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Oleoresin capsicum spray, better known as pepper spray, is a chemical weapon made from concentrated chili pepper extracts. In addition to causing intense pain and irritation of the eyes, respiratory tract, and skin, pepper spray can cause corneal abrasions and, in rare instances, death.

UpToDate, the clinical practice bible for doctors, nurses, and other health care workers, delivers just three hits for the search terms “pepper spray” and “oleoresin capsicum.” None of them provides information on treating patients exposed to pepper spray; one even recommends its use in controlling agitated patients. The omission of this treatment information, as well as a recommendation to use chemical warfare agents on patients, reflects the apathy of the medical community toward police violence in the United States, if not its tacit approval.


Ignoring police militarization and brutality directed at people of color — or participating in it through university private police forces — is especially disturbing given the long-standing tensions between academic health care systems and Black and brown communities. Despite their professed missions to serve society, academic medical centers often cause harm to surrounding low-resource communities of color. Damage has been and continues to be wrought through willful neglect, unethical human experimentation, predatory billing practices, community displacement, class-based care structures, and use of tax-exempt statuses to withhold funds from chronically underfunded communities. Segregation of health care access by race and class has exacerbated the disparate impact of Covid-19, contributing to excess deaths in Black and Native Americans.

The leaders at many medical schools and academic medical centers have released statements lamenting the killing of George Floyd and acknowledging the need to engage in the fight against racism. Even the most sincere letters contain few action items beyond “virtual reflection spaces” and “listening sessions.” While protests erupt in the streets and race-based police violence reaches a fever pitch, those in the medical community able to mitigate injury-related morbidity and mortality are generally absent from protest sites. Leaders of these centers for the most part stay inside their marbled fortresses, wringing their hands and attending town halls to discuss the very public health crisis raging outside their walls. Meanwhile, the street medics, legal observers, and journalists who are fulfilling their moral and professional obligations at protest sites have been directly targeted by police violence.

To mitigate harm, academic medical centers should provide emergency support during the ongoing protests against police brutality by delivering on-site health care for protesters. This includes setting up tents where protesters gather and providing treatment for injuries sustained due to police violence. Ambulances should stand ready to transfer those with serious injuries to hospitals without delay. Medical and nursing schools should train their students about protest medicine and equip them, and clinicians, with the ability to deliver evidence-based care for injuries caused by tear gas, pepper spray, rubber bullets, trampling, dog bites, police batons, flash-bang grenades, and more.


Schools of law should send faculty and students to act as observers and provide legal assistance. Journalism schools should send their own representatives to bear witness. The presence of large groups of sanctioned representatives from academic institutions could significantly deter police violence, protecting protesters. It could also help win the trust of communities that are often harmed by these institutions.

In addition to working to remove all types of racism from inside and outside of their communities, there is much academic medical center and medical societies can do. Here are just two examples from this week:

The American Academy of Ophthalmology condemned the weapons police are using that have already permanently blinded several protesters and damaged the eyes of many others. The academy also offered detailed, evidence-based advice to protesters on how to treat eye injuries caused by these weapons.

Yale New Haven Hospital and Yale School of Medicine, where we are students, donated 2,000 masks to the Black Lives Matter protest in New Haven on Friday and Yale volunteers distributed them. The donation was organized by resident physicians and supported by the chief medical officer of Yale New Haven Hospital and Dr. Gary Desir, chair of the department of internal medicine and the first Black person to chair any department at Yale School of Medicine. This donation is an important first step, but more must be done.

While academic centers can and should try to rebuild community trust by aiding protesters, they should not use protests as commercial or promotional opportunities, nor should they take them over. We cannot risk smothering the voices of the community members that started these grassroots movements. Instead, those in the ivory tower should leverage their considerable resources to protect the lives they say they value.

While gathering in crowds risks the spread of Covid-19, distribution of masks and hand sanitizer at protests can help mitigate this danger. People are risking their lives because this is a life or death issue for Black Americans. In eight large U.S. cities, yearly police killings of Black men exceed the national murder rate. In the U.S., police violence is the sixth leading cause of death among young Black men, and years of life lost to police violence is similar to those from maternal deaths or meningitis.

Clinicians do not battle perinatal mortality and infectious diseases with listening sessions and warmly worded emails. They do it with urgent, evidence-based medical care. It is time to cross the town-and-gown divide and take to the streets.

Carrie Flynn is a fifth-year M.D./Ph.D. student and Chinye Ijeli is a first-year M.D. student at Yale School of Medicine.

  • The premise upon which this entire episode is based is a Fraud or Falsehood if you prefer. A terrible event occurred that all agree should not have. Good research and data show there is NO systemic racism in policing. Per Heather MacDonald,researcher, “police shootings are not the reason that blacks die of homicide at 8 times the rate of whites and Hispanics combined: criminal violence is.” In 2019, police fatally shot 9 unarmed blacks and 19 unarmed whites( much decreased from 2015). Most of those”unarmed” either attacked police,attempted police gun confiscation or other offensive maneuver.
    So please reduce the hysterical rhetoric for this is a Political Movement using this as “a ruse” as civil rights leader Robert Woodson opines.

  • I can not speak to black people being harassed by police or white people – but the idea that police are killing black people in disproportionate numbers is false.
    The stats on this, used by the advocates for “reform” show about 200 black people killed by police every year. There are about 47M black people in the US- any individual black person’s chance of being killed by the cops is about 1 in 235,000 in a year.
    Over a lifetime, this means one has a not insignificant, but still very small, chance of being killed by a cop – and it is worth pointing out, many of those killed are very very young.
    And of course, that person killed may be connected to many others who care about them.
    So, this topic should not be blown off- but the fact is, white people get killed by cops, and not at some tiny rate compared to black people, roughly half as much – but the white crime rate, to be blunt about it, is less than half as high.
    Considering the difference in crime rates, the cops are simply not killing blacks more than whites – it is all a myth. ”
    Feeling angry because the cops were disrespectful, or even getting wrongly arrested, or even roughed up by the cops – none of which, in my opinion, are rare at all – is different than being killed.
    We’ve got cops being gunned down now, randomly, who did nothing at all – because of this paradigm of the cops killing black people – if there is a group out to kill you, doesn’t it make sense to kill them back? It might not save you, but at least you can even up the score?
    This has to stop – if this is going to be looked at from a public health standpoint, the true numbers need to be publicized.

    • Mr. White,
      Our piece certainly seems to have touched a nerve with you, as this is your third lengthy comment. You have not cited your claim that only 200 black people are killed per year by police or that they are not killed more than white people. We cited two credible studies in our essay that refute both of your claims; here they are again:

      It is difficult to analyze crime data because arrests and crimes committed are not the same thing. The fact that black people are arrested for crimes at a higher rate than white people could mean that they commit more crimes, or it could mean that they are arrested more often (even if they don’t commit more crimes). This is further complicated by likely confounding factors such as SES. Because of these and other considerations, there is no definitive evidence linking race to crime.

      There are, however, subsets of crime that have been thoroughly studied and demonstrate that black Americans face significantly more policing and arrests despite equivalent or lower rates of offenses. One example is “stop and frisk” in NYC. This has been studied extensively; one group reported that over 90% of those stopped were nonwhite. White people were found with weapons (the purported goal of the policy) significantly more often than black people–more than 6% vs less than 2%, respectively. Link to this paper:'s_Stop_and_Frisk_Program_A_Spatial_and_Statistical_Analysis/links/566598ba08ae192bbf9252f0/What-Do-We-Know-About-NYCs-Stop-and-Frisk-Program-A-Spatial-and-Statistical-Analysis.pdf

      Another well-studied example is drug use. White Americans use drugs at slightly higher rates than black Americans and sell drugs at similar rates. Black Americans, however, are significantly more likely to be arrested for drug use or sale. This chart demonstrates this stark difference:

      These and other examples, in the context of the history of white supremacy and criminal justice in this country, lead me to reasonably conclude that raw crime data is deeply misleading. I highly recommend the book “The New Jim Crow” by Michelle Alexander.

      Additionally, we condemn police violence against all people. We are outraged by every incident of state violence, no matter the race of the victim. This is highlighted by the case of the 75-year-old white man who was recently pushed by police in Buffalo, NY while simply talking to police officers. His head slammed into the sidewalk and video shows blood pooling under his head. Supporters of the #blacklivesmatter movement have spoken out against the incident and demanded accountability for the officers involved. 57 of their fellow police officers resigned in protest after 2 cops involved were suspended, demonstrating that the culture of violence (and denial of accountability) within police forces is widespread. Article and video:

      Finally, I find your rhetoric about police killing black civilians to “even up the score” utterly disgusting and indefensible. I hope you are not a member of the medical community (and must assume you are not, given your lack of critical thinking and apparent inability to find basic information on Google), though you seem to frequently comment on STAT articles. I am unlikely to respond to your other comments as I do not think you are making these explicitly racist and violent arguments in good faith. This response is mostly for the benefit of others who may not know much about this topic. I hope you are able to free yourself of the chains of hate that bind your heart and mind.

      Carrie Flynn

    • Dr. Flynn,
      I have to dispute almost everything you wrote. None of it seems to hold up.
      First, how many black people the cops kill every year – granted, I got my numbers from what appears to be an advocacy website, I should maybe be more careful. But everywhere I looked online, the number of about 200 came up – along with the number of somewhere around 1,000 total people killed per year – almost half white.
      Your claim of black men being 2.5 times more likely to be killed than white men seems to be verified by those numbers – of twice as many white as black people killed, but there are about five times more white people than black people -but if there are 200 people killed per year, over a lifetime of 70 years, 14,000 are killed – which is less than the 1 in 1,000 the PNAS paper claimed – though not way less, more like 1 in 1,500 rather than 1 in 1,000.
      I am not seeing any significant refutation of my claims in the papers you cited. If I am off, it is because the numbers given out by multiple sources are wrong, but I could be far off for all I know. I can not defend my numbers except again to say they are widely claimed by advocates who I assumed are not understating the numbers.

      But then you go into a claim “there is no definitive evidence linking race to crime” – to make this claim, you have to reject all evidence against it as not being “definitive” – the arrest rates, the conviction rates, the incarceration rates, and so on – and what about the claimed murder rates for black men – which is an interesting conundrum I think for someone with what seem to be your political views – we are constantly told black men, particularly young black men, are murdered at very high rates – so, is that a myth? IF not a myth, we are told most of the murders are committed by other black men. So, is THAT a myth, and they are really being murdered by other groups?
      Because if what we are told is true, that really a high number of young black men get killed by other young black men – then there is “definitive evidence” of a big difference in crime rate right there. If all the activists telling young black men “stop killing each other” are suffering under a delusion, you should let them know and maybe help find all those previously unknown and apparently not even suspected killers.
      Leaving aside that specific type of black on black violence- the “definitive” evidence for a much higher black crime rate is pretty much everywhere. When you tell me there is no such evidence, I can not really take you seriously. But, under the theory that I have to cite “studies” by academics to give you “definitive evidence” since you reject the entire criminal justice system and all the evidence around you, I will throw it back to you – do you have ANY evidence black crime rates are roughly the same as white crime rates overall? You claim drug use is more common among white people – that is not what I have seen and I very much doubt it – but leave that one aside – how about all the crimes people care about? Armed robberies, assaults, murders, rapes, car thefts, car burglaries, home invasions – do you have any evidence they are about the same? The burden of proof is on YOU, not me – you rejected the evidence of the criminal justice system as not being “definitive” while offering no evidence for that claim. The truth is, as some activists often lament, very disproportionate numbers of black men are in prison for crimes with victims – if you claim there are a bunch of white people – like 5 times as many white people – who committed comparable crimes but are not in prison for them – show me the evidence of that.
      I can not really abide a discussion with someone who will not admit the huge difference in crime rates is real. That is too far down the rabbit hole.

    • We did not select the photo for the article. More importantly, we denounce and condemn state violence against all people, regardless of race. I am sorry you find this serious issue humorous and hope you are not a medical provider.

  • STAT must have reimaged itself as a journal of political medicine. Recent retractions in NEJM and Lancet prove that science journals, and in this case STAT, are not obliged to reflect truth, especially the whole truth. Rather, the creative task here for journalists is “how can we spin this event into a story that supports black rights, and for other journalists supports destroying black lives and this country?”

    At least let’s start with the FACTS, not fables.
    The cop was no prince.
    What I know (from video): he was not seasoned at his job, should have had his colleague cops help him subdue Floyd, rather than watching this unapproved (?) neck-knee maneuver on him.
    This cop also had some prior charges of police brutality in past. Don’t know more details than that.

    Turns out Floyd was no prince, either.
    The media omitted a few salient details. The “victim,” Floyd had been high on fentanyl and methamphetamine later identified in 2 autopsies. He had a white baggie drop from his pocket while being apprehended. (It’s on the video, but minimized in media versions) The cops had been summoned to that spot by a store owner who reported Floyd. He had been trying to pass a counterfeit $100 bill and was high on drugs.
    What isn’t there is footage of Floyd before he had been put in that horrifying hold. We just see him go down, don’t have any idea what the police tried before that last move . Watching this death immediately sparks the protest, “No one should die this way.” No one should. But in war, mobs, even families, especially with drugs involved, rules of behavior unravel and things happen that shouldn’t. We don’t like it, but that’s different from deciding blame outside a Courtroom and without all the facts.

    “So what if he was high? Does that mean he deserves to die?”

    This question and answer only matters if you want to learn the truth.
    If you believe you have enough information to go out and loot, terrorize small business owners, beat some of them senseless, yank drivers out of their cars, then I guess this is the “now” America . Now you can do anything you “feel comfortable” doing. Reading beyond this point is not necessary, especially if you live in California or New York. Governments there will be on your side, protecting your liberties to injure those you don’t know. In fact, you should censor the rest of this article. More details will only introduce ambiguities that confuse, and may result in more thinking and less feeling.
    Anyone in ER, Psych work who has handled those “high” on the potentially psychotic producing combo of fentanyl/methamphetamine know that these folks spinning out are unreachable with words. In their minds, they may be fighting off space aliens. They easily break into violence. Floyd, the Everyman’s “Hulk” was big and flailing. He would have been a challenge for anyone to subdue, especially in the middle of a march/mob.

    About 1-2 months before, Floyd had been released from 5 years in prison. His crime was home invasion with 5 other men. He had subdued the pregnant mother-to-be, also black, by sticking the barrel of his gun against her swollen belly. She was alone when they burst through the door and ransacked her home for money and drugs. Before that, his other offenses every few years were about armed robbery, etc., with 6 months prison terms.

    For myself, watching Floyd’s death was wrenching, every moment the silent scream in my chest belting out “that’s enough.” The few moments we saw, likely selected for that effect, does not tell the whole story. Neither character in this mad collision of destinies was a prince of humanity. The assignment of blame should be done by a jury, not a mob and not a media who play “only need to know” reporting with the public .
    What we don’t need from a science journal is more noise on awful events jacked up to international coverage.
    Dear STAT, you have plenty to cover without being part of the problem.

  • I believe that the people who have it the very worst (in life in general) are the racial minorities who are also transgender, gay, etc. Often, people are only sympathetic to one group or the other, but rarely do we find people who are both racially tolerant and tolerant toward transgender people. Many years ago, I enjoyed being part of a school group where activities shared by multiple diverse school organizations (the blacks, the gay and lesbian group, the latino group, the transgender group, etc.) giving everyone a chance to meet people from different categories.

    Definitely time to stop violence toward Blacks. Also raising awareness of a group who’s life expectancy is reported to be in their 30’s in the USA, and below that in many other areas of the world, And,

    What I hope will come from this:
    1. Changes to public policy.
    2. Networking across state lines, sharing ideas, support.
    3. Protesters to report problems behind bars if arrested, any illness/covid, any horrible treatment.
    4. Respect for people of color/mixed race who are also members of other persecuted minority groups.

  • I hope my Comment will not be censored – I am making a point about statistical claims made in the article, which, if not valid, should be refuted by facts or logic, not simply suppressed.

    The authors link to a website which is making claims which I believe will be misleading to many people.

    They say “In eight large US cities, yearly police killings of black men exceed the national murder rate” – and link to “” which lists the cities, and shows how they compare to the national murder rate, which they claim is 5/100,000/year.

    The problem is, it appears there would always be cities on this list, no matter what the police do, (except renounce all deadly force) and in many cases, there would be no statistical significance to it.

    The reason is simple – some of those cities have so few black people, if there is one killing by police, the rate of killing will be very high.

    Hialeah Florida for example has per the Web, 1,200 black people.

    With the claimed national murder rate of 5/100,000/year – over the seven years of the study, 7 years x 1,200 people = 8,400 person/years – but it takes on average 20,000 person/years per murder – so if they cops kill one person in the seven years, they are way over the national murder rate – but this gives us no idea whatever if the Hialeah police are dangerous to black people – one incident simply does not reach any statistical significance at all.

    Similarly, many of the cities on the list have very low black populations so the same principle applies to them – one killing skews them to appear to be KKK lynchers, when in fact, they are good police departments (maybe, again we do not know really) and more importantly SOME police departments in some largely white cities will show up on the list because of pure chance.

    So, a claim is being made based on a statistic that can not, in my view, fail to mislead.

    Again, I hope the authors will address this rather than bury my Comment.

  • Anyone ever consider checking statistics to see if these claims have any basis in reality? No? Yes, that’s obvious. But yes, let’s base everything on feels and notions and obedience to leftist propaganda. All aspects of life are pop culture now it seems. Children and the uninformed are the arbiters of truth and critical thinking is a patriarchal device of oppression. I’d say Lenin would be proud, but he would still call you useful idiots. And remember the revolutionary maxim, ‘Even the liberal gets the bullet’.

  • I had to chuckle, the authors are actually from Yale.
    I am not going to say the cops never do wrong, obviously, but the rates of police killings of white people are lower, for the crime rate, than for black people – the entire Black Lives Matter meme is wrong- the police are not out killing black people more than others – it is actually less.
    I know there is racism in society – but we are also 155 years after slavery – that is a LONG TIME – and 56 years after the Civil Rights Act – and about 40 years into affirmative action, which really is unfair to those who do lose jobs and university admissions because of it.
    In a country of 330 Million people – there are going to be interracial abuses evrery day – and some of it will be motivated by racism, but the basic idea of cops out killing blacks in disproportionate numbers is proven false, beyond any doubt, by the DOJ stats. It is NOT happening.
    The protesters are weak-minded people who have been brainwashed by teachers, mostly, who grew up on “To Kill a Mockingbird” and the like – in other words, what MIGHT have been going on 70 years ago – we can all trust Hollywood to be accurate about history, right?
    It’s all a big delusion, and no one has the courage to say that.

  • Police killings increase Black-specific mortality rates. Even though only two percent of injuries from police interventions that require treatment in the emergency department or hospital result in death, 11 Blacks are almost five times more likely than are Whites to have a police intervention-related injury. 12 Little is known about the prevalence of nonlethal police violence that results in injury or disability. This is an area for further investigation.

  • “The prosecution of protesters charged with these low-level offenses undermines critical bonds between law enforcement and the communities we serve,” Mr. Vance said in a statement. “Our office has a moral imperative to enact public policies which assure all New Yorkers that in our justice system and our society, black lives matter and police violence is a crime.”

    • Pepper Spray – is a tool used by police during protests, because people who go to protests, might start out with good intentions, but it is an emotionally volatile situation. They start pushing in close to the police, screaming in their faces, calling them names, and some start hurling projectiles at them. There is mayhem and violence, even the signs have some violent saying on them.

      I can tell you this, if I went to a protest and acted the way a lot of these protesters act, aggressive, loud, insulting, waving my arms, and moving toward police, I would not be surprised to find myself in the middle of a riot.

      And sure, I might get pepper sprayed, even if I thought I was not doing anything wrong, because of the way that many people all together, can turn into a mob and overwhelm the police. I would expect to be pepper sprayed in some instances and actually, I’d rather be pepper sprayed than shot.

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