The Medical Myths of State Violence

A Review of Excited Delirium: Race, Police Violence, and the Invention of a Disease by Aisha
Beliso-De Jesús

In Excited Delirium (Duke UP, 2024), anthropologist Aisha Beliso-De Jesús explores how a long history of medicalizing state-sanctioned violence has contributed to the carceral arrangements that contextualize Black and Brown life in the U.S. The ongoing surveillance, confinement, and brutalization of Black bodies have long operated in tandem with medical theories that dehumanize Black people and justify their subjection to unremitting violence. 

This confluence is staged most clearly through interactions with police. At a time when the death of Black people at the hands of law enforcement is replayed on loop across every social media platform, we’re often told their untimely deaths are due to everything but what we see on screen. At the heart of Excited Delirium is a direct challenge to medicalized narratives that both prime Black people for premature death and scientifically blame them for dying. 

Medical examiners and law enforcement play pivotal roles in maintaining the cycle of racist scientific theorization and physical violence aimed at Black and, increasingly, Brown bodies. The theories that situate Black people outside the purview of full humanity both predetermine and justify the wanton violence enacted by law enforcement. 

Beliso-De Jesús examines this phenomenon by paying special attention to the ways Afro-Latiné religious practices were criminalized to bolster the fabricated diagnosis of “excited delirium syndrome.” Initially identified in 1980 by Miami-based medical examiner and self-proclaimed expert on Afro-Caribbean religious “cults,” Charles Wetli, excited delirium syndrome soon became a tool wielded by coroners and police departments across the country to absolve and erase police accountability for the deaths of Black women and men.

More specifically, Beliso-De Jesús unpacks the “deliberate and methodological way that racialized criminality is crafted through academic research and scholarship,” turning a critical eye toward Wetli’s notorious article, “Tattoos of the Marielitos.” In it, Wetli peddled harmful stereotypes of the dark-skinned Mariel Cubans, who—unlike their white Cuban counterparts—were met with incarceration upon arriving in the U.S., a fate largely justified through the criminalization of their Afro-Caribbean spiritual practices. Beliso-De Jesús compellingly reveals what could be considered the “Blackening” of Mariel Cubans in the U.S. and how this racialization was operationalized through police violence and incarceration. This process still plays out in the present day, where immigrant populations are criminalized and caged at the U.S. border, and where false medical diagnoses continue to hold utility in narrating—and naturalizing—Black death.

Beliso-De Jesús’s approach, which crosses disciplinary lines in anthropology, Black studies, Latinx studies, and carceral studies, also allows her to link excited delirium syndrome to the scientific abuse of Black women in the age of slavery. “Fascinated with African women’s abilities in childbirth,” she writes, “Europeans used the myth of Black female ‘superhuman’ strength to justify breeding them like cattle” (49). According to Beliso-De Jesús, Black women were “never allowed to be victims, even when murdered” in favor of reinforcing White expertise (55). This becomes the basis for continued violence aimed at Black and Brown people and the medicalized justification for serialized abuse. 

In this regard, Excited Delirium resonates with Dorothy Roberts’s seminal text, Killing the Black Body (1997), which maps the historic role of reproductive control and medical abuse in the regulation of Black life. While Roberts outlines how scientific racism and state power colluded to control Black women’s bodies through forced sterilization, coerced reproduction, and pathologized motherhood, Beliso-De Jesús extends this critique into the 21st century by showing how the medicalization of police violence works to naturalize Black and Brown death. Both scholars expose the enduring logics of racialized medicine and the institutional practices that legitimize anti-Black violence under the guise of scientific authority.

Across twelve chapters, Beliso-De Jesús presents the history of medicalized state-sanctioned violence via excited delirium syndrome through a compelling combination of historiography, ethnography, and memoir. Peppered throughout the text are the author’s personal stories and interactions, which help contextualize the far-reaching implications of the diagnosis and her positionality as an Afro-Latiné woman and scholar researching the spectrum of Black and Brown death within the U.S. carceral system. 

In a particularly poignant methodological turn, Beliso-De Jesús includes a series of journal entries at the end of each chapter, inviting readers to follow along with her unfolding discovery of the fraudulent diagnosis of excited delirium. “The journals also illustrate,” she notes, “how my Afro-Latiné cultural traditions are part of my own healing process—of being a scholar traumatized by what my research uncovered, of needing to find a way through this material” (9). In doing so, Beliso-De Jesús models a scholarly praxis that is deeply personal and political, one that centers not only interdisciplinary rigor but also cultural rootedness and emotional honesty.

While excited delirium syndrome has been formally discredited in recent years—most notably by the American Medical Association and other leading medical bodies—it continues to inform the coded language that police departments use to narrate Black death. Excited Delirium disrupts these pseudo-scientific frameworks that criminalize Black and Brown bodies and justify their brutalization. By drawing connections to the historical mistreatment of Black women during slavery, the Blackening of Mariel Cubans in the 1980s, and episodes of contemporary police violence such as the murders of George Floyd and Keenan Darnell, Beliso-De Jesús opens up space for further study at the intersection of race, police violence, and the historical weaponization of medical science. 

Blurring the lines between academic critique and embodied knowledge, Excited Delirium further offers a model for future scholarship that engages with the carceral state not only as a site of study but as a structure of feeling and lived experience. Beliso-De Jesús’s narrative strategy ensures that her readers are not just informed, but implicated—and therefore, made to reckon with the ongoing epistemic and physical violence that underwrites state-sanctioned death.

Kevin Morris is a native of Los Angeles, CA, and is currently a doctoral candidate at UMass Amherst. In addition to his interests in issues at the intersection of race, carcerality, and expressive culture, Kevin is a hip-hop head and sports junkie.