A young woman stands in the freezing cold outside an urban Baltimore hospital. The woman, covered only by a thin hospital gown, moans incoherently at the man capturing her suffering on cellphone video. As seen on the now-viral video, she’d been left there by security personnel employed by the supposed place of healing just a few yards away. It hurts to watch.

Mass media outlets are appalled. Where‘s the empathy? Another failure of our “broken healthcare system” and a screaming example of inequality on every level (she’s poor, female, African-American, and mentally ill). Case closed in the court of public opinion.

But those of us on the front lines working in our nation’s safety net hospitals don’t get to talk about the details of cases like this due to patient privacy laws. So let’s speak using the hypothetical “what if?”

What if the staff of this inner city hospital in a heavily impoverished area with a high crime rate, high drug abuse rate, high mental illness rate, and high rate of homelessness needed to deal with “frequent fliers” (patients who repeatedly use hospitals to satisfy basic needs for food, shelter, medicine, or other attention) on a daily basis?

What if many of patients at this institution had long complicated psychiatric and social histories, and as such are well known to multiple hospitals in the area?

What if this poor woman had suffered since childhood with mental illness and developmental delay, making it nearly impossible for her to function in society without help? What if there were a history of belligerence and violence towards healthcare staff and nonadherence with care plans, either for admission to the hospital or discharge to cold shelters? What if the ER, already quite busy trying to handle numerous other emergencies, determined she did not meet criteria to be admitted?

A lot of armchair psychiatrists are screaming, “It’s clear this woman should be in the hospital. She’s crazy and not competent to care for herself,” forgetting that mental status can wax and wane very quickly, and while being evaluated one’s competency is judged during a discrete time period by professionals (as opposed to a few minutes of cellphone video taken on the street). What if it’s also against the law to hold a patient against their will unless they demonstrate during the evaluation period that they are a danger to themselves or others?

What if this woman did not meet those criteria during evaluation, was offered a transfer to a shelter and refused, had burned her bridges at other shelters, and burned her bridges with family and friends?

What if there was violence on the part of the patient, with altercations and refusal to follow commands in the hospital after discharge, ultimately leading to an escort by multiple security personnel due to the strength and potential danger she posed to the staff? Let’s hypothetically imagine that this is what happened. Should she have been thrown out into the cold in nothing but a gown?

What if we added another “what if”…

What if she was given all her clothes and told to dress but refused to do so. What would you say then? Would you say, “Could it be her mental illness? Or could it be that she made a choice? Could it be that the security guards made a mistake, having dealt with so much belligerence and so many difficult patients?”

We don’t know. But here’s something that isn’t hypothetical: this case is a picture of disaster from start to finish in a city struggling with poverty, with difficult race relations, with inequity, with mental illness, with homelessness, with substance abuse. We shoulder our institutions of healthcare with the burden of solving the upstream societal problems that our pathetic, short-sighted political leaders have lacked the courage and human decency to address. We medicalize our social problems in the US, and then scream accusations at our frontline healthcare workers who are tasked with doing the impossible despite burnout, physical risk, daily humiliation and constant devaluation.

We look to our hospitals, to our doctors, to our nurses, to our respiratory therapists, to our social workers, to our psychiatrists, to our case managers, to our discharge planners, to solve the problems that we’ve been collectively too craven to solve ourselves. Then when a tragedy like this is documented on video (and this is just the tip of the iceberg), we ignore our failure to manage the root cause of the problem, instead pointing at the nearest scapegoat. People are outraged at the emergency department. Yeah, you should be outraged. You should be mad at the emergency department for failing in the face of impossible odds. But you should be furious at the larger system that failed this woman and hundreds of thousands of others like her who suffer daily.

What if we as a society addressed the upstream causes of homelessness, poverty, inequality, and chronic disease? What if we funded mental health care and provided safe housing and support for those in need? What if we shifted some of the 3 trillion dollars now wasted on ineffective healthcare towards that very end?

What if?

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Zubin Damania:                   Hey, Z-Pac. It’s your boy, ZDoggMD. Check it out. I’m live and direct from Z-office today, and I want to talk about a story that’s been going around the news all over the place. Multiple, multiple, multiple people have sent this to me over the last couple days. I watched this video of this young woman being discharged forcibly, it appeared, from the University of Maryland Midtown campus in Baltimore in what appears to be in the nighttime in very cold temperatures, and a bystander who happened to be a psychotherapist in town videotaped the proceedings. What you see in the video is a young African-American woman in a hospital gown shuffling around confused, disoriented, moaning, clearly she’s not dressed for the weather. There were, I think, three or so security guards, I didn’t count them exactly, but several security guards that dropped her off and then walked away and had an interaction with the gentleman filming and walked back in.

Zubin Damania:                   This clip has since gone viral. It’s pretty clear to understand why it might go viral. What you see on this video is a side of a story where you see a young black woman who’s clearly mentally ill, who’s clearly doesn’t have the capacity to be out on the street, in freezing cold temperatures in a hospital gown, sent away from a hospital, which is supposed to be a place of protection and healing and safety. Right? The whole time there’s editorial going on on the video, and it appears that security personnel have escorted this woman out and left her there on the street in this gown. Now, when we see a video like this, my first reaction, I think many people’s first reaction unless you’re, frankly, unless you know something else or you’re a racist or you’re just heartless, is, you see this, and you employ something we like to call empathy. You put yourself in this woman’s shoes and immediately feel the suffering of being put out on the street in freezing cold temperature.

Zubin Damania:                   The response is pain, outrage, indignation, anger. All of these emotions will be your first draft for most people, especially, but not limited to, non-medical people. Patients, laypeople will see this and will be furious. Honestly, it is 100% appropriate. When I saw this video, I was so angry that this could happen, and I thought, I’ve seen these cases of patient dumping where patients are dumped out on the street. We call it, in the hospital world, we call it dispo to street. Disposition to street. We send them out of the hospital to the street, because they don’t have a place to live, they don’t have followup, they don’t want followup, whatever it is. Not our problem anymore. That does occur, but in this case, someone who’s clearly mentally ill in freezing cold temperature, of course, has provoked national outrage.

Zubin Damania:                   Multiple news outlets have reported on this, and it is almost exclusively a story of, what are these evil devils at the University of Maryland Midtown campus, which used to be, apparently, Maryland General, but was acquired by University of Maryland in sort of a satellite campus. Mostly outpatient focus, from what I understand from people who have told me. Now, this is a normal human reaction, and this is why the press loves these stories. This is why these stories move action, and this is why people keep talking about empathy as a driver of action. Here’s a question. Is it a driver of good action versus compassion which is love in the face of all suffering? Let’s unpack this story. I’m in a unique position, Z-Pac, thanks to you. We have a tribe here where if something like this happens, I can put out an APB in the morning, which I did, I said, “Guys, in Maryland, tell me what’s really going on here. Give me all sides of this story. I want to hear what’s up, because the press is only going to give us X.”

Zubin Damania:                   The big tragedy of these cases is that healthcare professionals cannot tell their story openly because of HIPAA, because of patient privacy, which is very appropriate, but they cannot say, “Well, this is what happened,” and so as a result, you’re going to get only one side of the story, the story told by the video clip. Do you guys remember the Peter Gallogly case where the young woman was yelling, was yelled at by Dr. Gallogly, who was an emergent care doctor in Florida, and it looked very clear that he was being a jerk and was kicking her out? It then came out later through the police report, which was not a violation of HIPAA, it was a police report, what had actually happened that there was belligerence on the patient’s part, that they had pushed the staff, etc. Didn’t excuse anything, but it changed the context of the story. What’s going on here? Well, I have this unique position of having this tribe of people who work in healthcare.

Zubin Damania:                   I put out a call this morning, “Say, fill me out on the details in a broad sense. We’re not going to violate HIPAA. You just tell me what might be some of the backstory here that might help me, and we’re going to be respectful. The patient’s, I’m not using the patient’s name. I’m not showing her image. The patient’s mother has gone to the press and has already talked about some of this stuff from her angle.” Now, what I, now let’s imagine this. What we see is a woman thrown out on the street, abandoned in freezing cold temperature in a complete failure of compassion. That’s what we see on the tape if you just look at the tape. Now, what could we imagine, and I’m just going to pretend that I might know stuff from people who’ve been on nearby locations to this event? What if this was an inner city hospital in an incredibly impoverished area of Baltimore with a high crime rate, a high drug abuse rate, a high mental illness rate, a high homeless rate?

Zubin Damania:                   What if these hospital staff on a daily basis deal with quote-unquote “frequent fliers,” who are patients who are constantly in and out of the emergency department, who are known to multiple hospitals? What if people from multiple hospitals kind of could fill in some blanks on that, and you could start to get a picture of the potential that our patients at this hospital have long, complicated psychiatric histories, are well known to all the hospitals in the area and transport staff? What if we found out that this poor lady had suffered since she was a child with mental illness, developmental delay, and other things that would make it very hard for her to function in society? What if there was a history of belligerence and violence towards healthcare staff and nonadherence to plans, either for admission or discharge? What if the ER was already quite busy and trying to handle other emergencies, and what if, in this state, this patient refused, say, a transport voucher to a cold shelter or other sort of followup, and what if she did not meet criteria to actually be admitted as an inpatient?

Zubin Damania:                   There are a lot of armchair psychiatrists out there in the comments in particular, in the lay press, that are saying, “it’s clear this woman should be in the hospital. She’s crazy and not competent,” but you have to understand, these things wax and wane very quickly, and when you’re being evaluated, your competency is judged by professionals as to whether you are holdable on a psychiatric hold. It is against the law to hold a patient against their will unless they qualify for a psychiatric hold, and they’re a danger to themselves, a danger to others, they’re gravely disabled. What if this woman did not meet those criteria, was offered a transfer to a shelter, had maybe in theory burned her bridges at other shelters, burned her bridges with her family, who did not want to take her home, and therefore had washed their hands temporarily of her, did not know where she was?

Zubin Damania:                   What if all of this then led to violence on the part of the patient, where there were altercations and inability to follow commands in the actual unit, ultimately leading to a discharge that ended up having to be escorted by multiple security due to the strength and potential danger that this patient posed to the staff? Let’s just hypothetically imagine that this is what had happened. Does this make her being thrown out into the cold in a gown correct? Most people would still say no. Now, what if I added a piece of information? She was given all her clothes and told to dress and refused to do so. What would you say then? Would you say, “Could it be her mental illness, could it be that she made a choice?” We don’t know.

Zubin Damania:                   My point is, now she’s on the street being videotaped. We’re seeing a segment of a story. The other part of the story cannot be told except by me here, because I’m hypotheticalizing, and what if, then, we paint a picture of a disaster from start to finish in a city that is struggling with poverty, with difficult race relations, with inequity, with mental illness, with homelessness, with substance abuse, and what if we throw into the mix the fact that our institutions of healthcare have been shouldered with the burden of taking care of all of society’s problems that our pathetic, useless leaders in Washington, both on a state and a federal level, have not had the courage or the human decency to actually address on a global setting?

Zubin Damania:                   And what happens? They look to our hospitals, to our doctors, to our nurses, to our respiratory therapists, to our social workers, to our psychiatrists, to our case managers, to our discharge planners, to solve the problems that they are too much of cowards, that they are too craven to solve themselves. Then when something like this happens, which is the inevitable outcome of a failure to manage the root cause of the problem, which is mental illness, substance abuse, poverty, injustice, all those things that are now foisted on the people who work in that emergency department, and when something like this happens, what happens? People are outraged at the emergency department. Yeah, you should be outraged. You should be mad at the emergency department. You should be mad at the system that failed this woman and hundreds of thousands of others like her who suffer in our broken non-system.

Zubin Damania:                   Who has abrogated their duty to manage all of this? It’s our leaders, yes, but you know what? I’m going to be honest. It’s all of us. It’s those of us on the front lines. If we don’t stand up and make noise about this without pointing the finger, “Oh, the administrators who run the hospital,” and they apologize because they know this is a PR disaster. I’ve heard from people who know this hospital and they know the struggles that they go through, and there’s pro and con as to how good they are at managing them, but nobody denies that they care about the patients, that they’re overwhelmed, that they’re underfunded, and that they’re in what is effectively a demilitarized zone trying to solve societal issues on a daily basis with minimal resources when people who actually need a hospital bed right then are being displaced by people who are doing what they are incentivized to do, which is try to get shelter or try to get admitted by saying they’re suicidal.

Zubin Damania:                   This is the real outrage behind this story, and this is what nobody is talking about except for frontline healthcare providers, except for people suffering from mental illness. The peanut gallery, the mob, they want to jump on this. The guy who filmed it, he, it turns out he’s kind of an activist for this sort of thing, so it’s great to raise awareness, but it’s not about the heartlessness of the hospital, how he’s spinning it in the press. It’s about the heartlessness of a non-system that allows this to happen. Now, let me read two comments here that particularly stuck with me from people on the ground there. Now, one is from Emm Jater, who I think is a pseudonym. He’s a psychiatrist in Baltimore. Private messaged me and then put a public message out that got 689 likes on the thread that we started. Then the other one is from our zdoggmd.com/forums, where people can create anonymous profiles and leave messages without fear of retribution. We got a bunch of those.

Zubin Damania:                   Here’s what Emm says. “This is Baltimore, Maryland. This hospital is one of the poorest neighborhoods, and many use the ED like a homeless or detox center. The donations are few, and they get tapped very quickly. The homeless know that if they say they’re suicidal or have chest pain, the hospital can’t discharge them. About 60% of suicidal patients aren’t suicidal but need a place to stay because they’re hungry and they’re positive or withdrawing from cocaine, heroin, alcohol. That being said, of course, the patients who really need what a hospital can offer get squeezed out by those who were inappropriately using the ED. If you’ve never worked in an inner city ED, you have absolutely no idea how few resources are available and how no one funds the place. If you’ve never worked … On the contrary, Maryland hospitals have what’s called a ‘global budget,’ so if this lady is admitted within the last 30 days, and the hospital is financially penalized then for readmission. Yes, the state incentivizes hospitals not to readmit patients.” My daughter playing violin over there.

Zubin Damania:                   “Now, no idea if any of this applies to her case, but imagine working there under these conditions. Fund mental health. All this faux outrage about the opioid epidemic and bad mental health outcomes is meaningless unless we get more funding to open beds, provide shelter, treatment, and counseling,” for what I think is a disease. Right? “Bashing this medical center is scapegoating instead of addressing the real problem in our health care system.” Amen, Emm Jeter. That, that, and that’s from someone who works in that system. Here’s another one. TraumaTasha on the forum. This is what TraumaTasha writes. “I’ve worked in an East Coast inner-city level one trauma center. It’s tough. The situation is tough. Unfortunately, we will never hear the other side of the story.” Absolutely true. Right? Because we can’t tell that story, because of HIPAA and because of professionalism. Right? That’s why I’m trying to tell it in a roundabout way. All right?

Zubin Damania:                   “We do not know what led up to this lady’s discharge. Could it have been a ruthless discharge? Possibly, but I doubt it. For those who truly believe this is the case, please spend the day in an inner city ER and help the nurses solve the world’s problems. It is harder than you think. Some patients have burned all their bridges with family, have been kicked out of every shelter, or even more likely, the shelter has no room. What is an ER to do when their 90 beds are full, plus 20 patients on carts in the hallway, which by the way … ” That’s Vegas. That’s Vegas. All right? It’s all mental illness in the hallways. They’re all being boarded, because we have no place to send them. This is the U.S., people. This is the apex of the civilized world, and this is the best we can do for our own people, for our own society? I’m going to keep reading this.

Zubin Damania:                   “Sometimes patients can’t stay until morning just because it’s cold. Tell me how they should have let her stay in the lobby. For all we know, they did, and she abused the opportunity. Tell me how they should have gotten her dressed first. For all we know, they tried, and she became abusive and started accusing them of assaulting her. Tell me how there are always resources for these situations. I promise you there are not.” This is the true outrage of what happened in Baltimore, and now we have some comments. Melissa [Jensen 00:16:50], “Thanks for speaking up for medical professionals who can’t speak up for themselves.”

Zubin Damania:                   Melissa, this happened with the Charlie Gard incident in Great Britain. It happened with the Peter Gallogly incident. It happened in Delnor with the nurse who was taken hostage and raped, and what does the press say? “Nurse unharmed.” This is how they treat the people who take care of all of us, and you know what? We also have stepped back in a kind of inertia where we’re willing to accept this powerlessness. We have a massive voice, and this platform is only a tiny piece of that. Could you imagine just this little platform, we have 2,000 live people watching right now? We have thousands of comments.

Zubin Damania:                   We reach into every, the press comes to me after this and wants to interview me, and I tell them to F off, because I know they’re going to edit it in a way that isn’t going to be useful to get the story out, but each and every one of us has a voice. Each and every one of us can step up and be a part of this solution instead of pointing the finger where the problem isn’t. That’s not the problem. The problem is all of this, and it’s also the failure of our leadership to address it. We have a failure of leadership in this country across the aisle. Democrats, Republicans, Libertarians, I don’t care who you are. You suck at fixing these problems that are not intractable. We can actually make them better.

Zubin Damania:                   All right, let’s read a couple more comments. #SilentNoMore, [DD 00:18:10]. Absolutely, and this is a “Silent No More” case. If there was abusiveness in the hospital requiring security, right? Just got off work in the biggest EMS system in Florida. Narcan. The same guy twice this week, full ALS workup. Says Michael [Poicard 00:18:29]. People don’t want to help themselves. This is part of it, Michael, but I still subscribe to the disease model. Like this poor lady, if you look at her, just let’s forget empathy for a second. Empathy is feeling someone else’s pain. You don’t want to feel this Baltimore patient’s pain. You don’t want to feel Rebecca’s pain. That’s what her mom publicly said her name, her first name, is. You don’t want to feel Rebecca’s pain, because it will cripple you, it will destroy you, and it will make you make stupid decisions and rash short-term decisions like blaming the hospital for this problem.

Zubin Damania:                   The hospital shares culpability, but if you have compassion, which is the desire to show love, unequivocal love in the face of human suffering across the board, it is a bigger love, it is a bigger, wiser response to suffering. You don’t take it as your own, but you see it. You know it’s there. It’s a kind of cognitive empathy. You understand that this woman was probably abused as a child, that suffered in a difficult situation in a hard part of the country to grow up, and if there was racial bias and other inequity there, that adds another element to it, and you throw it all into mental illness, and what do you have? You have incredible human suffering, someone who is on the street in Baltimore in the winter, and it’s 30 degrees outside, and she’s standing in a patient gown because she refused to dress and became abusive with the staff, theoretically. Can you imagine the suffering?

Zubin Damania:                   Forget about her decisions and her capacity. Can you imagine the human suffering? Now, multiply that by 100,000, and that is the mental health crisis in this country. If we sit down, if we don’t do something and make a voice about it and stop blaming and switch to compassion and love, try to figure out how to solve these problems on a grand scale, we are complicit. All right, Z-Pac. My daughter’s going hardcore on the violin, so I’m going to end with a call to action. Hit “Share” on this. Send this to people who shared the Baltimore clip with you and tell them, “Just watch it. It’s just a few minutes. It’s from a doctor who’s talked to other doctors and other nurses and people on the front lines, and get both sides of the story so we can do something to actually make this better for all of us, especially those who are suffering, suffering, suffering the most.”

Zubin Damania:                   Come to the forum. Make your voice heard, zdoggmd.com/forum. Get people to follow this page, and I’m going to end with a quick, we do these little Facebook Ads. That helps fund the show. It’s targeted to you. If you don’t want to watch it, check out now. If you do, if you just sit through for another 15 seconds, it really helps our show. I love you guys. Stay safe, and we out. Thank you, Z-Pac. I love you. We out.


55 Responses to “The Hard Truth Behind That Baltimore Patient Dumping Video”

  1. Lea Lane

    I disagree with this. It doesn’t matter if she was abusive. Throwing her out in freezing weather in nothing but a hospital gown endangered her life.

    • Proseh

      Would it matter if she was abisive to you or one of your loved ones? Maybe a daughter, or your mother, or sister? It’s so easy to say it doesn’t matter when you’re not the one in the situation.

  2. Traci

    Thank you!


    All very good points ZDogg. Thanks for your viewpoint, once again.

  4. Stephen Vargas

    Thank you! As a hospital social worker I have been involved in more than my share of these discharges. I have always wondered why people come to hospitals and expect all their problems to be solved.

  5. sharon sawyer

    Totally agree with you on this. I work at a psychiatric facility and we are faced with these issues every day! Patients will say they are suicidal or coming off of drugs and just want somewhere to stay, eat and detox. Then they are right back out on the street using. Their families have given up on them, they are homeless and have nowhere else to go. They lie and say they are suicidal to get a couple week stay until their next disability check comes in and then they are demanding to be discharged. Even though our treatment managers work diligently for them, each and every time they are admitted, to find them shelter or a boarding home, they get kicked out and burn all the bridges and our hospital is the only place left for them to stay. And it is true, they become verbally and even physically abusive at times. They know they are protected within the confines of a “psychiatric facility” and will most likely not be arrested for their criminal behavior, where they would be arrested and taken to jail if outside on the street treating other people the same. I have had patients who refused to change their clothes and want to discharge in the paper scrubs we give them. I can understand how this can happen with any medical/psychiatric facility.

  6. Sheila Hoover, RN

    Well said

  7. Shirley Dodson

    My son is a dermatologist and I follow medical groups.

  8. Shirley Dodson

    Son is Derm. Dr.

  9. ARespiratoryTherapist

    This brought me to tears. These cases are heartbreaking. My heart goes out to everyone involved.

  10. George Ledyard

    We live in a system that is classicist and by extension racist. We can afford massive tax breaks for the already wealthy but we can’t afford to care for our poor. Thanks for providing such a concise and brilliant summation of what the problems are for health care providers operating in our impoverished areas.

  11. Linda

    Totally agree…my first thought was frequent flyer, no family, refuse recommendations. It even happens in suburban hospitals

  12. Beth

    Thank you, Thank you, Thank you I work in Cecil County Maryland, same Maryland healthcare rules very little support for patients with mental disease, substance abuse. These patients are high risk for head and neck cancers. Because we are a small community hospital we do not receive endowments like large cancer centers. I have my own fundraisers to help support the best I can. Our healthcare is a mess, but better than it was 10 years ago. How can we as a nation not care ? Thank you for all you do.

  13. Greg Kramp, Pharmacist

    What do you think: is it time to invite your representative to the ER on a full moon on a weekend?

  14. Greg Kramp, Pharmacist

    You make a pretty good argument for healthcare providers being more involved in politics. Who are some groups or politicians that are doing a good job of representing healthcare providers? #ZDogg2020

  15. Seen the Real Deal

    You are right. Been THERE; done that. The patient should have been given multiple blankets. The backstory is more complicated than a picture. Washington looks to US to solve their problems. The SYSTEM FAILS every DAY!!! Speak the truth!!!

  16. Ramona

    Thank you for this. We are not allowed to defend ourselves in the face of violence (we don’t get to punch back) and we can’t defend ourselves verbally to those uninvolved because of HIPAA. Sometimes the police ask if you want to press charges, but what’s the point? Most of the patients that are violent with us wouldn’t be deemed competent to stand trial for it. I love my patients and they’re why I get up and go to work every day, but sometimes all we get in return is violence and disdain. We take care of so many patients that have needs that don’t really require a hospital that it impairs our ability to have adequate staff and resources for the serious patients. I’ve had patients that come in repeatedly saying they’re suicidal because they’re lonely and they know they will have a 1:1 sitter to talk to if they say they’re suicidal. When the temperatures drop, we get a lot of chest pain and non-descript abdominal pain – homeless people have nowhere else to go and they know they can at least get a sandwich and a drink and warm up in the ER for a couple hours while we run labs on them. Detox and drug seeking are ever-present. There are few options for a lot of these people and they don’t have the support they need to actually resolve any of this, so we’re stuck in this limbo of staying alive repeat ER visits.

    Tacoma, WA

  17. valleyg

    You are a liar! this happened to me in Tacoma Washington and I have a terminal illness! so dont tell lies! You are making excuses. What if she this what if she that. You are just a typical medical head trying to cover the arse of a medical facility that horribly violated her rights and her as a human being. You idiot! A lot of people who are ill are well known by different hospitals because they are trying to find a good one! So stop making excuses! shame on you! Your point is dull

  18. W Sumner Davis

    ZDOGG. We have become a society that makes snap judgements based on 5 second soundbites. Everyone passes judgement, no one has suggestions or solutions.

  19. CGJam

    Its so unfair to leave her in such a manner in the cold especially because of her mental status. She is unfit to make rational decisions for her own safety and this was how her caregivers treat her? What does that say about us? So much red tape that her safety was jeopardized because the staff was overwhelmed? Its disgusting.

  20. Larry

    So what happened to the woman after she was filmed at the bus stop?

    It does not matter if she refused to get dressed. They should have dressed her against her will before they put her outside to die from Hypothermia.

    I thought Obama Care was supposed to fix this sort of thing. We are still stuck with this scheme to get Single payer health care. And BTW…it is the Democrats who are to blame for many of these people problems. They don’t care what their polices do to humans as long as they vote Democratic. I know Z is a bleeding heart liberal. I’m a conservative and I don’t care if we have single payer health care except that is is usually horrible health care. Ask any person who had to live under socialized medicine and then came to America.

    • proseh

      Would it matter if she was abisive to you or one of your loved ones? Maybe a daughter, or your mother, or sister? It’s so easy to say it doesn’t matter when you’re not the one in the situation.

      • Proseh

        The above commment was meant as a response to an earlier comment. Not sure why it’s here under this one comment.

      • Deborah Haber

        Forcibly putting hands on someone, even if it is in her best interest, is assault and illegal! If the facility did not have grounds to make her an involuntary patient, then there is not much they can do. By the way, this had nothing to do with Obama care.

    • Proseh

      So how do you suggest they go about dressing her against her will? Sedate her enough to get her dressed? Try to fight with her until they overpower her (How many people do you think that would take? Do you think anyone might get injured in that type of scuffle? How long after the sedation takes to wear off should they wait to put her out after they get her dressed- against her will, before they kick her out, properly dressed, on the street? Because they couldn’t if they sedated her to get her dressed since she’d end up laying there, properly dressed, in the freezing cold and probably freeze to death, anyways. Never mind all that though. Her rights overpower all the other patients and all the staff who would have to fight with and deal with her antics because she chose to act like a hethean.

  21. Kellie Thorne

    To me, an armchair psychologist, her refusing to dress herself is evidence of her admissibility to the psych ward. That’s the definition of “eminent harm to self” not to dress in the face of freezing temperatures!

    • Kellie Thorne

      Ooops! Of course, I meant IMMINENT harm to self, duh! Not enough coffee when I’d posted. 😛

  22. Lawtown

    AMEN and thank you…..

  23. Higgins,RN

    You are on point!

  24. Deborah Haber

    Mental health parity did a lot of good when the facilities that could take care of these patients were closed. Iowa and Illinois each had 4 state facilities and each state closed 2 of them. You are also right about patients who burned their bridges. Patients with a history of violence toward staff may stay in acute care hospitals for months before they can be placed!

  25. Sue Steel

    I agree..it is such a shame that the media only shows one side of the story. Showing the hospital, and those that work there in such a poor light only serves to widen the divide of problems that already exist.

  26. Jonathan Lloyd

    Nicely stated. Let’s get at the root of the problem, and throw our outrage at the awful system in this country. We all should be ashamed of how our country treats people.

  27. Mary Suggs

    Please tell me how Medicare for all will be paid for.. I agree we need it. What do I tell opponents of it.

  28. Jill

    You’re right – it takes a multi-disciplined, multi-pronged approach in order to stop these small tragedies, these slipped stitches in these hard lives the most disadvantaged patient population live. Until others help fill in the potholes hospitals will keep experiencing monetary penalties or burnout. (CMS and the OIG are so busy counting beans that the real world is passing them by)

  29. colleen

    My personal pet peeve, documented mentally ill are treated while in prison and then released to the street with no meds till they can on their own unmedicated means seek community mental health care where it takes about 3 months to get on meds. Appointment one intake . Appointment two mental health eval. Appointment 3 finally with someone who can prescribe ,meds. Where do they end up In the ED, and often within the 3 months the untreated violated their parole and go back to prison. Societal outrage should be the response here. The cost of giving a released mentally ill person a reasonable amt of meds and ensuring their scheduled f/u in the community could save billions. What a concept.

  30. Barbara

    I am a healthcare professional and I have worked in the ER and the ICU as well as home care.
    1) she has a head injury; where did this injury occur?
    2) she needed to be kept for neurological assessment and evaluation. She appears to have cognitive alterations; she cannot speak.
    3) she is a danger to herself and others and needs to be confined.
    4) she has a bandage on her right hand which is usually to shore up a an intravenous site.
    5) the healthcare people have a duty to protect and care for the patient once she is in the facility.
    6) the situation is one of patient abandonment and the healthcare personnel are responsible. It can be a torte law case.

  31. Mike Yestramski

    I did work, as a social worker, in a Baltimore City ED for 5 years. Not at MD General, but same city and same issues. I also was responsible for psych evals and deciding about detaining or not. Even our FF, our malingerers, our BPD people, our addicts, etc. would not have been treated this way. Yes, there is a greater systematic problem, but UMMC still bears the responsibility. Prior to UMD taking them over, this type of thing was well known to take place at MD General (and a few other area hospitals). So, I agree we don’t know the whole story, but I can guarantee I would’ve never discharged someone in that condition. She clearly met COMAR regs for involuntary detention.

  32. Correctional RN

    Amen, Amen.
    I am a RN Charge Nurse in a medium security prison, I see everyday inmates that are in the correctional setting because of drug abuse, being homeless and not getting the help they need on the outside. The war on drugs has placed people in prison, but did not offer assistance on the outside. The mental hospitals nation wide, have closed yet did not give the patients the means to survive.
    Our country has sent men and women off to war, yet not provided them with adequate mental health treatment, leading to drug addiction which leads to homelessness, committing crimes, etc.
    I am not justifying any crime being committed, I work with some very dangerous criminals, our chronic mental health pod is full of men who should have never been let out of the state mental hospital, yet they were and then went on to murder, rape and commit other crimes.
    Something in our nation needs to change, and I am ready to help fight the fight.
    Keep the videos coming, hopefully someone will listen and take notice.

    • Proseh

      I agree. I didn’t work at a prison. My husband did/does. He’s s CO and has told me about countless inmates who have no business in a prison cell. Besides the point of them being incarcerated for being mentally ill,the COs and most of the other staff of prisons are not trained in any fashion to deal with mental health patients. The poor guys and girls who have hardened criminals to deal with then have the added stress of trying to handle inmates (should-be patients) who are way beyond their scope of training to be correctional staff. How do you ‘correct’ or rehabilitate the mentally ill, those who are so mentally ill they eat their own feces and such? This country definitely needs reliable mental health facilities back in place. Prisons are not the place for such patients. It’s unfair for the patients and the staff.

  33. Amy Kerr

    Thank you, from a caretaker of a seriously mentally ill person, mother and advocate. Spot on! We ask you to help us but nuerological brain illness under the medical model, we ask you to help us get more beds, and treatment before tragedy. We ask you to help us advocate for assisted outpatient therapy, so thay we can help those suffering from Anosognagia, and prevent frequant flyers, jail and homelessness. Yes, please join us, far too long it has neen just the family members crying out abput this mental hell system. Far too long we sit eith our loved ones in ERs for fays before they get treated, while thier white matter in the brain is being destroyed. Far too long we wait for beds, support, treatment, and empathy. Please join us!

    • Amy Kerr

      Please reach out to Patrick Kennedy and his efforts to nationally change this awful gailing system today!

  34. Lynda McCarthy

    As a retired trauma center nurse from Detroit I can totally relate to this post. I believe the problem began when we became obsessed with violating someone’s civil rights. Up until that time patients could be admitted to a psych facility for many reasons besides homicidal/suicidal. Since that time the homeless problem has become out of control. So many of the homeless are psychiatric patients off their meds. The laws will never change because we live in a world where the individual has the right to decide their fate, So sad. On a side note, Hypothetically, if she was assaultive in the ER couldn’t the police be involved?

  35. Karen riches

    My son Jacob suffered from szrophrenia. And neurofibromatosis and cowdens disease. Went to an ER With chest pain. Made to wait 19 hrs. Hospital knew jacob. Had his records. He died on the floor that night. Yes the hospital was wrong but IT WAS HOW SOCIETY VIEWS THE MENTALLY ILL, the
    homeless, the poor is the real problem. Stigma keep led my son. Jake was with his group home and that didn’t even matter. It’s how the government and
    society don’t see them as a person. “THIS POPULATION IS BEST HIDDEN” as I was told by many. When jacob was alive I took him out in public all the
    time. Not if he was psychotic or very unstable. Yes he looked different and with his onset of szrophrenia acted different. Where we used to go people
    were scared first… but they learned. And even interacted with jake. I brought my boys up ( both are passed)
    people are basicly “STUPID”. We want
    to where the same styles, dance the
    latest dance, where the latest hair
    styles etc…… People need to learn and
    most will, when something or someone
    is different; people get scared. We are
    going to show them that you two
    “ROCK” and are just great people.
    People generally came around and
    we’re very good to MY boys ZDOGG.

  36. DJ Jaffe

    Thanks for your passion. Overall, I agree. But the tragedy in the hypothetical you have proposed might have been avoided if she was placed in Assisted Outpatient Treatment. It might have been avoided if, as a result of hypothetical violence, she had gone to mental health court. They hypothetical you propose could not really occur as the refusal to put on clothes outside would likely make someone in her condition meet the criteria for danger to self or others. And it might have been avoided with easier to meet civil commitment standards. And it might have been avoided if there were more hospital capacity. But you are right: ERs are part of the insane system. Also, there is one more group working to change this: criminal justice. As a result of mental health system failing to focus on SMI, SMI are being offloaded to police. DJ Jaffe, author of Insane Consequences: How the Mental Health Industry Failed the Mentally Ill. Also, there is one

  37. Amy Kerr

    Please reach out to Patrick Kennedy and his efforts to nationally change this awful failing system today!

  38. Mary Ann Renz

    I agree with what you have said. I am a mother of a son who developed paranoid schizophrenia at age 18 was in and out of state hospital for 13 years. In 1997 found right medication and never went back to state hospital and had a 11 year amazing remission. In September 2008 could not take medication any longer due to a blood condition that sometimes develops with the medication that can be fatal. In between medications he somehow got MRSA the deadly super bug and passed away at age 43 on 11/11/20/08. I advocate for a better mental illness system in America in his memory.

  39. Mary Ann Renz

    Thank You.

  40. Patricia Williams

    40 years of nursing. I have held a variety of positions but still LOVE bedside nursing. I am a dialysis nurse. I had a frequent flyer hit me once . I bypassed the ineffective standard procedure. I called the police and pressed charges. I let the administration at the facility know that what happened was a crime and that they were complicit. Administration is responsible for the behavior of staff and patients.

  41. Dawn Howell

    As a nurse in a busy ER this situation disheartens me and frustrates me beyond measure. There are always two sides to a story, yet so many are quick to judge and place blame. By all means, if this happened as depicted, the hospital should be held accountable. On the other hand, what about her actions and behaviors that may have led to her being in such a situation? People think hospitals have endless resources at their finger tips. The reality of the mental health situation intros country proves otherwise. Hospital ERs are for emergencies!!! use them accordingly. Being hungry and homeless is not a medical emergency, and faking symptoms to get inappropriate care and wasting resources is a burden to the healthcare system. If the homeless need out of the cold, by all means come in the waiting room and get warm or ask for a meal. Any nurse will gladly feed you and help you get warm. It’s called compassion for our fellow man, but I beg you, PLEASE PLEASE PLEASE do not abuse the resources just because it is there. Thank you for bringing the other side to light! The following is my response to a post of this video on another prominent celebrity’s page:

    It always amazes me how so many “outraged” people can show up to persecute when things like this are in the news. News flash….worse things than this happen to people every day! Where are you all when it’s time to vote on mental health levies or bills affecting your healthcare system? This is all of our faults! We live in a broken country…as long as we don’t see…we don’t care! How many of you would actually take someone in that showed up on your door step and needed help? Especially mental health help and homeless to boot? Not many of you I guarantee that! In the area I live in, mental health and homeless services are scarce. Many of the people who go to hospitals seeking these services spend days on end laying in an ER bed still not receiving what they ACTUALLY need! Who did this? We did! Nobody wants their taxes to be raised, but we want idealized care and help for all. Until we are the change we want to see then we shouldn’t be tearing apart anybody else for having to work within the mess WE created!

  42. kim

    What if that woman would have frozen to death or fallen asleep and been raped or killed . What if? No you got it wrong Zdogg this time. She was impaired period and unable to make decisions on her own. Even Security staff could see that.

  43. Sue

    Very good article! I was recently in the ER and in the 5 hours I was being treated, a woman, either suffering from dementia or high on something was screaming at nurses and doctors, not to touch her. Just when they got her calmed down, police brought in a big guy on something , carrying on with a stream of expletives. And that was a Saturday afternoon in the suburbs! God bless healthcare workers!

  44. Sue

    To All, this is a tragedy but if you think socialized medicine is the answer, think again. My friend grew up in England with the national health. If you think you’re waiting a long time to see a doctor, that’s nothing compared to the time you’ll wait if we switch to something like the British National Health. And the level of care will drop as well. She said you usually saw a nurse. And there is a waiting list. The older and sicker you are, the less care you receive because they can’t “waste” limited resources on you when there are younger, more viable people who need care. Hopefully you’ll die before they have to treat your heart disease, cancer, etc.. As far as this woman is concerned, she needs to be institutionalized for either mental illness, drug addiction , or both.

  45. Marge Galloway

    What if you are wrong? What if Baltimore changed its leadership, became a decent place to live and this still happened? That city is a slum. But, that not being the point, no matter how you look at it, that was wrong! If the situation warranted removing her, perhaps they could have put her in a cab, used the cash from some appropriate fund and sent her home. And there could be other options. Trash city aside that was a hospital shoving someone out in the cold. Where is the mercy in that? Put her in the psyche ward and see if she really does need help. Even if she was a screaming shrew, she shouldn’t have been thrown in he cold!

    • Noreen

      Put her in a cab to where? Use money from what fund? She is one of thousands a day that visit ERs. Admit to where? Psych units are busting at the seams with patients waiting days and sometimes weeks for a bed. Gov’t social workers are overloaded. Where was her family? She didn’t live them. This population is over looked and hidden which is disheartening. They can often times be very difficult to manage and potentially violent. You don’t know the whole story

  46. T H

    Medicalization of social issues is one of the reasons the ‘ED safety net’ is breaking down. It is worse in rural areas than in urban areas: even less availability of assets, personnel and money.