1. Racially motivated murder by paramedics
2. Paramedics raping patients
by Kevin Pezzi, MD
I've worked in several different emergency rooms in a variety of settings, and I've learned that some cities have a disproportionate share of people who do strange things. Unless you work in an ER of a town with a high “weirdness quotient” you may have a hard time believing that people can do some of the strange things that are described in my books. If that's true, it is a good sign: it means you are fairly normal and you haven't spent much time around the bizarre fringe element in our society.
In general, I think people are naturally incredulous when they read of incidents that are far outside the behavioral norms they have previously experienced. In this regard I'm just like you, except that I have a higher threshold of incredulousness as a result of being exposed to so many odd things that I once thought would have been impossible. Nevertheless, I can be very skeptical when I read about events that I had never heard of in the past.
It was with this mindset that I initially reacted with skepticism to information sent to me by a paramedic (who I'll call Ed) alleging that some of his co-workers had committed acts that were so extreme they could only be described as savage. However, Ed seemed to be genuinely and passionately repulsed by these acts, and he provided me with extensive documentation to support his allegations. The events that I found most heinous are summarized below. Warning: I will not euphemize the crude and offensive words since I think they are essential to a full and unadulterated appreciation of these acts.
- Ed said that his partner Clyde became enraged when they were dispatched to the scene of a motor vehicle accident involving a potential fatality. Clyde was apparently upset that this would not allow him to sleep during the remainder of his shift, hence interfering with his plans for the next day. Clyde allegedly said that if the person were “a nigger” then that person would die because he would not help him. After arriving at the scene of the accident and finding that the injured people were black, Clyde refused to assist them, leaving Ed to care for multiple victims by himself. After one person died Clyde began working, but Ed claimed that it was at such a deliberately slow pace that he was more of a hindrance than a help. Later, as the remaining victims were being transported in the ambulance to the ER, Ed said that Clyde taunted another patient while he was dying, saying that he purposely withheld care to kill him and his friend because they were black.
- On another occasion Ed reported that paramedics were summoned to assist a person who collapsed at home as a result of an apparent heart attack. According to Ed, the medic who attended to the patient simply closed the door and did nothing while his partner obtained a history from the patient's spouse, who was told that everything possible was being done. The medic with the patient allegedly waited until the cardiac monitor showed a flat line, then telephoned the patient's doctor to inform him of the death.
Murdering a patient by purposely withholding care (while maintaining a pretense of giving it) is not a rare event. When I was in training the senior residents would often announce that a certain code would be a “slow code” in which we would go through the motions of doing the right things but do them so slowly it would be of no use to the patient. On other occasions the senior residents would tell us to take our sweet time in responding to a code so that the patient would be more likely to have died by the time we arrived. They had more important things to do than save lives, apparently. If the senior residents thought a patient had lived long enough, they appointed themselves God, or at least head of the Death Panel.
UPDATE: My girlfriend's mother died soon after being treated by a doctor who uttered a revealing phrase (“it's not part of the plan”) in excusing his less-than-halfhearted effort to save her life. He thought she was too old, so she died. That was the plan.
I think these slow codes are ridiculous. If a person is being coded, then everything possible should be done for that patient. Lollygagging during the course of a code and then telling the patient's family that “we did everything possible” is dishonest and unprofessional. To the best of my recollection, all of these slow codes were ordered on people who were in poor health with a negligible chance of a recovery. Nevertheless, the law does not allow physicians to arbitrarily decide which people should be given a chance to live and which should be doomed to die.
I have had a few patients whose recovery could only be described as miraculous. I would love to take credit for their turnarounds, but I cannot honestly say that the care I delivered directly resulted in their recovery. If nothing else, these miracles underscore the fact that doctors can't always predict if a patient will recover. Hence, healthcare providers should not withhold care (or administer it halfheartedly) except when they are acting in accordance with the expressed wishes of the patient or his family, but halfhearted care is difficult to justify.
One might excuse the slow codes described above as resulting from well-intentioned but illegal physician arrogance, but withholding care from a patient who has a fair chance of being salvable (such as a patient with a heart problem) is totally inexcusable.
- Ed asseverated that paramedics from his city felt an obligation to the taxpayers to curb the abuses of the healthcare system perpetrated by black patients who were, they claimed, all on welfare. According to Ed, the paramedics fought this racial war by withholding care or, when that was not sufficient, by injecting patients with the wrong drug or an overdose of the correct drug. Killing a patient in this manner is easy to do and virtually untraceable in a practical sense.
- Ed said that he and his partner were dispatched to the scene of an accident and found a young woman unconscious in one of the cars involved in the collision. Ed alleges that his partner began gawking at the victim, commenting on how she was such a “nice piece of ass.” Ed began assisting another patient who was ejected from the vehicle while his partner moved the comatose patient into the ambulance. When Ed later opened the door of the ambulance he found that his partner had removed all of her clothing and was sexually fondling her. Ed resumed working on his patient, who was transferred to a hospital by another ambulance that had been sent to the scene. Ed said that his partner was later bragging that he had intercourse with the patient, and he marveled at her “tight pussy and firm tits.” Ed also reported that his partner stole her bra and panties as a souvenir.
Are paramedics playing God, deciding who lives and who dies? Are they defiling helpless young women? While I think such behavior is extremely rare, it does occur. Paramedics are not, however, the only perpetrators. There have been several well-publicized cases involving nurses, doctors, and dentists. No veterinarians that I know of, but even that wouldn't surprise me.
Several years ago I had a patient whose perversion was in a class by itself—I hope. In case any children are reading this, I'll euphemize this to spare them from being exposed to one of the few deviances that has not yet been covered by the media. This fellow's aberrancy centered on his pastime of sampling the sensory delights of females from different species. After that revelation, I wasn't very surprised when he told me that he wanted to become a veterinarian. I probably should have reported him to the SPCA, but that would have been a breach of patient confidentiality. Instead, I tried to dissuade him from boinking any more animals by telling him about the few cases I'd heard of in which animals, apparently not enjoying such intimate attention, put their molester's organ out of commission by biting it.
Don't interpret the next paragraph as a blanket condemnation of paramedics. Far from it. While I've encountered a few with a screw loose, almost all of them are good people with a host of admirable qualities. When my girlfriend mentioned a wonderful paramedic she knows, I thought of how the attributes she listed fit the ones I've known. Frankly, I wish I had more of what they have.
OK, enough digression, and back to the matter of paramedic malfeasance. I was particularly unnerved by Ed's assertions because they meshed with some suspicions that I've had about a few paramedics. While almost all paramedics are honorable people who are motivated by the desire to help people (and to pay the bills, of course), for a long time I have had a vague, admittedly inchoate, suspicion that a small percentage of them are not quite right mentally. In some cases my hunches are not just nebulous intuitions but concerns that have at least some basis in fact. A few female patients who were unconscious in the ambulance have subsequently complained that their undergarments were either missing or, in one particularly odd case, put on backwards. (If their blue jeans [or other outer garments] are still on but their underwear is missing or on backwards, something very odd happened!) Two women said they felt as if they'd just had intercourse, yet both denied any recent sexual activity. At the time I didn't know what to make of their remarks since I implicitly trusted the paramedics and it never occurred to me that they could do something so abominable. Whether or not anything did happen is debatable, but the next time I hear such a complaint I won't gloss over it.
In Love & Lust in the ER, I told the story about how I think (but couldn't feasibly prove) that an ER tech raped one of my patients: a gorgeous but comatose young woman.
In my blog, I discussed how my boss stopped working on a young child nearing death. I entered the room at the beginning of my shift to find him and others with their arms crossed standing so far from the patient that one might have thought the kid was radioactive. I knew they were just waiting for the patient to die so they could go lie to his mother how they did everything possible for him. I stepped in and saved the child's life. That was not a difficult “save.” For my boss to give up on that child was simply inexcusable, but he is not the only doc who prematurely pulls the plug on patients. The public would be outraged if they knew the prevalence of half-assed healthcare.
One of the first lessons that all emergency medical personnel (from EMTs and paramedics to ER nurses and doctors) learn is that treating patients rapidly often makes the difference between life and death. Therefore, it is easy to understand how a paramedic could kill a patient by sexually abusing her, because that wastes time. I wouldn't be surprised if a few twisted paramedics kill patients they rape so their crimes are less likely to be discovered; dead women obviously don't give birth, nor do they develop sexually transmitted diseases, nor do they complain about missing underwear, an unexpected discharge, or post-coital sensation.
Murder is also the missing link in understanding why EMTs or paramedics nutty enough to rape patients would risk doing that, knowing the patient might regain consciousness during the assault. If a patient woke up, murder could keep her from talking. Dead women tell no tales.
Can medical examiners detect these depredations?
I spent a month during medical school in the Wayne County Medical Examiner's Office, whose stated mission is to “provide forensic death investigations, autopsy, and toxicological services to the general public and medico-legal community so they can have documented, timely, and accurate cause and manner of death.”
Perhaps, if you're a big shot. Most stiffs on their cold slabs—at least the ones I saw—got only guesses, as in:
Obese male over the age of 40 = MI or “heart attack”
This quick guessing came as quite a shock to me. I'd grown up watching Quincy, M.E., a television series about a very principled county medical examiner (ME) who dug deep to determine the cause of death. That quest led Quincy to peer into things I never imagined anyone would look at, such as going past the anus and into the rectum to search for needle marks in a suspicious death case. Quincy might (a million years after once in a blue moon) examine semen inside the vagina of a woman who died in a car accident and DNA-test it to verify the paramedic who treated her didn't treat himself to a little fun, but in the real world, medical examiners don't have the time or resources ($) to consider every possible contributing factor to death. Paramedics know this, and some of the twisted ones exploit this inside information to literally get inside some women they wouldn't stand a chance with otherwise. Consequently, some healthcare personnel can and do get away with murder, figuratively and sometimes literally.
As a doctor, I filled out death certificates listing the cause of death, as if I always knew exactly what it was. Bereft of the requisite crystal ball, I could sometimes only formulate educated guesses on patients whose medical history was unknown to me—patients I'd never spoken to and had perhaps two minutes of contact with after they died—except the patient wasn't officially dead until I, as an MD, did a few quick tests to verify the person was indeed a goner.
Later, as an emergency physician, I'd sometimes speak with medical examiners about dead patients transported to the ER. In every case I recall, my guess about what killed them was accepted by the ME: a dream come true for killers who don't want to get caught. Are you reading this, Casey Anthony?
Caylee Anthony had an assiduous ME, Dr. Jan Garavaglia (a.k.a., “Dr. G”), yet she was still blasted by Dr. Werner Spitz, head of the Wayne County Medical Examiner's Office during my stint there. Dr. Spitz is a living legend as a forensic pathologist and I have enormous respect for him, but I lost a bit of it that day when he criticized Dr. G, saying her work was “shoddy” because she didn't open Caylee's skull.
When I heard that, I wondered if Dr. Spitz knew what his pathologists were doing: treating many dead people—especially young black males—as if they had cooties or something. I stood shoulder-to-shoulder with those forensic pathologists as they guessed at the cause of death, often without autopsies or even touching the bodies. Techs would bring in another stiff, and we'd stand around in our spiffy white coats and guess what killed 'em. The only time I recall seeing an ME touch a young black male was when a pathologist speared a scrotum with a huge needle and ignited the escaping methane gas with a Bic® lighter to form an instant blowtorch to entertain the impressionable young medical students under his tutelage.
What concerns me is that 99.999% of the time paramedics rape or kill patients, they get away with it. It's under the radar: it isn't detected and almost never reported. Ed is clearly an exception: principled, brave, and willing to devote his time and get involved in solving this problem instead of looking the other way. I genuinely respect Ed for that. If I get rich, I'll give him an award and a pile of cash because he deserves it. We often give adulation to people who don't deserve it, such as hot celebrities or athletes skilled at hitting or catching a ball. Wow. Really helps make the world a better place, doesn't it?
Doing the right thing means doing the right thing when no one is looking. In the early 1990s, I risked my future to save a young black male I had no responsibility to treat. In fact, by treating him, I could have been fired for breaking overly rigid rules and I could have been sued; I was supposed to stay in the ER and had malpractice coverage in it only. But on an uncharacteristically slow night shift, I gambled that I could be of more use to that inpatient, and I was: the residents were botching his code and almost certainly would have inadvertently killed him had I not arrived, spotted what they were doing wrong, corrected it, and administered the correct therapy.
“You can easily judge the character of a man by how he treats those who can do nothing for him.”
— Malcolm Forbes
Based on that, I have character because I went out of my way to save someone I couldn't bill, knowing that I had no malpractice coverage, and knowing that 85% of in-hospital cardiopulmonary resuscitations fail. The aforementioned paramedics waging their wicked race war do not have character; not only did they NOT do the right thing, they went out of their way to do the wrong thing.
Going out of your way to help others as a measure of character doesn't necessarily mean always doing it. I don't drink lemonade (it corrodes tooth enamel) but I stopped at what appeared to be a lemonade stand simply because I wanted to help the four young girls staffing it to reward their entrepreneurship. However, I didn't buy from a girl selling lemonade in LochenHeath during the Parade of Homes (2005? 2006?). I regret that because she appeared to be dejected from lack of sales, but I was tired. With an almost infinite number of ways we could help others, it isn't possible to help everyone in every possible way. While even good folks must be selective in helping, only evil people look for ways to hurt others.
I've previously written about a simple method I developed to eliminate racism, which I discussed in a Facebook note. Here is a synopsis of it:
Decades ago, my brother and I ridiculed one of our grandfathers who was brimming with racial intolerance. We made fun of him behind his back because he likely would have beaten us to a pulp had he seen the way we pilloried him for being a racist.
Perhaps the primary defect in racists is a lack of empathy. If you can put yourself in the shoes of someone else (that is, see things from his or her point of view), you can easily understand how reprehensible racism is. Even my grandfather and other staunch racists would abhor racism if they were victimized by it after being born into a different race.
If everyone followed my simple remedy for rapidly overcoming racism, I think that racism would be confined to sociopaths, whose lack of a conscience gives them a “couldn't care less” attitude about how they impact others. As I pointed out in a discussion of how I detest racism and those who irresponsibly make accusations of it, racism is a genetic relic present in all humans but expressed only in those who are too intellectually lazy to appreciate that it is counterproductive.
Interesting research: Virtual bodyswapping diminishes people's negative biases about others
“I know that I'm not perfect. … While we all have our prejudices and bigotries, we have to learn that it's an issue that we have to control, that it's part of my responsibility as an entrepreneur to try to solve it, not just to kick the problem down the road.”
— Wise advice from Mark Cuban
“It's a little embarrassing that after 45 years of research & study, the best advice I can give people is to be a little kinder to each other.”
— Aldous Huxley
Comment: It's a little embarrassing to admit how naïve I once was: I chose to work in Detroit, thinking that my simple messages about harmonizing with one another would make them stop slaughtering each other over drugs, jackets, and tennis shoes.
- Status profiling: Research suggests simply wearing a police uniform changes the way the brain processes information
- Don't count on strangers in medical emergencies, especially if you're African-American
- Human brain is predisposed to negative stereotypes, new study suggests
- Study Finds Some Uber and Lyft Drivers Racially Discriminate
Comment: Discrimination is ubiquitous; solutions to overcome it are not, but here's my answer.
- Fear of retaliation: Why we tend not to enforce social norms
- Early screening spots emergency workers at greater risk of mental illness
- Medscape Lifestyle Report 2016: Bias and Burnout: “… 40% of physicians admitted that they [had biases toward specific types or groups of patients]. Within the top 10 of those who said they did indeed perceive that they had some degree of bias were physicians who had the most direct contact with patients: emergency medicine physicians (62%) … One limitation in this survey is the issue of implicit bias, which occurs without conscious awareness.”
Comment: In other words, the prevalence of bias is even higher than reported because people don't admit to bias they possess but don't perceive.
- Racial bias in crosswalks? Study says yes: Drivers tend to discriminate based on race
Comment: More evidence that racism hasn't been sufficiently extinguished.
- Oklahoma police officer charged with raping women while on duty
- Insomnia leads to decreased empathy in health care workers
- High socioeconomic status increases discrimination, depression risk in black young adults
- Favoritism, not hostility, causes most discrimination
Comment: That may be true for various reasons discussed in my blog, yet some racism (such as that motivating the above-mentioned racial war perpetrated by paramedics) is clearly the result of people going out of their way because of hostility.
- I like your genes: People more likely to choose a spouse with similar DNA
Comment: This harmonizes with a mountain of evidence suggesting that people prefer others who are more like them in a variety of ways. Race is only one of them. Just as men will never lose their affinity for beautiful women, people will never lose their preference for folks more similar to them, so racism will never be entirely extinguished. That's a pipe dream. However, by using my “put yourself in their shoes” method, our conscious perceptions can be favorably altered. The unconscious bias, as evidenced by Project Implicit, will still be present in most people because “three-quarters of whites have an implicit pro-white/anti-black bias.”
- Can racial injustice be settled out of court?
- Thoughtful people more likely to infer improvements in race relations
- Clinicians may be driving racial disparities in health, review finds
- Racial bias may be conveyed by doctors' body language
- Racism May Accelerate Aging in African-American Men
Comment: And it may significantly abbreviate lifespan, as my above posting proves.
- Racism in healthcare linked to poor mental health
- Just Like Me: Understanding the Common Human Condition
Excerpt: “It was called the "narcissism of small differences" by Freud. … One of the more powerful means to counter the toxicity of such intolerance is reflecting on all the ways someone else, particularly someone from an "other" group, is "just like me."”
- [Nurse] Genene Jones, Serial Baby Killer, Scheduled For Early Release In Texas
Comment: That's one of many similar cases. Considering the percentage of sociopaths, it is surprising there aren't more such murders. Perhaps we're detecting only the tip of the iceberg. It would be easy to kill a patient and get away with it; healthcare providers have the means and opportunity. Add in motive (resulting from sociopathy or plain ol' revenge) and all necessary elements to murder are present. Revenge doesn't necessarily apply to revenge directed at a patient because of something he/she did. For example, a nurse who hates a doctor might get back at him by killing one of his patients so he is sued for malpractice. I suspect that one of my former bosses was targeted in this manner.
- Brain Can Be Trained in Compassion, Study Shows based on Compassion Training Alters Altruism and Neural Responses to Suffering
- The Bigger the Group, the Smaller the Chance of Interracial Friendship based on Structural effect of size on interracial friendship
- Xenophobia, For Men Only based on Fear Extinction to an Out-Group Face: The Role of Target Gender
- Racial Disparities Evident in Taking Sexual Histories in Emergency Departments
- Race a Factor in Whether Young Women Are Tested for Sexually Transmitted Infections
- Virtual Reality Could Help People Lose Weight, Fight Prejudice
- Prejudice Linked to Women's Menstrual Cycle, Study Suggests based on Fertility and Intergroup Bias in Racial and Minimal-Group Contexts: Evidence for Shared Architecture
- "Treating" Prejudice: An Exposure-Therapy Approach to Reducing Negative Reactions Toward Stigmatized Groups
- Mortician discovers gunshot wound in body after man's death ruled natural (no gold star for the Wayne County Medical Examiner's Office in this case!)
- Emergency Treatment May Be Only Skin Deep Excerpt: “Doctors’ unconscious racial biases may influence their decisions to treat patients and explain racial and ethnic disparities in the use of certain medical procedures.”
- Why Few People Are Devoid Of Racial Bias
- Unconscious Race and Social Bias Among Medical Students: Study Examines Prevalence
- Racial Biases Fade Away Toward Members Of Your Own Group
- Racial Bias Clouds Ability to Feel Others' Pain, Study Shows
- Study links disparities in pain management to racial bias
- New Perspective Diminishes Racial Bias in Pain Treatment Excerpt: “College students and nurses went to greater lengths to ease the pain of members of their own race . . . but a new study suggests that a quick dose of empathy helps close racial gaps in pain treatment.”
- Black Patients, Women Miss out On Strongest Medications for Chronic Pain Excerpt: “Black patients are prescribed fewer pain medications than whites.”
- Significant Racial Disparities In Cancer Therapy Still Exist Excerpt: “Black patients are significantly less likely than their white counterparts to receive therapy for various kinds of cancer.”
- Disparities Remain a Challenge in U.S. Health Care System, Say Experts
- Disparities in Stroke Care Prevail Among US Racial/Ethnic Groups, Experts Say
- Inequities Exists in Disease Burden, Health Care and Access for Minority Children Excerpt: “Minority children in the U.S. face a pervasive gap in the quality and extent of health care received compared to Caucasians.”
- Study Finds Racial Disparities in Hospital Readmission Rates
- Racial And Ethnic Disparities Detected In Patient Experiences Excerpt: “A study . . . found racial and ethnic disparities in patient health-care experiences, with minority patients having worse experiences than white patients.”
- Racial Disparities Persist In The Treatment Of Lung Cancer
- Racial and Ethnic Disparities in Surgical Care Identified
- Patient-Doctor Communication Is Worse For Blacks Than For Whites, Study Finds
- Blood Pressure Control Inequality Linked To Deaths Among African Americans
- Insurance and Socioeconomic Status Do Not Explain Racial Disparities in Breast Cancer Care, New Study Suggests
- Minority Children Less Likely to Receive CT Scans Following Head Trauma
- Race and Empathy Matter On Neural Level Excerpt: “African-Americans showed greater empathy for African-Americans facing adversity . . . than Caucasians demonstrated for Caucasian-Americans.”
- Less Empathy Toward Outsiders: Brain Differences Reinforce Preferences For Those In Same Social Group
- Psychologists Find Unintentional Racial Biases May Affect Economic and Trust Decisions
- Whites Believe They Are Victims of Racism More Often Than Blacks, Study Suggests (Comment: I've yet to hear of a white patient intentionally murdered by a paramedic who isn't white.)
- The Effects of Discrimination Could Last a Lifetime
- Discrimination Is Associated With Depression Among Minority Children
- Discrimination Hurts, but How Much? A Lot, If You're a Teen, Study Finds
- Discrimination Takes Its Toll On Black Women
- Prejudice Can Cause Depression at the Societal, Interpersonal, and Intrapersonal Levels based on Stereotypes, Prejudice, and Depression: The Integrated Perspective
- U.S. Army battling racists within its own ranks
- Heart Attack Victims in Rich, White Neighborhoods Twice as Likely to Get CPR Than People Who Collapse in Poor, Black Neighborhoods
- Experiencing Discrimination Increases Risk-Taking, Anger, and Vigilance
- Discriminated Groups Strategize to Avoid Prejudice
- Twist on evolutionary theory could help explain racism and other forms of prejudice
- Baby talk: Babies prefer listening to their own kind
Comment: A wealth of research indicates that people prefer interacting with “their own kind.” The roots of such bias and xenophobia are products of our biology that stem from our evolutionary history.
- Baboons prefer to spend time with others of the same age, status and even personality
Comment: People usually do, too.
- Discrimination during adolescence has lasting effect on body: Decades of unjust treatment impacts stress hormone levels, researchers find
- Increased internet access led to a rise in racial hate crimes in the early 2000s: Incidence of racial hate crimes increased by 20 percent when a new broadband provider entered an area
- Neuroscientists find evidence for 'visual stereotyping'
- Study finds evidence of racial, class discrimination among psychotherapists
- Major racial bias found in leading genomics databases
- Racial bias in a heartbeat: How signals from the heart shape snap judgments about threat