on January 22nd, 2015 1 Comment
Last week, more than one hundred Stanford graduate and medical students gathered to commemorate Martin Luther King, Jr. Day and remember the lives of Mike Brown and Eric Garner. On a white board that proclaimed “Black Lives Matter,” attendees wrote their thoughts. On the board, I wrote “Keep the conversation going,” and as part of that effort I’d like to examine one instance where the practice of medicine is deeply entwined, for good and bad, in the movement for equality.
Over the past several months, the role of racial bias in policing practices and the judicial system has been the subject of extensive discussion and protest, but what hasn’t been adequately discussed is the lesson in this for medical professionals. A catalyzing event for our national discussion has been the video footage of police use of a chokehold and its role in the death of Garner. However, there is a second video from the same incident that warrants scrutiny, particularly from the medical community.
The second video follows the minutes after Garner’s death. After prolonged moments of police prodding and the encouraging of his motionless handcuffed body to cooperate, emergency medical services arrive on the scene. In gloved hands and comforting voices, they appear to very briefly check for a pulse and then encourage Garner, unconscious, to cooperate with getting onto a stretcher.
In the background an observer asks why Garner is not receiving CPR, and a police officer replies, “He’s still breathing.” Given the video, it’s unclear whether or not Garner was actually breathing. What is clear is that progressing from a witnessed loss of consciousness, he eventually entered respiratory arrest followed by cardiac arrest in the presence of multiple medical and police personnel trained in CPR. To perform CPR in such an instance is standard of care and may have saved his life, but basic life support was not performed. Why? And I wonder: Would CPR have been administered if Garner had been white?
There were likely a complex mixture of assumptions, prejudices, and biases that led these health-care workers to not act to save Garner. There is no evidence of overt malice, but race, socio-economics, and deference to the authority of the police all likely played a role in influencing the medics’ actions, or lack of action. As they arrived on the scene, did the medics believe that CPR would just delay the inevitable? Were they worried of offending the authority of the police and exposing the police’s failure to initiate CPR? As medical professionals, we must learn from this incident and begin to recognize and dismantle our own prejudices and biases, wherever we may find them.