By Ryan Yousefi
By Chuck Strouse
By Terrence McCoy
By Terrence McCoy
By Terrence McCoy
By Michael E. Miller
By Kyle Munzenrieder
By Michael E. Miller
While Miami-Dade seems to be far outpacing more populated counties throughout the nation in the number of excited delirium cases, critics from the American Civil Liberties Union and the families of victims believe there's a reason the syndrome resembles overwrought fiction: because it is.
The syndrome is not listed in textbooks or recognized by the American Medical Association or the American Psychiatric Association. It has been met with skepticism as it has spread to the United Kingdom and Canada: A police psychologist in Canada recently made headlines when he testified that excited delirium is a "mythical... dubious disorder" used to justify the use of stun guns, and the Canadian Medical Association Journal has termed it a "pop culture phenomenon."
It is police, not excited delirium, causing at least some of the deaths, critics charge. Of 35 excited delirium death reports the Miami-Dade medical examiner's office made available to New Times, 23 of the subjects died after struggling with police officers. Besides the five tasing incidents, they were hogtied, headlocked, and pepper-sprayed. All were unarmed.
"It's overused by medical examiners across the country to hide brutal murders by law enforcement," says Ronald J. Kurpiers, an attorney who recently challenged the diagnosis in a U.S. Supreme Court lawsuit against West Palm Beach Police officers. "It's bullshit."
As for Xavia Jones's bereaved girlfriend, Carrie, she tells their 5-year-old daughter, Catherine, that Daddy died of a heart attack. "When she gets older," Carrie explains, "I'll tell her the whole story."
Asked if she thinks the police killed Xavia, Carrie scoffs. "I can tell you that he wouldn't have died if they weren't there."
Four decades before Robert Louis Stevenson is said to have scrawled his nightmare-inspired tale of rampage in a three-day cocaine-fueled writing spell, a horse and carriage pulled on to the manicured grounds of the McLean Asylum for the Insane in Somerville, Massachusetts. The coach had traveled 40 miles, and the 31-year-old woman whom orderlies struggled to extricate had "contended violently" the entire way.
She would be immortalized in scientific literature only as "E.A.P.," and she "attack[ed] wildly and discriminately all who approached her."
Her condition that day in July 1847 was a mystery. She was an Army wife, and her husband was away fighting the Mexican-American war. She didn't drink, so the asylum director, Luther V. Bell, ruled out she was suffering from the withdrawal mania delirium tremens. The normally reasonable woman had simply blown a fuse, it appeared, during tea with friends.
McLean Asylum was an opulent place, later home to the notably unstable such as Sylvia Plath, Rick James, and Ricky Williams. The patients ate lobster, and the psychiatric methods were relatively modern. But director Bell broke his own rule and tied E.A.P. to her hospital bed. For the next 16 days, she remained "highly excited" even as she was leeched and administered opium. She rarely slept and "recognize[d] no one."
Then E.A.P. contracted diarrhea. The next day, she simply died.
Bell observed 40 such befuddling cases of unexplained sudden mania from 1836 to 1849, with 30 of them ending in death. The "exhaustive mania" spurned him to publish an October 1849 study in the American Journal of Insanity.
He described the typical afflicted patient as uncomprehending and "suspicious," with dilated eyes and a "pinched-up... florid and greasy" face. "Oftentimes [the] sensation of danger will exhibit itself in the patient attacking any one who approaches him with a blind fury,'' Bell wrote. "If held, he will struggle with the utmost desperation, irrespective of the number or strength of those who may be endeavoring to restrain him... At the expiration of two or three weeks, your patient will sink in death."
The minority that weren't killed by exhaustive mania, wrote Bell, "emerge[d] in a state of absolute recovery at once."
While he noted that "almost every one" of those with the mysterious affliction was strapped to his bed, the doctor was clearly perplexed as to treatment options. He could only cautiously recommend small doses of opium and wine.
The affliction would become known as Bell's mania. Other early 20th-century scientists performed their own studies on similar lethal spells they called "psychotic furors" and "restraint psychosis." And more than a century after the mystery at the gilded asylum, director Bell's findings were revisited in a place he likely could not have imagined: the cocaine-flooded streets of 1980s-era Dade County.
As the Victorian upper crust had treasured its cure-all opium, Miamians doted on their chic white powder at the height of the disco era. "Cocaine was thought to be an open secret, a wonder drug that nobody ever died from," says Dr. Charles A. Wetli, who took his post as Dade County's second-in-command coroner in the late 1970s. Meanwhile, his office processed two overdoses a week.
So Wetli, also a University of Miami pathology professor, co-authored a scientific paper about "death caused by recreational cocaine use" — a revolutionary concept at the time. But it was more difficult to explain an influx of strange cases that began showing up on his gurney: subjects who had raged wildly before sudden death. Cocaine was found in their systems, but not enough to cause overdose.