COMMENTARY

Reflections on George Floyd, Derek Chauvin, and Racism in America

Lorenzo Norris, MD

Disclosures

April 06, 2021

Exhaustion, numbness, dissociation, and, most notably, anger are my emotional response when viewing the video of George Floyd's death. The homicide trial of former Minneapolis police officer Derek Chauvin activates the shared stress of those who experienced intergenerational trauma and the legacy of racism in the United States of America.

Dr Lorenzo Norris

On May 25, 2020, Mr Floyd died after Derek Chauvin used a lethal maneuver and placed his knee on Mr Floyd's neck for 9 minutes and 29 seconds. Mr Floyd has died physically, but his death is replayed through high-definition social media daily, if not hourly, as I write this article and think of the generational legacy of trauma that African Americans must cope with every day.

I struggle daily to explain this legacy to my daughters, students, residents, and colleagues. I hope to share with you some of my perspectives on the current trial and give you some insight as to how my training and personal life experience have affected my views on police brutality and the use of lethal force in African American men.

My earliest recollection of public video-recorded images of police brutality occurred when Rodney King was beaten and assaulted by the Los Angeles Police Department on March 3, 1991. At that time, I was a senior in high school, and the world was different. My clear expectation was that any attempt to resist police arrest would be met with overwhelming and potentially lethal force. This was simply a matter of my daily reality, so, while witnessing the assault of Mr King, the 17-year-old child didn't expect much, if any, real change to come about in regard to police brutality.

At that time, my mother kept me focused on one singular goal ― becoming a physician ― and protected me as best she could from the effects of intergenerational trauma woven into the African American experience.

The issue of police brutality and police-involved deaths has been recognized as a significant public health concern for some time. Over the three decades since the assault on Mr King, several researchers have examined these issues.

A review of all the research is beyond the scope of this piece. Still, I will highlight a study that I believe illustrates some conclusions scholars have come to regarding police use of lethal force and subsequent mortality in African American men.

A recent study by Frank Edwards, PhD, and colleagues, published in the Proceedings of The National Academy of Sciences, showed Black men were 2.5 times more likely to be killed by police over their life course than White men. The researchers also developed predictive models showing that 1 in 1000 Black men and boys will be killed by police over the life course, and that among all age groups, Black men and boys face the highest lifetime risk.

"Our analysis shows that the risk of being killed by police is jointly patterned by one's race, gender, and age. Police violence is a leading cause of death for young men, and young men of color face an exceptionally high risk of being killed by police. Inequalities in risk are pronounced throughout the life course. This study reinforces calls to treat police violence as a public health issue," the authors concluded.

Over the years, I learned from my attending physicians, colleagues in security, social work, nursing, ACT teams, and many other allied health professions that the responsibility to show restraint, calm, and compassion lies with those who have the power and trust of the public.

Research such as this helps validate on a visceral level what I was already taught: As a Black male, encounters with police can quickly become deadly, and you must remain calm or you could die. This thought process informed much of my thinking whenever I heard about a Black male being fatally shot by police.

My first response was to ask, "Was he resisting arrest?" At this time, my naive impression was that "if you don't resist or conflict, you'll live." It wasn't until my training in psychiatry that I realized that the duty to calm, support, and, most importantly, protect was the responsibility of the person who is given the trust of the public.

As a psychiatrist, I am humbled by the trust the public places in physicians to restrain patients and take part in their involuntary hospitalizations. Over the years, I learned from my attending physicians, colleagues in security, social work, nursing, ACT teams, and many other allied health professions that the responsibility to show restraint, calm, and compassion lies with those who have the power and trust of the public.

Mostly, I learned from my patients. They taught me to meet distress with compassion and humanity and not simply with force. With those lessons in mind, I now fast forward to July 17, 2014, and the death of Eric Garner. On July 17, New York Police Department officers approached Mr Garner on the suspicion that he was selling loose cigarettes.

Amid this encounter, Mr Garner was subjected to a chokehold, and his face was pinned to the ground while he could be heard saying, "I can't breathe." At this time in my career, I had just become a dean of student affairs at the George Washington School of Medicine and Health Sciences. I can still remember the response of my minority students and the sense of pain and anguish they felt watching the video of a chokehold used on a man saying, "I can't breathe."

At this point, my training would not allow me to see this as anything other than an unnecessary use of lethal force that would subsequently be ruled a homicide. I hoped that as a nation we had reached a "reckoning" because of Mr Garner's death and Michael Brown, Jr's, subsequent death in Ferguson, Missouri, in St. Louis County, on August 9, 2014. I hoped we were ready to finally address police brutality and excessive use of force that had disproportionally affected Black men. I was utterly wrong.

Black men such as Alton Sterling, Jamar Clark, and many others would die in fatal police encounters. So would Tamir Rice, who was 12 years old when he was shot and killed by a police officer.

This brings me back to the death of Mr Floyd. As I listened to the witnesses' testimony, it triggered an emotional response of sadness, fear, shock, but mostly anger. Some would consider it progress that the Minneapolis Police Department's top homicide detective testified that kneeling on Mr Floyd's neck after he had been restrained was "unnecessary."

The officer stated, "If your knee is on someone's neck, that could kill him." While I acknowledge this is a form of progress, we must ultimately address the other "substantial causal factor of death" for Mr Floyd, namely, the systemic racism present in a criminal justice system in the form of policies and procedures that allow for continued racial disparities and inequities.

There will be coverage of the court proceedings and a detailed dissection of the legal arguments. Questions regarding Mr Floyd's physical health and struggle with opiate use disorder will be raised by the defense. The debate about the substantial causal factor will be played out in the court and the media. Ultimately, we, as health professionals, need to ask ourselves, "Who has the power and the duty to do no harm?"

Lorenzo Norris, MD, is associate dean of student affairs and administration at George Washington University, Washington, DC.

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