兴奋性谵妄

查尔斯·韦特利告诉记者，典型的场景是在廉价的房间、一丛灌木丛或一座废弃的建筑里。

Charles Wetley told reporters, the typical scene is in a cheap room, a clump of bushes, or an abandoned building.

她们被发现时腰部以下赤裸，体内均检测出微量可卡因。

They were discovered naked from the waist down, and they all had trace amounts of cocaine in their system.

一篇刊登在

An article in

《迈阿密新闻》引用韦特利的话说，乍一看，她像是遭到了强奸和谋杀。

the Miami News quoted Wetley as saying, at first glance, it looks like she's been raped and murdered.

但他表示，事实并非如此。

But he said that wasn't the case.

韦特利说，这些女性很可能死于可卡因精神病。

Wetley said the women likely died of cocaine psychosis.

一篇报纸文章将其描述为：‘低剂量可卡因导致受害者突然发狂，并在几分钟内死亡。’

One newspaper article described it as, quote, sudden death from low levels of cocaine that caused the victims to go berserk and die within minutes.

一些女性被认为从事性工作。

Some of the women were believed to have been sex workers.

他和他的同事们表示，可卡因与性行为的结合导致了这些女性的死亡，他称之为兴奋性谵妄。

And he and his colleagues said that the combination of cocaine and sex is what led to these women's death, and he called it excited delirium.

你知道，他说黑人女性更容易以这种方式死亡，正是可卡因和性行为的共同刺激导致了她们的死亡。

And, you know, he said that black women were more prone to dying this way and that it was this combination of the stimulation from the cocaine and the sex that led to their death.

他告诉记者，当他们检查这些女性的尸体时，没有发现任何暴力侵害的迹象。

He told reporters that when they examined the women's bodies, there were no signs of assault.

尸检结果明确显示，这些女性并非被谋杀。

Quote, the autopsies have conclusively showed that these women were not murdered.

他曾一度提出一个理论，认为秘鲁的降雨 somehow 污染了一批可卡因。

At one point, he worked on a theory that rain in Peru had somehow tainted a shipment of cocaine.

警方关闭了这些案件。

The police closed the cases.

许多被发现死亡的女性来自牙买加、海地和波多黎各。

Many of the women who were found dead were from Jamaica, Haiti, and Puerto Rico.

她们大多数在二十多岁到三十多岁之间。

Most of them were in their twenties and thirties.

但到了1988年，一名名叫安托瓦内特·伯恩斯的14岁女孩被发现死亡，她的死状与之前其他女性如出一辙。

But then in 1988, a 14 year old girl named Antoinette Burns was found dead, and she was found dead in much the same way that the other women had died.

韦特利进行了初步尸检，再次声称她也是死于兴奋性谵妄。

Wetley did the initial autopsy, and he once again said that she too died of excited delirium.

伯恩斯一家对此提出了质疑。

And the Burns family pushed back.

我的意思是，这只是一个14岁的小女孩。

I mean, this was a young girl, 14.

他们说她不是性工作者。

They said she wasn't a sex worker.

她不吸毒。

She didn't do drugs.

她最后一次被人看到时，是搭邻居的便车去看电影。

She was last seen hitching a ride to the movies with a neighbor.

家人强烈质疑这一说法，但直到毒理学报告出来后，韦特利的理论才开始瓦解。

And and the family really pushed back on this, but it wasn't until a toxicology report came back, that Wetley's theory began to unravel.

安托瓦内特·伯恩斯体内没有可卡因。

Antoinette Burns didn't have cocaine in her system.

此后，首席法医——也就是韦特利的上司——重新审查了韦特利声称死于兴奋性谵妄的所有女性的死亡案例。

And after that, the chief medical examiner, so Wetley's boss, reviewed all the deaths of these women that Wetley had said died of excited delirium.

他发现的结果令人震惊。

And what he found was pretty startling.

首席法医回去查看了所有遇难女性尸检的照片。

The chief medical examiner went back and looked at the photos from the autopsies of all the women who'd been found dead.

他发现了嘴唇和颈部的损伤，以及眼睛出血。

He found lip and neck injuries and hemorrhaging in the eyes.

他说

He said

在许多案例中，这些女性明显是被勒死或窒息而亡的。

that in many of these cases, the women had very, very clearly been strangled or asphyxiated to death.

他说，这一点一眼就能看出来。

He said you could spot it a mile away.

我的意思是，他说这些女性——到那时已有近20人——实际上是他杀受害者，警方认为是一名连环杀手导致了她们的死亡。

I mean, he said that these women, nearly 20 by this point, were actually homicide victims, and the police believed that a serial killer was responsible for their deaths.

1989年，又有更多女性被发现死亡。

More women were found dead in 1989.

但到了四月，这些死亡事件终于似乎停止了。

But then in April, the deaths finally seemed to stop.

几个月后，警方宣布他们有了嫌疑人，一名33岁的男子查尔斯·亨利·威廉姆斯，他在四月因强奸罪被捕，而那正是连环谋杀案结束的时候。

Months later, police announced that they had a suspect in the cases, a 33 year old man named Charles Henry Williams, who'd been arrested on rape charges in April right when the string of murders ended.

但警方表示，他们没有足够证据指控他杀害了那32名他们怀疑他所杀的女性。

But police said they didn't have enough evidence to charge him with the murders of the 32 women who they suspected him of killing over almost a decade.

其中一名是他的邻居，还有四人是在他家附近被发现死亡的。

One of them was his neighbor, and four had been found dead near his home.

最终，他们以杀害一名19岁女子帕特里夏·约翰逊的罪名对他提起指控。

They ended up charging him with one murder of a 19 year old woman named Patricia Johnson.

在审判开始前十天，威廉姆斯在监狱中因艾滋病去世，当时他正因强奸罪服刑。

Ten days before the start of the trial, Williams died of AIDS while in prison, serving a sentence for rape.

但查尔斯·韦特利坚持认为兴奋性谵妄是真实存在的，至少有一些迈阿密的女性是因此死亡的。

But Charles Wetley stuck to his theory that excited delirium was real and that at least some of the women in Miami had died from it.

你可能会想，你知道，在……

You would think, you know, after

在安东尼特·伯恩斯案之后，在迈阿密发生这么大的事件——有人声称这些人都死于兴奋性谵妄，结果却发现她们是被谋杀的——这个术语本该彻底退出历史舞台。

the Antoinette Burns case, after this kind of huge thing in Miami where this guy said, oh, all these people died of excited delirium, and it turns out they had been murdered, that the term would have completely fallen out of favor.

但最终，它又重新出现了。

But, eventually, it reemerged.

当昆托·柯林斯一家的律师向他们提及兴奋性谵妄综合征时，贝拉说，和她父母一样，她以前从未听说过这个术语。

When the Quinto Collins family's attorney told them about excited delirium syndrome, Bella says that like her parents, she'd never heard of it before.

我觉得这听起来太蠢了。

I thought that sounds really stupid.

完全不像是个严谨的术语。

Does not sound very sophisticated at all.

但他向我们描述了他过去接触兴奋性谵妄的经历。

But he described to us his experience with excited delirium in the past.

在他们告诉我们兴奋性谵妄之后，我说我要做第二次尸检。

So after they told us about excited delirium, I said I want a second autopsy.

所以，我的意思是，首先的问题是，这笔尸检费用怎么付？

So it was a you know, I mean, I think the first thing is how do you pay for this autopsy?

家人表示，独立尸检最终花费了他们18,000美元。

The family said the independent autopsy ended up costing them $18,000.

当结果出来时，报告显示安吉洛死于窒息。

When it came back, it said Angelo had died of asphyxiation.

他们仍在等待县方官方尸检的结果。

They were still waiting to hear the results of the county's official autopsy.

2021年1月13日，他们在当地一座教堂的花园里为安吉洛举行了追悼会。

On 01/13/2021, they held a memorial service for Angelo in the garden of a local church.

几个月后，他的家人接到通知，县方将举行验尸官听证会。

Months later, his family was notified that the county would hold a coroner's inquest.

这是一场由县方传唤多位证人的听证会。

It's a hearing in which, the county calls several witnesses.

律师本·尼森鲍姆。

Attorney Ben Nissenbaum.

通常，目击杀人或死亡的证人会在验尸官听证会上向陪审团作证。

Typically, the witnesses to the killing or death testify before jurors at the coroner's inquest.

验尸官听证会的陪审团并不决定谁对死亡负责，只确定死亡的‘原因和方式’。

The jury at a coroner's inquest doesn't decide who is responsible for the death, only the, quote, cause and manner of death.

陪审团的结论将被记录在死亡证明上。

What the jury finds goes into onto a death certificate.

陪审团判定死亡属于他杀、自杀、自然死亡还是意外。

The jury determines whether the death was a homicide, a suicide, a natural death, or an accident.

2021年8月20日早晨，在安吉洛去世八个月后，昆托·柯林斯一家前往当地法院。

On the morning of 08/20/2021, eight months after Angelo had died, the Quinto Collins family went to the local courthouse.

听证会向公众开放。

The hearing was open to the public.

来了很多人，有朋友和家人，也有记者。

Lots of people had showed up, friends and family, but also journalists.

贝拉说，那些当天要作证的警察在法院对公众开放时就已经在法庭里了。

Bella says that the police officers who are going to be giving statements that day were already in the courtroom when the doors were open to the public.

当我们有机会进去时，我妈妈和我决定坐在警察旁边。

And then when we got the chance to come inside, my mom and I decided to sit right next to the officers.

这次听证会并不是由法官主持，而是由一名名叫马修·吉夏德的律师主持，他是由县里聘请的。

The court hearing wasn't led by a judge, but by a hearing officer, a lawyer named Matthew Guichard, who'd been contracted by the county.

吉夏德解释说，在他们所在的康特拉科斯塔县， sheriff 同时兼任验尸官，也就是说， sheriff 负责确定死亡的原因和方式，并参与安排验尸官听证会。

Guichard explained that in their county, Contra Costa County, the sheriff is also the coroner, meaning the sheriff determines the cause and manner of a person's death and is part of arranging coroner's inquests.

当一个人在警方羁押期间或与警方互动时死亡，必须举行验尸官听证会。

And when a person dies in police custody or during a police interaction, a coroner's inquest is required.

加利福尼亚州是少数几个县 sheriff 可以同时兼任县验尸官的州之一。

California is one of just a few states where a county sheriff can also be the county's coroner.

马修·吉夏德解释说，这不会像电影里看到的那样是一场审判。

Matthew Guichard explained that this wouldn't be like a trial you might see in the movies.

他说：‘不会出现律师站起来提问的情况。'

Quote, there won't be lawyers standing up and asking questions.

他说他会负责向证人提问，并且他已经审阅了案件中的所有文件、音频和视频记录。

He said he would be the one asking the witnesses questions and that he had reviewed all of the documents, audio, and video recordings in the case.

律师本·尼森鲍姆坐在法庭上，与昆托·柯林斯一家一起旁听。

Attorney Ben Nissenbaum was in the courtroom with the Quinto Collins family watching.

我们可以提交问题，但听证官有权决定不提出这些问题。

We do get to submit questions, but the hearing officer can decide not to ask those questions.

所以听证官拥有全部权力。

So the hearing officer has all the power.

你知道，他们可以决定陪审团能听到哪些内容。

You know, they can decide what what the jury gets to hear.

共有六名证人被传唤。

Six witnesses were called.

包括县法医、三名在安提奥克家中现场的警察、一名警探，以及地区检察官办公室的一名侦探。

The county's forensic pathologist, three of the police officers who are at the house in Antioch, a police detective, and a detective from the DA's office.

贝拉和卡桑德拉不在证人名单上。

Bella and Cassandra were not on the list of witnesses.

在这四小时的听证会中，他们从未提及我母亲或我的名字。

Throughout that four hours of this inquest, they didn't mention my mother or myself by name.

我们是母亲和姐姐，这感觉有点奇怪，因为虽然我们不是证人，但整个故事的每个方面都涉及母亲和姐姐。

We were the mother and the sister, which just felt kind of odd because, you know, we weren't witnesses, but every aspect of the story involves the mother and the sister.

第一位证人是为安吉洛进行正式尸检的法医。

The first witness was the pathologist who had performed Angelo's official autopsy.

家人不知道法医发现了什么。

The family didn't know what the pathologist had found.

他们仍然没有看到正式的尸检报告。

They still hadn't seen the official autopsy report.

但他们确实知道他们自己出资委托进行的独立尸检结果，该结果认定安吉洛死于窒息。

But they did know the results of the independent autopsy that they had ordered and paid for themselves, which had concluded that Angelo had died of asphyxiation.

独立尸检在安吉洛身上发现了称为点状出血的迹象，这是眼睛中因毛细血管破裂而出现的小红点。

The independent autopsy had found something called petechial hemorrhages on Angelo, small red marks often found in the eyes from broken blood vessels.

这一点很重要，因为这类迹象通常支持窒息死亡的结论。

Which is important because they tend to support a finding of an asphyxiation death.

但县法医作证说，他在安吉洛身上没有发现点状出血，也没有提到任何其他窒息迹象。

But the county pathologist testified that he had found no petechial hemorrhages on Angelo, and he didn't mention any other signs of asphyxiation.

他详细介绍了毒理学报告的结果。

He went over the results of the toxicology report.

报告显示，安吉洛体内含有咖啡因和香烟中的可替宁，还有一种抗癫痫药物，通常被认为是安全的。

It showed that Angelo had caffeine in his system and cotinine from cigarette smoking, as well as a drug for seizures, which is generally considered safe.

后来，昆托·柯林斯家族的律师指出，安吉洛在去世前几天在医院接受了抗癫痫药物治疗。

Later, the Quinto Collins family's attorney pointed out that Angelo had been given anti seizure medication at the hospital in the days before he died.

法医还发现了一种名为莫达非尼的药物，这种药物通常也被认为是安全的。

The pathologist also found a drug called modafinil, which is also generally considered safe.

它用于治疗发作性睡病，但有些人会超说明书使用，以保持清醒和警觉更长时间。

It's used to treat narcolepsy, but people sometimes use it off label to stay awake and alert longer.

法医表示，莫达非尼可能促成了安吉洛的死亡，因为他提到有一种与药物使用相关的病症会致人死亡。

The pathologist said that the modafinil could have contributed to Angelo's death because he said there's a condition linked to drug use that kills people.

他说：‘这种病症尚不明确。’

He said, quote, it's poorly understood.

这被称为兴奋性谵妄综合征。

It's called excited delirium syndrome.

现场观众对此作出了明显的反应。

To which there was an audible reaction from the crowd.

这既令人震惊，又荒谬可笑。

It was shocking, and it was laughable.

我忍不住大笑出来，并非故意，但就是有这样的反应。

And I laughed out loud, not on purpose, but, you know, I just had that reaction.

当我意识到自己这样做了，心想：哎呀。

And when I realized that I had done that, I thought, oops.

于是我走出了法庭。

And I walked myself out.

法医表示，安吉洛的死因是：急性药物中毒引发的行为异常，导致在逮捕过程中因体力消耗而死，诊断为兴奋性谵妄综合征。

The pathologist said that Angelo's cause of death was, quote, excited delirium syndrome due to acute drug intoxication with behavioral disturbances due to arrest related death with physical exertion.

自从律师首次向他们提及兴奋性谵妄以来的八个月里，罗伯特说，他们一直在不断了解更多信息。

In the eight months since their lawyer had first told them about excited delirium, Robert says they'd all been learning more.

随着时间推移，人们越来越难以相信他们还会把死亡归咎于兴奋性谵妄，因为即使你相信兴奋性谵妄这种伪科学，即使你阅读了他们自己的报告，安吉洛的情况也不符合。

As time went on, it became difficult to think that they would still blame excited delirium because even if you believed in the pseudoscience of excited delirium, even if you were to read their own reports, Angelo didn't fit.

这就是为什么现场人群会如此震惊，因为我们所有人都对兴奋性谵妄有了更深入的了解。

That's why there was such a shock in the crowd because we had all become much more informed about excited delirium.

通常，兴奋性谵妄都被归咎于那些吸食可卡因、冰毒之类毒品的人。

Typically, excited delirium was blamed on people that were taking Coke or meth or something.

但把责任推到烟草和咖啡因身上。

But to blame it on tobacco And caffeine.

香烟和另一种让人无法入睡的东西——这些都从未有过致死案例，嗯。

Cigarettes and this other thing that prevented you from sleeping, which had never had any deaths Mhmm.

这意味着，即使按照他们自己的标准，他们的兴奋性谵妄案例也极其牵强。

Meant that they had the flimpsiest case of excited delirium even if you went by their own standards.

接下来，卡沙德向陪审团播放了贝拉拨打911的通话录音，三名当晚在安提奥克家中参与处置的警察出庭作证。

Next, Cashard played Bella's nine one one call to the jury, and three of the four police officers who had been at the house in Antioch the night Angelo was taken to the hospital testified.

其中两名警察表示，他们曾将膝盖压在安吉洛身上，但时间非常短暂。

Two of the officers said that they'd had a knee on Angelo, but only very briefly.

最初，警察称有一名警官膝盖压在了他身上。

Originally, the police had said one officer had a knee on him.

然后，检察官办公室的一名侦探作证说，他查阅了安吉洛过去的一次事件记录，当时邻居报警称安吉洛行为异常，试图翻越围栏。

Then a detective with the DA's office testified that he had looked at Angelo's old incident when a neighbor had called the police because Angelo had been acting strangely, trying to climb a fence.

调查人员表示，根据急救人员的说法，安吉洛心跳很快，还说有一名警察称安吉洛承认自己吸食了冰毒。

The investigator said that according to the paramedics, Angelo had had a fast heartbeat, and he said a police officer had said that Angelo had admitted to being on meth.

古沙尔说，他认为医院的一名医生也持相同看法。

Gouchard had said he thought a doctor at the hospital had believed the same thing.

接着，古沙尔告诉陪审团不要考虑刚才关于冰毒的陈述，因为他指出这涉及的是之前的事件，而法医此前已作证称安吉洛的血液中并未检测出冰毒。

Then Gouchard told the jury to not consider what had just been said about meth because he said it was about a previous incident, and there was no evidence of meth in Angelo's blood as the pathologist had previously testified.

在证人作证结束后，古沙尔提醒陪审团，他们只需判定死因，而非追究谁负有责任。

After the witness testimonies, Gouchard reminded the jury that they would only be deciding on the cause of death, not who was responsible.

他们有四种选择：他杀、自杀、意外或自然原因。

They had four options: homicide, suicide, accident, or natural causes.

陪审团被告知，不需要达成一致意见，但多数人必须达成共识。

The jury were told they didn't need to reach a unanimous decision, but a majority of them would have to agree.

盖沙德让法庭所有人离开，只有陪审团留下进行审议。

Geshard cleared the courtroom while the jury stayed back to deliberate.

大约十五分钟后，他们达成了 unanimously 的裁决。

After about fifteen minutes, they'd reached a unanimous decision.

当陪审团裁定为意外时，你感到惊讶吗？

Were you surprised when the jury ruled it an accident?

没有。

No.

一点也不。

Not at all.

当我听到法医的证词说是兴奋性猝死时，我就预料到会是这样的结果。

When I heard the the testimony from the coroner that it was excited delirium, then I that's what I expected would happen.

我觉得这就是设立这个机制的本意。

And I felt like that was the intended that was the purpose of it.

昆托·柯林斯一家已对安提奥克市、其警察局长以及2020年12月那晚出现在他们家的四名警察提起诉讼。

The Quinto Collins family had filed a lawsuit against the city of Antioch, its police chief, and the four police officers who were at the family's house that night in December 2020.

几个月后，本·尼森鲍姆对县里的法医进行了取证。

Months later, Ben Nissenbaum deposed the county's pathologist.

这位法医带着一名律师来到他的办公室。

The pathologist came to his office with a lawyer.

实际情况是我给他看了我们尸检时拍摄的照片，显示昆托先生眼睛中的点状出血。

What happened was I showed him the pictures from our autopsy that showed the petechial hemorrhages in mister Quinto's eyes.

于是他仔细看了这些照片，一遍又一遍，反复看了好多次。

And so he looked at them, and he looked at them again and again and again and again.

奥根医生实际上承认了，是的，这些是点状出血，在他看来，这些出血需要时间才能形成，而在他为安吉洛做尸检时，这些出血尚未出现。

And doctor Ogan actually acknowledged that, yes, those are petechial hemorrhages and that in his view, they take time to develop and that they simply hadn't developed at the time that that he did Angelo's autopsy.

他说，约束措施也在昆托先生的死亡中起到了作用。

What he said is that the restraint also played a role in mister Quinto's death.

这位法医表示，如果他在做尸检时发现了这些点状出血，他会将窒息列为死因之一。

The pathologist said that if he had found the petechial hemorrhages when he did his autopsy, he would have added asphyxiation to his diagnosis.

但他仍然认为兴奋性谵妄的诊断是正确的。

But he still believed the excited delirium diagnosis was right.

我们马上回来。

We'll be right back.

感谢 Squarespace 的支持。

Thanks to Squarespace for their support.

制作网站可能令人望而生畏，尤其是因为这往往是人们对你的企业第一眼看到的东西。

Making a website can be intimidating, especially because it's often the first thing people see about your business.

如果你想打造一个给人留下良好第一印象的网站，你不需要多年的编程经验。

If you wanna build a website that makes a great first impression on people, you don't need years of coding experience.

你只需要 Squarespace。

You just need Squarespace.

它是一个一体化的网站平台，专为帮助你在网络上脱颖而出而设计。

It's the all in one website platform made to help you stand out online.

Squarespace 提供了你需要的所有工具，让你的网站按你想要的样子呈现，销售你的服务，并无论从事何种行业都能顺利收款。

Squarespace has the tools you need to make your website look exactly how you want it to look, sell your services, and get paid no matter what business you're in.

你可以从专业设计师打造的模板库中进行选择。

You can choose from a library of templates designed by professionals.

或者，如果你不想逐个浏览所有模板选项，Squarespace 的 Blueprint AI 可以为你搭建一个网站。

Or if you don't wanna scroll through all the template options, Squarespace's Blueprint AI can build a website for you.

只需几分钟，根据几个提示，它就能从不同模板中提取内容，为你创建所需的网站。

In just a couple of minutes based on a few prompts, it'll pull from different templates to create the website you need.

前往 squarespace.com/criminal 申请免费试用。

Go to squarespace.com/criminal for a free trial.

当你准备上线时，使用优惠码 criminal 可享受网站或域名首单 10% 的折扣。

When you're ready to launch, use the offer code criminal to save 10% off your first purchase of a website or domain.

嗨。

Hey.

我是卡拉·斯威舍。

Kara Swisher here.

我想通知大家，Vox Media 将重返德克萨斯州奥斯汀的西南偏南大会，进行你喜爱播客的现场录制。

I wanna let you know that Vox Media is returning to South by Southwest West in Austin for live tapings of your favorite podcast.

请于 3 月 13 日至 15 日前来参加，现场录制《今日解析》《Tuffy Talks》《Prof G 市场》以及当然还有你最爱的两档播客——《Pivot》和《On with Kara Swisher》。

Join us from March 13 through the fifteenth for live tapings of Today Explained, Tuffy Talks, Prof G Markets, and of course, your two favorite podcasts, Pivot and On with Kara Swisher.

舞台还将呈现蕾妮·布朗、亚当·格兰特、马奎斯·布朗利、基思·李、维维安·图和罗宾·阿尔琼的演讲。

The stage will also feature sessions from Renee Brown and Adam Grant, Marques Brownlee, Keith Lee, Vivian Tu, and Robin Arjun.

这一切都是由Odoo赞助的Vox Media播客舞台在西南偏南活动中的组成部分。

It's all part of the Vox Media podcast stage at South by Southwest presented by Odoo.

请访问voxmedia.com/sxsw进行预注册，并获取您的创新通行证专属折扣。

Visit voxmedia.com/sxsw to preregister and get your special discount on your innovation badge.

要注册，请访问voxmedia.com/sxsw。

That's voxmedia.com/sxsw to register.

真的，你应该去注册。

Really, you should register.

活动门票总是售罄，我们期待在那里见到你。

We sell out, and we hope to see you there.

在‘兴奋性谵妄’这一概念于20世纪80年代被提出后，它开始逐渐获得关注。

After the idea of excited delirium was proposed in the nineteen eighties, it started gaining momentum.

2008年10月，一场为期三天的关于警察羁押期间死亡事件的会议在拉斯维加斯的一家酒店举行。

In October 2008, a three day conference on deaths that occurred in police custody was held at a hotel in Las Vegas.

此次活动由一个名为‘预防羁押期间死亡研究所’的机构赞助。

It was sponsored by something called the Institute for the Prevention of In Custody Deaths.

演讲者包括医生、法医和科学家。

Speakers included doctors, pathologists, and scientists.

其中一位演讲者是查尔斯·韦特利，这位法医曾提出，迈阿密多名女性的死亡是由于兴奋性谵妄所致，因为她们体内含有可卡因。

One of the speakers was Charles Wetley, the medical examiner who had theorized that the deaths of a number of women in Miami were due to excited delirium because they'd had cocaine in their system.

1995年，查尔斯·韦特利搬到纽约，在那里担任法医。

In 1995, Charles Wetley had moved to New York, where he worked as a medical examiner.

尽管韦特利在迈阿密的理论在那些谋杀案中并未得到证实，他仍持续谈论兴奋性谵妄。

Even though Wetley's theories in Miami were unproven in those murder cases, he continued to talk about excited delirium.

记者雷努·雷亚萨姆。

Reporter Renu Rayasam.

他继续将可卡因使用与兴奋性谵妄联系起来。

And it continued to link cocaine use with excited delirium.

他真的非常坚信这个观点。

He was just really convinced of this idea.

然后这种观点以多种方式迅速流行起来。

And then this sort of idea really took off in a lot of different ways.

当

When the

2008年在拉斯维加斯召开的会议公布时，查尔斯·韦特利被介绍为一位在20世纪80年代可卡因泛滥时期识别出‘兴奋性谵妄’的医生。

two thousand and eight conference in Las Vegas was announced, Charles Wetley was introduced as one of the doctors who had identified excited delirium, quote, in the cocaine wild nineteen eighties.

这次会议承诺，与会者将通过专注于达成关于兴奋性谵妄共识的专题分组讨论，共同推动执法、医疗和法律领域的历史进程。

The conference promised that, quote, attendees will help make law enforcement, medical, and legal history through topic specific breakout groups focused on arriving at a consensus about excited delirium.

这次会议由一个由泰瑟公司律师发起的组织主办。

The conference was organized by a group that was started by a lawyer from Taser.

他们制造电击枪。

They make stun guns.

他们说，嘿。

They say, hey.

这些电击枪并不会致人死亡。

These stun guns don't kill people.

它们是警察使用其他武力方式的一种替代方案。

They are an alternative to kind of other uses of force by police.

在后来接受路透社采访时，查尔斯·韦特利表示，他研究过涉及泰瑟枪的死亡案例。

In a later interview with Reuters, Charles Wetley said that he had studied deaths involving tasers.

在绝大多数情况下，这些死亡是由兴奋性谵妄引起的，而不是泰瑟枪的电击。

And in the vast majority of cases, those deaths were caused by excited delirium, not the taser shock.

我从未见过一个案例，能说我能确定泰瑟枪确实导致了死亡。

Quote, I've never seen a case where I could say that a Taser actually contributed to the death.

他告诉路透社，泰瑟公司曾多次聘请他作为针对该公司的诉讼中的专家证人。

He told Reuters that Taser had hired him many times to be an expert witness in lawsuits against the company.

雷努·雷亚萨姆表示，这场关于羁押期间死亡的会议成为了一个转折点。

Renu Rayasam says that conference on in custody deaths became a turning point.

从这次会议中诞生了一份极具影响力的白皮书，名为‘非兴奋性谵妄’。

From that conference emerged what ended up being this really influential white paper, unexcited delirium.

它被称为《非兴奋性谵妄综合征白皮书》。

It's called the white paper unexcited delirium syndrome.

所以，在这种医学或科学背景下，白皮书就像一份关于某个主题的详细指南或报告。

So a white paper it's like, in this sort of medical or scientific context, a white paper is kind of like a detailed guide or report on a topic.

这份白皮书由美国急诊医师学院于2009年发布。

The white paper was published by the American College of Emergency Physicians in 2009.

这篇论文的作者共有19位医生，其中许多是急诊医学教授。

The authors of the paper were 19 doctors, many of them professors of emergency medicine.

其中有几位曾以某种方式与Taser公司合作过。

A few of them had worked with Taser in some capacity.

我们联系了制造电击枪的公司Axon。

We reached out to Axon, the company that makes tasers for common.

我们没有收到回复。

We didn't hear back.

如果你阅读这篇论文，回头去看美国急诊医师学院2009年的白皮书，它会大致说明他们对激越性谵妄的看法，并呈现相关研究。

So if you read the paper, you go back and read the 2009 white paper from the American College of Emergency Physicians, it sort of lays out, okay, what they think excited delirium is, and it presents this research.

当然，所有这些研究都存在循环论证的问题。

Of course, all the research is sort of circular.

这正是最初提出这一理论的同一组专家。

It's from the same group of experts that have been talking about the theory in the first place.

他们说，好吧。

And they say, okay.

兴奋性躁动没有生物标志物。

There are no biological markers for excited delirium.

再次强调，没有检测方法或标准诊断标准，但他们列出了他们所谓的这些特征。

Again, there's no tests or standard diagnostic criteria, but they lay out what they say are these features.

如果一个人具有超人的力量、极高的疼痛耐受性或呼吸急促，那么他们就患有兴奋性躁动。

If someone has, like, superhuman strength or really high pain tolerance or rapid breathing, then they have excited delirium.

这份白皮书还列出了其他可能表明某人患有兴奋性躁动的迹象，例如‘对警察在场无反应’、‘大量出汗’和‘对玻璃或反光表面有吸引力’。

The white paper listed other signs that someone might have excited delirium, such as a, quote, failure to respond to police presence, profuse sweating, and a, quote, attraction to glass or reflective surfaces.

我以前从未听说过这种叫兴奋性躁动的东西，这让我感到不安又好奇。

I had never heard of this thing called excited delirium, and I I was troubled and curious.

2020年，阿尔琼·比朱是一名在纽约罗切斯特一家医院进行研究实习的医学生。

In 2020, Arjun Byju was a medical student doing a research fellowship at a hospital in Rochester, New York.

当一名叫丹尼尔·普鲁德的男子在经历警方制服事件后被送往重症监护室时。

When a man named Daniel Prude was brought to the intensive care unit after an incident which included being restrained by police.

阿琼并没有治疗这名男子，但后来他听说了他，以及他的尸检报告将‘兴奋性谵妄综合征’列为死因。

Arjun didn't treat the man, but later he heard about him and about how his autopsy had listed excited delirium syndrome as a cause of death.

阿琼说，他向一些教授询问过此事，但他们都没听说过兴奋性谵妄综合征。

Arjun says he asked some of his professors about it, but none of them had heard about excited delirium syndrome.

像美国医学会、美国精神病学会和世界卫生组织这样的机构都不承认这种病症。

Groups like the American Medical Association, the American Psychiatric Association, and the WHO didn't recognize it.

于是阿琼开始自己做研究。

So Arjun started doing his own research.

他就像普通人一样，先从谷歌开始搜索，最先出现的都是大量警察培训材料、全国各地警察部门的手册，以及YouTube上用于培训的视频。

Well, he just started with Google, like everyone does, and the first things that came up were a lot of police training material, manuals from police departments across the country, videos about it on YouTube for training purposes.

阿琼说，他找到的培训材料几乎都提到了超常力量以及如何应对它。

Arjun says the training materials he found almost always mentioned superhuman strength and how to deal with it.

患有兴奋性谵妄的人无法通过常规的言语缓和技巧来控制。

Somebody with excited delirium can't be taken down with the normal de escalation techniques of verbal cues.

他们说需要多名警员。

They say they need many officers.

他们说需要多次电击。

They say that they need many electroshocks.

一家名为纽约聚焦的新闻机构获得了罗切斯特警察局2016年制作的关于兴奋性谵妄的培训材料，并发现其中大量内容似乎源自由泰瑟公司律师创办的‘监禁中死亡预防研究所’发布的一张海报。

A news organization called New York Focus got access to Rochester Police training materials on excited delirium created in 2016 and found that a lot of it appeared to come from a poster published by the Institute for the Prevention of In Custody Deaths, the organization that had been started by a lawyer at Taser.

这张海报提供了如何制服兴奋性谵妄患者的建议。

The poster had advice on how to capture someone with excited delirium.

引述：泰瑟电击设备已被证明是迅速制服这一类人员最有效的方法。

Quote, Taser electronic control devices have been shown to be the most effective for quickly capturing this category of individuals.

在一次警察培训演示中，有几张幻灯片列出了需要警惕的行为表现。

In a police training presentation, a couple of slides had a list of behaviors to look out for.

其中包括幻觉、无端的恐惧或恐慌、怪异行为，以及‘我说不上来气’。

They included hallucinations and unfounded fear or panic, bizarre behavior, and, quote, saying I can't breathe.

这些幻灯片还配了图片，比如一张脸上沾满血迹的赤裸僵尸照片、一张浩克的照片，以及演员兼喜剧演员乔丹·皮尔满脸汗水的照片。

The slides included photos, like one of a naked zombie with blood on its face, one of the Incredible Hulk, and one of the actor and comedian, Jordan Peele, with sweat running down his face.

这张幻灯片解释了兴奋性谵妄的四个阶段。

The slide explains the four stages of excited delirium.

第一，体温升高。

One, elevated body temperature.

第二，躁动不安。

Two, agitation.

第三，呼吸停止。

Three, respiratory arrest.

第四，死亡。

Four, death.

其中一个观点是，所谓兴奋性谵妄患者对疼痛的感知会降低。

One of the ideas is that people with excited delirium, quote unquote, have reduced pain perception.

他们引用了这些人砸碎玻璃、承受多次电击的例子。

And they cite instances of them smashing glass and withstanding multiple electroshocks.

在这一描述中，使用了大量带有强烈倾向性的术语。

In that description are all these very loaded terms

带有

with

所有这些负面标签，比如怪物、类似动物的行为和超强力量。

all this baggage, like monster and and animal like behavior and extreme strength.

我认为这触及了种族刻板印象，因为这些案例 overwhelmingly 是黑人男性，年轻的黑人男性。

And I think that plays on racial stereotypes because overwhelmingly, these are black men, young black men.

第二个角度是，关于疼痛感知差异的问题，在医学史上有着令人尴尬的悠久历史——长期以来，医生们相信非洲裔人群的疼痛感知不同，需要更少的麻醉剂，皮肤更厚，神经末梢更不敏感。

The second angle is that this question of differences in pain perception has an embarrassing legacy in medicine, A long legacy of of physicians believing that people of African descent have different pain perception, require less anesthetic, have literally thicker skin, have literally less sensitive nerve endings.

因此，许多极其残忍的手术、实验和截肢都是以这种说法为借口进行的。

So very gruesome things from surgery to experimentation to amputation were carried out under that guise.

我认为，我们在这套关于兴奋性谵妄患者疼痛反应减弱的叙事中，看到了这种历史的延续。

And I think that we see that legacy in this narrative of people with excited delirium having diminished pain response.

人权医师组织表示，黑人和有色人种的死亡被归因于兴奋性谵妄的比例严重偏高。

The organization Physicians for Human Rights says that the deaths of black people and people of color have disproportionately been attributed to excited delirium.

兴奋性谵妄也在乔治·弗洛伊德案中被提及。

Excited delirium also came up in George Floyd's case.

录像中有一名警察说：嘿。

There's an officer on the tape saying, hey.

我们认为他可能患有兴奋性谵妄。

We think maybe he has excited delirium.

在审判中，被控杀害乔治·弗洛伊德的德里克·肖万的辩护律师表示，肖万作为一名‘合理的警察’，一直在留意兴奋性谵妄的迹象，因为警察就是被这样训练的。

At trial, the defense attorney for Derek Chauvin, who is accused of killing George Floyd, said that Chauvin had been watching for signs of excited delirium as a, quote, reasonable police officer because that's what police were trained to do.

一名明尼阿波利斯警察作证说，她曾培训新警员如何识别这种综合征。

A Minneapolis police officer had testified that she trained new officers on how to recognize the syndrome.

检方传唤了一名医生作证。

The prosecution called a doctor to testify.

他说他认为兴奋性谵妄是真实存在的，但乔治·弗洛伊德并没有表现出任何症状。

He said that he believed excited delirium is real, but that George Floyd had none of the symptoms.

德里克·肖万被裁定犯有杀害乔治·弗洛伊德的罪行。

Derek Chauvin was convicted of killing George Floyd.

在乔治·弗洛伊德死亡，以及2019年和2020年其他几名有色人种男性在警察拘押期间 allegedly因兴奋性谵妄死亡之后，雷努表示，情况开始发生变化。

After George Floyd's death and the deaths of a number of other men of color who had died in police custody in 2019 and 2020, supposedly from excited delirium, Renu says things began to change.

我认为真正改变局面的是这些死亡事件的视频 footage，尤其是乔治·弗洛伊德的死亡。

I think what really changed the game was video footage of these deaths, and in particular, George Floyd's death.

我认为这促使很多人重新审视这个术语。

I think that caused a lot of people to take a look at this term.

它迫使许多原本支持这一术语的团体转而放弃它。

It forced a lot of groups that had been supportive of the term to turn away from it.

在压力下，美国急诊医师学院于2021年开始有所退缩。

And under pressure, the American College of Emergency Physicians in 2021, they started to backpill a little bit.

到了2023年，美国急诊医师学院撤回了2009年的白皮书，并表示我们错了。

And in 2023, the American College of Emergency Physicians retracted that 2009 white paper, and they said we got

我们错了。

it wrong.

Renu说，自那以后，全国各地的警察部门都已从培训材料中删除了‘兴奋性谵妄’这一术语。

Renu says police departments across the country have since removed the term excited delirium from their training materials.

但让我举个例子，说明仅仅禁止这个术语可能还不够。

But I'll give you an example of how just kind of banning the term may not be enough.

明尼阿波利斯《明星论坛报》报道，在明尼阿波利斯警察局的培训材料中，有一组PowerPoint幻灯片，上面的‘兴奋性谵妄’一词被划掉，并替换为‘伴有困惑和谵妄的严重躁动’这一术语。

So the Minneapolis Star Tribune, they reported that in training materials for the Minneapolis Police Department, there are these PowerPoint slides, and the words excited delirium were crossed out and replaced with the term severe agitation with confusion and delirium in parentheses.

所以，是的，这个概念只是换了个名字继续存在。

So, yeah, this concept that, you know, that exists just with a different name.

在关于‘兴奋性谵妄’的白皮书被撤销前六个月，安吉洛·昆托的家人曾试图更改他死亡证明上的死因。

Six months before the white paper on excited delirium was withdrawn, Angelo Quinto's family tried to have the cause of death on his death certificate changed.

在县法医与本·尼森鲍姆会面并同意窒息是导致安吉洛死亡的促成因素后，他的家人主张安吉洛的死亡应被定性为他杀。

After the county pathologist had sat down with Ben Nissenbaum and agreed that asphyxiation had been a contributing factor in Angelo's death, his family argued that Angelo's death should have been classified as a homicide.

他们没有成功。

They were not successful.

2021年，加利福尼亚州州长加文·纽森签署通过了八项新的改革法案。

In 2021, California governor Gavin Newsom signed eight new reform bills into law.

其中一项禁止可能导致窒息的约束手段。

One of them bans restraints that can cause asphyxiation.

2023年，加利福尼亚州成为全美首个禁止使用‘兴奋性谵妄’及相关术语（如过度活跃性谵妄和疲劳性躁狂）的州。

And in 2023, California became the first state to ban the term excited delirium as well as related terms, such as hyperactive delirium and exhaustive mania.

这改变了法医处理案件的方式。

What it's done is to change the way that the cases are resolved by coroners.

我认为这产生了实际影响，因为现在法医更常将约束行为列为死亡原因之一。

And we've seen that have a real effect, I think, because now much more we see that coroners are including the restraint as part of the cause of death.

2024年，安提奥克市议会宣布决定与昆托-柯林斯家族和解，赔偿750万美元。

In 2024, the Antioch City Council announced that they decided to settle with the Quinto Collins family for $7,500,000.

安吉洛于2020年12月26日去世后，他的家人保留了那年圣诞节为他准备的礼物。

After Angelo died on 12/26/2020, his family kept the presents they'd wrapped for him that Christmas.

他们从未打开过这些礼物。

They never opened them.

他的母亲卡桑德拉告诉我们，每年圣诞节，他们都会把安吉洛的礼物拿出来放在树下。

And his mother, Cassandra, told us that every year at Christmas, they bring out Angelo's presents and put them under the tree.

自安吉洛去世后，安提奥克市成立了一支新的非警察危机应对团队，专门处理涉及精神健康危机的求助电话。

Since Angelo's death, the city of Antioch launched a new non police crisis team that will respond to calls about people in a mental health crisis.

安吉洛去世后不久，当晚拨打911的妹妹贝拉告诉记者：‘我问侦探，那天我是不是该打另一个号码，他们告诉我没有其他号码，而我做得对。'

Shortly after Angelo died, his sister Bella, who had called 911 that night, told reporters, quote, I asked the detectives if there's another number I should have called, and they told me that there wasn't and that I did the right thing.

但做对的事并不会害死我哥哥。

But the right thing would not have killed my brother.

她说，现在有其他人可以联系了。

She said, now there's somebody else to call.

这个团队以安吉洛命名，叫做安吉洛·昆托社区响应团队。

It's named after Angelo, the Angelo Quinto community response team.

《犯罪》由劳伦·斯波尔和我共同创作。

Criminal is created by Lauren Spore and me.

娜迪亚·威尔逊是我们高级制片人。

Nadia Wilson is our senior producer.

凯蒂·毕晓普是我们监制。

Katie Bishop is our supervising producer.

我们的制片人包括苏珊娜·罗伯森、杰基·西西科、莉莉·克拉克、莉娜·西利森和梅根·卡南。

Our producers are Susanna Roberson, Jackie Cicicco, Lily Clark, Lena Sillison, and Megan Canane.

我们的节目由薇罗妮卡·西蒙内蒂混音和制作。

Our show is mixed and engineered by Veronica Simonetti.

朱莉恩·亚历山大为《犯罪》每一集创作原创插图。

Julienne Alexander makes original illustrations for each episode of criminal.

你可以在 thisiscriminal.com 上看到这些插图，也可以在 thisiscriminal.com/newsletter 订阅我们的通讯。

You can see them at thisiscriminal.com, and you can sign up for our newsletter at thisiscriminal.com/newsletter.

我们希望你能通过加入我们的会员计划《犯罪Plus》来支持我们的工作。

We hope you'll consider supporting our work by joining our membership program, Criminal Plus.

你可以无广告收听《犯罪》《这是爱》和《菲比读悬疑》。

You can listen to Criminal This Is Love, and Phoebe Reads a Mystery without any ads.

此外，你还能获得额外剧集。

Plus, you'll get bonus episodes.

这些是特别剧集，由我和《犯罪》联合创作者劳伦·斯波尔讨论各种话题，包括我们如何制作剧集、本周引起我们关注的犯罪故事，以及我们最近喜欢的东西。

These are special episodes with me and criminal co creator Lauren Spore talking about everything from how we make our episodes to the crime stories that caught our attention that week to things we've been enjoying lately.

要了解更多信息，请访问 patreon.com/criminal。

To learn more, go to patreon.com/criminal.

我们在 Facebook 上是 This Is Criminal，在 Instagram 和 TikTok 上是 Criminal_podcast。

We're on Facebook at This Is Criminal and Instagram and TikTok at Criminal underscore podcast.

我们也在YouTube上，网址是youtube.com/criminalpodcast。

We're also on YouTube at youtube.com/criminalpodcast.

《Criminal》是Vox Media播客网络的一部分。

Criminal is part of the Vox Media Podcast Network.

在podcast.voxmedia.com上发现更多精彩的节目。

Discover more great shows at podcast.voxmedia.com.

我是菲比·朱迪。

I'm Phoebe Judge.

这是《Criminal》。

This is Criminal.