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On the first day of Derek Chauvin’s trial for the murder of George Floyd, a 13-year-old boy in Chicago was killed by a policeman. On the last day of the trial, the day the jury found Chauvin guilty, transit police officers in San Antonio shot and killed a man on a VIA bus. 

These were not isolated events. “On every day that followed, all the way through the close of testimony, another person was killed by the police somewhere in the United States,” reported the New York Times. 

Actually, it was worse. Deaths at the hands of police while the nation’s eyes were trained on the Minneapolis trial averaged more than three per day. In San Antonio alone, four men died in officer-involved shootings during the trial. 

In addition to the VIA incident, a 46-year-old man with a lengthy arrest record who was firing shots at the airport on April 15 killed himself after being wounded by a policeman. The next day an officer shot and killed two men during a West Side traffic stop, reportedly after the driver pulled a gun and shot at the officer. 

On average, more than 1,000 people in the United States are killed annually by police officers – about 35 per 10 million. Quite a few nations’ law enforcement forces have higher rates, but they are not countries with which we should want to be compared. Venezuela appears to top the list, with 5,287 killings in 2018, according to a U.N. report. Others include El Salvador and the Philippines.

Closer to home, Canada is averaging less than a third of the U.S. rate, according to a Canadian Broadcasting Corp. report last year. England and Wales, where the population is about 56 million, has seen a yearly average of 2.3 killings by police between 2009 and 2019, according to the Independent Office for Police Conduct. That works out to about 0.4 per 10 million.

By the standards of affluent nations, the United States has an epidemic of police killings. That is clearly not entirely the fault of police. One obvious factor: U.S. law enforcement officers encounter many more suspects who are armed, or at least whom police suspect to be armed. 

But there have to be more reasons for the epidemic. The fact that Blacks and Latinos are killed in significantly higher proportions than their portion of the population suggests one angle, but there surely are others. 

The Chauvin trial is a graphic example of a case that could have been avoided. The advent of cellphone and body cameras has unearthed many more cases that previously would have been unrecognized, cases in which police reports were either incomplete or mendacious. Yet indictments like Chauvin’s are very rare and convictions even rarer.

There are good reasons for this. Prosecutors know that jurors tend to be sympathetic to police officers, whose jobs put them in danger. Policing is the rare profession in which those at the bottom of the organization make some of the most consequential decisions, and they often have to do it in seconds or less. A police chief makes decisions with broad-ranging impact, but he or she usually has considerable time to study the matter. An officer on the street sometimes has to make life-or-death decisions in an instant.

Still, inevitably an officer will sometimes make the wrong decision – sometimes culpably, many times not. When an officer such as Chauvin unreasonably uses force, he should be charged. Those who abetted him or covered up for him should also be, as is happening in the Floyd case because it was so outrageous and so clearly captured on videotape.

I have referred to the thousand police killings a year as an epidemic not only because the number is so out of line with that of similar nations, but because the medical terminology offers a good analogy. 

Until about 20 years ago, U.S. hospitals lost an epidemic level of patients to central line infections – the contamination of catheter tubes placed into large veins to deliver medicine to the heart or other organs. They can remain in place for months and are subject to infection. For many years these infections were considered an unavoidable hazard.

But in 2001, Dr. Peter Pronovost, then a critical care physician at Johns Hopkins University, came to believe that most such infections were not unavoidable. His efforts led to a paradigm shift, converting many hospitals in the United States from “car crash hospitals” to “plane crash hospitals.”

The distinction is between society’s reaction to car crashes versus airplane crashes. At most, car crashes normally result in an investigation sufficient to satisfy insurance companies as to which driver’s policy should pay for the damage. By contrast, airplane crashes lead to thorough and expert investigations designed to learn anything that can help prevent a recurrence. Lessons learned are then promulgated throughout the airline industry and often are required to be applied.

Pronovost found that considerable research had already been done on central line infections. As Sarah Kliff wrote in an excellent article for Vox.com, “The Centers for Disease Control and Prevention, for example, had a 150-page document recommending 90 different things that research had shown to prevent central line infections.”

But the recommendations had not been ranked according to effectiveness and made easily applicable. Pronovost identified the most effective recommendations and made a checklist for medical personnel similar to an airplane pilot’s. It included such items as thoroughly washing their hands (which an alarming number of hospital workers were too casual about), using gloves and covering themselves and patients with sterile clothing, avoiding catheters in the more germ-infested groin area, and removing catheters as soon as they were no longer needed. 

Pronovost did more than create the checklist. After finding that his hospital’s doctors were using it only 30 percent of time, he also became a chronic pain in the gluteus maximus enforcing its use. First he got the surgical intensive care unit stocked with everything that was needed, then he persuaded nurses to call out doctors who weren’t following procedure.

Within six months, central line infections at Johns Hopkins were down 70 percent. Then the Michigan Hospital Association got wind of Johns Hopkins’ results and persuaded 60 of the state’s roughly 100 hospitals to use a version of Pronovost’s list. A key part was a four-hour training session for nurses showing them how to insert the lines and encouraging them to insist doctors follow the list. A 2006 study showed that within three months of implementing the checklist, central line infections in 104 intensive care units were down that same 70 percent. 

Nationwide, the change has been major but has not matched Johns Hopkins and Michigan hospital improvement levels. Between 2015 and 2019, central line infections were down 31 percent, according to the Centers for Disease Control and Prevention. Apparently we still have a large number of car crash hospitals. Medical cultures are hard to change.

So are police department cultures, but cultural change is needed in order to get rid of the “bad apples” more efficiently and to help the “good apples” avoid violent endings. The disciplinary procedures being negotiated with the San Antonio police union are important but hardly culture-changing. What if the San Antonio Police Department became a “plane crash” department rather than a “car crash department” when it comes to police shootings?

Investigations are done now to determine whether an officer should be disciplined or indicted. What if an investigation by a separate team – perhaps including someone from the police academy as well as outside experts on de-escalation – was conducted not to blame anyone but to learn from mistakes, including honest errors, and develop a checklist that officers could be drilled on? The team would often find that nothing could have prevented a tragic outcome. But certainly like doctors, police officers could often learn from tragic deaths. 

The analytical team could also investigate and learn from dangerous situations that were handled without violence. We not only need to get rid of a few bad apples. We need to end the epidemic. 

Rick Casey

Rick Casey

Rick Casey's career spans four decades of award-winning reporting on San Antonio. He previously worked as a metro columnist for the former San Antonio Light and, later, the San Antonio Express-News.