See also: In defense of the police hold used on George Floyd
George Floyd’s death one year ago caused a national level of rioting and vandalism and even deaths. It also put something called “excited delirium” in the spotlight. George Parry at The American Spectator, Andrea Widburg at American Thinker, and Jack Cashill (at both venues) all have written insightfully about the political, scientific, and legal issues related to the death of Mr. Floyd and the prosecution of Officer Chauvin. The bottom line, if one seriously considers the medical evidence, is that Derek Chauvin did not murder George Floyd.
I have done a video demonstration with two male subjects that shows that there is no way that Officer Chauvin killed Mr. Floyd with the same prone restraint seen in the video of Mr. Floyd’s restraint and death. My analysis of the events is that the combination of drugs, excitement, exertion, and a bad heart caused Mr. Floyd to die from cardiac arrest -- just like a man who dies shoveling snow.
Recently, the American Medical Association (AMA) house of delegates and the American Psychiatric Association publicly condemned using the diagnosis Excited Delirium in cases like that of George Floyd, and also condemned using sedation and psych drugs on agitated and delirious individuals in emergency situations. These pronouncements were cheap shots that played to a woke racialist mob and ignored both medical science and the truth. That’s no surprise, though, because the AMA Board of Trustees, in June 2020, declared their support for critical race theory, equity, and anti-police campaigns.
Delirium has been around a long time as a phenomenon with many names. Delirium is a severe loss of normal ordered thinking and emotions, i.e., psychotic break. The excited or agitated form is more noticeable and harmful because sufferers are violent, dangerous, and self-injuring to the point of suicide. They’re also more likely to have medical complications, including death, from muscle and kidney injury, dehydration, hyperthermia, blood pressure, and heart problems.
I saw my first delirious patients early in my junior year in medical school, 52 years ago, as a student assigned to the locked psych ward at Douglas County Hospital in Omaha. Since then, I have seen and treated hundreds of cases of delirium caused by alcohol, PCP, LSD, and cocaine, of course, as well as medical or mental health disorders that affected brain function. Delirium is real and often violent. The proper response is to treat to remove the cause and to control the agitation and wild behavior of agitated (excited) delirium using sedation to calm and antipsychotic medications to restore mental functions. It’s routine and effective.
In 2008 the American College of Emergency Physicians (ACEP) commissioned a panel of experts to research and write a monograph on Excited Delirium -- yes the same thing that the AMA and APA say doesn’t exist. The experts on the panel were accomplished and experienced. Their research was outstanding, tracing the history and medical management of excited delirium over the many decades it has been reported.
In his article at The American Spectator, Jack Cashill focused on Dr. Martin Tobin, a lung specialist with no apparent expertise about cause of death, particularly traumatic causes of death. Nevertheless, Dr. Tobin, when shown the infamous video of Mr. Floyd’s last minutes, declared, “You’re seeing here fatal injury to the brain from a lack of oxygen.”
In fact, what the video shows is that Mr. Floyd was active, noisy, and calling out while essentially being held down on his stomach. Tobin testified that Chauvin and the other officers “restricted Mr. Floyd’s breathing by flattening his rib cage against the pavement and pushing his cuffed hands into his torso, and by the placement of Mr. Chauvin’s knees on his neck and back.”
Mr. Cashill points out that Dr. Andrew Baker’s detailed autopsy showed no neck or chest injury damage.
Layer by layer dissection of the anterior strap muscles of the neck discloses no areas of contusion or hemorrhage within the musculature…. The thyroid cartilage and hyoid bone are intact. The larynx is lined by intact mucosa.
Dr. Baker further mentioned prominently that Mr. Floyd’s face and eyes had no petechial hemorrhages (small bleeding spots), which are an important sign of asphyxiation or strangulation.
The autopsy showed that Mr. Floyd’s brain had no injuries from lack of oxygen. Moreover, Dr. Tobin, who is a lung specialist, presumably knows that the main muscle for breathing is the diaphragm, which is inside the chest wall and abdominal cavities. Chest expansion is an accessory to breathing, not a necessity, which is why paralyzed people who cannot move their chests can nevertheless continue to breathe using their diaphragm.
The autopsy did not show excess fluid in the chest cavity or microscopic abnormality in the lung tissue. Mr. Floyd’s lungs weighed in at normal for a man his size. Microscopy of lungs, adrenals, kidneys, and liver showed only normal post mortem congestion. The autopsy did not suggest opiate-associated pulmonary edema (wet lungs) in the autopsy.
Finally, nothing in the autopsy showed that Mr. Floyd died from an overdose. His levels of marijuana, fentanyl, and methamphetamine were intoxicating but not lethal, as described in Dr. Baker’s excellent explanatory materials included in the autopsy. Thus, Mr. Floyd’s levels were 11 and 19 nanograms respectively for fentanyl and methamphetamine. Lethal fentanyl levels range from 3 to more than 100 nanograms per milliliter and vary because of the extreme potency of fentanyl and the fentanyl tolerance of frequent users. Lethal levels of methamphetamine are in the hundreds of nanograms per milliliter.
What killed Mr. Floyd? Look to his heart.
Most importantly, the autopsy showed that Mr. Floyd had severe multi-vessel arteriosclerotic/atherosclerotic coronary artery disease and hypertensive heart disease (thick muscled big heart). These create the risk of a rapidly fatal heart arrhythmia, especially under stress, exertion, or excitement.
Dr. Baker, of course, has seen what is a perfect storm of bad heart disease, exertion, excitement, cardiac arrest. Why, then, didn’t he speak the truth and give his medically reasonable opinion about the cause of death?
After all, the proper conclusion on the cause of death was right there in the autopsy’s findings. Still, Dr. Baker caved under pressure from the mob, the political situation, and prosecutors. George Parry also reported, on pleadings from Officer Thao (another defendant) that politically motivated physicians threatened Baker’s reputation.
Experts in trials should be guided by the evidence and the science. As Albert Einstein said. “No amount of experimentation can ever prove me right; a single experiment can prove me wrong.” Likewise, Richard Feynman, the brilliant physicist and Nobel Laureate said “It doesn’t matter how beautiful your theory is, it doesn’t matter how smart you are. If it doesn’t agree with experiment, it’s wrong.”
Prosecutors are supposed to be officers of the court and representatives of the government with justice as their highest obligation. The last thing they should be is scalp hunters or enablers of a lynch mob.
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