Arrested at Hospital for Demanding Medical Care, Woman Dies in Jail Cell

by Cara on March 29, 2012

in class and economics, disability, human rights, law enforcement, parenthood, patriarchy, race and racism, reproductive justice, violence against women and girls, women’s health

Anna Brown, a Black woman with a ponytail, looks at the cameraTrigger Warning for medical neglect and abuse, police abuse, and discussions of the child welfare system

The St. Louis Post-Dispatch reports:

Anna Brown wasn’t leaving the emergency room quietly.

She yelled from a wheelchair at St. Mary’s Health Center security personnel and Richmond Heights police officers that her legs hurt so badly she couldn’t stand.

She had already been to two other hospitals that week in September, complaining of leg pain after spraining her ankle.

This time, she refused to leave.

A police officer arrested Brown for trespassing. He wheeled her out in handcuffs after a doctor said she was healthy enough to be locked up.

Brown was 29. A mother who had lost custody of two children. Homeless. On Medicaid. And, an autopsy later revealed, dying from blood clots that started in her legs, then lodged in her lungs.

She told officers she couldn’t get out of the police car, so they dragged her by her arms into the station. They left her lying on the concrete floor of a jail cell, moaning and struggling to breathe. Just 15 minutes later, a jail worker found her cold to the touch.

Officers suspected Brown was using drugs. Autopsy results showed she had no drugs in her system.

Six months later, family members still wonder how Brown’s sprained ankle led to her death in police custody, and whether anyone — including themselves — is to blame.

The way the Post-Dispatch exploits family members’ personal sense of guilt that is a normal part of grieving, equating it with much larger forces, would have you believe that Anna Brown’s death was just a tragic accident. But the way Brown died was not the result of a few bad choices. It was the result of a myriad of institutional violences: white supremacy, the broken health care system, police brutality and the prison industrial complex, the racism and classism of the child welfare system, ableism and its intersection with racism, dehumanization and criminalization of (suspected) drug users, and the lack of housing as a human right, among others. Anna Brown did not die with the dignity we afford to human beings, but with the contempt we reserve for garbage. And a woman’s humanity is not just forgotten and cast aside with no systemic reason.

The institutional violence against Anna Brown began long before her death from an undiagnosed yet treatable condition, and her death can only be understood within the context of this long string of abuses.

Anna Brown was one of 10 children. She graduated from Kirkwood High School. At 18, she had her first child, a boy. She had a daughter nine years later. Brown was raising them alone when a tornado destroyed her north St. Louis home on New Year’s Eve 2010. She moved to Berkeley.

Shortly after, she lost her job at a sandwich shop. Bills lapsed. The electricity was turned off. So was the gas. And the water.

Family members say Brown and her children appeared fine during visits at Davis’ home in Normandy.

They weren’t.

In April, a state Children’s Division representative found Brown’s toilet filled with feces. Burn marks scarred the floors and sinks where Brown had used small fires to stay warm. One refrigerator could not be opened. Insects and rotting food filled another, according to state reports given to the Post-Dispatch by Brown’s family.

Brown was not lucid and seemed confused as Berkeley police arrested her for parental neglect. The courts awarded legal custody of the kids to the Children’s Division. Davis could have physical custody, as long as Brown didn’t live with her.

Brown’s home was condemned. She ended up on the streets. She lived in four homeless shelters from May to September 2011.

At first, she visited her children at her mother’s home. That ended in June, when Brown started telling the children they didn’t have to listen to their grandparents and called the police to report they were being abused. Police found no evidence of abuse.

After that, Brown had supervised visits with her children at the Children’s Division. She also called her mother daily to check on them.

Brown, who later started receiving treatment for mental illness, is just one of countless examples of the way that the child welfare system is an active agent of racism, classism, ableism, and sexism. Earlier assistance could have easily prevented the loss of necessary utilities like heat and water, could have kept food in the fridge, could have provided mental health services to Brown if needed, could have helped her care for her children. This crisis almost certainly could have been avoided.

But as Dorothy Roberts shows in her incredible and important book Shattered Bonds: The Color of Child Welfare, the system sees these means of assistance as undeserved, and either refuses to provide them or makes access to them overly burdensome. Indeed, the child welfare system, instead of acting to keep families healthy, works mainly as a means of social control of Black populations. While Native and Latino children are also generally overrepresented in the child welfare system, the overwhelming majority of children are Black — in some cities, virtually all are Black. Virtually all also come from families that are poor. And the vast majority of cases are not of the kind of child abuse we see on the news, but of “neglect.” As Roberts explains, “neglect” generally means being poor — not having access to adequate food, shelter, or child care. But as in Brown’s case, the system does not give beds to families when it deems they do not have enough, does not provide housing vouchers when they see shelter as inadequate, does not increase food stamp allotment when children are going hungry, or provide child care when parents cannot afford it but still have to work. The child welfare system instead almost always acts too late, and has only one means of intervention: removing the children from their parents, who are usually mothers.

Brown’s children were not only removed from her, but explicitly forbidden from living with her, even when another adult in the household was acting as their carer, even though there was no evidence that she posed a physical danger or threat to her children. The system deliberately acted not just to keep the children safe and cared for, but to keep mother and children apart. In the child welfare system, separating Black children from their mothers is seen as the only means to keep them safe, even when other options are clearly available.

Further, once the children were provided for, the system lost interest in Brown’s own well-being. Like so many poor people of color with mental illness(es), she was not given housing and access to mental health services, but instead ended up homeless — a state which only exacerbates existing mental illness, and would be incompatible with reuniting her with her children. And after this series of assaults on Brown’s rights and humanity, it is her mother who is left feeling the guilt for forcibly complying with an abusive system:

Davis also faults the St. Louis County Family Court, which she said forced her into a heartbreaking dilemma after the state took away Brown’s children on a claim of neglect. Davis could take in her grandchildren or her daughter, a judge said, but not both.

“I’m mad at myself because if I hadn’t listened to the courts, she would still be here,” Davis said. “If she had been here at this house, she would be here today.”

Anna Brown attempted to access health care from the position of a Black homeless woman who had been deemed an “unfit mother” and who was perceived as “mentally unstable.”  The social forces of white supremacy, classism, misogyny, and ableism ensured that she therefore entered this system, a site in which innumerable oppressions are enacted, as someone perceived as far less than fully human. If homeless people are inhuman, if being an unfit mother is close to the worst thing a woman can be, if being Black is both criminalized and associated with worse health care outcomes across the board, if “crazy” people are to be either feared or ignored, this inevitably impacted the care that she received.

Despite repeatedly complaining of the same symptoms, Brown was not believed. The medical staff in charge did their tests, and decided that they knew better than Brown about her own body. Instead of reviewing their work — ultrasounds were apparently conducted to check for blood clots — or searching for alternate explanations, they decided that Brown must be lying, perhaps looking for drugs. This call was irrefutably tied to Brown’s race, gender, homelessness, and mental health status. Real-life medicine doesn’t work like House. But if anyone thinks an insured white guy with no history of mental illness would have been pinned with “drug-seeking behavior” and literally dragged away in handcuffs, they’re living in one hell of a different United States of America than I am.

Anna Brown was arrested for demanding medical care for a condition that killed her several hours later. For seeing herself as deserving of life, for knowing that her constant pain was not normal or acceptable, for demanding that somebody give a damn and recognize her humanity, she was thrown in jail and died alone on a cold cement floor. An officer waited for three hours with Brown to see a doctor who could declare her “fit for confinement,” so that he could drag her from a police car when she could not walk. Who devoted those same levels of time and resources to saving her life? Who cared as much about why this homeless Black woman was in so much pain and distress as they did about locking her up?

Both the police and the hospital have shirked responsibility:

St. Mary’s officials say they did all they were supposed to do for Brown. “Our records show that, in this case, everything that should have been done medically was done properly. We found nothing that would have changed this tragic outcome,” according to a statement.

Police Chief Maj. Roy Wright said his officers had no way of knowing Brown’s condition. “A lot of times people don’t want to stay in jail and will claim to be sick,” he said. “We depend on medical officials to tell us they’re OK.”

We found nothing that would have changed this tragic outcome.

I am not a doctor. Even if I were, I do not have access to Anna Brown’s medical records. I do not know if the ultrasounds were conducted properly. I do not know if there were additional tests that could or should have been done. I do not know if her condition was not diagnosed because of carelessness and prejudice, or because it simply could not be diagnosed. I do not know how or if Anna Brown could have lived.

But I do know one thing for sure: she did not have to die like she did.

It was not inevitable that she was charged with “trespassing” at a hospital while complaining of a legitimate medical condition. It was not inevitable that her pain was ignored and treated as a fabrication. It was not inevitable that she be literally dragged away in handcuffs because she could not walk and because authorities just needed another Black body locked up. It was not inevitable that she die alone on a cold floor, in a way that we would never wish on animals. It was not inevitable that a homeless Black woman asserting herself was perceived as being “on drugs,” or that being “on drugs” revoked her right to decency and humanity.

I do not know that Anna Brown had to die. But even if she did, she could have died in a hospital bed. She could have been given the same dignity afforded to insured white people who aren’t (actually or perceived as) “crazy” or “on drugs.” She could have not have had her identity as a mentally ill, homeless Black woman equated with criminality and worthlessness. She could have been treated like the human being she was, as a person whose life had value.

And anyone who cannot see that is the one who is actually lacking humanity.

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{ 11 comments }

1 André Harrison March 30, 2012 at 10:37 am

Thank you for sharing this. I concur 100%.

2 Mok March 30, 2012 at 2:09 pm

Speaking as someone who just recently survived the medical condition that killed Anna Brown, I can definitely say that there were other tests that could have been run. My ultrasound came back clear too, but they also ran a D-dimer test (detects clot breakdown products), and that got me a diagnosis. The D-dimer test is actually *cheaper* than the damn ultrasound.

3 meditatingontherain March 30, 2012 at 2:51 pm

I keep reading that line from Anna Brown’s mother:
“I’m mad at myself because if I hadn’t listened to the courts, she would still be here,” Davis said. “If she had been here at this house, she would be here today.”

I keep thinking, she’s probably right, that if Anna and her kids could have lived in the same place with her, she (Davis) would have been able to keep an eye on things, given some of the support needed, and everything would have been that little bit better for their whole family. Heck, the social services should have thought “Hey, here’s someone who can let us know immediately if we need to step in and support, and who we can rely on to hold the fort in the mean time, because these are her grandchildren and her daughter and she knows and cares for them better than we can.”

4 FemmeForever March 30, 2012 at 4:49 pm

Anna Brown’s story breaks my heart into a million pieces. This could easily have happened to me. I am a black woman with no insurance who suffered the same condition. Thankfully my ultrasound was positive but I still had to fight for basic human decency when I couldn’t walk. When you are a black woman in a world that hates womanhood and especially hates black womanhood ANY expression of adulthood is seen as being difficult and a problem. The piece is brilliant, right on, and so, so, triggering of the demonizing black women suffer everyday just for believing we have the right to exist.

5 Anne March 30, 2012 at 8:11 pm

This story gave me chills. There but for my privilege go I. Like Mok, when I had blood clots/PEs, my ultrasound came back clear. My D-dimer was elevated, but when the urgent care clinic that ran the D-dimer sent me to the emergency room, the ER very nearly sent me home anyway. I’m young, healthy, active, have no family history of clotting disorders, and have no other risk factors for blood clots. I was the anti-poster-child for blood clots, so they dismissed my claims of shortness of breath, inexplicable feeling of anxiety, and high heart rate. My blood pressure and pulse looked “normal” even though what’s in the normal range for most people is elevated for me. It was only after they re-ran the D-dimer (which came back even more elevated than the first one) and rather grudgingly ran the CT that they discovered I had a veritable shower of blood clots in both lungs.

My own clots were small enough that, although numerous, they weren’t life-threatening. I shudder to think of what would have happened if they had been more serious, and if I didn’t have so many layers of privilege to protect me. The ER folks barely believed me as it was. Without the privilege of being white (and insured), with a partner present to advocate for me, I’m certain they would have sent me packing. My heart breaks for Brown.

6 Cassandra March 31, 2012 at 7:08 pm

“I do not know if there were additional tests that could or should have been done. ”

As a lab worker, I will echo the commenters who say a D-dimer should have been done. This a blood test that shows if there are clots breaking down in the body, such as would happen in a Deep Vein Thrombosis (DVT). DVT is not uncommon after a sprain or break in the leg, especially in women. Injury combined with inactivity cause blood to pool and clot in a vein in the leg. Sometimes as this clot breaks down, pieces break off. These pieces can travel to the heart, eye, brain, or lung (as in Ms. Brown’s case – this is called a Pulmonary Embolism), causing organ damage and/or death.

7 Linda March 31, 2012 at 9:57 pm

I lost my 41 yr old Brother to cancer 2 yrs ago. I believe the illness had a chance to proliferate because every time my brother went to the Hospital complaining of pain he was sent sent away because they thought he was Drug seeking! I am so angry & bitter w/the Hospital. the personel treated my brother like he was nothing.Until an oncolagist that happened to be there took a look @ him. & discovered the cancer. Well on it’s way. I bless him 4 helping My Brother 4 Free. But as far as this young Woman there but for the Grace of God go any of us. Unless you are doing well or keeping your nose above the water ,Your not promised anything tomorrow. There is so much anarchy in the Government Tom’s looking out for Tom, no one is looking out For the People . God bless us All as we Move forward . Rest in Peace Anna Brown

8 skeptifem April 1, 2012 at 4:55 am

D-Dimer blood testing is usually done to rule out blood clots. Some hospitals have a more specific test for DVT. Clinical laboratory results have generally been the basis for action at the hospitals I have worked at. Here is a free algorythim for diagnosing DVT.

http://www.arupconsult.com/Topics/VenousThromboembolism.html#tabs=1

What I don’t understand is why they didn’t send her to the acute psychiatric floor, being “unstable” and all. Jail would not help someone with a mental health problem.

9 Tracy Chessor April 6, 2012 at 7:28 pm

I do not totally agree that race was the issue here. I am white, divorced after 22 years, on disability and Medicaid, I have a mood disorder, and have chronic migraines. I am treated the same way at the ER. I was treated much better on private insurance.

My doctors do not treat accute headaches in the office and send me to the ER. One local ER will not give me pain shots. The other limits how often I can come. I am not seeking drugs. I have a pain contract with my pain management doctor and have turned down prescriptions. I get nerve blocks which involve numerous injections in my face, head, neck, and back to help with pain. I used to have daily headaches. I hate needles but it is a way of survival. I average two to three headaches a week. I have plenty of meds if I want to “feel good.” When a headache is severe and not managed by my home meds the only way to break the cycle is an ER visit. They can not refuse to treat me but can refuse to effectively treat me. Had I ever got confrontational, they most likely would at the least call security or possibly have me arrested.

I lived in a shelter for abuse victims for three months after leaving my husband. If I needed treatment I had insurance so I received it. However, many of the other woman who had no insurance went to the ER and were misdiagnosed or brushed off. I do not share about my mood disorder because I am automatically labled even though it is controlled with meds. Being on disability and Medicaid, has made a major difference. I am treated with far less dignity and respect. In some instances race may be a factor, but overall being homeless, poor, on government assistance, or having a mental illness does affect the treatment people receive. I went from being a respected middle class house wife to being a crazy single woman on government assistance and my world is nothing like it used to be. The only thing I gained was getting out of a very abusive marriage, which means now I am victimized by others.

10 Cara April 7, 2012 at 11:03 am

Tracy, seeing as how I explicitly and repeatedly discussed how disability, homelessness, poverty, and lack of insurance factored in here, I see no point to your comment other than an attempt to deny the impacts of racism and uphold your own white privilege. People of color are disproportionately likely to be poor. Further, they are much more likely to be misdiagnosed with serious mental illnesses AND to fail to receive actually-needed mental health services. So to say that race is not a factor because it’s about poverty and mental illness is flat out nonsensical — being about poverty and mental illness INHERENTLY MAKES IT ABOUT RACE.

The fact that poor and/or mentally ill white people are treated poorly does not mean that poor and/or mentally ill people of color are not generally treated worse. The fact that class and disability were clear factors here — as extensively discussed — does not mean race was not also a factor, and a very large one at that. I am very upset by your comment, because it serves to actively draw attention to your own experiences as a white woman while actively drawing away attention from and DENYING the experiences of women of color. That is not okay.

11 Heather April 28, 2012 at 4:40 pm

This woman should not have died, and the fact that she did hurts my heart, I hope her family can recover from the loss. The fact that she was treated worse than a dog being put down…horrifies me, she deserved so much better. So very much more than the piss poor “care” she was given.

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