Dr. Doug Murdock's critique (“Standing for Justice and the Police.” [letter] EMN. 2020;42:27; https://bit.ly/3lT2n6J) of Dr. Graham Walker's column, “What does ‘Defund the Police’ Mean to the ED?” (EMN. 2020;429; https://bit.ly/3hP5af2) prompted me to reread Dr. Walker's article.
I once again found the article to be balanced, compassionate, and open-minded about solutions to the problems facing society while at the same time carefully avoiding criticism of law enforcement. Dr. Murdock appeals to fear by eliciting imagery of a criminal holding a 9 mm handgun to the head of an officer, while Dr. Walker rationally addresses the uncontroversial concern that our police forces—like our EDs—are being asked to do too much.
Dr. Murdock attacks a common straw man, namely, that advocates of “defunding” want to deprive law enforcement of its right to self-defense. This is yet another example of poisonous tribalism in today's society eroding our ability to have constructive discussions. A fair reading of Dr. Walker's article clearly refutes the claim that he “wants to punish those who aim to protect the rest of us.”
Because the term “defunding” triggers controversy, I propose something that is consistent with many years' worth of right-wing and left-wing talking points. Let's demilitarize the police instead of defunding them. Whatever resources are freed in that respect should be added to the effort to increase funding for vital community services such as mental health care. The political right has often advanced support for mental health in lieu of gun control measures, and here is a chance to walk the talk. The analogy to the emergency department would be redirecting a small portion of our resources to ensure that we no longer have to manage psychiatric boarders and to help not-sick patients be seen by urgent and primary care so we can focus on what we do best: resuscitation and saving lives.
Also, Dr. Brian Tobe's letter in the same issue argued that Hawaii is farther west than Unalaska, AK, “in all respects.” (EMN. 2020;42:9; https://bit.ly/3ff8gZd.) There are various ways to measure this, but longitude is the gold standard for measuring westerliness. The Iliuliuk Family and Health Services in Unalaska lies at approximately 166°32'21”W. The westernmost hospital in Hawaii (according to Wikipedia) is the Kauai Veterans Memorial Hospital at approximately 159°40'18”W. Alaska is so far west, crossing the antimeridian, that it can claim the title of the most westerly and the most easterly state in the United States. The editors got it right the first time.
Malcolm Schongalla, MD