Military and Police

“Excited Delirium”

By T.B. Lefever:

It was an abnormally chilly winter night in Georgia. From what I can remember, the air was cold and windy. It was probably thirty degrees out but felt more like the teens I grew up enduring during most of my life in the northeast.  I was fresh out of the police academy, playing the police for the first time in my life, and admittedly, I didn’t know what I was doing.  You can imagine the level of surprise I felt as I was driving down one of my beat’s main thoroughfares to see a nearly completely naked man staggering in the middle of the busy road and shouting inaudible and garbled words that sounded more like animalistic growls and shrieks the way I recall it.  Then I saw the flashing blue lights of several state patrol units.  I flicked my emergency lights on, got out, and watched as three troopers approached the man on foot. I followed behind, not really sure what I was witnessing or what the insanity stemmed from in the first place. The troopers shouted verbal commands over and over again for the man to get on the ground. He was already covered in scrapes, dirt, and what looked to be glistening sweat despite the frigid weather conditions.

After repeated commands for the man to get on the ground and comply, the naked man’s loud screams, grunts, and growls persisted, along with wildly spastic and aggressive bodily movements directed towards the troopers that signaled this incident wasn’t going to end without some physical intervention.  Out came the tasers. I witnessed a single taser pop from one of the troopers and the man fell like a tree.  The state guys then put the man in custody while I held back traffic on the busy roadway to make sure none of us got smacked.  Moments later, I hear them saying, “He’s low”, jargon for a subject’s vitals deteriorating. It appeared that the trooper could not feel a pulse.  Moments later, the ambulance showed up and loaded the man in before speeding off to the hospital. I gave the old “Code 9” to the troopers as it was their case and went on with the rest of my shift. I don’t know for certain how that particular incident played out to this day. I think the man must have pulled through as I received neither a call from the troopers or a subpoena as a witness despite giving my name and badge number for their report.  I never heard anything about it on the news either, which I assume I surely would have if he had gone permanently “low”. I’ve seen many people get tased and their body doesn’t begin to shut down as a result.  This was my first time seeing a case of possible “excited delirium” up close and personal.

“Excited delirium” is a controversial and hotly debated medical condition sometimes attributed to in custody deaths.  I am no medical professional, but in citing Vincent Di Maio, a retired forensic pathologist who has written a book on it, the condition has been around since as early as 1849 in medical literature without any major objection to it until recently.  Back then it was known as “Bell’s mania”.  The modern day name, “excited delirium”, was coined during the cocaine epidemic in Miami during the 1980’s.  Di Maio estimates that there were between 600-800 cases of excited delirium per year as the drug reached the height of its popularity that decade.  Deborah C. Mash, a professor of neurology at the University of Miami, asserts that “schizophrenics, bipolar patients and users of cocaine and methamphetamine are particularly prone to excited delirium. Their heart rates soar, and they become paranoid and delusional. Body temperatures can reach 105 degrees or higher….The signals between the heart and brain become chaotic. Normally, you have a feedback mechanism that will help to normalize respiration and cardiac rate and rhythm, but these fail.  The brain can be cooked.”

While the condition is not classified in the American Psychiatric Association’s gold standard Diagnostic and Statistical Manual of Mental Disorders, and the American Medical Association has no official policy regarding “excited delirium”; the disorder has been accepted by the National Association of Medical Examiners and the American College of Emergency Physicians.  To put it plainly, there is staunch support on both sides of the argument.  The American Civil Liberties Union backs the opposition in their assertion that the diagnosis is used “as a means of white-washing what may be excessive use of force and inappropriate use of control techniques by officers during an arrest.” In addition to the claim that the term is used as a cover-up for deaths resulting from police brutality, critics of “excited delirium” also link deaths diagnosed with the condition to the use of the taser.

Once again, I am no medical professional.  All I can provide is anecdotal evidence of the condition from what I have personally witnessed on a few occasions and the stories I have been told by several officers with years upon years of combined on the job experience.  The common trend in cases of “excited delirium” seems to be that the subjects are either on drugs, under a state of severe psychosis, or both.  Another insight I have gained through the cases I can speak on is that there is almost always a stripping of clothing down to complete nakedness no matter the temperature.  The act of sweating profusely and tearing clothing off in freezing temperatures certainly has the appearance of a correlation to extreme overheating of the body in my simpleton mind.  I’ve even heard first hand officer accounts describing “excited delirium” subjects to have been tearing at their own flesh and hair, a similar behavior exhibited when small children are tragically left to die in locked automobiles by negligent parents on hot summer days.

Any officer that has been in a tussle with a person high on drugs such as crack, meth, or PCP knows that the drugs are a game changer. On top of countless stories I have heard from fellow officers, I have personally witnessed utterly average human beings go into “Hulk-mode” and perform great feats of strength such as a 150 pound male pushing up off of the ground and shaking off the two 200 pound officers on his back like a bull.  I’ve also witnessed tasers and police grade pepper spray having virtually no effect on people in this mental state.  Increasingly powerful drugs such as “Flakka” and bath salts are hitting the streets and increasing the number of potential “excited delirium” cases across the country.  As a person who has trained for over a decade in wrestling and boxing, I feel that I can hold myself together in most physical situations I encounter.  Despite this, I wouldn’t want to have to go hands on with the man on bath salts that was shot while chewing off a victim’s face in Florida a few years back.  If “excited delirium” symptoms are as billed, a person experiencing them is basically in the blind rage of “Hulk-mode” with the added incentive to further go nuts as their body burns up from the inside out.

Based on my experience and research of the topic, it appears that better recording of cases involving “excited delirium” needs to done in order for the debate on whether or not it actually exists for it to be settled properly.  More medical research is paramount in regards to putting this hot button issue to rest as it will surely re-emerge as a national headline at some point in the near future in today’s political and societal climate.  Regardless of whether or not one supports police, it would behoove agencies to come up with innovative ways to deal with “excited delirium”.  The ACLU has brought up the argument that we treat animals in our society with more humanity when they get out of control by tranquilizing them while we electrocute and shoot our fellow human under the same conditions.  I disagree with the premise that those in my profession are so sadistic that we’ve gone out of our way to invent a fake medical condition which allows us to beat and electrocute people to death with impunity.  I will, however, gladly shoot tranquilizer darts if they allow me to do my job, go home, and stay out of prison.

T.B. Lefever is an OpsLens Contributor and active police officer in the Metro-Atlanta area. Throughout his career, Lefever has served as a SWAT Hostage Negotiator, a member of the Crime Suppression Unit, a School Resource Officer, and a Uniformed Patrol Officer. He has a BA in Criminal Justice and Sociology from Rutgers University.

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