When Labelling Patients Causes Patients to Die

I found this story how a homeless woman died very disturbing:

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.

The throwaway, disposible patient

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.

There seems to be no simple answer.

Actually there is a very simple answer. At some point in her care, a nurse or physician decided Anna Brown deserved to die. I don’t mean literally a health care professional wrote Anna Brown’s chart, “This patient deserves to die.” But someone decided — a nurse, a physician, or maybe it was a collective, Emergency Department judgment —  that because Anna Brown was homeless, because she was black, because she was poor, because she had made multiple visits, because she was still in pain, because she advocated for herself by making a fuss, because she possibly had (undiagnosed) mental health issues, she was not entitled to proper care.

She was labelled. She was drug-seeking. She was crazy. She was a frequent flyer. And that killed her as surely as if a nurse had bolused potassium chloride.

I will tell you why I think this is true.  Because Anna Brown had made repeated visits, and no one took her seriously. Because she told staff about her increasing pain, and no one believed her. Because she was unable to walk, and no one thought to ask why. All of these are enormous waving red flags for any emergency department health care professional, and neither physician nor nurse did anything about them. That’s the thing about labels: they contain their own little subjective judgements about patient care, and obscure the obvious.

If Anna Brown had been a middle-class white woman with a nice home, a job and a car, I am willing to bet — no, I know the outcome would have been different — or at least, she would not have died, gasping for air, from a pulmonary embolism on a cold jailhouse floor. There certainly would not have been any of this Kafkaesque horror of being in obvious distress with a deep vein thrombosis, about to throw a clot, and being utterly unable to get help at the very place where you might expect it.

I will let the public in on a little secret. We all do it. Each and every one of us. I don’t exclude myself. We all label patients. It is deeply embedded in the culture of health care to the point where it is an accepted practice. We all call patients drug seeking and crazy and frequent flyers and failures-to-die and failures-to-cope. We laugh at them. Hell, there are whole blogs and books devoted to the art of ridiculing patients we have already labelled. (Though when you think about it, there is nothing quite as charming as making fun of  human beings who are powerless, is there?) Has any one ever thought labelling patients might cloud and impair clinical judgment? Or that it dehumanizes patients and is just plain wrong?

There is also this from another blogger who writes:

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.

[But go read it all.]

Don’t think I have much to add.

[Via.]

[UPDATE: A long time reader suggests instead of the word label, I should use "profile," as in "racially profiling." Once upon a time I might have thought the word unnecessarily inflammatory --- but now I am not so sure.]

[UPDATE II: Small corrections to syntax. Hobbit not cooperating.]

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  1. #1 by Lisa on Monday 02 April 2012 - 1203

    I believe most ER staff have been guilty of “thinking” frequent flyer, drug seeker, etc but it always our responsibility to determine if the person is sick or not. I don’t understand what they were thinking if they didn’t do a full workup on this patient to rule out all emergency conditions. That can be frustrating because you must do full workups on everyone and that clogs the system up with people who don’t need all the testing but the responsibility still falls on the ER to determine if the person is sick or not. When ER staff become burnt out and cynical, awful things can happen This outcome is so sad and irreversible.

    • #2 by torontoemerg on Monday 02 April 2012 - 1209

      I guess what gets me about this case is that Anna Brown was pretty clear something as very wrong — and even still nothing as done. Thanks for the comment.

  2. #3 by J on Monday 02 April 2012 - 2138

    I’m not sure of your logic. I am a white, middle class woman who was labeled as well. I was strewed w/o the proper tests for my pain that wasn’t easily explained. I was told I was drug seeking until I too almost died and got the surgery I needed after a new resident not yet jaded took me seriously. People of all ages, races, and socioeconomic classes are treated poorly by er’s if they ever come in for a chronic complaint they can’t easily fix.

    It’s sad but true and I’d be happy to share my agonizing story that led to a surgery and 3 week stay in icu and a step down unit.

    • #4 by torontoemerg on Tuesday 03 April 2012 - 0552

      Well, speaking from my own experience working both here in Canada and the US. There is a lot of hidden — yes, I will use the term — racism in health care, and we very often proceed from a very comfortable middle class PoV.

      That being said, I would be glad to publish your story here: email me at TorontoEmergencyRN (at) gmail (dot) com.

  3. #5 by Anonymous on Tuesday 03 April 2012 - 1140

    The difference in ‘labeling’ and ‘profiling’ is that profiling studies Behavior and behavioral patterns, as in: what kind of ‘pattern of behavior’ defines a serial killer? Labeling is the use of a word or set of words to ‘conveniently’ describe a person based on his/her behavior, race, past history, etc. It is important to differentiate between the two terms.
    The ‘labeling’ which happened in this case is tragic to say the least. And, yes, we HAVE all done it-especially when we were young and trying to be ‘hip to the unit’. As we age and gain experience we begin to ‘know’ that these are EXACTLY the kinds of patients who will sue you! Why? Because they have NOTHING TO LOSE by trying. And the media is always sniffing around for some kind of emotional, racially-charged story to keep their ratings up.
    However, I find it MORE disturbing that if she was indeed a ‘frequent flyer’ there was no mention of a review of her past history. Was she actually treated for the sprained ankle? Did she have risk factors for a deep vein thrombosis? Apparently so, from the immobility (could not walk), recent lower extremity injury and perhaps other things which were not mentioned. If she had indeed been to 2 other ERs that same week and the 3rd one sent her to jail without giving her a basic history and physical then a ‘cascade’ of neglect was already in play. Several different professional disciplines: Nursing, MD and law enforcement ALL failed to pay attention to this patient in more than one facility.
    Remember that with all of our technology, there is NO test, scan or other procedure which can ‘measure’ an individual’s PAIN. It is entirely subjective and persons with chronic pain from severe arthritis, vascular insufficiency, etc. are often ‘labeled’ as drug-seeking.
    On the issue of basic human ‘Rights’ such as housing, health care, etc. one must remember that individuals have the Right to Refuse to take care of their health, to live in ‘decent housing’, to eat the ‘right’ foods and any other expectations which the educated class-black, white or Hispanic-believes that they should do.
    I have patients who throw away their Meals on Wheels dinners, who choose to buy cigarettes and alcohol over medications, who refuse to leave their ‘lean-to’ shacks for an apartment, etc.
    However, when these people DO show up in your ER, you have a professional responsibility to evaluate and examine them no matter HOW busy you think you are.
    There will ALWAYS be time to talk to the lawyers…

  4. #6 by hopeful on Tuesday 03 April 2012 - 2203

    Well i know from personal experience that calling a lawyer does nothing. My brother was seen in an emergency department several times for back pain. He was treated as a drug seeker. After a month of dealing with nurses and doctors who did not believe he should be there he ended up paralyzed. After he ended up paralyzed he decided to sue. It was a big hospital so they had great lawyers. My 52 year old brother ended up in a nursing home. While he was in the nursing home they found out he also had cancer. He passed away 2 years later. My brother felt that all the suffering and pain he had been through would be worthwhile if the hospital would leave his family with a settlement. After my brother died the lawyers told our family we would be responsible for all of the lawyers fees if we didn’t drop the case. As a family we decided to let it go. But i have a lot of resentment to that hospital for what they put my brother and our family through. I work in health care and i see it all the time. So i agree people need to stop judging people and start just doing what they are there to do…help people.

  5. #7 by Les @ LPN Programs on Wednesday 04 April 2012 - 2336

    How can they possibly ignore Anna Brown? The fact that she came to the hospita several times complaining of the pain should have been enough to order additional tests etc. Bias is unacceptable and I never really thought this was happening in the US, more so in the healthcare industry. Where I come from, someone would have been compassionate enough to care!

  6. #8 by jenjilks on Thursday 05 April 2012 - 0911

    I have a client with many of the same issues, with a story startlingly similar, except she did not die.
    Someone, bless her, listened to her, understood the situation, and they discovered the thrombosis.

    She in a woman with mental health issues, treated in a small, local hospital, on welfare.
    I bless those who diagnosed her, and hope those who did not listen to her – learned a lesson.

  7. #9 by kmomjl on Thursday 05 April 2012 - 0943

    She had a negative US for DVTs yet the sutopsy showed clots in her lungs and legs. Something happened.
    The cautionary tale is that all of us are just a heartbeat away from a life event that could spiral us downward. In her case, losing her home to a tornado.
    I live in St. Louis. I worked at the sister hospital of St. Louis University. I’m pretty sure if she was white and well insured she would have been admitted with “intractable pain” even in the absence of other findings.
    Very tragic.

  8. #10 by WhiteCoat on Wednesday 11 April 2012 - 1054

    Wow.

    Someone on my blog suggested that I check out this post after I just posted about this story yesterday.

    To all of you who think “something more should have been done,” what should that “something” have been? She had multiple tests and exams performed for the same complaint – including sonograms which showed no blood clots the day before she died. She was having the same pain in her legs since she was hospitalized the week before. Gold standard test for DVTs is ultrasound. Do we repeat the ultrasound every day? Every hour? What other testing was “necessary”?

    TorontoEmerg – think of all the patients you see with back pain requesting narcotic pain medications. Do you order serial MRIs on them to rule out the possibility of cauda equina? Or tumor? If so, what is the medical basis for the testing? If not, why? I’m assuming you don’t. When you miss the one patient who has a tumor and becomes paralyzed, you’ll be harangued because “obviously” the patient had something wrong and you neglected to address it. Yet once you tell the patients that they won’t be receiving any narcotic pain medications, many of the patients in severe pain stand up, curse at you, and storm out of the emergency department.

    You say that Ms. Brown was “unable to walk.” The article showed that a nurse saw her standing the same day that she couldn’t walk. How many patients do you see who come to the emergency department and can’t get out of their car when they arrive? That’s a “red flag” that something is wrong. Do you order a million dollar workup on all of them? How many patients do you see who have had dozens of normal CT scans for their chronic abdominal pain? Is that proper medical care? I could go on and on, but you get the point.

    The problem is that your post suffers from horrible hindsight bias. You knew the outcome and now you’re bashing the people who treated Ms. Brown because they didn’t have the ability to look into the future to see what would happen.

    Yes, the outcome was horrible. Yes, there were miscues and miscommunication. I’m sure that Ms. Brown was “labeled” as someone trying to game the system. Society “labels” every aspect of our lives every day. President Obama is “liberal.” Ron Paul is “crazy.” Pit bulls are “dangerous.” Doctors are “rich.” Baby pandas are “cute.” Doing so doesn’t make us bad, it makes us human. Someone who was articulate and polite to the providers and to the police may have been treated differently. One of my readers said this was the “perfect storm” of events leading up to Ms. Brown’s death.

    To say that Ms. Brown didn’t receive proper care or that her complaints were ignored is just wrong. I’m betting if you ordered all the testing you think Ms. Brown should have received on all of the patients who walked through the doors at your emergency department, *you’d* be the one being ridiculed.

  9. #11 by Granny RN on Wednesday 11 April 2012 - 2215

    What ‘WhiteCoat’ gives is more information than I found in the original piece that was posted. When only a limited amount of biased information is posted we tend to react ONLY to that which we read or hear. This is a normal and common human response to sensationalized events in which limited and biased information is given in order to elicit a knee-jerk, emotional response. And she/he is correct-none of us can predict a person’s future outcome especially when all of the appropriate testing has been negative. Deaths from unclear causes happen every day. Clots need only a few minutes to form and conceivably they could have occured after the patient left the ER and went to jail.
    This is the danger of trying people/events in the Court of Public Opinion. The real Truth is very often ‘glossed over’ by the sensationalism.

    • #12 by torontoemerg on Thursday 12 April 2012 - 0858

      Thanks for your reply. I don’t think I was being sensationalistic in describing what happened to Anna Brown — but your mileage may vary. And I drew my information from exactly the same news story as WhiteCoat. I do think given the clinical picture as reported the scenario you imagine is unlikely, but who knows? In the event, I think you can say either “The causes of Anna Brown’s death are too complex to fix” or else you can start thinking of the systemic root causes, like racism, or the fact Brown was indigent, and maybe had psych problems. Ignoring them changes nothing.

  10. #13 by Granny RN on Thursday 12 April 2012 - 1202

    I was not sure if it was a ‘first person’ account or a news story (in which case all things are made clear regarding ‘sensationalism’). ‘Labeling’ exists EVERYWHERE and we are all subject to it as nurses, drivers, parents or just plain being ourselves. I have no doubt that I have been ‘labeled’ many times in my career. Racism and discrimination are not confined to any one particular group or ethnic background. It is unfortunate that this poor womans’ death has been used by the media to elicit an emotional response from the public but that is what irresponsible ‘journalists’ do in order to sell newspapers, keep ratings up, etc.
    In countries which honor Freedom of the Press it is sometimes unfortunate that we must allow what might be an ambitious reporter who is looking to make a name for his/her self to publish things which inflame the public. However, there is also a professional responsibility on the part of the media to exercise good judgement and ‘rein in’ inflammatory or inaccurate statements so that the legal system can do its job. Already the man who shot Trayvon Martin in Florida is being tried in the Court of Public Opinion.
    And all of that is just wrong.

  11. #14 by Deadly Dismissal (@DeadlyDismissal) on Sunday 29 April 2012 - 0318

    Hold on just a minute. Deciphering the random collision of viewpoints here seems a bit like sifting through a train wreck. For example, WhiteCoat comes here (at my suggestion) and challenges this blog. Then GrannyRN goes to a level of extreme way beyond WhiteCoat’s, such that she even contradicts him. If you read WhiteCoat’s original blog on this topic, he writes that he was surprised that the story didn’t receive more media attention than it did:

    http://www.epmonthly.com/whitecoat/2012/04/anna-brown-and-appropriate-emergency-medical-care/

    He states that “Christine Byers wrote an excellent article describing events that took place, and then wrote a follow up article in which the hospital defended its care. I’m hoping that the St. Louis Post-Dispatch commends her for her work. She did a great job with the stories.”

    Then GrannyRN comes along and states: “It is unfortunate that this poor womans’ death has been used by the media to elicit an emotional response from the public but that is what irresponsible ‘journalists’ do in order to sell newspapers, keep ratings up, etc. In countries which honor Freedom of the Press it is sometimes unfortunate that we must allow what might be an ambitious reporter who is looking to make a name for his/her self to publish things which inflame the public.”

    Are you saying Christine Byers, the original reporter who broke the story, and who WhiteCoat praises, is irresponsible and just “looking to make a name for herself”?

    There are yet many unanswered questions, and I’m onboard with those who are trying to get more coverage for this story than it’s received, which is in no comparison to that of the Trayvon Martin story.

    • #15 by Granny RN on Sunday 29 April 2012 - 0921

      That which you call ‘the random collision of viewpoints’ is what we, in America also refer to as ‘debate’ and is a traditional and honored part of our national culture.
      My very FIRST post on this topic is #5 which was published under the name ‘anonymous’ for whatever reason. Perhaps I had not ‘registered’ a name at the time on this site.
      This particular event occurred in Canada under a health care system which is often used by proponents of a National Healthcare System (aka ‘Government Run’) as an example of a ‘perfect model’ in which EVERYONE is treated evenly at all times. Just isn’t so. The same problems exist in any system where humans are involved.
      The report is that the woman in question died as a result of blood clots which were apparent at Autopsy but not on the venous ultrasounds which were performed as stated in ‘WhiteCoat’s comments. I have not met many reporters who had extensive knowledge of the blood clotting ‘cascade’ and the pathophysiology associated with it. Did this esteemed member of the Press follow this patient around all day from place to place watching for something to happen? Or did she take the information from reactions of others to the fatal outcome of the situation. WhiteCoat seems to have more information than the original posting (for which comments were invited) which gives a more reasonable accounting of the patients’ history and treatment on the day in question.
      We have lived with an overly reactive society here in America which takes its information from what an editor/reporter decides to put in print or on the air instead of looking past the hype, and in far too many cases such as those which get tried in the Court of Public Opinion here there is always MORE to the story.as WhiteCoat has shown us. And yes, this very process is also evident in the Trayvon Martin coverage. Pain and suffering sells papers and pushes up ratings which can and does influence the public decision making process. The media can and does influence public policy and even the election process by what it chooses to present and how it is published/broadcast.
      Only those who were actually THERE in the ER on the day in question know what REALLY happened.

      • #16 by torontoemerg on Sunday 29 April 2012 - 2104

        I’m thinking I want to respond more fully to all of these points, esp. WhiteCoat’s remarks, hopefully later on this week. At the end of it, though, Anna Brown is still dead, right, and I think throwing up our hands and stating “oh we will never know what killed her” is evasive at best.

        • #17 by Granny RN on Monday 30 April 2012 - 0010

          We all know that ‘hindsignt is ALWAYS 20/20′ and it is always correct to review and reassess our actions or inactions in any case but especially those in which harm or death occurred. Apparently from the story even the Medical Examiner could not absolutely give a precise cause of death when all was said and done. And WhiteCoat makes some very reasonable points. When DO we ‘say When?’ At what point does one finally STOP doing ultrasounds and other exams when there have been only Negative results? Is it really reasonable to keep someone in a hospital bed for an indefinite period of time, testing and re-testing over and over, waiting for something that might NEVER happen? In effect such a course of action would be the equivalent of holding a patient ‘prisoner’ and subjecting him/her to repeated tests looking for that which may never be found. We do not have the benefit of this womans’ entire medical history, lifestyle and other factors to consider but the reporter made CERTAIN to include the fact that she was BLACK, POOR, HOMELESS and ‘possibly’ mentally ill. Why was it necessary to put all of that information out there except to stir an emotional response from the public? Did the person who wrote and published the story KNOW these things as matters of FACT or of her own ASSUMPTION? Did she ‘hang out’ at the local ER one day waiting for someone who fit a certain ‘profile’ to show up and see if anything would happen? There are reporters who DO this sort of thing just as there are those who go running up to a wrecked car to see if there are ‘remains’ inside.
          The simple truth is this: Humans are Human, we do the best that we can with the knowledge that is made available to us, we cannot ‘save’ everybody and we cannot prevent every possible problem, and sometimes bad things happen. It does NOT mean that every ‘homeless, poor, black woman’ who was sent home from the ER without being admitted for an endless battery of tests because the ones that she just had gave Negative results was being ‘labeled’ or even ‘profiled’ and denied treatment because of it. In fact, Most health care workers tend to ‘overtreat’ such people just to AVOID the kind of trouble that happened in this case. We do not LIKE to have to see people ‘hauled away’ by the police but we DO have to consider the rest of the patients that we ALSO have a duty to treat who may be even sicker but are quietly waiting their turn.

  12. #18 by James Trimble on Thursday 03 May 2012 - 2159

    As a professional Emergency Room nurse, I take both issue and offense with the manner in which this entire issue is presented as a classic example of racism in emergency medical treatment. The selectively edited and incomplete article appears to be a moment of opportunity for the author to air their personal complaints and emotions on the issue of race. I cite the author’s own quote within the entire article (http://thecurvature.com/2012/03/29/arrested-at-hospital-for-demanding-medical-care-woman-dies-in-jail-cell/) of “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.”
    Really? The author admits to having no evidence of any wrong doing; yet has the gall to point a finger at ER workers while shouting “RACIST!!!!”. The victim, if there is one, would be the ER workers who are forbidden to disclose their professional actions in patient care due to the patient confidentiality laws. We aren’t allowed to defend ourselves in the court of public opinion. We can’t justify our actions or describe our patient care when some village idiot decides to publish race-baiting diatribes for public review. We, the people who provide emergency care, are tasked with suffering these indignities in silence. As an emergency room RN, I should think that a responsible journalist or publisher of a website would seek truth, facts, and supply complete information before labeling (to use the author’s own term) actions in medical care as ‘racist’.

    • #19 by Granny RN on Thursday 03 May 2012 - 2219

      Same thing that I have been writing. Sensationalist ‘reporting’ designed to stir up an emotional response.

    • #20 by torontoemerg on Friday 04 May 2012 - 0807

      I agree the majority of ED nurses and physicians practice without regard to race, sex, ethnic origin etc. I myself have had the accusation hurled at me at a couple of times. (See here and here. for posts written about those occasions) But you would have to be mightily naive to believe for a minute that racism (or any other of the myriad ways humans label other humans) never influences treatment decisions, or that all health care professionals are as pure as the driven snow in this regard.

      I will point out that race was only one of factors I mentioned which may have played a role in how Anna Brown was treated. And despite all the heated rhetoric, Anna Brown is still dead, and she deserved better.

      • #21 by Granny RN on Friday 04 May 2012 - 0920

        You ‘mentioned’ her Name, Race, ‘Homeless’ status, economic status and the ‘possibility’ of a history of mental illness.
        With all of the people out in CyberLand screaming ‘HIPPA Violation!’ one has to ask: did Anna Brown or her next-of-kin give CONSENT for all of this to be published in the first place?
        If she had been a WHITE woman with all of the aforementioned
        characteristics, would this story have even MADE the News?
        Did her case achieve this notoriety simply because she was BLACK?
        That, you see, is the difference between reporting the NEWS and attempting to stir an emotional response with a story, in this case based on the persons’ RACE.

        • #22 by torontoemerg on Friday 04 May 2012 - 1130

          Two point: as far as I can tell identifying personal characteristics were disclosed to the reporter in the original article, so I am not clear why this would be a violation of patient confidentiality.

          Second, are you saying racism doesn’t exist anywhere, in any hospital?

          • #23 by Granny RN on Friday 04 May 2012 - 2224

            It is certainly a relief to learn that all of the ‘personal identifying characteristics’ were freely disclosed by SOMEONE to the reporter in question. Wonder who it was? Was there a Family Member someplace who ‘found’ this homeless, poor, possibly mentally ill black woman and came forward? Did a Staff Member call the press? Someone who ‘staked out’ the jail perhaps?
            Racism exists in ALL places and in ALL peoples. Always has. In America it has been traditional to blame ALL Racism on Whites against Blacks. This is not correct. To single out ONE race just does not cut it anymore. There is now also a large Hispanic population as well as a significant number of ‘mixed’ race people. Suppose that a patient who has one White parent and one Black parent was involved? Which ‘half’ of the 50/50 ‘mix’ does one blame? Wouldn’t it be the fair thing to blame BOTH races? Or suppose it was even MORE scrambled? Like a Black grandparent with a White mother and a Hispanic father? Want to spread the blame 3 ways?
            The point is that keeping the Race Card in play serves no purpose except to keep the Racism going. And as long as it keeps going there will continue to be hate crimes and other unpleasant manifestations of the Race-based discrimination that everyone is supposedly trying to Overcome.
            The media does not practice wisdom or discretion in far too many situations. It can and does influence public opinion and behavior on a regular basis. And (gasp!) reporters do not always put their OWN personal biases aside

          • #24 by torontoemerg on Tuesday 08 May 2012 - 0914

            The media does not practice wisdom or discretion in far too many situations. It can and does influence public opinion and behavior on a regular basis. And (gasp!) reporters do not always put their OWN personal biases aside.

            Well my own biases and blinders are pretty evident. ;)

            All kidding aside, this is a topic I do want to get back to soon, because I think there are still some things to be said about hindsight bias. I appreciate your engagement with the issue.

          • #25 by Granny RN on Tuesday 08 May 2012 - 1131

            Do not overlook the main Point of my responses:
            ‘The point is that keeping the Race Card in play serves no purpose except to keep the Racism going.’
            Now, we can continue to beat this dead horse or agree to disagree. No one is Perfect and ALL humans, Including ‘People of Color’, have their own biases regarding race, religion, sexual practices, personal appearance, etc. etc.
            At the end of the day we will have changed NOTHING because the patient will Still be Dead and no one can do a thing about it now.
            So, I will ask again: If Ms. Brown were a WHITE woman, would any of this have ever made the papers?

  13. #26 by GrannyRN on Saturday 09 February 2013 - 1236

    I just got back to this blog and found this note. Are you asking the questions about the ‘bottom line’ and ‘supply’ to me or someone else?

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