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- [00:02]
Megan
Hi, I'm Megan and I've got a new podcast I think you're going to love. It's called Confessions of a Female Founder, a show where I chat with female entrepreneurs and friends about the sleepless nights, the lessons learned, and the laser focus that got them to where they are today. And through it all, I'm building a business of my own and getting all sorts of practical advice along the way that I'm so excited to share with you. Confessions of a Female Founder is out now. Listen wherever you get your podcast.
- [00:37]
David Duchovny
Hi everyone. I'm David Duchovny. Join me on my podcast, Fail Better, where we use failure as a lens to reflect on the past and analyze the current moment. I speak with makers and performers like Rob Lowe, Rosie o' Donnell, and Kenya Barris, as well as thinkers like Kara Swisher and Nate Silver to understand how both personal setbacks and larger forces impact our world. Listen to Fail Better wherever you get your podcasts.
- [01:08]
Trayvon Free
Lemonada this podcast contains descriptions of violence and police brutality. Please be advised.
- [01:18]
Richard Burns
Going by the side, I just worry.
- [01:20]
Trayvon Free
About the vet delirium or whatever. Okay, this recording is of two former police officers in Minneapolis. It's a little hard to hear, but they're discussing what to do. And as they have George Floyd restrained face down in the street with a knee to his neck, and we hear the first officer, Thomas Lane, say something kind of odd. He asked Derek Chauvin if they should turn George Floyd on his side because Lane is worried about, quote, excited delirium or whatever. George Floyd died that day under the weight of Chauvin's knee. And both of these officers are now serving prison time for their role in killing him. This was May 25, 2020, and we've all learned a lot since then about how people, and black men in particular, are killed by the police in this country. But even as we've studied and written our legislators and marched in protest, there's still some things about deaths in police custody most of us don't understand. Like this excited delirium thing. It might sound unfamiliar, but it actually comes up a lot. And in cases that you've heard of, like George Floyd and Daniel Prude, it's.
- [02:27]
Dr. Joy Carter
Been deemed that Daniel Prude was in a state of excited delirium when he encountered police on March 23rd of last year.
- [02:35]
Trayvon Free
And Elijah McClain.
- [02:37]
Megan
Victims are said to exhibit wild behavior and extreme strength. And it is widely used by police and paramedics to justify injecting someone with ketamine.
- [02:46]
Trayvon Free
And Manuel Ellis.
- [02:47]
Megan
He died shortly after paramedics got there. The four Tacoma police officers involved were placed on administrative leave. Dozens marched the streets of Tacoma to protest police brutality and racial.
- [03:00]
Trayvon Free
A study from Maryland in 2017 found that excited delirium was referenced in 11% of cases where someone died in police custody. And when these cases go to court, the concept of excited delirium can be used to argue that the police did nothing wrong. And as we've seen in the news, the term is disproportionately applied to people of color, specifically black men.
- [03:22]
Dr. Joy Carter
Excited delirium is not a thing and it has just gone way too far.
- [03:29]
Richard Burns
This thing is being perpetuated throughout the country and people are dying unnecessarily. End of story.
- [03:35]
Trayvon Free
I'm Trayvon Free and you're listening to the untold the injustice happening in your own backyard in this episode. How did Taser, a couple of doctors and a handful of so called experts take a meaningless psychiatric term and get it picked up by police departments, medical professionals, and courtrooms all over the country? You're going to want to hear this story.
- [04:02]
Richard Burns
He had reason to believe in his mind that he was in danger. And so he left the home. He left the home to cool down.
- [04:13]
Trayvon Free
This is Richard Burns. In 2010, his brother Pat had an argument with his girlfriend and left his home in an agitated state.
- [04:21]
Richard Burns
Now this is January in the middle of winter, so it's cold out. And he had on boxer shorts and a long sleeve T shirt and no, no shoes or socks. Like he just, he just bolted out of his, out of his house. We understand that he may have gotten disoriented and went to what he thought was his house and it was actually his neighbor's house.
- [04:46]
Trayvon Free
Rich and his brother Pat, who we're talking about here, they had a close relationship. They were the youngest two boys in a family of six kids. They were the best men at each other's weddings. Rich describes Pat as loving, a good fisherman, a big Orioles fan, and very handsome. At this point, Pat's two daughters were 15 and 7 years old. Pat had been through a lot of trauma in his life. He also had a history of bipolar disorder. And this night he had cocaine in his system. For whatever reason, Pat seemed to believe someone was trying to kill him. And he ended up breaking through a window at his neighbor's house and forcing his way inside. Here's his brother Richard again. He's telling his perspective on Pat's forced entry into their neighbor's home.
- [05:30]
Richard Burns
And if you're awoken to something like that, it's a bit upsetting which it was to that homeowner as well. And so she had the option of taking the frying pan that was in her hand and smashing him across the back of his head and. Or not. And she recognized that it was Pat. She went to grade school with the dude, and she's like. Even though he came at her aggressively, she calmed him. She didn't. She just said, hey, Pat. Pat. And so he recognized he was at the wrong spot and left the home. And he went outside and sat down in the drainage ditch and waited. And while that was going on, the woman's son was in the basement and called 911.
- [06:20]
Trayvon Free
Four squad cars came racing over and found Pat sitting outside.
- [06:24]
Richard Burns
And somehow, 15 minutes later, those cops. Tasers had been discharged 21 times. And he was placed down on a stretcher after being hogtied, which is a position where people shackle their feet together and then shackle their hands together.
- [06:55]
Trayvon Free
Pat didn't survive the encounter. He was taken to the hospital and removed from life support. Four days later, the coroner for the county determined that Pat's death was caused by excited delirium. And we should note, Pat was white. And white people make up about 32% of excited delirium cases. We're telling his story today because it illustrates just how deceptive our criminal justice system can be when it comes to investigating excited delirium cases.
- [07:23]
Richard Burns
They were saying excited delirium. This guy, this. Your brother had excited delirium.
- [07:28]
Trayvon Free
That's Richard again, Pat's brother. After hearing that Pat was on life support, he rushed from Florida to Illinois to figure out what had happened.
- [07:36]
Richard Burns
What's it mean? You know, I never heard of it before. And, you know, I've watched Quincy and I've watched csi, but I've never heard of excited delirium. I didn't know what it was. I wanted to understand what this thing was. If it happened to my brother, could it happen to me? You know, sort of thing like, is it valid? Is it not valid? And so, you know, that's why when I was told that this is how. Why my brother died, it was frustrating in a way, because the conclusions that were presented did not include some very significant details of his death. One of which was that he had been tasered more than 20 times, another that he was hogtied face down on a stretcher. And, you know, and several things like that, that. Well, that's not how he died. He died because of this thing that is called excited delirium.
- [08:41]
Trayvon Free
Taser devices keep a log of when they're fired. Which confirmed that the officers on the scene with Pat discharged their tasers 21 times. An independent autopsy showed that the level of cocaine in Pat's system was too low to cause death and that injuries from the restraints and from the use of tasers were present on his body. But the county coroner's office only listed cocaine and excited delirium as Pat's cause of death, which Rich finds suspicious. And he's been on a mission to get to the bottom of these questions ever since his brother was killed. So what is excited delirium? And what would cause the police or a medical examiner to think someone had it? Joanna Naples Mitchell is a human rights lawyer and the co author of a new in depth report on excited delirium that is getting a lot of attention. The report was published by Physicians for Human Rights and really investigates the problems with the use of the term. Joanna walks us through a basic definition.
- [09:38]
Joanna Naples Mitchell
So excited delirium is first of all a pseudoscientific concept that originated in the 1980s in the forensic pathology literature.
- [09:48]
Trayvon Free
And that literature includes a long list.
- [09:50]
Joanna Naples Mitchell
Of symptoms, including agitation, attraction to glass surfaces, extreme sweating, rapid breathing, being inappropriately clothed, not responding to the presence of police, and even overtly racist terms like superhuman strength and imperviousness to pain.
- [10:08]
Trayvon Free
Superhuman strength, impervious to pain? Are we talking about a Marvel superhero? These are really damaging descriptions. And we're gonna get more into why that is later. Now, delirium alone is a medical term that's recognized by most professional organizations. It basically describes a confused or incoherent mental state.
- [10:28]
David Duchovny
Just to be clear, those patients exist. I see them quite regularly. There are a lot of people out there having a bad day, and we have to take care of them, and we have to keep everyone safe in the process.
- [10:40]
Trayvon Free
Dr. Brooks Walsh has been an emergency medical physician in Bridgeport, Connecticut for the last 15 years. And before that, he was a paramedic. He's seen many patients with delirium. He says keeping people safe includes understanding what's really going on with them.
- [10:54]
David Duchovny
Delirium is a symptom, a sign that there's something else going on in the body. And it's our responsibility to figure out what that is. No one dies of delirium. They can die of the infection that's provoking this delirium. Certain kinds of strokes might produce a delirium like appearance, and it'd be very important to figure that out. A problem with a low oxygen level certainly can appear as delirium, and no one would ever Say that that person died of delirium. Instead, they would say that they died of the problem causing the low oxygen.
- [11:24]
Trayvon Free
Delirium can also be caused by certain medications or high doses of drugs like alcohol and cocaine. In every case, there's some underlying issue that's causing the delirium symptoms. The same goes for when medical professionals cite the term excited delirium. It's not excited delirium. There's an underlying issue, and that underlying issue is excessive force. A recent literature review found that 90% of excited delirium deaths were associated with restraint. And the authors of that review wrote, there is no evidence to support excited delirium syndrome as a cause of death and the absence of restraint.
- [12:02]
David Duchovny
There's often discussion about if a different term should be used instead of excited delirium. And really it's not the term, it's the whole concept. The inevitability of the death, the inhuman qualities of the person with excited delirium, the problematic racial language.
- [12:22]
Trayvon Free
Simply put, the whole concept is based on pseudoscience. Dr. Osagi Obasogi agrees. He's a law professor at the University of California, Berkeley, and also teaches in Berkeley's Joint Medical Program and School of Public Health.
- [12:37]
Dr. Osagi Obasogi
So from the perspective of many medical professionals, they see excited delirium as a way to understand how and why people tend to kind of spontaneously die while in police custody. However, the term itself often obscures more than it reveals. That is to say that this term has been used to obscure the. The violence that is often perpetrated against these individuals, either by the police or sometimes by medical professionals themselves.
- [13:02]
Trayvon Free
Basically, excited delirium is obscuring systemic racism. A recent study Dr. Hrabowski conducted looked at 166 deaths attributed to excited delirium over a decade and found that about 43% of the time the victim was black. Even though black people make up around 12% of the US population.
- [13:22]
Dr. Osagi Obasogi
And so this idea of the hyper masculine, out of control, aggressive, black or brown man is a stereotype that aligns with how excited delirium conceives of the person who is thought to be suffering from the. From the condition. And they come together in a way that allows black and brown men in particular to be automatically judged to be experiencing that. That condition of excited delirium, which may very well lead to unusual forms of force being applied to that person that can lead to their death.
- [13:55]
Trayvon Free
Excited delirium first suggests that a person who is acting strange, who maybe seems confused or is undercloth or look sweaty, they might have superhuman strength and not feel any pain. And if you believe that this is true, as is too often the case when police approach a black man in distress, you might think it makes sense to restrain that person faster or more forcefully in order to keep everyone safe and excited. Delirium suggests that a person might just die spontaneously, in which case police and manacle examiners would have less reason to think that police restraints or any other violence on the scene had anything to do with the death. This all creates a cycle where using more force seems justified and the consequences of that force are less scrutinized.
- [14:42]
Dr. Osagi Obasogi
The idea that African Americans somehow have deficient bodies that can lead them to, in a sense, spontaneously die on their own in a way that obscures the broader violence that occurs in their community. Though those parallels should not be overlooked.
- [14:58]
Trayvon Free
Dr. Hoboski points out that going back in history to slavery and even earlier, black people have been described in western medical literature as dangerous, prone to violence, and somehow not capable of suffering in the way that a white person would. These dehumanizing ideas and the racist language behind them were used to justify slavery. Brutal experiments were done on enslaved black people in an effort to show that black bodies were different in everything from intelligence to the thickness of a person's skin. None of this is true, and these racist stereotypes have continued to re emerge throughout history, even after they've been repeatedly debunked. This has helped normalize the apathy our society exhibits towards black people. A study that was published in 2016 showed that one third of white medical students and residents surveyed still thought that black people literally have thicker skin than white people. The white students and residents also consistently underrated the amount of pain they thought black people would feel in a hypothetical situation, which made them less likely to recommend appropriate treatment. I went to the doctor in 2016 for a pinched nerve, and let me tell you, it was really hard to get pain medication. And that 2016 study is not an outlier. It's a testament to how these harmful stereotypes can have long lasting impact. It's why we're talking about the connection between excited delirium and race today. So let's go back to Rich and his brother Pat, because what happened next in their story gives us real insight into how the term excited delirium can distract from other important details. When a person is killed in police custody. Reports from that night indicate that Pat was agitated and appeared to be confused. He was outside in the snow without shoes or socks on, which might indicate he was overheated. And reports from his family about his injuries indicate that officers used a high level of force when restraining him that night. Here's Rich again.
- [16:56]
Richard Burns
And even though he was unarmed and things like that, all of a sudden he's dead. And the explanation to me raises red flags from the get go.
- [17:07]
Trayvon Free
Before an autopsy or any official investigation was complete. Before Pat was even dead, Rich was informed that excited delirium would be listed as the cause of his brother's death.
- [17:19]
Richard Burns
So this attorney tells me, here's what's going to happen. Your brother's in a coma right now, all right? If you folks decide you're going to remove life support, they're going to do an autopsy because the police were involved. They're going to do an autopsy with a person who's not qualified to do autopsies. So I would recommend that you let the coroner know that you wanted an independent autopsy with somebody who's board certified in forensic pathology. It's going to cost you guys about $3,000. We said fine as a family, we agreed to do it. And our guy concludes these things like the multiple taser shots and the fact that he was hogtied face down on a stretcher contributed to his death at least a little bit.
- [18:07]
Trayvon Free
You know, when Rich says that the autopsy would be done by someone who wasn't qualified, he, he's referring to the fact that it was not going to be done by a certified forensic pathologist. In the United States, every locality has their own rules for who can certify death. And sometimes it gets messy.
- [18:26]
Dr. Joy Carter
A forensic pathologist is a medical doctor who has subspecialized in forensic pathology.
- [18:33]
Trayvon Free
This is Dr. Joy Carter. She's a board certified forensic pathologist and the first black chief medical examiner in the United States. A forensic pathologist is the most qualified person to investigate a cause of death. They do at least four additional years of specialized training after they complete medical school and they have to pass a professional exam to complete their qualification. The problem is that we don't have enough of them. About half a million sudden or suspicious deaths occur in the US each year. And yet there are only about 500 full time forensic pathologists working in the country, which means that thousands of cases every year are reviewed by people who may not have this specialized medical training. In some areas, the person in charge of death investigation is called a medical examiner, which indicates that they're a doctor, but not necessarily a forensic pathologist. And then finally there are coroners.
- [19:24]
Dr. Joy Carter
A coroner is an elected official, not necessarily a physician. In California, for instance, the small county sheriff who runs for election is the coroner they must hire forensic pathologists to do the work and make that medical determination. In the Midwest, you have a combination of civilians who run as coroner, who don't have any required background other than perhaps a high school diploma. The problem is you have all of these groups that are allowed to certify death, and it can be very political. The medical examiner, particularly the chief medical examiner, who oversees death investigation independently of the police and prosecutor, is neutral. You deal with the facts only, and you shouldn't have any interference on the way that you do your work and how you certify death on the death certificate. But when you have an elected person who has a constituency, you have the risk of that person interfering at times with the person doing their work. So that's why it's very important to understand we have all of these systems intermingled in this country.
- [20:46]
Trayvon Free
In Pat's case, the person doing the autopsy for the county was a doctor, but not a certified forensic pathologist. So wanting to make sure that they got an unbiased opinion, Rich and his family shelled out the $3,000 to get an independent autopsy from a board certified forensic pathologist. And it showed that the use of a hog tie restraint contributed to Pat's death.
- [21:06]
Richard Burns
And our. Our guy's autopsy, our pathologist never saw the light of day, even though I had pushed and pushed and pushed and pushed to try to get it to the light of day.
- [21:20]
Trayvon Free
The system is already set up in a way that makes it hard for families to get independent evidence included. It's expensive, it's conf. The family is likely still grieving, and the local police or the local coroner, who often work closely together, may be hostile to a family that they think is trying to make law enforcement look bad, which Rich says is what he experienced.
- [21:41]
Richard Burns
And the coroner basically was very aggressive to me and said she knew what I was up to and it's not going to work. And I'm like, lady, whoa, back up, man. My brother just died. And we want an autopsy. But if you don't want to do it, don't worry about it. Just know I'm one. I want. We're going to pay a doctor separately to do it. She's like, fine, we'll arrange that.
- [22:06]
Trayvon Free
Rich did get the independent autopsy, but for reasons that are not entirely clear, the county's coroner did not include the findings of the independent autopsy when they held a special hearing called a coroner's inquest, which made it harder for Rich to share what he believes to be the truth about his brother's death.
- [22:23]
Richard Burns
It's kind of hard to let the world know because Pat was a nobody from Springfield, Illinois. And people, you know, he was painted as a bad guy in the newspaper. So people. People are like, we don't want to know. Even though me and this attorney and a newspaper reporter put all these pieces of the puzzle together to expose this excited delirium stuff. And this coroner was ousted out of the community. So we had a temporary victory. But guess What? That was 11 years ago, 12 years ago, and the whole system hasn't changed. Hasn't changed.
- [23:12]
Trayvon Free
The dangerous way Pat was restrained, the 21 shots from police tasers, the murky investigation. These things are still killing people and explaining away suspicious deaths today, more than a decade after this happened to Pat. It's not okay.
- [23:28]
Richard Burns
Nothing's talked about. And so nobody knows about this stuff. Nobody's ever heard of excited delirium. But when families like mine come out and say, hey, this. This thing happened to my family, happened to anybody else, you know, and you start hearing, yeah, happened over here, over here, over here, over here, you start going, whoa, what is this? You know?
- [23:53]
Trayvon Free
And in all of these excited delirium cases, there just isn't good research to back up the diagnosis.
- [23:59]
Richard Burns
There is no test to say this person has excited delirium. Let's, you know, even post mortem, even after the person dies, there is no let's like cte, if you know what that is With NFL players getting concussions, they. They can, after the person has died, look at their brain and say there's this change in the physical part of what's going on in their brain, and so then they conclude that they had this disease. Well, you can't do that with excited delirium. There is no enzyme or whatever that is created.
- [24:37]
Trayvon Free
Since excited delirium can be listed as a cause of death without any physical evidence, and since there are often not living witnesses available to challenge the accounts of police officers, it can be almost impossible to argue that police restraints and other use of force caused the death. And the term excited delirium is just one in a long line of pseudo scientific terms that the justice system can use to make sure police aren't prosecuted when a person dies in their custody. Here's Dr. Obasogi.
- [25:06]
Dr. Osagi Obasogi
We really need to address the history of those, of those narratives and really equipped both medical professionals and folks in law enforcement to understand, detect, and disabuse themselves of those ideas.
- [25:19]
Trayvon Free
Right? It's the history and the racism behind these words that have allowed junk science to flourish and to perpetuate injustice. We get into that history, including the time Dr. Carter received a letter from Taser right after the break.
- [25:46]
Megan
Hey, I'm Reshma Sajani, founder of Girls who Code and Moms First. I consider myself a pretty successful adult woman. So why is it that in midlife as I'm about to turn 50, I feel so stuck? Join me as I try to find the answer on my so called Midlife from Lemonada Media. I talk to experts and extraordinary guests about divorce, exercise, menopause, sex, drugs, and more to understand what we're going through and how to make the most of it. Listen wherever you get your podcasts. I'm Hasan Minhaj and I have been lying to you. I only pretended to be a comedian so I could trick important people into coming on my podcast. And Hassan Minhaj doesn't know to ask them the tough questions that real journalists are way too afraid to ask. People like Senator Elizabeth Warren.
- [26:31]
Richard Burns
Is America too dumb for democracy?
- [26:34]
Dr. Joy Carter
Outrageous.
- [26:35]
David Duchovny
Parenting expert Dr. Becky how do you skip consequences without raising a psychopath?
- [26:40]
Megan
That's a good question.
- [26:41]
Trayvon Free
Listen to Hasan Minhaj doesn't know from Lemonada Media.
- [26:44]
David Duchovny
Wherever you get your podcasts.
- [26:51]
Trayvon Free
And we're back. You ready for some history? Doctors have been trying to describe and diagnose psychiatric disorders that can lead to sudden death for a long time. Back in 1849, there was a psychiatrist named Luther Bell. He worked in an asylum, and he described a type of exhaustive mania that in extreme cases could lead to death. But even though Bell's mania gets brought up as evidence that excited delirium has a long medical history, Bell was actually describing a very different condition. The people he saw were in delirious states for two to three weeks. They didn't die in a matter of minutes or hours. And as the medical field started to better understand various forms of infections and psychiatric conditions like schizophrenia, the term Bells mania faded into obscurity. So what does this ancient medical lingo have to do with how people die today? Well, some doctors revived the concept of Bell's mania when they created the term excited delirium during the war on drugs.
- [27:51]
Dr. Joy Carter
This began in the mid-1980s as the rise of crack cocaine was seen initially in the Miami area.
- [28:01]
Trayvon Free
This is forensic pathologist Dr. Joy Carter. Again in the 1980s, she was just completing her training. At this time, there was a doctor in Miami, Dr. Charles Wetley, who started documenting cases where people became delirious after ingesting cocaine and died. And he wrote about what he said was a racial pattern in these deaths.
- [28:19]
Dr. Joy Carter
After cocaine psychosis Dr. Wetley was the deputy chief medical examiner of Miami when I did my rotation as well as my one year training. And during the late 80s they had a group of women, largely black, in one section of the county primarily. And it was explained that they were dying because they were having a sexual encounters with men, black men who were using cocaine. As a matter of fact, Dr. Wetley even used the term the male of the species, as if people of color were a different species than other human beings. It was quite inflammatory.
- [29:05]
Trayvon Free
The mid-80s, when Dr. Wetley and his co author, Dr. Fishbane, are first publishing on excited Delirium, is at the height of the war on drugs. And there are some old really racist ideas flourishing at the time that get scooped right into the description of excited delirium. Their paper described what they called unusual cocaine related deaths among black men using all the symptoms we described earlier. High body temperature, sweating, confusion, unexpected strength, and not feeling pain. So these black men were dying with what was considered non lethal levels of cocaine in their systems. And their deaths were attributed to excited.
- [29:42]
Dr. Joy Carter
Delirium, totally ignoring the fact that people that were dying in police custody were also being restrained in very unusual positions. Hog tying, where the arms and legs are pulled behind the body and tied together, which puts tremendous pressure on the thoracic cavity, the lungs and the ribcage.
- [30:05]
Trayvon Free
And then, as Dr. Carter just mentioned, Wetley expanded the definition to include cases where black women had died after ingesting small amounts of cocaine. Twelve black women, in particular, many of them assumed to be sex workers, were found dead in Miami. Wetley theorized that these women all died from excited delirium after ingesting cocaine and having sex. But it didn't take long for this troubling theory to start falling apart.
- [30:31]
Dr. Joy Carter
During my fellowship training in Miami, I had a case of a young girl who was found dead. And this young lady had no cocaine in her system.
- [30:45]
Trayvon Free
This girl was originally thought to be part of this rash of excited delirium deaths. But the evidence Dr. Carter was examining just didn't add up.
- [30:52]
Dr. Joy Carter
And the detectives began to talk and realized they had similar cases in a very confined area. And they went back and start looking at the cases and saying, wait a minute, maybe it's not cocaine psychosis.
- [31:10]
Trayvon Free
As Dr. Carter was finishing her training, the chief medical examiner, Dr. Davis, started looking back at the other women who had died in this one particular area.
- [31:18]
Dr. Joy Carter
Dr. Davis went back and reviewed over 20 cases that had been called excited delirium. They were rerolled as homicides.
- [31:29]
Trayvon Free
In fact, these cases were rerolled as homicides all committed by the same person, a serial killer. And once the explanation of a sighted delirium was removed as a distraction, detectives found and arrested a man who they believe was responsible for the rape and murder of 32 women.
- [31:48]
Dr. Joy Carter
And despite that happening, this term spread through the country.
- [31:54]
Trayvon Free
So how did the term spread despite this outrageous story you just heard? Well, here's how it went down. It started with a former medical examiner and a forensic nurse. They were a married couple, and together they wrote a book called Excited Delirium Syndrome, which they dedicated to all law enforcement and medical personnel who have been wrongfully accused of misconduct. And then Taser, now known as Exxon Enterprise, bought and distributed enough copies of the book to give one to every single forensic pathologist in the country. Dr. Carter witnessed it all.
- [32:28]
Dr. Joy Carter
I couldn't believe it. The next thing I know is it's really in use in Texas. Texas is not really that close to Miami. But yet anyone that was in police custody and dying suddenly became excited delirium.
- [32:45]
Trayvon Free
Taser seemed to really like the term excited delirium because it provided an alternate explanation of why someone died after being tased, which allowed Taser to keep promoting its weapons and saying that the electric shocks are harmless.
- [32:58]
Dr. Joy Carter
But when the Taser group came out and there were cases where someone had perhaps been tased more than five times, more than 10 times, they literally threatened forensic pathologists. If you call this a death due to taser, we're going to sue you. This is excited delirium. That's why they died. I honestly think this group did more to spread this ill conceived incorrect terminology than any other group across the country. That is my opinion as to why it spread.
- [33:37]
Trayvon Free
Not every excited delirium case involves the use of a taser. But excited delirium does serve as a catch all term to explain why someone died, which means it can take the focus off of taser use. And in addition to distributing the book, Dr. Carter noticed Taser taking active steps to promote the use of the term. She herself was once contacted by the company.
- [33:56]
Dr. Joy Carter
I received a letter on a person that had been tased multiple times. And before I was even done with my investigation, up comes this letter from Taser. And it was something like, no one has died from tasing. And I'm thinking to myself, you don't know basic electricity like I do. And you can't tell me how somebody died because you're not a physician, you're a company sending out these form letters. So I did notify the general counsel of the letter. You know, I wasn't going to let that faze me. You know, you can't put pressure on a forensic pathologist who's simply doing their job.
- [34:39]
Trayvon Free
Dr. Carter said that eventually multiple medical examiners complained about these letters and Taser stopped sending them out. But that didn't stop them from spreading this term around the world. According to reporting in the Guardian, Taser sent letters to police departments in Australia offering to help after cases where a Taser was used and someone died. The company reportedly suggested sending brain tissue samples from the deceased to Taser affiliated experts in the US and the human rights lawyer Joanna, who you heard from earlier. Her team found that the small group of experts on excited delirium had an outsized influence on getting excited delirium taken seriously.
- [35:17]
Joanna Naples Mitchell
Our physicians found that they really were very poor quality studies.
- [35:20]
Trayvon Free
The American College of Emergency Physicians, a group of ER doctors, published one of the most influential papers supporting the concept of excited delirium in 2009. But the paper had some problems.
- [35:32]
Joanna Naples Mitchell
Several of the experts who worked on that paper, I say experts very loosely in terms of their self identified expertise, did have associations. Affiliations with Taser were being employed as defense experts by Taser or actually serving as advisors to Taser and being paid. And none of that was referenced in this paper when it was published.
- [35:51]
Trayvon Free
In a statement sent to our producers on September 19, Axon, formerly known as Taser, stood by the idea that excited delirium is a unique and potentially deadly medical condition and concluded their message to us with this statement, quote, because individuals who suffer this condition will display erratic, unpredictable and often violent behaviors, law enforcement personnel may be required to use some measure of force to safely gain control of these subjects. Axon is committed to providing law enforcement with less lethal tools that will further its mission to protect life in these scenarios. And this is a statement that Joanna find concerning.
- [36:30]
Joanna Naples Mitchell
It's really dangerous because what does Taser say in the law enforcement responses? They're saying, use a Taser, this is a solution. But just from the standpoint of a medical emergency, I cannot imagine a physician's organization or medical association saying, yes, when you see someone who's behaving erratically in a psychiatric or substance use crisis, Tase them. That is the appropriate response. So it's really infuriating that Taser is basically promoting weapons sales with the statement saying, oh, you see some erratic, we have the solution. And that's of course what seems to be motivating their whole investment in excited delirium. But it's just really despicable.
- [37:07]
Trayvon Free
So excited delirium started out describing death from cocaine use, most often when police were present. Then it started to show up anytime someone died suddenly in police custody. And then Taser threw their weight behind it. And the term became ingrained in the vocabulary of police doctors, medical examiners, and even lawyers all over the country. And now that it's so ingrained in the language of our legal system, it comes up in all sorts of cases, even when Tasers are not involved, like we saw with George Floyd. And adding to this mess is the fact that a few medical organizations were convinced. The national association of Medical Examiners and the American College of Emergency Physicians have both published papers giving credibility to the term. These are respected groups who have influence in the medical medical field, which means that the organizations that published on excited delirium have given the term legal legitimacy, whether or not they intended to. We reached out to both of them for comment. The national association of Medical Examiners didn't respond to us. However, they have said elsewhere that they never formally recognized excited delirium as a diagnosis and that one of their papers was references. The term is no longer current. Meanwhile, the American College of Emergency Physicians did get back to us. In a statement to our producers. They focused on updated language. They wrote, quote, including the accurate term Hyperactive delirium with severe agitation in clinical literature or death certificates can improve the ability of healthcare professionals to recognize and subsequently treat patients with similar signs and symptoms. Unfortunately, as multiple of our sources pointed out, this appears to be a rebranding rather than a substantive change. And Taser continues to use these murky statements by medical groups as a way to legitimize its use of the term. In their statement to us, Exxon, formerly known as Taser, called out these papers as proof that the term is recognized as a valid medical diagnosis. And so, at this point, as Dr. Carter mentioned, the term has taken a life of its own to justify police brutality.
- [39:15]
Dr. Joy Carter
When you have civilians and law enforcement and media saying, at the first onset, this had to be excited delirium, the autopsy is not even done. Drug testing is not done. It becomes an opinion that is incorrect and overused and just rubber stamped. This is what happened. And it ignores the fact that we have these very violent takedowns of individuals.
- [39:43]
Megan
Who need help, it almost seems as if the true symptoms of excited delirium are, you know, whatever you want. Plus, an officer restrained this person to death or asphyxiated this person or Tased this person to death.
- [40:00]
Trayvon Free
We'll meet the Quinto Collins family and learn how people like them are challenging the use of this term after the break.
- [40:11]
Megan
Hi, I'm Erica Mahoney. You don't know me, but you know a version of my story, because by now we've all felt the impact of senseless gun violence.
- [40:20]
David Duchovny
I think a stray bullet flew past me because I hear the.
- [40:24]
Dr. Joy Carter
It was that horrible feeling of dread. Something's wrong.
- [40:28]
Megan
Four years ago, my dad was killed in a mass shooting. My podcast Senseless is about moving forward after the unthinkable. Senseless from Lemonada Media, premiering June 17th. I'm Meredith Goldstein, host of the Boston Globe's Love Letters podcast, which features real people from all over the world telling stories about their relationship lives. This season, we're talking about how to change for the better.
- [40:54]
Trayvon Free
I just remember thinking, like, wow, this.
- [40:56]
David Duchovny
Is what a healthy relationship looks and feels like.
- [40:59]
Megan
The reason why I'm getting emotional. I didn't want to leave you. I never thought I would be this way again. Join us at Love Letters, wherever you get your podcasts.
- [41:14]
Trayvon Free
We're back.
- [41:16]
David Duchovny
Hey, I think the last time I did one of these video logs was almost a year ago now.
- [41:22]
Trayvon Free
Angelo Quinta was a young Filipino immigrant who lived in Antioch County, California, near San Francisco. In 2019, he uploaded a video of himself to Facebook. He was walking near his home and reflecting on his life.
- [41:37]
David Duchovny
I left the Bay Area because I was dealing with a lot of my own stuff, my own personal issues. It got too intense for me. So I left and I left all the creativity that I once had. Well, at least I feel like that.
- [41:59]
Trayvon Free
Angelo had joined the Navy earlier that year and was excited for the fresh start. But after just a few months, the Navy determined that Angelo had a severe allergy, which meant he couldn't actually continue his service. He was honorably discharged and came back home.
- [42:14]
David Duchovny
And it was just a huge blow. Came back to the Bay Area basically. Basically with nothing. I know I have a guardian angel watching over me, but, you know, this time I've moved out, finally have a car. I am back in the game development, and I'm just inspired again.
- [42:39]
Trayvon Free
Angelo died at 30, just one year after he recorded this video. His death followed an interaction with police where he was restrained face down on the floor. And the death investigation concluded that excited delirium caused his death. In December of 2020, Angela was having a mental health crisis, and his family called 911 for help. Four officers were sent to their home. Here's his sister Bella and his mom Cassandra, explaining to us over ZOOM what happened that day.
- [43:10]
Megan
So the police came in and saw my mother was restraining My brother in a bear hug on the floor, floor, you know, chest to chest. And my brother had calmed down significantly just because comfort, especially from mom, was all that he wanted. And then they separated them and they were, you know, lightheartedly commenting, oh, Mom's strong, Mom's strong. While they were putting him down on the floor, he said, please don't kill me. Please don't kill me. And I said, they're not going to kill you. And then the officer said, we're not going to kill you. And one officer put the knee, lower leg at the back of his neck. Eventually, the paramedics or the EMTs arrived and the officers flipped him over and there was blood coming out of his mouth. His eyes were rolled up in his head, and he was completely unresponsive. He looked limp. He actually looked dead when. When I saw them flip him on his side.
- [44:27]
Trayvon Free
The EMTs performed CPR and restarted Angelo's heart, but he never regained consciousness and died in the hospital three days later on December 26th. Angelo's family says that right away they witnessed the system springing into action to defend the police and obscure the facts of how Angelo died.
- [44:47]
Megan
I think the COVID up started when the paramedics arrived, because when we got the copy of the EMT report, they told the EMT officers that he was combative and that he was on methamphetamine, which was not true.
- [45:14]
Trayvon Free
The toxicology report performed during intake at the hospital confirmed that Angelo did not have meth or any other commonly abused substances in his system that night. And they only became aware that meth was included on the EMT report months after Angelo died. The family says they were also prevented from seeing Angelo in the hospital or even communicating with his doctors, which they felt was part of the COVID up.
- [45:37]
Megan
We were taken to the police station where they repeatedly misled us about his condition, prevented us from finding out about his condition, including rushing us off the phone with the doctor.
- [45:49]
Trayvon Free
After Angelo's death, his family met with their lawyers and were told about excited delirium. The Quinto Collins family had never heard of the term before, but it was clear to them right away that it was a tactic to absolve the police of responsibility for killing Angelo.
- [46:05]
Megan
And then, sure enough, the sheriff contracted pathologist concluded that my brother's cause of death was due to a quote unquote, poorly understood syndrome, Excited delirium syndrome.
- [46:23]
Trayvon Free
Poorly understood. It sounds like even the pathologist wasn't convinced that excited delirium is real, and yet they still went with it. The Quinto Collins family does not agree with the conclusion. They believe that the police restraint killed Angelo and they want justice for their loved one. Angelo's family members have become activists. They started the organization justice for Angelo Quinto and have had some major legislative successes. Here's Angelo's stepdad, Robert we helped State assembly member Mike Gibson pass AB490, which is a law that bans. That bill banned the use of restraints that are known to lead to positional asphyxia in the state of California. After George Floyd's death, many places passed laws intended to protect people from dangerous police restraints, but lots of these were watered down and ended up only banning chokeholds. The Quinto Collins family helped get California to pass a new law that broadens the protection so that other people won't be held down in the way that Angelo was. But their activism has also hit some roadblocks. Just last month, in early September of 2022, the Contra Costa District Attorney decided not to press charges against the officers who restrained Angelo on the floor that night.
- [47:37]
David Duchovny
The family of Angelo Quinto and supporters gathered outside the State Building in Oakland Wednesday demanding justice and accountability. Angelo Quinto Quinto's family says the District Attorney's office made false claims in its report that cleared the officers. They're hoping the AG's office, the California.
- [47:54]
Trayvon Free
State Attorney General, has since taken up Angelo's case and is reviewing evidence from the coroner's report, including that Angelo died of excited delirium syndrome. The more people we talked to for this episode, the more it felt like the tide may be turning on the use of the term excited delirium. More broadly, many sources told us that the term has become stigmatized and only a few organizations still support its use.
- [48:18]
David Duchovny
It was the work of the Physicians for Human Rights and the story and the timeline and the history that made it real, present and apparent that the term was historically racist. And because of that, problematic Patrick Caceres.
- [48:36]
Trayvon Free
Is an independent investigator for the BART Police Department. In March of 2022, the Bay Area Rapid Transit, or BART Police Department, became the first police department in the country to remove the term excited delirium from its policy manuals. They instructed officers not to use it in any reports.
- [48:55]
David Duchovny
It doesn't really add anything substantive to the police reports or police work. Police officers don't need to use the term to say this person was agitated and upset and they appear to be under the influence and weren't responding to police commands.
- [49:15]
Trayvon Free
Patrick reviewed the police reports from the BART Department over the last three years and found that the term excited delirium came up about eight times per year.
- [49:23]
David Duchovny
It is a very difficult, I guess, fact to accept that there are officers that have used it inappropriately. And so having that research and knowing really what it looks like within a department really opens the conversation. And it really did sort of have us look at what's really important.
- [49:48]
Trayvon Free
And as more and more organizations stop using the term, Patrick is hopeful that the impact will be significant.
- [49:55]
David Duchovny
And I think it's going to make a difference going down the line. I think. I think that that shared space is going to make a difference for other police departments as well. Us talking about this now isn't just words. It's not even just police department. It's not even just medical. We are talking about a conversation about.
- [50:14]
Trayvon Free
Systemic racism and really challenging Systemic racism. And the dangerous use of dehumanizing language can't stop at one police department or even at the field of law enforcement. Removing this term from our medical and legal establishments will hopefully lead to fewer deaths and greater accountability. But if we want to make sure that a new phrase doesn't just take the place of excited delirium, we'll need to stay vigilant and keep learning about how racism and pseudoscience can advance harmful concepts when people aren't paying attention. Dr. Oboski told us that one way to make sure we don't keep repeating the same mistake is to focus on coroners and medical examiners. These people have a lot of power in communicating how and why a person died. And if they are cognizant of our history and careful to use language that is scientific and widely accepted, we might be able to avoid these issues in the future. If you want to get involved in reforming how police and medical professionals use this term, you can stand with Angelo Quinto's family by contacting the California Attorney General, Rob Bonta, and urging him not to rely on the debunked term excited delirium as a cause of death. Head over to our show Notes to find a petition and a letter you can send to your local police chief, sheriff and district attorney urging them to discontinue the use of excited delirium in your area. And finally, you can follow Campaign Zero, CampaignZero on Instagram and Twitter to stay up to date on the latest activism related to excited delirium.
- [51:46]
Richard Burns
You.
- [51:54]
David Duchovny
Hey, it's me, Jay Ellis. Yeah, I just wanted to pop in here and say thank you all for listening and a big, big, big thank you to Trayvon for taking over the mic. Flowers, flowers, flowers. You were absolutely amazing. Listen, that is it. For this season of the Untold Story, but I know there are still more more stories we need to share, so I look forward to meeting y' all back here next time. See you then.
- [52:24]
Trayvon Free
The Untold Story is a Lemonada Media original presented by Campaign Zero. This episode is produced by Nicole Gilin with production help from Hannah Boomershein and Priscilla Alaby. Our supervising producer is Kristin Lepore. Our production intern is Jayla Everett. Fact checking by Steve Crichton Music, sound design and mixing by Hannis Brown Engineering from Andrea Christensdotter. Our executive producers are Jessica Cordova Kramer, Stephanie Whittles Wax, Jerae McKesson and Jay Ellis. Thank you so much to everyone who shared their stories and to all the folks who helped us with this episode. Check out our show notes for links to the Physicians for Human Rights report on Excited Delirium and a documentary Rich made about his brother's case. For bonus content from the Untold Story, subscribe to Lemonada Premium on Apple Podcasts. I'm Trayvon Free and you can find me Trayvon on Instagram and Twitter. Thanks for listening. Peace.
- [53:25]
Megan
Parents. We know the childcare crisis is not just another headline. It's a daily struggle playing out in millions of homes across this country. Hi, I'm Gloria Rivera and this is no One Is Coming to Save Us this season. We're demanding a child care system that actually works for kids, parents and educators. We mean free birth to five, full day nearby, easy to apply. No One Is Coming to Save Us Season five from Lemonada Media. Out now. Tired of the same old political shouting matches and talking points? Looking for thoughtful conversations that go beyond the headlines and help you understand issues that matter?
- [54:11]
Dr. Joy Carter
I'm Sarah.
- [54:12]
Megan
And I'm Beth. Together we host Pantsuit Politics, a podcast where we bring grace, nuance and perspective to the news because democracy deserves more than hot takes.
- [54:21]
Dr. Joy Carter
Join us as we approach politics and current events with curiosity, empathy and and a commitment to understanding the bigger picture.
- [54:26]
Megan
If you want to stay informed without the anxiety, we're the show for you. New episodes drop on Tuesdays and Fridays. Subscribe to Pantsuit Politics wherever you get your podcast.