The racist, xenophobic story of “Excited Delirium” – Mother Jones

Mother Jones; Steven Freeman; Duke University Press

When the police kill someone, A coroner lists the cause of death – which plays an important role in whether a police officer is held accountable.

Some of these findings protect the police from possible liability. One of them is “excited delirium,” a syndrome that is not listed in the Diagnostic and Statistical Manual of Mental Disorders or the International Classification of Diseases. Studies have shown that most deaths attributed to this term are the result of aggressive restraint.

Aisha M. Beliso-De Jesús, professor of American studies at Princeton University, traces the history of “excited delirium” in a new book. Excited Delirium: Race, Police Brutality, and the Invention of Disease– and calls it a “very useful tool that has enabled forensic scientists to participate in these cover-ups.”

Beliso-De Jesús spoke to me about the racist and xenophobic views behind this term, the devastating impact this pseudoscience has on the families of the deceased, and what needs to be done to move forward.

Forensic pathologist Charles Wetli first used the term “excited delirium” in the 1980s to trivialize the deaths of black sex workers who were later found to have been murdered by a serial killer. Does the origin of the term suggest that it has a dehumanizing effect?

Medical diagnoses are meant to help people. But as we can see from the example of delirium, and particularly the misdiagnosis of the cases you refer to – the misdiagnosis of black women strangled, murdered and raped by a serial killer – which Charles Wetli described as “sex deaths by cocaine,” that horrific term was actually used to support his argument.

He used the deaths of these black women to argue that blacks, whom he considered a separate species from whites, had a certain genetic defect (which caused them to die spontaneously.

He argued that black women were dying from using small amounts of cocaine and engaging in sexual activity that he believed or presumed was consensual. Then he argued that black men were dying spontaneously in the presence of police officers. This reveals so much dehumanization.

How did Wetli use and misunderstand Afro-Latin American religions to rationalize the delirium of excitement?

The connection between Wetli’s research on Afro-Cubans, cocaine, and Excited Delirium Syndrome is neither direct nor obvious, but I think it is much more subtle and deep-rooted. So we are in the 1980s, during the Mariel shipping crisis, when 125,000 Cubans arrived in Miami as refugees – and these Cubans who arrived there were darker, poorer, and less wealthy or less resourced than the Cubans before them, who were whiter and more wealthy.

Wetli was in his first years as a new resident, and at the same time there was a mass criminalization of this community. You can see it in stereotypes like the famous Tony Montana from Scarfacethis sweaty, irritable, sexually hungry gangster who is addicted to cocaine and murder.

Charles Wetli’s research on Afro-Cubans and cocaine, particularly on the tattoos of Afro-Cubans, is a participation in this longer-lasting criminalization of Afro-Cuban religions. He has this hobby in which he describes himself as an expert on Afro-Caribbean religions, or cults as he calls them.

He says that mainly black and Latino men tend to get aggressive, sweaty and overheated – basically they burn themselves out because of their aggressiveness. And as a result, he argues, they die, and the police witness their deaths. With the Afro-Cubans he studies, this becomes a pattern where he blames religion and Cubans as these aggressive criminals, almost a Plague infection in the United States.

How was the label “excited delirium” used in connection with the killing of black people by the police to how deadly other forms of police violence can be, such as the use of stun guns?

The delirium of excitement allowed certain deaths to go unnoticed for a long time. In shootings, the cause of death is perfectly clear. But this term completely ignored these deaths for many years.

The delirium of excitement shows that the person’s behavior – Cocaine use or exaggerated masculinity, aggressiveness — lead to their deaths. As a result, there is a very scary, medicalized cover-up of police violence. Without the footage of George Floyd’s death, many people would have taken the original argument for granted: that he was simply a man who died from medical issues. That’s what (Minneapolis police) posted when his death first occurred. Without the bystander video, the world really wouldn’t have known that this was someone who was basically murdered in front of everyone.

Have you noticed anything in conversations with family members of people whose deaths were described as delirium of an excitatory nature?

Many of the family members I’ve spoken to are relieved, because for many years people have blamed the victims. One family I interviewed was told that their father died suddenly during a police chase, that it was because of his drug use and that his heart had spontaneously caught fire. There were other stories that said that the police may have run him off the road. Questions about this were completely ignored in the narrative.

These people, who are labeled as dying of “excited delirium,” are often viewed as written off by society, similar to the way that murdered and raped black women were written off as so-called “crack whores.” This instrumentalization (of the term) by the police justified blaming the victims and, in many cases, created a buffer for police and doctors to collaborate to write off entire communities.

The American Medical Association came out against “Excited Delirium” in 2021. What do you think needs to change for this racist pseudoscience to be rejected?

I’m really glad to see that there are a lot of people, a lot of organizations, a lot of states right now that are actively working against excited delirium. I think it’s (a trend) that came out of the uprising of people after 2020, when they came together and recognized the systemic police violence.

This practice has not disappeared simply because people stopped using the term. People are still being stunned and choked to death. Police still put their weight on people’s bodies and use chokeholds. People complain that they cannot breathe and eventually die. Coroners and medical examiners still use the same medical justifications, such as heart failure and drug use, instead of acknowledging the role of police brutality in these deaths.

We must continue to ensure that we focus not only on this term, but on the broader structure of policing in the country and how these two institutions – medical institutions and police institutions – are linked.

This interview has been edited for length and clarity.