Excited Delirium: Of Mice and Men

Once upon a time, when my daughter was only a little girl, a grackle somehow found its way down our chimney and into our living room hearth.  The greenish-black bird squawked and flapped, while Claire, a passionate animal lover, wailed and flapped a bit herself.  I rushed to the basement and returned wearing my welding gloves.  Armored almost to the elbows, I gingerly opened the glass grate and grabbed the grackle as gently as I could in a gloved hand.

      In the 20 seconds it took to carry the grackle from the fireplace to the front door, it died of fright in my right hand.  Opening the door, I tossed the carcass into a bush, while simultaneously pointing skyward with my free hand.  “There it goes,” I shouted, as Claire’s eyes followed my left hand.  “Where, Daddy?  I don’t see it.”  “It flew right up into those branches,” I assured her.  Later, while she played, I snuck outside and disposed of the dead grackle.

      Claire it was who convinced me to throw away my old-fashioned mouse traps, replacing them with have-a-heart plastic contraptions.  The concept was for the mouse to enter the narrow plastic tube, tipping it forward and causing the little yellow backdoor to drop shut.  No nasty snapping of the little fellow’s neck… that was the idea.  The traps worked, too.  Trouble was that, almost without exception, when I inspected a closed trap, I found a dead mouse inside.  My best guess is that, like the terrified grackle, the trapped mice died of extreme fear.  Wouldn’t it really be more humane to snap their necks, getting it over in an instant?  I drove up to True Value Hardware in the Manoa Shopping Center and bought a half dozen of the old-time spring traps.  I’ve been using them ever since.     

Those are the instances that came to mind when I heard recently of a phenomenon called “excited delirium.”  The British prison system issues this definition to its penal officers: “Excited delirium is both a mental state and physiological arousal. Excited delirium can be caused by drug intoxication (including alcohol) or psychiatric illness or a combination of both.  Cocaine is a well known cause of drug induced excited delirium.”  According to a recent article in the Canadian Medical Association Journal, “Some people in states of excited delirium die while in police custody.Emerging evidence suggests that physical restraint in certain positions may contributeto such deaths.”     The doctors who wrote this article reported, “In all 21 cases of unexpected death associated with excited delirium, the deaths were associated with restraint (for violent agitation and hyperactivity), with the person either in a prone position (18 people [86%]) or subjected to pressure on the neck (3 [14%]). All of those who died had suddenly lapsed into tranquility shortly after being restrained.”     The concept first came to national attention in the U.S. in 2003, when news media ran a video clip of a 350-pound suspect struggling against Cincinnati police.  The confrontation occurred in a White Castle parking lot.  On the tape, a verbal exchange escalates into an attempt to subdue the huge man, who battles back.  The two arresting officers are joined by back-up.  All in all they whack the man some 40 times, before he suddenly calls out for his mother and then turns deathly still.      The case touched off a controversy which continues to the present moment.  Proponents of the notion of excited delirium attribute it to “an overdose of adrenaline.”  Recalling the grackle’s pounding heart in the few seconds before it died in my hand, I find this explanation persuasive.      Critics, however, contend that excited delirium is just a mask for police brutality.  They point out that most alleged cases of death attributed to excited delirium occur during or immediately after fierce altercations, accompanied by forceful restraint of the suspect.  Neither the American Medical Association nor the American Psychological Association officially recognizes the diagnosis.  Neither does the International Association of Chiefs of Police, according to NPR’s “All Things Considered” program.     On the other hand, Dr. Vincent Di Maio, former Bexar (pronounced “bear”) County, Texas, medical examiner, told NPR he saw three to five legitimate cases per year.  Dr. Maio, whose territory included the Lone Star State’s capital, Austin, estimates several hundred cases annually around the nation.      The controversy won’t be resolved any time soon.  For now, I’m weighing in on the side of those who believe that, whether you are a man or a mouse, you can quite simply be scared to death.  


3 Responses to “Excited Delirium: Of Mice and Men”

  1. I agree with you. I have done the research and firmly believe in “excited delirium” or more to the point acute agitated delirum brought on by chronic and/or acute substance abuse, or mentla health drugs.

    As for the depth of research of NPR — it is abismal..
    1. Agitated delirium has been around, and documented since 1849 – Journal of Insanity, Dr. Luther Bell.
    2. Excited delrium was the descriptive term coined by Dr. D.A. Fishbain (in association with Dr. Charles Wetli) in 1982 to describe the agitated delirium state brought about by chronic and/or acute cocaine abuse.
    3. If NPR insists that “excited delirium” is not real because it is not listed as a medical billing code – -which is the principle reason why it is not listed — then, “alcohol intoxication” also is not real – because it also as not listed as a billing code recognized by the AMA.
    Bottom line — there are numerous treatises, many (over 300) articles, etc. on the topic of drug induced agitated delirium — i.e. “excited delirium.”

    A little research may go a long way to reducing the ignorance of some who spout unsubstantiated opinions. However, that ignorance may also serve well for creating (baseless) sensationalistic controversy, and for proposgating the biases or agendas of others (e.g. NPR, ACLU, AI, etc.)

    Do a little research, have an open mind, come to objective as opposed to subjective, conclusions based on published research and there isl no doubt that “excited delirium:” does exist and will increase in numbers in the future …. simply look to:

    1. Death in the US – mortality – drug abuse is the no. 2 cause of death just below vehicle crashes and the numbers (in a 5 year period) jumped from 12800 to over 20,000.

    2. The number of people going to hospital emergency rooms for drug related problems is growing rapidly. Meth went from under 50,000 such entrances to over 150,000 in just a few years.

    3. The age at which people in the US are abusing illegal stimulants is growing.

    4. Just last week the FDA put a black box warning on Ritilin — yes, it can cause sudden death. And, Ritilin has been shown to affect a person’s brain the same as illegal stimulants (including cocaine and meth).

    It is very sad that NPR and others would rather ignore the true causes of teh problems — drug abuse, untreated mental health issues, etc.

  2. This response from Mr. Says is ridiculous. The fact is, the Police and their experts have manufatured this defense to support extreme cruelty and violaitons of civil rights. The next time the cops beat the crap out of you Mr. Say and smash your chest in while your hogtied behind your back, maybe you will change your silly opinion.

  3. Extremely great post, definitely enlightening stuff. Never ever imagined I’d discover the info I would like in this article. I’ve been looking all over the web for some time now and was starting to get discouraged. Luckily, I happened across your blog and got precisely what I was struggling to find.

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