Sunday, November 25, 2007

Obey or Die

As a follow-up to the previous post, I thought I'd point you toward the latest installment in Arthur Silber's series A Nation on the Edge of the Final Descent, subtitled Obey or Die.

Also see Alexander Cockburn's story on Dr. Catherine Wilkerson, who is facing felony charges for basically trying to do her job (in this case treat a victim of police brutality):
Here's how Wilkerson described what happened next, on this site on March 13 of this year.
I heard a commotion in the hall and stepped out of the room. In the hall I saw the same huge cop on top of the second protester who'd come to the first victim's aid. The cop had the man, a relatively small guy in his forties, pinned down, arms pulled behind his back, getting handcuffed. The cop used PPCT against this person also, not once but twice. The man writhed and cried out in pain.

The cop used his far-greater strength and body weight, along with the force of his knee on his victim's back to press his chest against the floor. It would be impossible for a person to inflate his lungs pressed against the floor with his hands cuffed behind his back like that. Asphyxiation being a well-known cause of death of people in custody, when the man started calling out that he couldn't breathe, I approached, identified myself as a doctor, and instructed the cop to turn him over immediately. The victim went limp. The cop turned him onto his back. I saw that the victim had a wound on his forehead and blood in his nostrils. He was unconscious. Reiterating numerous times that I was a doctor, I tried to move to where I could assess the victim for breathing and a pulse. The cop shoved me, until finally, after my imploring him to allow me to render medical care to the victim, he allowed me to determine that the victim was alive. But he refused to remove the cuffs despite my requests. A person lying with hands cuffed beneath his body risks nerve damage to the extremities and, moreover, cannot be resuscitated. I continually re-assessed the man, who had now become my patient, and who remained unconscious.

Eventually an ambulance arrived, along with the fire department and a contingent of Ann Arbor police officers. While the paramedics went about their business, the first thing being to have the cop un-cuff the patient, I tried to fulfill my obligation to my patient. I tried to oversee what the paramedics were doing, which, contrary to protocol and the normal relationship between physician and paramedic, was all that I was allowed to do. I was forced to stay away. What I witnessed in the course of their treatment appalled me. When the patient didn't respond to a sternal rub, one of the paramedics popped an ammonia inhalant and thrust it beneath the patient's nostrils. If you're interested in what's wrong with that, google Dr. Bryan Bledsoe, foremost authority on paramedicine, and read his article condemning this dangerous practice. That it's "just bad medicine" is sufficient to make the paramedic's actions unacceptable, but what happened next made my blood curdle. He popped a second inhalant and a third, then cupped his hands over the patient's nostrils to heighten the noxious effect. "You don't like that, do you?" he said.

At that point I issued a direct medical order for him to stop, but he ignored me. "What you're doing is punitive," I said, "and has no efficacy." Then as the patient retched, rather than rolling him onto his side to avoid the chance of his choking on his own vomit, a firefighter held his feet down and yelled, "don't spit." In thirty years of doctoring, I have never witnessed such egregious maltreatment of a patient. Again I spoke up, "this is punitive." I hoped to shame the paramedical into stopping his unethical behavior."
Please note that at no point did Wilkerson do anything other than offer verbal advice.

[snip]

Buck Davis tells me that "ten or fifteen years ago this case would have been a slam dunk, on First Amendment and medical privilege arguments, with no physical contact with the cops, all in liberal Ann Arbor." Wilkerson would have been swiftly acquitted.

"But now people are scared to death. They know the social system is falling apart. They no longer have a generous spirit. I've learned that the erosion of the economic and social fabric means people want to believe the cops. They're frightened. So I'm not as arrogant about 'slam dunk' cases as I once was."
The words of a lawyer staring at the abyss that we are careening toward at breakneck speed.

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