Waiting-to-Death, or Security and Asylum-Seeking in a Hospital ER

Whom am I to tell my private nightmares to if I can’t tell them to you?

—Estragon, Waiting for Godot

Waiting

“To wait,” according to the Oxford English Dictionary (OED), is to do nothing for a period of time in expectation or hope that something will happen. A “waiting room” is an antechamber for people who are obliged to wait (OED).

“Detention” is compulsory delay, confinement, restraint, custody, from the Latin for “hold back” (OED). Those being detained are made to wait.

Clarkson Avenue. Building G. Early Morning

Kings County Hospital in Brooklyn is one of the largest municipal hospitals in the United States.¹ The hospital is a sprawling complex on Clarkson Avenue that has more than six hundred beds and sees half a million patients a year. The hospital hosted New York State’s first open-heart surgery. The first human image from an MRI machine was made in this facility, and its doctors invented the hemodialysis machine for the treatment of kidney failure. Its centers for diabetes, Parkinson’s disease, stroke, and pediatric trauma have achieved recognition. It boasts having the “cutting-edge of technology” and providing “the most modern procedures with state-of-the-art equipment” (Kings County Hospital Center n.d.). It is, then, a place of vitality, where our biological capacities to live are managed and extended (Rose 2006). For a number of years, however, the psychiatry ward of Kings County Hospital, housed in Building G, was the focus of a civil rights lawsuit for a record of patient neglect. In this building, in the waiting room of the psychiatry ER, a patient named Esmin Green died of an untreated blood clot while waiting for care.

Esmin Green was an undocumented immigrant to Brooklyn from Jamaica who had been living in the neighborhood surrounding Kings County Hospital for several years. In June 2008, at the age of forty-nine, she was brought by friends to the psychiatry ER because she was experiencing psychosis. This was not her first visit; she had a history of psychotic episodes. Upon arrival, she refused medical review and then was involuntarily admitted, a common practice for psychiatric patients who are deemed unable to consent to medical treatment. She was given a tranquilizer and put in a hospital gown.

Because of a scarcity of beds in the ward, Esmin Green was left in the waiting room in the company of a few other patients. She waited there for twenty-four hours while hospital staff and security guards ignored her. One of the local newspapers, the New York Daily News, offered this account of her final minutes:

Green, 49, a native of the island of Jamaica, was brought to Kings County because of “agitation.” At the end of her waiting room stay, she keels over face down, legs splayed, in plain view. No one does anything.

She lies there for 20 minutes. A security guard comes by, looks at her and leaves.

Roughly 10 minutes pass. Green thrashes her legs.

Roughly 5 more minutes pass. Green rolls over and shortly stops moving.

A security guard checks Green out and leaves her.

A patient summons help. A nurse checks for signs of life—by nudging Green with her foot.

Too late; resuscitation is futile.

(“The Snake Pit” 2008)

Such a detailed description was made possible because Esmin Green’s death was videotaped. The security cameras, tracking from four different angles, watched and recorded every move of the patient and the staff.

Death, Watched

The local and national media circulated the security tapes of Esmin Green’s death and replayed them for weeks, instigating a public outcry. The images of Esmin Green collapsed on the floor, and of the nurse poking Green’s body with her foot, went viral on the Internet. Journalists and bloggers highlighted the case as evidence of discrimination against poor, black, immigrant, and mentally ill persons. Others also pointed to a systemwide crisis in psychiatric care in the United States. There were vigils by advocates for the mentally ill. The hospital admitted culpability...