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Terence Keel, "The Coroner’s Silence: Death Records and the Hidden Victims of Police Violence" (Beacon Press, 2025)
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- [00:00]
A
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B
To tell this story, I had to become a reliable narrator. I could not allow my beliefs about democracy, truth, or even death to prevent me from seeing the violence and brutality we are willing to tolerate for the illusion of safety in America. Bearing witness to the many lives lost to police violence allowed me to realize that our shared experience of life's end does not inspire compassion among law enforcement or jail staff. Dying at the hands of police does not engender empathy from the investigators who write death records and official autopsies. In custody deaths hardly seem to matter to lawmakers that enable these tragedies to thrive beyond the public's awareness. People in state custody become less than human and those that perish are denied dignity, respect and forgiveness. I did not fully understand this myself until I sat with the dead and saw how local governments misremember them. I wish I could tell you Americans are certain to have solved this problem, but I can't. The future of our lives in state custody is far more precarious than we realize. And so a part of me had to perish to write these pages. Pages that open the coroner's death records and the hidden victims of police violence by award winning scholar, founding director of the Biocritical Studies Lab and a professor of human biology, society and African American Studies at UCLA Terrence Keel. Terrence, welcome to the New Books Network.
- [02:43]
C
It's an honor to be here. Happy to have a conversation. Thank you.
- [02:47]
B
So talk to me about the impetus of this book. What prompted you to write it?
- [02:52]
C
Well, there are a great number of things that really prompted this book. I think that in many ways, the public execution of George Floyd, which continues to reverberate within our nation now with the recent ICE raids, was for me a turning point in my thinking as a scholar and my thinking as a historian. To witness his death, but then to later read his autopsy. There was a massive discrepancy between what we all saw with our own eyes and what the medical examiner in Hennepin county ultimately wrote. And that death record was one that said that it was a homicide, but really tried to say that George Floyd had a bad heart. He had fentanyl in his system. There was sickling in his blood, creating an alternative picture, almost suggesting that he was responsible for his own death. And so I asked, how many more George Floyds are there? And when I began to raise this question, it became very clear to me that our death investigation system is broken. The records that we supposedly keep for people who lose their lives in police custody are not there. And many of us are just unaware of just how widespread police violence and death is.
- [04:06]
B
I think you're, you're, I think, perhaps getting a little bit to my next question. In the very preface of the book, you write that it's an unusual book, but so are the autopsy records written for people killed by law enforcement. What do you mean by those records are unusual?
- [04:24]
C
The. If you, you know, what's interesting about our death record system is that most Americans will probably never read an autopsy. And I say that because the, the state laws that govern access to these records are not uniform across the 50 United States, the continental United States. And so when you read these records, they're written as almost as if there is no expectation that the public will ever look at them. And the trouble with that is that these records are produced in the public's interest. They're designed to give an account of what happens before, during, and after someone tragically loses their lives in police custody. And what one would expect in a record like that are clear language that links the actions of police to the victim's bodies. Records that make it obvious and plain who exactly was accountable for this loss of life. But these records actually don't do this. And what I found in reading these records is that they are written in such a way where the agency of Police and law enforcement is minimized, erased, downplayed. And what gets elevated very often are the actions and behavior and pre existing conditions of the people who die in police custody. Creating a kind of story that provides cover for police and law enforcement and doesn't really actually offer the transparency that it claims it provides for the public. So in that way it is strange. And then, you know, in addition to that, there's a, there's an aspect of these records that downplay the protagonists which are, you know, the victims of police violence. We get this sense that these people don't really matter, the stories don't matter. And I think that that is something that's especially troubling for family members and communities who are reading these records who, who see how our local government misremember the victims of police violence.
- [06:13]
B
I had this, I had this experience reading this book and I said this to you before we hit recording, but this, I loved this book and it's one of those book, it's one of those books I think everyone should read. I don't know if it's immediately obvious to everyone that they should read it. And I guess what I mean by that is, is you know, the coroner, silence, death records and the hidden victims of police violence. Police violence touches all of us. And yet I, I feel like there is, it almost feels niche, a little bit of maybe some if someone who's interested in the criminal justice system or social justice, which. Absolutely. But I did not realize till reading this book how many assumptions I had simply as an American about the way that these systems work. And that was the most shocking to me, the things that I thought I understood. And yes, as a ragged American, I actually started my career in the criminal justice. In the criminal justice space. I, I was a lawyer for a time also. So I get like in my past I have some of that proximity to it, but. But to me that is even more shocking, you know, and I watch, I watch a lot of crime shows on tv. I think like, it makes me like the more average American from that standpoint. But talk about, talk about your process in putting this book together and talking to people about it in this idea that like, I really think we all think we know this stuff.
- [07:50]
C
Right? You know, I had a similar reaction too. I mean your, your reaction. Reading the book was my reaction. Writing the book. At every step I found myself vacillating between rage and anger and shock and depression and disappointment and then swing back to hope when I saw just the people on the ground working to change the system in the beginning of the book, I talk about how I needed to lose a part of myself and I had to really be a reliable narrator of this system. And what I meant by that is I'm trained as a historian of science and medicine. I teach at a prestigious academic institution. These academic institutions are aligned in certain ways with local, state, and federal government. And the way that I have trained students, thought about my own work and research is that we do give. We should give deference to scientific and medical authority. We should trust a medical examiner and coroner. And so I read these records initially with the perspective of, well, let me believe what the medical examiner has to say. But it wasn't until I worked with community and I worked with grieving mothers and families and organizations that see how these records provide cover for police and law enforcement that I began to realize these are not records that are actually written in the public's interest. They're not actually written to protect democracy. They're written to protect law enforcement and the officials that empower them. And that required me to change the way I thought about how to tell this story. And I just thought at a very simple, basic level, we need to think about how this is a pro. This is a crisis of American democracy. I was shocked to learn that Looking across the 50 states in the US there are only six states where an autopsy is mandatory if someone loses their life in police custody. And those states are Illinois, Mississippi, Nevada, South Carolina, Virginia, and Wisconsin. Everywhere else, either the autopsy is not mandatory, which we give the power to the medical examiner to make this decision, or the state law doesn't actually make it very clear that there needs to be a mandate. And that's staggering because wouldn't we want to know about people who are dying during arrests or people who are dying in jail or people who are dying in process of being booked? I want to live in a world in a democracy where I know that information. So our laws don't actually allow this. And so that was one of many moments of writing this book and realizing just how broken and unaccountable this system actually is. And one last thing I think that you're pointing at to with your question. You are right. At some level, this book presents itself as if it's just about death investigation and corners. But it isn't. Because when you look at the people who are losing their lives, first of all, every single demographic in American society is found in our death ledger, which means it's not just black men and Latinos, it's white people, it's conservatives. It's Christians, it's non binary folks, it's mixed race people, it's people who have disability. But it's also people who are unhoused or who are underemployed, who are suffering from substance abuse. And when you begin to really think about all the vulnerable populations that are dying in police custody, then suddenly the problem is much bigger. It's not just it is about policing and it is about getting the medical examiner to tell the truth, but it's also about these other systems that are broken, that are broken and causing people to get caught up in the trap of law enforcement and over policing.
- [11:19]
B
You mentioned the statistic there, talking about six states. Of course there's a, there's a lot of statistics in the book that are really fascinating. One that, that I made note of is just the numbers when we're talking about death in police custody. You know, sort of what are we talking about? American police kill on average 1200 people a year during arrest or while attempting to place them into custody. And that's a, it's, it's a huge number. It's, it's also, and you have a whole chapter about this in the book as well. The fact that somebody has died during arrest or while they're being attempted to be taken into custody to me is necessary, necessary evidence that something has gone wrong. Like there is no, there's literally no other explanation for that death. Then something has gone wrong. And, and that to me, and also more Americans will die this year while in the custody of law enforcement than in Canada, Germany, Australia, New Zealand and the UK combined was another stat.
- [12:22]
C
Yeah, you know, it's, it's, what's important about that statistic is that it's an undercount. That's the tragedy of it all because the way this death investigation system works, it relies on police to disclose the names of the people that they are killing. So we can already see there's a conflict of interest. And Congress, when it passed the Death and Custody reporting act in 2000 and then updated in the sort of 2012, 2014, it never really gave a lot of resources or quite frankly any strong penalties or consequences when police undercount or misreport and the data is out there. There's been so many studies to show police misclassified. They do things like release people from their custody when they know someone is on the precipice of dying. They do a lot of different things to deflate the numbers. And so the way that I like to think about it is that really five people will die today in police custody, either during arrest or in jail. But we're really only going to know the names of three of those people. They're going to be people who are forever going to be lost to police violence, whose names we will not be able to recover. Prior to the year 2000, we didn't have a national registry collecting names of people who died in custody. Just think about that. So that means there isn't a single entity at the federal, state or local level that can tell you all the names of the people who died in police custody in 1968 or 1975 or 1915 at the zenith of public lynching of black Americans. We just will never know all those names. And that's because we never bother to count the dead. We create statistics for things that we care about. And while we do have a system in place, it isn't actually getting to the truth in the way that we need. And the only way that we can get there is by looking at the system with clear eyes and being honest about what we see and being reliable truth tellers and witnesses to this sort of inhumanity of the system.
- [14:24]
B
Yeah, you just talked about having no national account was one of the things I found shopping shocking because again, I assumed. I assumed I could Google it somewhere and find an answer. And that's also something that I've shared with people repeatedly since reading your book, asking, did you know this? And of course, every single person I've talked to is like, what are you talking. I had no idea. I had no idea. Similar. The other thing I found surprising when you talk about the records is I made the assumption that a person, whether it be a journalist or an attorney, could get death records through a FOIA request so long as there wasn't an active case. Like, I get the, there's an active case, you can't have it. But I made. I made the assumption that a simple, you know, Freedom of Information act request, which I think all 50 states have some sort of FOIA laws, would. Would get the records.
- [15:24]
C
It turns out not to be the case. There are only 14 states where autopsies are part of the public record. There are another 11 states where they are part of the public record. You can FOIA them, but those records can be withheld. The state law is explicit about this. Those records can be withheld under certain circumstances. So that leaves 26 of the states where either you can't see an autopsy at all or it's unspecified in state law. And I thought initially, oh, this would map on to red and Blue states. Right. But that isn't true at all, as it turns out. New York, for example, autopsies are not part of the public record. You can't FOIA them. You can't use right to no requests. The only people who can get death records in the state of New York are lawyers and next of kin. But you can get an autopsy in Florida or Texas.
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B
Is it related to unionization? Unionization? I mean, just in terms of, you know, groups fighting on behalf of different constituencies?
- [16:22]
C
I think the state of New York is a complicated one because it was one of the first states to modernize the medical examiner. Because in the 19th century and early parts of the 20th century, the death investigation system was an alternative path to becoming a politician or to be a statesman. And that became a system that was easily corrupted because you could do death investigations and get paid by local constituencies and then ignore most of the public. But also it was a system that didn't require physicians and people to be physicians to do death investigation. And so when the state of New York modernized, I believe a couple of things happened, which is true across the nation as a whole. The system became more insulated from the public in general. So things like transparency, democratic accountability, these things become less the focus of what a death investigation becomes. And then on top of that, I think the state of New York is complicated because Also during the 20th century, district attorneys and state attorneys began to take on the exclusive role of prosecuting on behalf of the state. So there was a period earlier in time where the power of prosecution was widely diffused, which means private lawyers could prosecute on behalf of the state. It also meant that a coroner could have the power to determine what rules were broken and what charges could be brought against someone who killed someone. And so in the effort to modernize New York and streamline these processes, and I think reduce power to the hands of a small number of elites, death records get taken off of the public record. Each of these states has their own narrative. But I think where it leaves us is a system across 50 different states that don't work all the same and that don't actually even record the same amount of information. I mean, at the bare minimum, an autopsy should contain an anatomical summary of the person's body, a toxicology report, and most importantly, a narrative about what happened before, during, and after. I've gathered records across the country, and sometimes all three of those place, three of these components are in place. Sometimes they are not. Sometimes they're redacted. Sometimes it's very difficult to even look at the writing because it's written in hand and you actually can't see the content. Sometimes it's typed out. The format of the forms change. So it creates this a real problem if you want to have a government agency that wants to do comparison across states over time and can't do it if you can't look at the records. And when you can get the records, if they're not all telling you the same information, it's hard to gather sort of conclusions about what's going on.
- [18:54]
B
Can you talk a little bit more about your research for this book? And I'm curious about what maybe what you expected to find, what you did find. And you just shared some things as well. I'm just. I'm interested in kind of all of the facets of it.
- [19:08]
C
Well, I initially thought that surely there were some government agency that collected the names of everyone who died in custody. What I discovered is that there are two different sources of information that are available to the public about people who die in custody. There is the Bureau of Justice Statistics, which sits under the doj, the Department of Justice. They gather information about deaths that take place in jails. So not federal prisons, not state institutions, but jails and county facilities where the sheriff has jurisdiction. Private prisons, or just not private prisons at all. Just county jails, Just the jail systems themselves. So federal and private prisons have their own reporting stream. So the DOJ will. Will gather information from all of these facilities, but what they publicly release, they will release the information about the county jail system, but not the state and private federal institutions. They have their own reporting mandates. The question is why? That doesn't make any sense. If we want to be transparent, we should allow all this information to be made public. Then when it comes to dying during arrest or being booked, that's an entirely different set of problems. Because while the DOJ and the BJS tries to collect that information, it again relies on policing and law enforcement to disclose that information. What I discovered is that there were other researchers and nonprofit organizations who were already trying to fill in the gaps, which is one of the things I've learned doing this book. We often very. We often very think that, you know, academics and professors have the answers and the solutions to problems. And sometimes that's true, but more often than not, there's a local organization that's already working on an issue that. That has a sense of where. Where the problems lie. And I began to realize that there were nonprofit data scientists who were gathering information from news reports and on the scene, witness reports and even in many cases, policing report. These are crowdsourced data, data that's publicly available, so data from things like Fatal Encounters, which is run by a nonprofit organization that discloses the names of people who die in custody. There were many media sources that we relied on. And so my team had to. We had to be multidisciplinary and interdisciplinary in our work. We had to know data science. We had to gather these multiple data sets and make them talk together. We had to work with community partners who were on the ground who were dealing with this issue, who are dealing with local officials. We also had to research the laws around in custody death and the autopsy record and transparency, and figure out and map out, as we do in the book, how each of the 50 states operates a little bit differently. And then we had to think about, and I had to think about, in writing the book, what's the public health consequences of all this state violence? Right. Like, what does this all mean? And in many ways, to tell this story, I had to tell a story about the history of medicine and the evaporation of the social safety net. Because I mentioned before, we are arresting people who die because they have substance abuse issues or who have mental health issues. And when you look at the states or the counties of where those deaths are happening, it is very often in places where social resources are evaporating. Affordable housing is very difficult to get access to. People don't have access to health care. I mean, for Christ's sakes, we're still having this debate about universal health care and giving people access to health and treatment. And so all of these things I had to sort of think about as a researcher to tell this story.
- [22:46]
B
I'm reflecting on something you just touched on. You have an entire, entire chapter called Society Lives in the Body. And you write, I make the case in this chapter that we struggle to recognize the appearance of society inside the bodies of vulnerable people because our perceptions of health remain hostage to the discriminatory intentions that were braided into American medicine and the field of public health at the end of the 19th century. And so you go back quite a ways.
- [23:19]
C
Yeah. So it's, you know, if we want to understand health in America, we have to understand how the federal government and state and local governments have failed African American people. And the reason why we have to understand that is that after the Civil War, there was a very short and temporary experiment in actually providing medical care, medical institutions, to formerly enslaved black people who were trying to make their way in the various counties and cities where they found refuge. After the War. The war devastated so much of the infrastructure in the South. But it also made it very clear for the radical Republican reformers there needed to be an entirely new infrastructure developed so that we could properly meet the medical needs of these new Democratic citizens. And what happens essentially after the end of Reconstruction is that the federal government begins to pull away from its investment in the lives and health of black Americans. And you can't pull away in this country from one demographic without influencing the others, right? So if you live in a government or live in a nation state where the government says you're free to get sick or to be healthy, and it's really not our job to intervene in the price of medical care, because to do so would mean committing you to socialism or to do so would mean erasing your freedom. And so we're going to leave it to states and counties to determine who gets access to medicine, what medical research looks like, what infrastructure looks like for healthcare. But when you have that as a mandate during Jim Crow segregation for there's an active attempt to disempower black Americans and other non white minorities to remove them from the Democratic franchise. And what you're talking about are cities and counties that are actively discriminating against people of color by doing things like not having enough hospitals develop within their neighborhoods. I was doing research here in Los Angeles. There were really only two state hospitals serving the entire population of southeast la, which included black Americans and Latinos and Asian populations. And we're talking about an hour trip on the bus to go see a physician. And in a time where people didn't have that kind of time, you know, people needed to work. And so the, the decay of our health infrastructure or the sort of piecemeal way that it was developed over time has left all of Americans vulnerable to hypertension, to mental health conditions, to substance abuse issues. Right? If we even look now debates around the extension of the Affordable Care act subsidies. If you look at the states that are opposing those subsidies, there are states that lead the nation in lower life expectancy. There are states that lead the nation in cardiovascular disease and illness. There are states that have chronic health conditions. Why? Because the health infrastructure is not robust there. And so one way to tell that story is to understand that we haven't really exercised these ghosts of wanting to believe this nation belongs to white Americans. And we haven't really fully moved into the position to understand that we need health for everyone. We are a better nation, we are a more safe nation when we know that people can live in cities and neighborhoods and get the treatment that they need. And when we don't have those systems, people find themselves ill, people find themselves disenfranchised. And tragically, as I'm finding in this book, in this research, you know, trapped by policing and losing their lives under circumstances where no one should die.
- [26:59]
B
We spoke before about the Death and Custody Reporting act and your research as well. Talk about the list of lost lives.
- [27:10]
C
The list of lost lives is a data set that researchers in my lab put together. And we pulled this data set from multiple sources that hadn't been talking to each other. As I mentioned a little bit earlier, it's very difficult to get data about death in custody. There are some government records that are useful at the federal level, but they don't tell the full story. And if you want to know the deaths of people who are, who lose their lives during arrests, you have to be creative and pull together alternative data sources. So we did that and so we pulled together these figures and we provide our best estimate of the names of people who have died during arrests in the United states over a 20 year period beginning in the year 2000, which we thought is a great time to start, because that's when the Death and Custody Reporting act started. And what we found is that over that 20 year period, 32,104 people lost their lives during arrest in the United States. The percentage of black Americans, Latinos, is overrepresented. We are a smaller percentage of the population. And so we are in this demographic and in this list at a higher percentage, given how small we are as a population. But the largest group, in terms of just raw numbers are white Americans making up about 34% of all of those deaths. But every demographic is represented. We have populations from the Middle east, we have Native American populations, Hispanic, Asian, Pacific Islander population. Every racial demographic is represented. But to put that figure into context, between 1608 and roughly 2020, America has executed around 16,000 people going back to 1608. So if you just think about that, in just 20 years, police have killed more than twice the number of all people who have been executed. I'm Sorry, in just 20 years, police have killed more than twice the number of all people who have been executed in American history going back to 1608. And that's just in a 20 year period. Right. And again, we don't know about the deaths in custody between 1980 and 2000, or 1960 and 1980. Right. So this is a staggering problem. And we wanted to create a list that would capture the names of these victims and Provide as much information as we could get our hands on and make this publicly available. This list of lost lives is accessible to any of your listeners. You can download this list of lost life through our UCLA data verse that allows people who are interested in seeing this problem with their own eyes to see these actual names. I think it's one thing to talk about a big figure, 32,000, but it's another to actually see the names of the people and the ages of the people. I mean, the. We have people in there who are teenagers who are in this. This death record, and we have people who are in their 80s who are also dying in police custody. It's a really is a tragic sort of failure of our democracy for people.
- [30:19]
B
That, you know, the numbers make their head spin. And a little bit you have this quote from Alex Piccaro of the Bureau of Justice Statistics that says Americans know more about the number of flights delayed on any given day of the year than the number of people dying in police custody.
- [30:39]
C
That's right. What does that tell us about what we value? What does that tell us about our criminal justice system? You know, I think we have all have been influenced by the mythology that police make us safe, and that is the only way to make ourselves safe, really. We need police and law enforcement to do that. I think law enforcement plays a role in creating safety in our society, but it cannot offer the kinds of security that most of us need. Most of us need our material needs met again, wages that can compete with inflation, access to healthcare, you know, living in affordable housing, having access to competent physicians. These are the things that make people in their everyday lives feel safe in their bodies, feel healthy in their bodies, and allow us to understand that we are part of a collective, that we have governments that actually care about the livelihood of your children or your grandparents or your spouse or whoever it is that's in your life or you, for example. And when people don't feel this in their everyday lives, people don't feel safe. But because we've got this sort of propaganda that allows us to think, well, whenever we don't feel safe, pick up the phone and dial 91 1, our understanding of what safety and security look like, looks like is distorted. And I think part of the work that I talk about in the book and point to is that we have to start reimagining what safety really does look like in our nation. And it begins with providing the most basic material needs.
- [32:12]
B
Well, yes, and the transparency. You had a quote or you talk about this thing in the book where Again, I'll go back to my own assumption. You know, we sort of assume that there, that information is available. And you talk about the fact that, again, most people don't even think about that they can't have access to this or that the records don't exist unless and until, God forbid, someone in there close to them is killed. And then they want to access it and they're. And they learn for the first time, this is not available to you.
- [32:50]
C
But, you know, our death investigation system didn't used to work like that.
- [32:53]
B
Yeah, talk about, talk about the history of it. I thought that was really fascinating as well.
- [32:57]
C
You know, the history is fascinating. And, you know, so prior to emancipation, 17th century, 18th century, really, the coroner is one of the oldest democratic institutions in American history, partly because coroners, when America was still a colony of the British, were called Crowners. And their job was to make sure that if someone who worked for the Crown because there was investment in creating plantations and creating, moving resources from North America back to the center of the empire, if for some reason someone died on that voyage, or someone died when creating a plantation, or someone just died because of yellow fever, the crowner would investigate that death, determine what resources and what debts had to be paid, and then everything else had to be returned to the crown. After American independence, Crowners became coroners with sort of the translation of the role to one of investigating the deaths of people who happened under mysterious circumstances. Now, if someone died in, let's say, 1815, what the coroner would do is that they would call an inquest together of 12 free white male citizens, because they were the ones that counted as citizens at that time. And they would talk amongst themselves about what happened before, during and after this person perished. They might ask questions about what. Was there any strangers in the area at the time? Is there sort of any suggestion that maybe there's some sort of disease or pandemic going on? Is there a murderer that's loose? These are the kinds of things that these 12 jurors would come together and sometimes they would say, well, I think it was, you know, John Doe who did this. And I saw this person with this weapon just a few days ago. Maybe these things are connected. The jury would then influence and tell the coroner who was responsible. And then the coroner would then go get the sheriff and go arrest this person. This was a form of direct democracy. People were directly a part of, not just in a ceremony, a ceremonial or empty way, directly engaged in what happened. When it came to the distribution of justice after 1865, going in again to Reconstruction. And then ultimately after the end of Reconstruction, this democratic institution begins to erode. And I talk about in the book about the Hamburg massacre in South Carolina, small black town subjected to the violence of white nationalists. Many men who were part of the National Guard in South Carolina, black men were killed. They knew who the perfect who, the people who were responsible for this death. They do an inquest, an all black inquest. They name the names of the people that the sheriff is supposed to arrest. Sheriff doesn't do it. The governor of the state of Carolina doesn't do anything with this. Shortly thereafter Reconstruction ends. And that in many ways anticipates what happens to our democratic institutions under racial segregation. They become more concentrated in the hands of the few, particularly white citizens and white male citizens. People become removed from the process of democracy. The coroner itself starts to work more closely aligned with state government officials and less with the people. And so now we begin to have things where coroners don't actually run for office. They're appointed by local government. So they're not accountable to a local constituency. They're not accountable to anyone who might pull them out of power. If you look to our present now state like California, medical examiners are appointed by local government and they don't have term limits. They can be there as long as local officials say that they can. They don't have to run for office, they don't have to campaign. And what that looks like in real time is they may write records that dis, that sort of misremember the victims of police violence that provide cover for policing. And it's very difficult to get them out of power unless a local official says that this person isn't doing their job. And tragically, where I think the system operates now is that coroners are the first line of defense for the state against the public. Because if you die in custody and family raises the lawsuit and they find that the medical examiner says, oh, this person died from a homicide because of police, that then makes it more possible to file a settlement against the county. And you know who pays for that settlement? The same people that appoint the medical examiner in the state of like California and other states operate this way. And so it's a system of insiderism that pretends at some level to be democratic and accountable, but in practice is quite something else you talk about in.
- [37:49]
B
The book as it relates to transparency. That transparency is not only about access to the death records which we've talked about, but it also involves the language used to describe lethal police violence. Again, this is something else that was just really eye opening for me. Talk about this language piece.
- [38:12]
C
You know, it's again, when we look at a death record, what we would hope to see is something similar to what we might see when we go to our physician's office. Right? You go to the doctor, your elbow hurts. The doctor raises some questions, well, why is your elbow hurting? And you might say, oh, I was playing tennis or I fell down at my job. They might write up a description of what happened. And they may say in very clear language, patient fell, injured right elbow. I'm prescribing this painkiller. When you bring that expectation to a death record, you're going to find yourself disappointed because often these records read as if people are dying alone, as if they are not in the presence of policing and law enforcement. So there are language I talk about in the book where, for example, Alicia Thomas is a 33 year old, 34 year old black woman in southeast Los Angeles. She's experiencing a mental health crisis. She leaves her children with the police department, she returns home, police follow her, she's dead within 10 minutes. But the way that the death record is written is that the medical examiner says that she was uncooperative. When police tried to arrest her, they used a light restraint maneuver. Shortly thereafter, she became unresponsive. So in that description, we don't know well, why was she unresponsive? What does it mean, a light maneuver to subdue someone? Because I'm a martial artist and I train and there's no such thing as a light maneuver of subdual. When you subdue someone, you're using force. So that sort of language sort of orients. It sort of has a kind of persuasive moral logic to it. It says police tried their best, they were light handed, they tried to reason, and this person was just unreasonable. So they did their vests. And because this person had a history of cocaine abuse or substance abuse or preexisting health conditions, this is why they died. Which is what this death record said. And so reading this, it became very clear to me, you're right, it's not just about, can I get access to the autopsy? I want an autopsy that puts in clean, clear language the action of police and the effect of this action on the bodies of the people that they were arresting. Going again. I think as a nation, we have a hard time understanding that we carry society in our bodies. Police represent law enforcement. So when law enforcement do things to our body, we need to have a death investigation system that can See this? And medical examiners have at their disposal classifications to actually tell us this. They could say someone died in jail of a homicide, comma, medical neglect, meaning this person died in jail and the death seems to be the responsibility of incompetent healthcare inside or homicide, institutional neglect. The deputies didn't do their job in checking in on this person. They put someone with mental health issues in solitary confinement that exacerbated those conditions and that drove someone to committing suicide. It's available for medical examiners who do this, and I write about this in the book, saying that we need them to have more courage and moral clarity about what's going on and to understand that there is a growing public that's paying attention to the records that they write. They're not just writing for themselves and for the local officials that appoint them. They are writing for the people.
- [41:38]
B
I was making a note when you were talking about this because one of the other questions I wanted to ask you that you just went to is you write, in all of the autopsies I reviewed for this book, almost never did I find a medical examiner or court coroner attribute an in custody death to larger systemic issues within law enforcement, our criminal justice system, or inequities within our society. And I wanted to ask you, well, what would it look like if they did attribute. And I think you just said, gave some examples. The former lawyer in me, when you say something like, like due to medical neglect, for example. Well, the word negligent neglect isn't any more precise, I don't think, than any other word really. Like, what's like, you know, thousands of lawyers are arguing at this moment in a court of law about whether or not neglect was involved in ABC xyz.
- [42:53]
C
So right now, very few medical examiners even use medical negligence or institutional negligence. They should and they could, but they don't. So part of transforming the system is understanding that the goal would be to have a system that writes in the most capacious way things like 35 people have died inside of Los Angeles county jails this year. It's a new record. 60% of those deaths seem to be concentrated on the third floor. That third floor has a documented history of deputy gangs using violence as initiation into those gangs. I have seen out of that 60%, you know, 100% of those people with injuries and wounds that are in consistent with someone in solitary confinement. I believe that there is an institutional accountability here. So I'm going to label this a homicide comma, institutional neglect, for example. They could do that. It's within Their ability to use statistics to think in a more capacious way about what's going on. And you know, part of the work that we're doing in my lab is providing local officials with that data. We do reviews of people who die in custody, we keep track of the numbers here in Los Angeles, the largest system in the country, with the idea that if not the death investigator, that the very least families or local officials can see these patterns. But your, your question is an interesting and important one because even in the medical side, there are cases that I read about in the book that I know about in other contexts working with families where people will go to jail because of a substance abuse issue, be given a substance to help detox. But at medical intake, say, I have allergic reaction to this drug, do not give it to me, and they get that drug to that person anyways. This woman, Nikki Capaci, a single white mother in New York, was a registered nurse, injured her back because she was on the lift team, which requires lots of physical labor. She has health insurance, so she's getting prescribed drugs. But then her employment status changes and then she has to turn to street recreational drugs plus opioids. So she has an abuse problem, which tragically is a very common story for many Americans. She gets arrested because of her having the substance abuse issue. She gets put into a jail facility in upstate New York, is told at intake that they're going to be giving her a chemical compound to help her with withdrawals. She says, don't do this, give me the one that I know I have a positive reaction to. They ignore her. She dies on camera, There's a camera inside of her jail cell where she's telling the sheriffs, I'm not feeling well. I, my heart is racing, I can't breathe, I feel lethargic. And they ignore her. On camera, they say, you're fine, there's nothing wrong with you. She dies on camera. That's an example of medical negligence plus institutional homicide. These deputies had more than enough time to check in on her and to take care of her health, medical needs. And so I think the system, I want, the system that we deserve as a public is one that, where these records are robust and full throated and they give us a complete comprehensive picture of what happened. But to get there, we need to push and demand for medical examiners to do more. And I think in this moment, demanding them to do more is to actually use words like negligence and accountability because they aren't doing that right now.
- [46:18]
B
There's another word I want to Touch on because you bring it up in the book. Also, is, is the conclusion of undetermined correct? Talk about, talk about undetermined.
- [46:30]
C
Well, the undetermined death classification is one of a few. So there are natural, homicide, suicide, undetermined. And these classifications are used by medical examiners not just in the United States, but around the world. The International Classification of Diseases uses these classifications to gather information about death. The undetermined death classification makes the least amount of sense for someone dying during arrest or in police custody. Because when you look at the way that the national association of Medical Examiners name define what an undetermined death should be, they say it's akin to being somewhere in a desert and you come across some bones and some human remains and you don't have enough identifying information about that person or the circumstances under which they died. Therefore the death would be undetermined. It's an environment where you don't have enough data or information. Dying inside of a jail is a data rich environment. What do I mean by that? I mean every aspect of a person's life in jail is regulated. How much sun time they get, whether or not they're in general population or solitary confinement. The food they eat, the visitors that they see, the water that they drink. There are cameras in many of these facilities. There are regular state managed checkpoints that sheriffs are supposed to routinely go to each cell and make sure that the person is alive and well and document this. So how can someone in an environment with that much data die in ways that are undetermined? It doesn't make a lot of sense. Where medical examiners will lean is they'll say, well, there are competing classifications potentially going on here. And because of this, this is what makes the death undetermined. And I don't buy that argument. I think that the undetermined argument is an easy way to sort of minimize accountability. And instead, medical examiners need to make a determination that makes sense again in a context where they have a lot of information available to them. And in the cases that I've seen around the nation, but especially here in Los Angeles, there are a lot of people in their 30s who are Latino or who are black or who are unhoused or who are suffering some substance abuse issue and their deaths are being classified as undetermined. And there's a pattern there around the use of that classification that points to something nefarious going on. And I think, you know, this is supposed to be modern science and medicine, so we should be able to use things like the environment and Data to help us be more precise in our classifications. And that hasn't been happening.
- [49:14]
B
What has been the reception of the book thus far?
- [49:18]
C
So I've been on a book tour now for the last few months and have traveled to many parts of the country talking about the work, and it has been very graciously received. I have had the opportunity to meet more family members and community organizers who have said to me, you're narrating my story. What you describe is what I went through when I lost my brother or my son, or what we witnessed when we were working for families, trying to get records from the county or trying to get clarity from the medical examiner about what happened. It's been very well received. And I think that many see in the stories of these victims themselves, and even for people who are not actually then touched immediately by, you know, state violence or police violence, they can say, well, you know, the degree of separation between myself and someone who I know has opioid addiction is very small. I know family members who have mental health problems, and some of those people are just one bad mental health day away from finding themselves in law enforcement custody. So that's been the sort of response and conversation, and it's been a lot of people just shocked by the data and shocked by the lack of transparency in the system and really surprised that we haven't been having this conversation before. I think in some ways, all of the momentum and goodwill of the George Floyd Breonna Taylor moment has waxed and waned, as often these things do. And so I'm glad that I'm releasing this book at a time to remind us of those commitments again. The George Floyd protest was the largest global protest in modern history. Practically every continent had a protest. Well, that work isn't done. People are still dying in custody. In fact, the rates of deaths in custody have actually gone up in certain states and counties since those moments. So now is the time for us to remind ourselves of those commitments, especially as we're dealing with ICE agents who are now killing American citizens and civilians, in addition to a bunch of other people who are being detained and losing their lives because of medical neglect or institutional homicide.
- [51:25]
B
For the readers of the book and for listeners. For listeners, I hope listeners will also become readers of the book as well and go out and get a copy and read it. But is there a call to action for listeners? Like, what can those of us like me, I've read the book, now my eyes are opened. What is my role in moving us forward?
- [51:50]
C
Great question. Well, there are a few Things. Perhaps the most practical thing is to. I encourage you and your listeners, whoever's listening, find your local organization that's already working on reforming either the death investigation system or police transparency or government record transparency. These are public goods that have to be defended and fought for in a democracy. And if we leave it to our local officials, they would prefer us not to know about what's going on. And so many. It's very often the case that local organizations are already aware of this and they're doing the work. So that's the first thing, I think. And these organizations are always looking for new life, new energy, more members of the public who care about these things. I can't tell you how many rallies or how many protests or how many memorials I've gone to in Los Angeles, and I've watched the numbers wax and wane. Given what's going on in our media cycle, we need people who are more invested into the system. But then there's something that I think is a bit more local and more intimate and personal, and that is we have to see ourselves in the victims of police violence. I think we internalize this binary moral universe that says when you're on the wrong side of the law, if you get arrested or you go to jail, you deserve that something is wrong, you did something bad. And in some cases it may be true. But we have a criminal justice system for a reason, so that people can go in front of a judge, either defend their innocence or be sentenced. None of this happens when you die in custody. All these people who died in custody never got the opportunity to go in front of a judge. Many of these people were nonviolent offenders. We have to ask ourselves, do we want to live in that society? Is that justice? Is that what safety looks like? What happens if you have a bad mental health day or lose that job and tragically have to turn to other things to sort of take care of pain management. What might happen to you in that system, Those are the kinds of things that I think we have to do. And it's a kind of practice because there's so much available to us to not think this way, to rely on old patterns and old institutions that are no longer serving us.
- [54:03]
B
The book is the Coroner's Death Records and the Hidden Victims of Police Violence by Terence keel. Find Terrance terrencekeel.com and I'm your host, Sullivan Sommer. You can find me on my website, ollivansummer, on Instagram, at the sullivansummer and on substackullivansummer. Thank you for listening to the new.