I Think, Therefore I Profile

Two recent events have propelled the issue of profiling to the forefront. Arizona Governor Jan Brewer signed an immigration bill that "requires police to question people if there is reason to suspect that they're in the United States illegally." And on May 1, a Pakistani-American failed to set off a car bomb in Times Square.

In both situations, Americans are exhorted to refrain from profiling. Mayor Bloomberg warned us, "We will not tolerate any bias or backlash against Pakistani or Muslim New Yorkers." Governor Schwarzenegger joked, "I was also going to give a graduation speech in Arizona this weekend. But with my accent, I was afraid they would try to deport me."

Whatever you do, the elites tell us, don't profile! But is that even humanly possible? In my earlier work in hospital nursing, we profiled from the minute we clocked in for our shift. We didn't call it profiling, of course. When I worked in the ICU, we called it "assessment." In the ER, it's known as "triage."

In the hospitals I've worked in, when a patient enters the emergency doors, he is directed to see the nurse at the triage desk first. My job was to make an instant judgment: Does this patient need to be whisked straight back to the ER proper, or can he register first and wait his turn? Sometimes the decision is easy, like when the patient thrusts a profusely bleeding forearm through the triage window. Other times I had to rely on instinct based on years of nursing caring for hundreds of patients. That instinct can easily be called profiling. Asking an experienced nurse to stop profiling in her work is like telling her to stop thinking. Not gonna happen.

For example, a typical ER note on a patient might read: "60 yo obese BM amb to ER c/o CP." Translated: Sixty-year-old obese black male walked into the ER complaining of chest pain." I'm positive that Al Sharpton would be horrified at the profiling in my note: ageism, size-ism, sexism, racism. But every bit of that note is important and tells the physician that this patient is acute. His age, size, and sex place him in three risk categories for a heart attack. And like it or not, African-Americans have a greater incidence of high blood pressure, another high-risk group. Ignoring the patient's race to avoid profiling is tantamount to malpractice.

Profiling saves time by assisting us to work more efficiently. Instead of treating each patient as a Level 1 trauma, an experienced nurse-profiler is able to organize her caseload in order to give each patient the appropriate and necessary care. Contrast this with our current TSA airport procedures. Since screeners are forbidden to use their natural instincts to profile, every passenger must treated as a terrorist. Thousands of hours and billions of dollars are wasted on useless searches. I have yet to hear of a routine TSA screening actually turning up an explosive. No one is surprised, however, to hear of the terrorist who slipped through, such as the Christmas Day underwear bomber. When everybody is profiled as a level 1, no one actually gets treated as a level 1.

Profiling saves lives. Many years ago I was working nights in an ICU at a county hospital. One of our patients, a young gang member, had been shot by a rival gang. We were warned that members of that gang were threatening to come to the hospital to "finish the job." During that shift, I was very grateful that hospital security was actively profiling everyone who came into the hospital, looking for young males of a specific race who fit the profile of that gang. The last thing I and my co-workers wanted was for a gang member to sneak in while security was questioning the elderly wife of the patient in the next bed.

The way I understand the Arizona law, police officers are expected to verify the immigration status of people they encounter during the performance of their jobs. All sorts of media, entertainment, and political stars are working themselves into a tizzy, positive that cops all over Arizona are going to start hassling random Hispanics, demanding to see their papers. As President Obama says, "If you are an Hispanic-American in Arizona, your great-grandparents may have been there before Arizona was even a state, but now suddenly if you don't have your papers and you took your kid out to get ice cream, your going to be harassed[.]"

I find this scenario ridiculous, because if the job of policeman is anything at all like the job of a nurse, then they don't have time to start hassling toddlers getting ice cream. Arizona is plagued with drug cartels and kidnappings, much of it tied to illegal immigrants. Believe me, the cops are busy enough. Besides, I have a feeling that the police are just as talented at profiling as nurses are. For the cops, appropriate profiling is a matter of survival. Listening to that profile instinct during a routine traffic stop can mean life or death. 

So let's all stop apologizing for profiling. A highly developed profiling/intuition displays an intelligent, experienced, and practical mind. President Obama and the Democrats can do all they can to make profiling illegal, but I'm going to keep on doing it. I can't help it.

You have a problem with that? Call a cop.

Carol Peracchio is a registered nurse.