Transcript: Norman Archer

As a medical student, you hear the stories, and you wonder when you will see things with your own eyes. When I moved to San Francisco in the summer of 2020 to start medical school,I started to hear about the heavy police presence at San Francisco General Hospital. It frustrated me to learn that the city’s Department of Public Health was spending over 20 million dollars a year to directly employ the San Francisco Sheriff's department to act at the hospital’s security. It horrified me more to hear from hospital staff about the police violence involving patients receiving care.

Stories of police shackling a pregnant patient to the bed, breaking a patient’s arm while responding to a behavioral health crisis, belittling a Spanish speaking patient for not understanding English, refusing to let a minor call her parents, and serving warrants to several patients trying to seek care. These testimonies were disturbing, and the data demonstrated clear disparities; despite Black people making up less than a quarter of visits to the emergency department, they make up a majority of use of force incidents by the police.

All of these stories came rushing back three years later when I finally found myself rotating through the emergency department as a fourth year medical student. There was a young, Black patient, who was brought in with multiple gunshot wounds - although the patient was medically stable, he was experiencing an intense wave of emotional distress, and things with his care team were starting to escalate. From around the corner, I saw three sheriffs walking toward the patient's room, and I felt the hair on the back of my neck stand up. I was scared for my patient. Scared that I was about to witness another story, another data point, another injustice.

But I was also hopeful. Hopeful that this time things might work out differently. Not because of some stroke of good luck, but because I had spent the past three years working with a grassroots coalition to try and interrupt the criminalization of our patients and advocate for alternatives to policing in our healthcare system.

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Back in 2020, I had become involved with DPH Must Divest, a community coalition of healthcare workers and students that seeks to remove the Sheriff's Department from the city's Department of Public Health and San Francisco General Hospital and reinvest the funds into the community to create systems committed to care, de-escalation, and community accountability. 

As a part of DPH Must Divest, we advocated for reductions in policing, expansion of behavioral health resources, and funding for a community safety pilot.

 A series of small actions became a collective movement - with every email, petition signature, testimony, meeting, and weekly Zoom gathering, we campaigned for DPH administrators and city officials to make changes to the annual city budget that led to less policing and more care.

Our advocacy was instrumental in getting a reduction, although not elimination, of the number of sheriffs that were employed at the hospital. A key victory was the major expansion of a Behavioral Emergency Response Team (BERT) - a team of psychiatric nurses and technicians with training in de-escalation that could be the first responders to patients with behavioral crises in the hospital. As Ruth Wilson Gilmore has said: “Abolition is about presence, not absence. It's about building life-affirming institutions.” Although there is still work to be done, these changes were a step in the right direction. Abolition is about progress.

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As I saw those three sheriffs walking down the hallways, I noticed that the BERT team had already made it to the room, and were liaising with our care team about what to do. Then, a BERT team member, seeing the Sheriffs nearing the room, walked out, raised a cautionary hand, and asked the Sherrifs to stop. The tension that had been building was suddening cut. The BERT team informed the Sheriffs that the situation was under control and that they could leave. 

In some ways, it was just a simple no. A brief, but firm refusal to utilize policing as a means of security or de-escalation. But to me it represented so much more. It represented years of advocacy. It represented the healing environment that is possible when we have safe staffing for our nurses and doctors and an alternative to policing when responding to patients in crisis. 

To me, abolition does not describe a world in which we do not have police, it describes a world in which we do not need police. The racialized systems of policing, surveillance, and incarceration are prevalent in nearly all parts of American society, and healthcare and medicine are no exception.  Medicine has a long history of perpetuating oppression, discrimination, and injustice, and I would like to see our community engage more seriously with the practice of abolition as we strive for social justice and equity. I believe that policing and the carceral system are some of the most egregious public health crises of our lifetime, and we must reinvent, not reform, the system in order to see any substantial change.

Medicine must recognize and address that policing is not designed to be a healing system and is never the answer to conflict in the healthcare setting. Healing cannot happen when people seeking or providing care are traumatized by past and present experiences with law enforcement personnel in healthcare spaces. We must invest in policies and practices that are grounded in healing instead of relying on the inherently violent system of policing to keep our patients and providers safe in clinics and hospitals. 

My name is Norman Archer and I am a fourth-year medical student at UCSF in San Francisco, California. I believe that the abolitionist values of imagination, justice and healing are essential to the practice of medicine.