"I'm Going to F*cking Kill You"
Failure to appropriately address true threats in America has evolved to an unacceptable new normal.
This week, in the emergency department, a patient in their 40s was brought in by law enforcement officers (LEOs) on an involuntary psychiatric hold. He had been aggressively threatening people in a public place, telling them he was going to kill them. He was intoxicated and belligerent and physically violent to the point that he required both physical and chemical restraints to protect himself and our staff.
His nonstop yelling was agitating in an already high stress, high stakes environment where people come to get better, not be exposed to the constant screaming of a belligerent drunk person cursing and threatening others.
Moving from room to room, I encountered a 6-month-old with COVID, a 3-year-old with severe autism and vomiting, and a patient in their 80s with sepsis. Despite providing the patient multiple doses of several different highly potent sedatives, the constant yelling was unnerving, disrupting everyone present.
Ultimately, after not too long, I entered the patient’s room to ask that he stop yelling as it was upsetting the department. He said he had to go to the bathroom and I notified him that he had a condom catheter on and he could urinate, but we could not let him up to the bathroom because it was a danger to himself and the staff. He said:
“If you don’t let me go to the bathroom I’m going to come to your house and kill you and your fucking family. You don’t know who I am. You’re. Fucking. Dead.”
In reviewing his chart, this person had been placed on involuntary psychiatric holds before and the most recent note stated this patient did not have a mental health condition, he had a severe alcohol abuse problem. That is to say, this was not a medical problem, this was a criminal problem.
However, when I contacted the LEOs to help, explaining that despite this patient telling them he has a mental health condition, he did not, and he was medically cleared to be removed from the emergency department and taken to jail for processing.
In addition to upsetting everyone in the emergency department, I mentioned that he had made a threat against me and my family. I was asked if I felt truly threatened and I stated I did. However, I was told that there was no reason for the LEOs to take the patient into custody because the patient did not have the means to harm me; one of the reasons provided was that he did not know where I live.
I was also told that he had said the same to the LEOs when they brought them in earlier that evening, but that they did not feel threatened by him, not noting the fact that they carry firearms and are authorized to use force as needed, while we in the emergency department do not and are not in the same position.
Ultimately, the LEOs left this drunk, belligerent patient in our emergency department after being told that this was a case of a person with a drinking problem threatening others in our hospital emergency room and causing great disruption.
This is a reflection of a larger pattern that has come to redefine acceptable Free Speech. Looking to the country under the past several years, we can see that violent threats have shifted from unacceptable statements of intent to harm, to mere acts of speculation that cannot be proven until the harm has already occurred. This is a serious problem, one that defies all logic, yet is the new normal.
At the larger level, violent threats against doctors, scientists, public health officials, politicians, judges, state and federal law enforcement ect… have been intertwined with the impunity given to disinformation. Put together, we now live in a society where a person can spread dangerous falsehoods in defiance to all available evidence, and when those speak up to challenge these false assertions they are publicly and privately exposed to threats of violence, of which both are now inactionable.
What’s so odd about this is the acceptance of it by those in the position to refute this dangerous new normal. Some things are solved via criminal matters, while others are solved through civil matters. Some require mediation and a robust plan to mitigate harms resulting from this issue. But none of this is happening.
The reframing of the First Amendment to protect dangerous, previously unacceptable, speech and often speech related conduct, is evident at the national level. This is a top down and bottom up approach to redefine acceptable social norms which benefits lawlessness.
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Note: for readers with any HIPAA related concerns, see Speech Rights of Health Workers Bolstered by Appeals Court Ruling.
Well, anyway, thank you for your viewpoint on this subject despite the unhinged ramblings of yet another sociopath. I believe he missed the entire point of your essay; but I also imagine it really doesn't matter to him. He wants his own rants to be heard and read, thereby proving the point you are making. Carry on, regardless...
I’m so sorry that you have to experience such a default in your emergency room. There was NO reason that this disruptor of anger and belligerent behavior should have been left in your ER. Stay safe!