S1:E2 Dead Don’t Float but They Do Vote

10 JUN 2020

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The dead don’t vote but they do float.

Whilst murder stands as the most egregious crime on the books, the crime for which we extended the greatest punishment and hold the offender in the lowest regard, it is apparently not a crime to tamper with the dead after they become numbers on a piece of paper.

The dead, and the space around a dead body, create a presumed crime scene with three exceptions: Death in care facilities, death in hospitals, and death when in hospice. For professionals such as medical personnel and law enforcement officers, we follow routines / protocols. We carefully, respectfully, step through processes. As EMS chief in a tiny town in Vermont with no police department, I expect to remain with the crime scene for at least 4 hours. Maybe I’ll be released when the detectives arrive at hour two. Maybe I’ll leave after the medical examiner calls me to evaluate if he makes the lengthy drive.

Over thirty years ago, as young EMT on ambulances in Metro Boston we slogged our way through a horrible hot spell. Pre-shift, we stocked coolers with ice and boxes of body bags. Hour after hour the crews responded to hot cramped apartments with dead bodies: primarily elderly and immigrant folk. Bag, tag, zip, and chill with ice. We’d beet feet the moment a cop arrived. The assumption of crime vaporized with the heat. We managed a public health crisis. Dead bodies became hazards. And in Massachusetts, ambulances don’t transport dead people – we only transport patients.

This is the spectrum. In times of peace and calm, we hold hands. We carefully guide families through a difficult day. Families gather, mourn, remember, and bury the dead in accordance with their own traditions. In the Army, you never leave a fallen comrade. In Jewish communities, one sits shiva. In Muslim communities, the people wash and care for the dead.

Flip a switch to turn on calamity, we wheel a wagon through the street shouting: Bring out your dead. When it comes down to it, a society cannot have dead bodies rotting on the third floor of a triple decker (the Boston word for a row house or terraced housing).

When I arrived in Puerto Rico following Hurricanes Irma and Maria to work for the Governor on the financial recovery process.  I sat at the table below the sign: Governor’s Authorized Representative. There is a picture of me in Forbes Magazine saying something hopeful: “Meet the programmer trying to prevent the second disaster”.  Two investigators (an MBA and an engineer) returned to our table daily with dumbstruck stories of horror and sadness.

What do we do about dead bodies floating in the flooded road? The continuing rains of October 2017 washed a hillside away liberating corpses from the community graveyard.

Dead bodies rotted at the morgue and funeral homes. The facilities had no power, no refrigeration. It took time and FEMA funds to develop a plan: drive the island, pick up the dead bodies then place them in 55-foot refrigerated trucks guarded by the U.S. Army’s 246th Quarter Master Company. On the 11th of November 2017, there were 11 such trucks with bodies. In 2019, these trucks still held corpses.

Container Trucks with Corpses
Container Trucks with Corpses (c) 2018 Xavier Garcia/Bloomberg

There is no handholding. No ritualized washing and mourning during these tortured times. Instead of a somber moment capturing a social security number, a date of birth and the correct spelling of a name, officials (me included) focus on saving the living.

Instead of recognizing that over 4,000 Citizens of the United States likely died due to the impact the storms, the governor of Puerto Rico reported 64 deaths.  

In 2017 the government worked to define Hurricane-related deaths. How does one define a hurricane related death? Is a body floating in water the days or weeks after a storm the result of the storm? What about people who died because their medications went unrefrigerated? Or people who died of a diabetic or cardiac emergency who could not get prompt medical care? Or people who died of sepsis or infection due to lack of medical care?  Within a year, academics argued that 2,950 people should be in that count. In 2020, friends in Puerto Rico stand firmly that we lost 4,000 Americans as a result of that storm. 4,000 people from a population estimated between 3 and 4 million.

In the matter of a few weeks, 1/10th of 1 percent of the population died. 4,000 voters gone. 4,000 people who participated in a struggling economy disappeared.

It matters!

64 people, 2,950 people or 4,000 people. What is the truth? We don’t know. And the dead don’t vote, do they (well, not legally anyway). The dead have no voice – none except the words scribble on their death certificates. That is the final word on a human life, the final slip of paper.

What would happen to me if I tampered with the evidence surrounding a death I attended? I know the answer. I’d be investigated. It is wrong, likely criminal for me to do so.

Who are we as a people when we tamper with evidence?

One would think the voice of the dead matter. What are they trying to tell us? We’ll only know if we listen.

100 years ago, Influenza ravage the globe. The death count remains disputed. We almost forgive this. No computers, paper records, a world at war, etc.

Today? The fifty-eight states and territories with a population of 300 million folks and we haven’t a clue how many people the current pandemic is killing. Jurisdictions vary in their rules. Fred is a COVID-related death because Fred tested positive. Barney had COVID but died of a stroke. Wilma has all of the COVID symptoms but the test showed negative – a test that has a margin of error of 30%.

What is a test with a 30% margin of error? It is the same as saying: this test lies one-third of the time.

What do you want written on your death certificate?  

You don’t get a vote.

Like Puerto Rico did following the 2017 hurricanes, we have stacked our dead in refrigerated trucks. We exceeded capacity. New York City stacks the unclaimed dead in mass graves on Hart Island – a 130-acre island accessible only by ferry boat.

Months from now, researchers will comb through states vital statistics and death certificates striving to give the dead a voice. They will ask each silent corpse, what did you die of during the pandemic?

What have we learned from Hurricane Maria in Puerto Rico?

What did we learn from the 1918 pandemic?

What have we learned so far in 2020?

You can answer that just as well as I