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Hate Medicine

dr-in-prison-hate-medicine

We watched him dying. Everyone on our wing had their own diagnosis.

“Cirrhosis.”

“It’s jaundice. Look at how yellow he is.”

“How can you tell? He’s hispanic.”

“Next time you get close to him, look at his eyes. They are yellow.”

“I bet he has liver cancer. Look at how skinny he’s gotten. If he weighs a hundred pounds I’d be surprised.”

Several of us wrote requests to medical. “You really must help this man.” Somebody took a guard quietly to the side of the dayroom after our requests went unanswered.

“You see that guy standing on the wall next to 101 cell?”

“Sure.”

“He’s dying. When you do an in and out, take a close look at him. He never goes to chow, his celly says he has chronic diarrhea. Somebody has got to do something for him. Medical is ignoring us.”

At first, our attentions were discreet. But later we openly made pests of ourselves, asking him daily if he needed help, if he was feeling okay. His stoic refusals led us to believe he was committing an agonizingly slow suicide. Finally, medical responded, though we were certain it was too late. He refused treatment time and time again. To the Warden’s credit (how word reached him nobody is sure), when he saw the man in the infirmary, he was having none of their official resignation.

“What are you doing for this  man?”

“Nothing. He’s refusing treatment.”

“Oh, hell no! He’s going to the hospital. Now!”

That was the last we saw of him. We’ve heard nothing since about whether he lived or died but we kept him in our prayers.

It’s probably like this in other states but certainly in Texas, the prison system is loathe to even hint that they employ people who care about inmates. Thus, every nurse station is labeled an ‘infirmary,’ every form requesting medical care is a ‘sick call,’ and you pick up your medication at the ‘pill window.’ Outside. Rain, snow, sleet, or shine.

To say that prisons do a poor job of delivering health care is a gross understatement. Prison Legal News has been at the forefront of reporting and litigation on behalf of inmates who’ve suffered medical malpractice. You can find, in their archives, article upon article describing lawsuits against prisons which have neglected inmates to the point of serious injury and death. In many cases, suffering could have easily been prevented.

A libertarian-minded person might argue that government hires the least qualified since they pay below-market labor rates; look at the VA for instance. There may be some truth in that. Yet, incompetence alone can’t account for such widespread malpractice. Diseases that are routinely vanquished outside prisons are rampant and life-threatening inside them. When is the last time you heard of someone dying of a staph infection or sepsis in a hospital? It happens rarely because staph and sepsis rarely go unrecognized or untreated. In prison?

“Here’s an Ibuprofen. Go back to your cell.”

And that is after one has waited up to 72 hours for the infirmary to respond to your sick call request.

This indifference isn’t because medical staff are incompetent but because they’re trained to be belligerent. That sounds like hyperbole, doesn’t it? it’s not.

Not all belligerence leads to injury or death. Most refusals to provide care merely result in dramatic cost savings. Let’s face it, garden variety colds and flus resolve themselves. Nobody dies. They’re uncomfortable is all. Inmates will be forced to work anyway, threatened with disciplinary hearings which can jeopardize parole chances, a win-win for prison wardens.

Not all malpractice results in legal action. Very few inmates have the resources to litigate a malpractice suit.

An inmate on my unit, we’ll call him Bob, was diagnosed with brain cancer his last time down. He was given an emergency parole but was convicted of another DUI and sent back to prison. After arriving, he was transferred to the Mumford Unit to have his tumor removed. The surgery required that doctors cut away a piece of Bob’s skull. Once his tumor was removed, the piece of bone that had been cut away was fastened back to his skull using four screws and two metal plates.

About five months ago, Bob showed me a two-inch piece of bone that had pushed itself through a wound in his scalp. Also pushed out of his scalp was a titanium screw. Alarming to say the least. Bob put in a sick call request and the nurse was concerned enough to schedule a trip to the neurologist.

Going to see a medical specialist in a Texas prison is an ordeal. TDCJ does not have the resources to employ specialists at every unit. Depending on the type of specialist, an inmate might have to be transported hundreds of miles by bus, cuffed to another prisoner. In the worst case, you’re chained, shackled and hog-tied. Prior to travel, you’re required to pack all of your property and inventory it. Then at 6 AM, you’re taken to a holding cell where you can wait up to four hours for the bus to arrive.

Bob was shackled and hog-tied on his trip to the neurologist. Not once, not twice, but three times was he sent, each trip excruciating and humiliating. On the third trip he was able to converse with the specialist.

“Bob, I have good news and bad news.”

“Okay, what’s the good news?”

“The good news is you’re cancer-free. Your MRIs are negative. No sign of cancer at all.”

“That is good news! What’s the bad news?”

“We can’t see any sign of missing bone, nor can we find any of the screws we used to re-attach the piece we cut out during your surgery.”

“Wait, what?”

“They aren’t showing up. I can’t explain it really.”

Bob literally has three screws loose in his head somewhere. Unless he lodges a serious complaint, the medical professionals obligated to care for him have officially washed their hands of him.

Perhaps you’re still not convinced that belligerence is cultivated. TDCJ contracts its medical care to a corporation called UTMB* Correctional Managed Care, at several of its units. Outsourcing indemnifies it from medical malpractice lawsuits. It also jeopardizes its reputation for being tough on inmates by using a company that has the word ‘care’ in its name.

Another inmate at this unit is suing TDCJ and UTMB for injuring him and neglecting to treat his injury, namely a separated shoulder caused by an officer’s assault. The suit went to trial (Charles R. Adams v. Lieutenant Bailey, et al., – Civil Action No. H:12-CV-02520). The transcript of the trial contains UTMB’s admission of professional belligerence towards inmates.

Dr. Erin Jones, who interned as a psychiatrist and has not even one hour of experience in osteopathy, was called as an expert witness by UTMB’s lawyers. In spite of her lack of experience, she was allowed to give testimony on Adams’ shoulder condition. More interesting was the beginning of her testimony on behalf of the defense.

Q: Then when you went to work for UTMB in the correctional managed health care system did you receive any kind of training?

A: Yeah, we had training that’s called NEO.

Q: What is that?

A: New Employee Orientation. And it’s — working in corrections is very different from working in free-world medicine. And so we had to learn —

Q: Explain to us why. What is different about it?

A: Well, there is a lot more patients that want something for secondary gain. There is — basically eighty to ninety percent of our patients are either lying or exaggerating on their symptoms to try to get something. [Treatment, perhaps?]

And then, my job every day — and it’s a challenge — is that I have to find that ten to twenty percent that are really sick and take care of them because they need my help, you know. But then, you know, I don’t want to waste my time on something that’s not real, you know.

There you have it. A UTMB employee admits, under oath, that UTMB trained her to treat up to 90% of her patients as if they are lying. It’s truly absurd for Dr. Jones to complain that her job is so difficult. Imagine coming home from work and reporting that you had a terrible time disregarding 90% of your duties. Whew!

“That ten percent I did was hard but I enjoyed doing it.”

Jones offered no empirical evidence to support the claim that such a high percentage of inmates are lying and I suspect that its because UTMB doesn’t offer any either. Plain, common sense suggest the claim is a fabrication. Texas inmates are charged a $100 annual co-pay for any non-chronic care (even though they are not paid for their work). Chronic care is care for issues such as diabetes, cancer, or pre-existing conditions discovered during prisoner intake. Why would an inmate lie ‘to get something’ when it costs them $100 to do so?

It’s preposterous to conclude this unless you are interested in getting paid for work you refuse to perform. Planned, systemic belligerence. It’s not health care, it’s not medical practice, it’s hate medicine. No amount of honey can make it palatable.

*University of Texas Medical Branch

TDCJ Inmate

We All Matter

This is an email I received from our remarkable friend “Joseph,” incarcerated in Washington’s Monroe Correctional Complex. Joseph is organizing an inmate fundraiser, to help us pay for our new website after we lost our funding.

Oddly, America, and I suppose humanity as a whole has a long history of allowing our diversity to cause divisiveness.

When the English first began settling here, they persecuted and slaughtered innumerable Native Americans. Then as more Europeans came, the divisiveness continued as the Irish, German, Italian and others were designated as less than because they were different.

The era of slavery, which many of us (myself included) imagine as ending after the civil war, took on many more sinister faces.

One startling example is the Black Codes, which were enacted by the southern states post war, and required freed “blacks” to have a written verification of employment every year, else they were arrested for vagrancy, and rented out to the highest labor contractor. Then, since they were not slaves which required food and health to be useful, they would work them to death, or beat them brutally and leave them to die.

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This provoked the Reconstruction Era, and brought about the 13th, 14th, and 15th Amendments to our constitution.

However, the horrors persisted through the 1960’s when the civil rights movement gave a minor reprieve… Which brought about the creation of our modern prison industrial complex. Devastation to communities torn asunder by the incarceration of their (for the most part) men, fatherless children, families without providers…and then the return of men damaged beyond repair by their incarceration experience. Men who further burdened their communities by the cruelty they often had to embrace in order to survive inside.

Our diversity in here has caused divisiveness, historically. Whites v Blacks, Latino v Latino…and all of us against the guards, as well as society.

We are all human. We are all citizens of America. We all matter. We all have much more in common than we do differences.

Yes, my dear friend, you and I know this truth, but how do we get that message to the people that do not know?

When I get out, I intend to do public speaking and one of my key goals will be to raise awareness about the continued value of every man, woman, and child. Free or incarcerated.

Update: Yvette Louisell

We blogged about Yvette last August, and are can now report that she has been approved for work-release.

Des Moines Register story here, see text below.

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For the first time in almost 28 years, convicted murderer Yvette Louisell soon will live outside the walls of prison.

The Iowa Board of Parole voted Friday to move her to an Ames work-release program, ending years of legal wrangling that overturned an earlier sentence of life without parole.

Louisell was convicted of first-degree murder in 1987 for the killing of Keith Stilwell inside his Ames home. She was a 17-year-old college student at the time of the murder.

She is one the first Iowa inmates convicted of first-degree murder as a teenager to be granted conditional parole after a 2012 Supreme Court ruling declared that mandatory life-without-parole sentences are an unconstitutional form of cruel and unusual punishment for those who committed their crimes before turning 18.

There are more than 30 Iowa inmates who fall into this category.

She has received support from church members, sentencing reform advocates and even the prosecutor who convicted her of murder. They’ve all argued that Louisell has matured during her decades as an inmate and is ready to be released.

Louisell detailed the accomplishments she has made in the 10 months since her last parole hearing on Friday via a video feed from the Iowa Correctional Facility for Women in Mitchellville. She has a leadership role with a group that prepares inmates for release, and she has taken an increasing number of supervised trips outside the prison.

On Thursday, she rode on a DART bus to the downtown Des Moines headquarters and learned how to read bus schedules and download the transit authority’s smartphone app, she said. She earned an instructional driver’s permit during a trip to an Iowa Department of Transportation licensing center.

“Ms. Louisell has done above and beyond all that has been requested of her in the last few years, and certainly the years before that,” her attorney, Gordon Allen, told the parole board. “She’s ready to move on.”

Louisell and Allen spent three years in litigation, which ultimately led a district court judge to set aside her original life-without-parole sentence and open the door for her to one day leave prison.

Her bid for a new sentence went before the Iowa Supreme Court, and the ruling set significant precedent for how Iowa judges can sentence young people convicted of first-degree murder.

Louisell’s transition to a work-release facility will not be immediate. There is a waiting list at the Ames facility, parole board chairman John Hodges said.

Promising future

Louisell had a promising future when she graduated from high school in Michigan at age 16 and accepted a full scholarship to Iowa State University, where she planned to study politics. But she drank heavily and began suffering academically. On Dec. 6, 1987, she stabbed and killed Stilwell, 40, in his Ames home.

Louisell met the older man after taking a job modeling at a local art institute where Stilwell took classes. Stilwell, who was handicapped and needed canes to walk, offered to pay the struggling college student for private modeling sessions at his home.

At her trial, Louisell testified that he cornered her with a knife and threatened to rape her one night after she decided to quit posing privately for him. Louisell claimed that she stabbed Stilwell in self-defense after struggling for control of a knife, but she also took his wallet and tried to use his credit card at a mall before her arrest.

In a 1996 interview, Louisell said that abuse she suffered as a young child played a role in her crime. She also hedged her past claim that Stilwell tried to rape her.

“It had a lot more to do with my mental state than it had to do with his actions,” Louisell told Des Moines Register reporter Thomas O’Donnell in the interview from prison. “Because of what I came out of I took him to be threatening, you know, to be almost trapping me in a way that was very familiar to me. I didn’t have the sense to realize I could just get up and walk out of this situation.”

None of Stilwell’s family members was at Friday’s parole board hearing.

No early freedom

U.S. Supreme Court Justice Elena Kagan wrote the majority opinion in the 2012 ruling that deemed mandatory life-without-parole sentences unconstitutional for minors. She wrote that life sentences should only be used for the “rare juvenile whose crime reflects irreparable corruption.”

In late January 2014, Story County District Court Judge James Ellefson sentenced Louisell to 25 years in prison — a move that would have allowed her to be free within days.

But the ruling was put on hold while the Iowa Supreme Court considered whether Ellefson had the authority to fashion a sentence that would release Louisell while bypassing the parole board. The seven justices unanimously overturned the lower judge’s sentence last year, ruling that decisions about the release for most young killers should be left to the parole board.

Since the U.S. Supreme Court ruling, at least two other Iowa inmates sentenced as teens to life without parole have been released.

Kristina Fetters, who was imprisoned for killing her great-aunt, was released to a Des Moines hospice facility in 2013 after she was diagnosed with inoperable breast cancer. On May 12, the parole board granted work release to Mitchell Ronek, who was convicted of killing a man at a hotel in Maquoketa in 1984.

Turbulent childhood

Louisell had a turbulent childhood growing up in a family scarred by divorce and her mother’s mental illness, according to a history of her case written in the 2015 Iowa Supreme Court ruling. Louisell accidentally took LSD and experienced hallucinations when she was only 3 years old after finding the drug in her home.

In Friday’s interview with the board, Louisell said a major factor in her crime was letting her life spiral out of control without asking for help. Prison psychologists and others helping her prepare to leave prison have taught her to set aside her own independence, she said.

“I’m a very independent person, but I know that not asking for help is a huge part of what led me down the path to committing my crime,” she said. “If I have any problems, they get dealt with at the first opportunity.”

Louisell is active in Women at the Well, a prison ministry at Mitchellville coordinated through the United Methodist Church. Finding and becoming active in a church would be one of her first priorities upon leaving prison, she said.

Louisell and Allen asked the parole board to consider granting a full parole Friday, under the condition that she move into the Butterfly Freedom House, a faith-based transitional home in Ames. But, Hodges and other board members each said they preferred a more gradual release.

Louisell will be eligible for full parole at the recommendation of her parole supervisor.

Letters From Prison: The Price of Stupidity

by Frank E. Page Sr.

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Kilby Correctional Center, Montgomery, Alabama

The first officer that any male who goes to prison in the state of Alabama will meet is known as “Michael Jordan.” This is not his real name, but the nickname given him many years ago as he looks like a shrunken version of the more famous basketball player. if he had had a stroke. Inmates in Alabama county jails know and warn first-timers about this officer. I have had personal encounters with him and I would like everyone to be aware of this 30-year “decorated” officer.

Kilby Correctional Facility has a no smoking policy in the chapel for any type of religious service, or when going to see the captain (whose office is located in the chapel). Each dorm would execute church call a little differently, but all inmates had to go through a checkpoint office to get to the chapel. Kilby keeps different types of inmates separated, so there are fences inside of fences, with checkpoints along the way.

Read more…

Letters From Prison: Frequent Unexplained Deaths

From a prisoner in Sing Sing facility in New York.

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Q: Please indicate issues you would like to see addressed in your facility.

A:  Actually, everything, because management could not run a hot dog cart for a week without going out of business. Clearly they want recidivism. Keep the cells full – just like a hotel needs its rooms full. Sing Sing may be best prison in NYS, but very badly run.

Main problems are health care with ZERO education, prevention, healthy diet, age appropriate care or exercise for older men. We have frequent unexplained deaths of fairly young men. Our pharmacy is very prone to errors. After our Nurse Administrator was “fired” and arrested, they gave her another job in mental health which is technically a different agency. She kept her parking spot! Does it sound like a certain church? Educational opportunities are here only for those who fit profile of 20-25 years, above average IQ, interested in college, and no mental illness. That is about 150 out of 1600. My GED classroom has 20 seats. About 1000+ men need a GED. Obviously, this “does not compute.”

Roughly half the population has substantial mental health problems (on psych meds, zero impulse control, talking to themselves, self-medication / drug abuse, very low intelligence, illiterate in any language). Treatment of mentally ill is overmedication, zero exercise, poor diet and isolation.

For those of us who came to prison with skills and education, the problem is no opportunity to use or maintain skills. Our library is okay for fiction, otherwise zilch. Very old, e.g., vacuum tube electronics and a book on Fortran IV (might be valuable to a collector?). Car books have carburetors and crank windows.

Drug problems are major. Head in the sand about problem because “they” don’t want to explain how drugs can get through a forty-foot-high concrete wall. (Staff, of course.) Only control point is poverty of most prisoners.

Letters From Prison: A Hard Life

CKirby 10-3-2015

I am 33 years old. I have no family but a brother who is also in prison. I have really had a hard life. I was kidnapped from my grandma by my mom, physically and sexually abused, forced to live and stay in closets, from hotel to hotel, for four months. I was tied down to a car seat with an extension cord and left on a doorstep of a group home, all at the age of four years old. I was in many different placements as a child.

At the age of 18 I was kicked out of state custody with no after-care, and was found to be SMI (seriously mentally ill). At 18 1/2 years old, I was sent to prison for $500 of forgery and given four and a half years, plus two years in county jail. I did not get out of prison until age 25. I had no family, and no place to go. Seven months later I was attacked by a man and defended myself, and ended up going to prison for four more years. I got out at 29 years old, was found to be mentally disabled and put on disability. At the age of 32, I was stopped by the Gang Unit because I have a lot of tattoos. I was walking down Broadway Road and they wanted me to strip down to my boxers on the main road to take pictures of my tattoos. I said no. They got mad – four of them jumped me, and then took me to jail. I mentally broke down, slipped out of my handcuffs and hit one of the four officers two times with my hand, and for that I got 28 years flat. I don’t have anyone.

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