Every time the police are scrutinized, they look worse

I highly recommend this 3-part, thorough article about the police by Radley Balko. It’s central focus is on the Minneapolis Police Department (which is a horror) and on George Floyd, but it’s wide-ranging and indicts the corruption, racism, and brutality of police forces everywhere.

It’s a long series, and I can’t possibly do it justice, so I’ll just highlight one thing that leapt out at me. The police all around the country have resorted to a phony medical excuse for deaths in police custody. You’ll hardly believe it — it’s called excited delirium.

Excited delirium, on the other hand, posits that some people just spontaneously die during intense, high-stress interactions with police, through no fault of law enforcement. It’s also highly dubious and not supported by any major medical organization.

Over the last several decades, there’s been a concerted effort to pressure medical examiners to diagnose excited delirium when the real cause of death was positional asphyxia. This not only exonerates cops who kill, it encourages police practices that will lead to more deaths.

George Floyd’s death prompted renewed scrutiny of excited delirium and its origins. This was overdue.

The first reason to be skeptical of the condition is that it’s rarely if ever diagnosed outside a law enforcement context. If there really is a condition that causes people to die spontaneously during a mental health crisis, while under the influence of some drugs, or while panicked with no accompanying signs of medical distress, we ought to see it under other high-stress, volatile scenarios like street or bar brawls, or when people are forcibly admitted to psychiatric facilities. This just doesn’t happen.

The origin of excited delirium is shonky and steeped in bigotry. But it doesn’t involve police or police restraint. The condition was first described in the mid-1980s by Miami medical examiner Charles Wetli after a wave of black sex workers were found dead under mysterious circumstances. Because some of the women had cocaine in their system, Wetli theorized that there must be something about the physiology of black women that causes them to spontaneously die after mixing cocaine with sex.

The phrase “physiology of black women” ought to have set off alarms all over the place. Yeah, this swarm of dead black women whose bodies are littering the streets…nobody killed them. They just drop dead when mixing cocaine with sex. Yeah, that’s the ticket. File those corpses away under “natural causes”. No way they were murdered.


Despite the absurdity of Wetli’s theory, it precluded homicide as a manner of death, which made it much more difficult for police to investigate the possible murders. It wasn’t until a victim was found in a similar state as the other bodies, but had no cocaine in her system, that the city’s chief medical examiner reviewed the doctor’s work in the other cases. He found evidence of asphyxiation that Wetli had overlooked. Police eventually arrested a serial killer named Charles Henry Williams for the murders. Williams is now believed to have killed at least 32 black women through asphyxiation.

Wetli was promoted and became a medical examiner in New York, where he continued to promote ludicrous, racist theories.

You might be saying right now that George Floyd was not a woman and wasn’t having sex, so how does this relate? Well, fact-free explanations can expand without restraint.

In the absence of any accountability, Wetli continued to develop his theory in ways that proved convenient for law enforcement. He expanded excited delirium to also include black men, particularly those who die in police custody. “Seventy percent of people dying of coke-induced delirium are black males, even though most users are white,” he once said. Instead of concluding that perhaps this was because police were more likely to use excessive force against black men, Wetli added, “It may be genetic.” The diagnosis has since expanded to include “exhaustive mania,” a form of excited delirium that, conveniently, occurs in people who haven’t ingested drugs or alcohol.

If I had a nickel for every instance of a racist saying “it’s genetic”, I’d be able to buy back Twitter from Elon Musk.

Excited delirium is even more useful for the cops. In addition to making their victims conveniently drop dead while leaving the police blameless, it has several other symptoms that play into the cop’s battery of excuses.

There is no diagnostic test for excited delirium. Instead, it’s become a catch-all diagnosis based on a broad range of symptoms and behavior that could be attributed to any number of conditions — symptoms like erratic behavior, psychosis, public nudity, and, weirdly, a tendency to propel oneself through glass.

But the most absurd supposed symptoms are an imperviousness to pain and “superhuman strength.”

There are obviously some drugs that can dull a user’s sensitivity to pain. And a rush of adrenaline can prompt a person to run faster or lift more weight than they otherwise might. But the idea that excited delirium can give people near-superpowers has been incredibly harmful. The claim doesn’t merely excuse brutality, it practically demands it. It also reinforces racist tropes about the brutishness of black men.

This isn’t merely old racist nonsense from the 1980s, it was part of the MPD’s training materials at least as recently as 2021.

You know, maybe it’s not true that all cops are bad. I think you could make a good case that many of them are racist, gullible, and not very bright. They’re not intentionally evil, they’re just so damned stupid that they stumble into badness.


  1. StevoR says

    “Excited delirium?” Huh so that’s the euphemism for death by killer cop aka homicide frompolice brutality /excessive use of force now.

  2. birgerjohansson says

    British police:
    “How many more women will die as UK police forces ignore sex offenders in their ranks?” | Yvonne Roberts | The Guardian

    “It was so wrong’: why were so many people imprisoned over one protest in Bristol?” | Protest | The Guardian

  3. raven says

    The solution to the “excited delirium” problem is clear.
    Teach that it doesn’t even exist.

    Then teach the police and other responders about positional asphyxia, which does exist and is not uncommon.
    And, how to avoid causing positional asphyxia. Which is simple.

    If people can’t breathe, they will die.

  4. raven says

    Positional asphyxiation does occur occasionally without having anything to do with the police.
    It can result from a seizure, stroke followed by a fall, anything causing sudden unconsciousness, and overdoses of drugs and alcohol.


    Positional asphyxia occurs when the mechanics of normal respiratory processes are impaired by the position of the body, not by external crushing forces. It is a well-known complication of drug and alcohol intoxication.

    I saw a case of that once.

    The guy, early 20s, was sitting and playing a video game. Lost consciousness, and fell forward while sitting. Died.
    He had alcohol, Xanax, and methadone in his system, not enough to be fatal by themselves but enough to knock him out.

  5. Walter Solomon says

    It seems we are going back to the days of drapetomania“. Except now it’s being used to cover up murder so its possibly even worse than it was then.

  6. raven says

    It seems we are going back to the days of drapetomania“.

    Those days never left.

    Every minority gets their own diseases. Imaginary, invented diseases.

    The latest invented diseases are for Trans people.
    They suffer from ROGD, Rapid Onset Gender Dysphoria which doesn’t exist caused by social contagion, which also doesn’t exist. (How come being cis isn’t caused by social contagion, when 99.5% of the population are…cis.)
    Mostly the haters just call them crazy and Fake, since spelling words like Onset and Dysphoria are too hard.

    Being Gay was once in the DSM as a mental illness.

  7. microraptor says

    raven @6: positional asphyxiation is why the recovery position exists in first aid. To insure that an unconscious person doesn’t stop breathing.

  8. eastexsteve says

    Many of these overly aggressive cops are on steroids, which contributes to their enmity toward the communities they serve, yet no testing for cops whose behavior warrants it. A few department’s are beginning to test for steroids, but that’s more the exception than the rule.


    “Blue-lies matter”.

  9. whywhywhy says

    I did not realize that there are so many ways to say “tortured to death”, but never underestimate humanity.

  10. christoph says

    (Not so) Fun fact: The actual cause of death for crucifixion is positional asphyxia.

  11. StevoR says

    Meanwhile in Oz :

    SA Police has defended its rising use of tasers, after the ABC obtained video of officers tasering a man who was on crutches. The man, who cannot be named for legal reasons, told the ABC the tasering was unwarranted, dangerous and broke his hip…. (snip).. Bodycam footage shows the man closing his kitchen door and limping away from the officers. One says: “Just tase him, mate”, before his colleague shoots the man in the back with a taser, making him fall hard onto the floor.
    “I felt like someone squeezed the air out of my lungs. I couldn’t move. I just went down, had no control whatsoever,” the man told the ABC. “I broke my hip. I felt something loose in my hip and painful and I knew something was broken. I told them that and they called an ambulance.”The police report said the incident had aggravated a pre-existing injury. SA Police said it could not comment on the case.


    Then there’s Zachary Rolfe and what he did to a teenage Indigenous kid (murder). :


    Plus the Media – killer cop kollusion. :


  12. VolcanoMan says

    Sure, not all cops may be bastards, but I care little about their intentions to do good in the world (if those intentions are indeed legitimately held). They prop up an unjust system, one that could not exist without them, and of which they are the accepted guardians only because of centuries of propaganda, telling us that police are our friends, and that if you’ve done nothing wrong, you have nothing to fear from the sharp end of the legal spear. But we need to find a way to fully de-fund the existing police before completely re-structuring law enforcement, making them more effective at fewer tasks while giving them far less sweeping powers. If you take away their money and their toys, you could use the savings to actually provide decent mental health care to those whose only “psychiatric interventions” come from the police, while employing unarmed traffic wardens to fulfill the road-safety role that the police do such a poor job of doing themselves. Sure, there will still be evil people in the world who do despicable things (just like there are now, although I have seen no compelling evidence that the exact way our society chooses to enforce the law at present is particularly effective at fighting violent crime)…but the adverse impact to society from those people (something that could be mitigated by alternative approaches to policing) pales in comparison to that of the evil people in uniform doing despicable things with no chance of ever facing any serious consequences.

    Moreover, those who are drawn to the authority of the badge because they are genuine assholes who get off on abusing others would not be given the opportunity for such a pathological personality trait to be rewarded and reinforced by a well-paid, respectable (to this day, unfortunately) career (of course, the military is the other option a minimally-educated person can count on to nurture their latent authoritarianism, but frankly, that path is also on my significant cutbacks list). And so they might legitimately find themselves becoming less blatantly authoritarian, given that such people need to feel like they are “normal” at all times, and a society which reduces how much authoritarian traits are normalized would see those traits mostly suppressed in those who possess them (as they struggle to be the sheepiest sheep who ever sheeped).

    Altogether, having a force of heavily-armed, power-hungry cowards with no accountability may make some people feel safer, but the evidence shows that not only are they NOT safer than they would be in a much less heavily-policed society, millions of others are far LESS safe when policing is conducted as it is today.

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