Excited Delirium

In this week's episode Senior Editor Rachel Still unpacks the legal system’s embrace of “excited delirium,” a discredited medical theory used to explain deaths in police custody. We trace its origins in the flimsy case reports of Miami medical examiner Charles Wetli, its spread through small, deeply flawed studies, and its weaponization by law enforcement and expert witnesses. Drawing on the work of Physicians for Human Rights and Osagie K. Obasogie’s Harvard Law Review article, we explore how courts transformed pseudo-science into “legal fact” through precedent and evidentiary shortcuts. We discuss the racial genealogy of pathologizing Blackness—from drapetomania to schizophrenia to excited delirium—and how these diagnoses have served to legitimize state violence. The episode also highlights recent developments: major medical organizations rejecting the term, states like California, Colorado, and Minnesota banning its use, and the Elijah McClain trials exposing its deadly consequences. Ultimately, we argue that excited delirium isn’t medicine—it’s narrative, power, and the law working to shield the state from accountability.