Frontline Footage

Abstract

Reprint no. 47/1/86004 Address for reprints: Marion R Sills, MD, Department of Emergency Medicine, Suite 1450, Children's National Medical Center, 111 Michigan Avenue NW, Washington DC 20010-2970[Sills MR: Frontline footage. Ann Emerg Med December 1997;30:834-835.]Cortez, a tall, black 17-year-old, came in with his small, grey grandmother. She perched stiffly on a hospital chair as her grandson explained why he came to the ED. “I got jumped. Four police officers.”“Could you tell me what happened?”“They pulled up in this car, and everyone ran. I run down Wolfe Street and get hit in the back of the head and I'm out. I wake up and there's this black cop coming towards me and he kicks me in the head and I'm out again.”“How did you know they were officers?”“They was in regular clothes, but I seen their badges. Also, when the police cars come, they was hanging together, the cops and them.”“So you were assaulted by cops.”“Mm-hm.” I am torn between skepticism and my sense of injustice. This is a tough neighborhood, and tension between cops and young black men runs high.“Are you hurt anywhere?”“Well, I got up and went to my grandma's and she bandaged me up.” He shows me a palm with a couple of small clean Band-Aids. He had a bruise on his scalp and some scrapes on his shoulder. Conspicuously impatient as I examined him, Cortez got to his point: “I want to press charges.”“Against the police?”“That means you have to talk with the cops now.”“Yeah.”Before leaving to call the police precinct, I completed my examination and history; he had no medical problems, took no street drugs, and had no police record. I handed him a cup for a urine specimen, explaining the need to look for trauma-related blood. Perhaps he knew this was also for a tox screen; perhaps he was just nervous: he said he doesn't need to pee. I gave him a big cup of water to help.The police responded promptly to my phone call. Two bulky blond cops stood over the seated Cortez telling him he's crazy for pressing charges, that the judge will never believe someone like him, and don't you know you can get put away for years for false charges against a cop. He was not visibly intimidated. Perhaps this ED is the safest place in the neighborhood for Cortez, the only place he knows he can't be struck by a large white cop. Perhaps he was using this demilitarized zone to his advantage, taunting the cops with the one charge that turns scrutiny away from his demeanor—legal or otherwise—and directs it toward theirs.The police investigator arrived—cool and neutral, he deflated the tension erected by his colleagues. He worked skillfully to flesh out the details of the story. I verified that Cortez's abrasions were consistent with the story he told the cops.A medical photographer took pictures of Cortez's scrapes. I rebandaged his cuts and asked again for the urine sample. His urine contained no blood, so I discharged him with his grandmother. He requested a copy of his ED record to give to his probation officer to show why he missed today's appointment. Later that day, the urine tox screen came back positive for cocaine, opiates, and marijuana.Given his probation status and his positive tox screen, Cortez's story would likely not stand up in a court of law. As poorly as this reflects on his integrity, I cannot forget the image of the fuming, bulky cops, standing inches from Cortez, describing what they thought of him and his kind. If the cops could go that far in the presence of physicians, could they not have inflicted Cortez's wounds out on the streets?From the cops' perspective, Cortez was kicked by another young man from the neighborhood, probably over some matter involving the drugs he was using rather than dealing, and now he was accusing the cops of inciting the very violence they risked their lives to prevent.Police officers in this neighborhood run the front lines between armies of young men seemingly hell-bent on destroying each other with dime-a-dozen assault weapons at the slightest provocation. Perhaps if physicians met patients on their own turf, we would feel the same fear and anger the bulky cops had unleashed on Cortez.For many neighborhood witnesses to the violence, the line between police and physicians is blurred. Several moms in my clinic have told me that the casualty figures for young black men would be lower if doctors would only save them at the same rate at which they save white gunshot victims. “They see a brother's black skin and they assume he's a dealer, so they put him in a corner while they work on the white guy.” A mother of one of my patients told me that when her brother had been shot in the head, “the police drew a line around him on the pavement which means he was dead, but the doctors then took him away in the ambulance and kept him in the hospital for 2 days doing experiments before they finally decided he was dead. They called my poor mother to the hospital when it happened and told her he was still alive, but he was really dead because he had the line around him.” Perhaps the closest approximation to “physician brutality” is the oft-voiced theory that doctors invented HIV to wipe out the black population, and that it's only because white homosexuals got infected that scientists are trying to find a cure; some claim the cure exists but “only in California.”And physicians approach their patients with some prejudices as well. Pediatricians are more likely to report black mothers as child abusers than white mothers, despite little evidence to show any racial differences in abuse rates.Neither police nor physicians have proactive solutions to this warfare; we become involved when a conflict has already culminated in violence. There are probably heroes in other versions of this story, brave individuals who cross the tense battlelines of distrust and achieve a small foothold of detente; perhaps a neighborhood son who returns to his community as a cop; perhaps a minority business leader who negotiates an intergang peace accord; perhaps a local preacher who secures a brief ceasefire by bodily occupying a street corner for an evening. But overall the story remains, in every hourly update, a war correspondence without heroes, without meaning, and without end. Reprint no. 47/1/86004 Address for reprints: Marion R Sills, MD, Department of Emergency Medicine, Suite 1450, Children's National Medical Center, 111 Michigan Avenue NW, Washington DC 20010-2970 [Sills MR: Frontline footage. Ann Emerg Med December 1997;30:834-835.] Cortez, a tall, black 17-year-old, came in with his small, grey grandmother. She perched stiffly on a hospital chair as her grandson explained why he came to the ED. “I got jumped. Four police officers.” “Could you tell me what happened?” “They pulled up in this car, and everyone ran. I run down Wolfe Street and get hit in the back of the head and I'm out. I wake up and there's this black cop coming towards me and he kicks me in the head and I'm out again.” “How did you know they were officers?” “They was in regular clothes, but I seen their badges. Also, when the police cars come, they was hanging together, the cops and them.” “So you were assaulted by cops.” “Mm-hm.” I am torn between skepticism and my sense of injustice. This is a tough neighborhood, and tension between cops and young black men runs high. “Are you hurt anywhere?” “Well, I got up and went to my grandma's and she bandaged me up.” He shows me a palm with a couple of small clean Band-Aids. He had a bruise on his scalp and some scrapes on his shoulder. Conspicuously impatient as I examined him, Cortez got to his point: “I want to press charges.” “Against the police?” “That means you have to talk with the cops now.” “Yeah.” Before leaving to call the police precinct, I completed my examination and history; he had no medical problems, took no street drugs, and had no police record. I handed him a cup for a urine specimen, explaining the need to look for trauma-related blood. Perhaps he knew this was also for a tox screen; perhaps he was just nervous: he said he doesn't need to pee. I gave him a big cup of water to help. The police responded promptly to my phone call. Two bulky blond cops stood over the seated Cortez telling him he's crazy for pressing charges, that the judge will never believe someone like him, and don't you know you can get put away for years for false charges against a cop. He was not visibly intimidated. Perhaps this ED is the safest place in the neighborhood for Cortez, the only place he knows he can't be struck by a large white cop. Perhaps he was using this demilitarized zone to his advantage, taunting the cops with the one charge that turns scrutiny away from his demeanor—legal or otherwise—and directs it toward theirs. The police investigator arrived—cool and neutral, he deflated the tension erected by his colleagues. He worked skillfully to flesh out the details of the story. I verified that Cortez's abrasions were consistent with the story he told the cops. A medical photographer took pictures of Cortez's scrapes. I rebandaged his cuts and asked again for the urine sample. His urine contained no blood, so I discharged him with his grandmother. He requested a copy of his ED record to give to his probation officer to show why he missed today's appointment. Later that day, the urine tox screen came back positive for cocaine, opiates, and marijuana. Given his probation status and his positive tox screen, Cortez's story would likely not stand up in a court of law. As poorly as this reflects on his integrity, I cannot forget the image of the fuming, bulky cops, standing inches from Cortez, describing what they thought of him and his kind. If the cops could go that far in the presence of physicians, could they not have inflicted Cortez's wounds out on the streets? From the cops' perspective, Cortez was kicked by another young man from the neighborhood, probably over some matter involving the drugs he was using rather than dealing, and now he was accusing the cops of inciting the very violence they risked their lives to prevent. Police officers in this neighborhood run the front lines between armies of young men seemingly hell-bent on destroying each other with dime-a-dozen assault weapons at the slightest provocation. Perhaps if physicians met patients on their own turf, we would feel the same fear and anger the bulky cops had unleashed on Cortez. For many neighborhood witnesses to the violence, the line between police and physicians is blurred. Several moms in my clinic have told me that the casualty figures for young black men would be lower if doctors would only save them at the same rate at which they save white gunshot victims. “They see a brother's black skin and they assume he's a dealer, so they put him in a corner while they work on the white guy.” A mother of one of my patients told me that when her brother had been shot in the head, “the police drew a line around him on the pavement which means he was dead, but the doctors then took him away in the ambulance and kept him in the hospital for 2 days doing experiments before they finally decided he was dead. They called my poor mother to the hospital when it happened and told her he was still alive, but he was really dead because he had the line around him.” Perhaps the closest approximation to “physician brutality” is the oft-voiced theory that doctors invented HIV to wipe out the black population, and that it's only because white homosexuals got infected that scientists are trying to find a cure; some claim the cure exists but “only in California.” And physicians approach their patients with some prejudices as well. Pediatricians are more likely to report black mothers as child abusers than white mothers, despite little evidence to show any racial differences in abuse rates. Neither police nor physicians have proactive solutions to this warfare; we become involved when a conflict has already culminated in violence. There are probably heroes in other versions of this story, brave individuals who cross the tense battlelines of distrust and achieve a small foothold of detente; perhaps a neighborhood son who returns to his community as a cop; perhaps a minority business leader who negotiates an intergang peace accord; perhaps a local preacher who secures a brief ceasefire by bodily occupying a street corner for an evening. But overall the story remains, in every hourly update, a war correspondence without heroes, without meaning, and without end.