AND HEALTH CARE AND TRAINING, CAN ACTUALLY DO A LOT OF WORK, AND IT HAS DONE A LOT OF WORK.

AND SO, I AM HOPEFUL, EVEN AS I KNOW THERE'S ONGOING RESEARCH THAT NEEDS TO HAPPEN.

>> PROFESSOR, THANK YOU SO MUCH FOR TALKING WITH US.

>> THANK YOU SO MUCH FOR HAVING ME.