17 July 2017

Bipolar Is Bullshit, Part 2 of 2

SHARING IS CARINGShare on FacebookTweet about this on TwitterShare on LinkedInEmail this to someonePin on PinterestShare on TumblrPrint this page

plates6

Read Part 1 of 2 here.

With the affirmative insanity defense working only two percent of the time, it’s safe to say that we reject it in this country.  We dislike excuses and justifications, especially for crime; we prefer retribution.  If we turn our diagnostic eye toward an offender’s own history of trauma, we assign victim status to the perp and this upends the culture of blame and shifts it towards therapeutic justice and away from the pound of flesh we want to measure on our all-knowing scales.

Who can we impugn if the perpetrator is a victim?  If we start feeling sympathy or even empathy for defendants in criminal cases, we start admitting that we’re like those defendants because we’re all victims in some way.   The PTSD-qualifying events in the Diagnostic and Statistical Manual, every shrink’s playbook, are restricted to experiences that hover around death.  The truth is that trauma lurks everywhere, even those benign places we frequent every day.  Divorce.  Humiliation.  Rejection.  Glass ceilings.  Childhood illness.  Getting arrested. Racial profiling.  Failure in anything.  Any experience of utter powerlessness is traumatic and even the most powerful people have experienced powerlessness at some point in their lives.  Those prosecutors with especially severe avenging-angel complexes probably developed their stances from experiencing their own trauma.  I don’t care what court you appear before; no judge grants immunity from pain.

Many people balk at the idea that everyone’s traumatized in some way but I think it’s true.  Trauma was once explained to me using the analogy of a stack of china plates.  If you drop the stack, then you would expect the bottom-most plate (Plate #1) to shatter in the worst way and the degrees of damage to the plates to decrease as you move away from the plate of first impact (i.e. if the bottom plate is No. 1, one would expect that No. 3 would bear more cracks than No. 7 and No. 7 more than No. 10). Bu  trauma doesn’t work that way.  The bottom plate usually sustains the most damage but often Plate No. 2 remains intact while Plate No. 6 shatters, or Plate Nos. 2 and 3 are unbroken while Plate No. 8 breaks; the plates don’t always respond they way we think they would. They’re unpredictable, kind of like people who break the law.

Trauma is like that plate-breaking force.  It has different effects on different people depending on their circumstances at the time of impact so trauma’s tear through society will be neither neat nor expected.  Who’s to say that, because your divorce didn’t shatter you,then no one else’s divorce should have shattered them? Or a that a car accident can’t have the same effect as watching your mother get beaten to death by your father? There many gradations in trauma make which make seeing it as universal counterintuitive.  But let’s face it – each of us does battle every day. Everyone’s a combat veteran of daily life.

Because it’s so prevalent is probably why PTSD remains really only a sort-of diagnosis in  criminal courtrooms; it clearly has a second class status.  At most, it’s an adjunct to other “real” mental illness and rarely the operating diagnosis in determining punishment of an offender.  When PTSD alone anchors an insanity defense, prosecutors frequently dismantle it because trauma is from the un-evidenced past – it only reaches the court record through someone’s self-report, and that someone is considered an inveterate liar by the system.  It’s possible people are malingering to avoid responsibility so prosecutors’ suspicions aren’t baseless. But forensic psychiatrists know about them and shy away from the diagnosis of PTSD for an insanity defense almost in an attempt to help the defendant.

Recently, researchers discovered a way to test objectively for PTSD; the gene p11 has been found to be significantly more expressed in the mitochondrial RNA of people who suffered trauma.  Patients – and doctors and prosecutors – can know more definitively what treatment avenues to pursue and which to ditch. Technically, now they can rely on something as conclusive as a serum blood test instead of someone’s word.

When evidence of a PTSD diagnosis is confirmed by prosecutors, studies have shown that the courts incarcerate those defendants less often, almost always sentencing them to probation, not prison. You would think that lawyers everywhere would be clamoring for these tests for their clients. I know better. I’m sure they’re smugly unaware of how this new discovery could help the people they represent.

Like I said, it’s safe to assume every woman in here has bipolar in their charts instead of PTSD. The ladies that had proper PTSD diagnoses never came inside. All that epidemiology everyone has on us in corrections? It’s totally incorrect. It’s bullshit.

THREE IDEAS IN CRIMINAL JUSTICE FROM JULY 10 – 16, 2017

booker warren

Senators Cory Booker (D-NJ) and Elizabeth Warren (D-MA) introduced a new bill, the Dignity for Incarcerated Women Act, which will, among other things, assure federal prisoners access to quality tampons and pads free of charge, keep pregnant women out of solitary confinement, and give them free phone calls to speak to their children.  If passed, it would be the first legislation that specifically addresses how prisoners are treated and their humanity. But it’s been proposed by Democrats in a Republican Congress with a White House that wants to get tough on crime. Not only will it not pass, it won’t get a vote.  Remember it’s the thought that counts.

The U.S. Sentencing Commission released data that show that there are more white people getting sentenced to mandatory minimum terms than people of color. You will notice that this hasn’t made much of a splash in the news.

A columnist in Minnesota wrote a compelling piece on looks in the courtroom and a recent study about the effect of appearance in sentencing. The study found that, when defendants with scars on their faces were sentenced, they received less time. Researchers suspect it’s because the facial scars are objective evidence of trauma that judges can rely on and feel some sympathy for the defendant before them. Read the post above again.

 

SHARING IS CARINGShare on FacebookTweet about this on TwitterShare on LinkedInEmail this to someonePin on PinterestShare on TumblrPrint this page
10 July 2017

Bipolar Is Bullshit, Part 1 of 2

SHARING IS CARINGShare on FacebookTweet about this on TwitterShare on LinkedInEmail this to someonePin on PinterestShare on TumblrPrint this page

moods

It should just come with the mug shot and fingerprints.

Most people in prison with me have “treatment resistant bipolar disorder” noted somewhere in their medical records, meaning we had been diagnosed with the disease but medication (allegedly) never kept our behavior in check. It’s safe to say that we all have it, at least in name.

And it’s bullshit.

Bipolar disorder is over diagnosed at ridiculous rates. A study from the University of Texas Center of Excellence on Mood Disorders (a name that sounds like it was created by a classically manic person – we certainly don’t need any centers of mediocrity dedicated to this, do we?) reports that rates of bipolar disorder overdiagnosis range from 4.8 to 67 percent, a range of over 62 percentage points. The Depression and Bipolar Support Awareness organization estimates that 6 million people have bipolar disorder – that would mean that over 4 million people have been misdiagnosed. If cancer or diabetes were over-diagnosed over two thirds of the time, public outcry would deafen doctors. But this rate of over-diagnosis is permissible in mental illness because bipolar disorder is a convenient stand-in for what we don’t want to be aware of, namely trauma in someone’s background.

Where bipolar disorder is over-diagnosed, post-traumatic stress disorder (PTSD) is under-diagnosed.   PTSD underdiagnosis is estimated to be as high as 40% which should be expected. One of the first studies targeting this problem with PTSD  found that patients who were under-diagnosed tended to be lower-functioning, less educated and younger than the people properly diagnosed. Criminal courtrooms and jails give you the most bang for your buck when you’re looking for people who can’t express themselves properly and explaining your past is what gets you a valid PTSD diagnosis. Shit, mistakes are practically guaranteed in here.

They’re not necessarily made out of malice. At least initially, bipolar disorder and PTSD can mimic each other. Each disease drags depression with it. Post-traumatic hypervigilance can look just like hypomania. Both illnesses disturb sleep. Confusing them is easy.

Where psychiatrists get away with misdiagnosis murder is when medication fails to treat their diagnoses.  Real disease often responds to medication; relief arrives quickly to someone who’s truly ill.

Doctors don’t always look for alternate causes of irrational behavior in patients who are taking medication; instead they downshift into a psychiatric default and deem the bipolar patient “treatment resistant” which translates, as a practical matter, to “intractable” and “dangerous”  which is really unfair since there’s no single definition of treatment resistance. It’s not a clinical phenomenon; it’s made up. The lack of standards for treatment resistance proves that psychiatrists can’t believe they would ever misdiagnose a patient; the patient just can’t heal herself of the illness they happened to pick for her. Are a diabetic person’s insulin levels “treatment resistant” to chemotherapy? No, because it is the wrong medication for the disorder. I’m “treatment resistant” to sickle cell anemia medications. Want to know why? I don’t have sickle cell anemia.

The inaccuracy in modern mental health treatment allows psychiatrists to be trigger happy. Because the connection between childhood trauma and adulthood crime has been proven so many times it’s practically drawn with a black Sharpie, it’s essential that a treatment provider inquire into the history of an allegedly bipolar patient who’s in criminal trouble. Most doctors don’t, but when they do, psychiatrists co-opt the language of PTSD and call traumatic events “triggers” for bipolar disorder. Scientifically, this doesn’t make sense. External events can’t cause organic brain disease that, according to the shrinks themselves, is often genetically generated. That’s like saying a car accident triggered Lyme Disease. Nature doesn’t work like that.

Understandably, mental health providers don’t want to look beyond bipolar disorder to discern if their patients are suffering from PTSD. If doctors were to probe their patients’ pasts, they would unearth some gruesome stories. They would find a woman who was raped by her uncle with a hot curling iron as a child. She’s here. They would discover a man who lost four fingers at age three because his mother’s whose alcoholism was so severe that she was not aware he was playing with the washing machine or being molested by her best friend from high school. he was in the cell next to me in Milford lock-up.

Psychiatrists would encounter Tom Cahill, an Air Force Veteran who was gang raped, repeatedly, for 24 hours when he was jailed for civil disobedience after protesting the Vietnam War. All three of these people were diagnosed with bipolar disorder even though the fact patterns of their lives – had they been properly explored – practically sent out engraved invitations to PTSD diagnosis.

People complain a lot about the phone companies and commissary giants profiting off mass incarceration but, for me, the biggest pigs at the correctional trough are the pill brokers. Big Pharma makes bank on bipolar disorder medications whether the diagnosis they treat is correct or not. Understandably, Abbott Laboratories, the manufacturer of the leading bipolar disorder medication Depakote, co-sponsors Bipolar Disorder Awareness Day with the National Alliance of the Mentally Ill (NAMI) because the more aware you are of the constellation of symptoms ascribed to bipolar disorder, the more likely you are to look for hope for your pain in a pill – one of Abbott’s pills. Between 2001 and 2006, Abbott made $13 billion on Depakote alone, some of it from illegal marketing of the drug as a dementia and schizophrenia medication, uses for which Depakote was unapproved by the Food and Drug Administration. It looks like Abbott was trying to raise awareness of those illnesses, too.

If you went through our charts in the medical building, you’d find bipolar disorder somewhere in every single chart. I would lay odds on it. Bipolar disorder is the biggest red herring going.

And PTSD is the red-headed stepchild.

Read Part 2 of 2 here.

THREE IDEAS IN CRIMINAL JUSTICE REFORM FROM JULY 3 – 9, 2017

Maria-Isabel-Garduno-Martinez

Maybe it’s because she’s a woman but I’m surprised that the right-wing media hasn’t picked up on this story to buttress the Trump administration’s ‘bad hombre’ narrative. Isabel Martinez, a Mexican national and mother of five, is accused of murdering four of her children and their father (a fifth child was injured). When she appeared in court on Friday, she waved and waived her right to counsel, saying that the people and her faith will always be her attorney. “Those are my attorneys, that’s why I’m here,” she told Gwinnett County Magistrate Judge Michael Thorpe, who replied with unprofessional sarcasm and then didn’t order the psychiatric evaluation the whole scene was begging for. This is common with self-representation; defendants with severe disabilities and deficits ask to represent themselves and courts oblige, saying proceeding pro se is a constitutional right. Yet, when a defendant who has a chance at beating the government at trial wants to represent himself or herself, this constitutional right evaporates. I watched it happen myself.

New Jersey Governor Chris Christie has until midnight Monday to sign a bill that would require a “racial impact statement” to be considered whenever a criminal justice law is about to pass the legislature so that they don’t extend the disproportionate effect of incarceration on racial minorities. New Jersey would be the fourth state to pass such a statute; it’s at the top of the list of states that have decarcerated themselves in earnest, but the racial disparities in that shrinking population are getting worse, which isn’t what you’d expect.  The statement probably isn’t a bad idea, but it seems almost redundant. Are we not considering the impact other laws will have on communities of color? Wasn’t this type of analysis already in place – how laws will affect the taxpayers who foot the bill for them – for every kind of law ? I argued that we also need to consider a  “gender impact statement” for laws. We should have a disability impact statement, too, right? I don’t see how this idea is new. It shouldn’t be.

The Daily Beast ran an interesting article on why new suspects are rarely charged when wrongful convictions are discovered. The United States has 263 overturned murder convictions but only 16 new suspects have been charged. The defendants who are charged later typically point to the evidence introduced at the first trial and tell the jury: there’s your reasonable doubt right there. And they’re right.

SHARING IS CARINGShare on FacebookTweet about this on TwitterShare on LinkedInEmail this to someonePin on PinterestShare on TumblrPrint this page
8 May 2017

Impatient Warning

SHARING IS CARINGShare on FacebookTweet about this on TwitterShare on LinkedInEmail this to someonePin on PinterestShare on TumblrPrint this page

OLYMPUS DIGITAL CAMERA

ADVANCE ONE STEP

Rachel* had a miscarriage, you know,” my cellmate said from behind me in line. Rachel, one 25 year-old woman on my floor, was lined up behind my cellie. Two months into her pregnancy, a fetus emptied itself out of her and into an industrial-flush toilet without Rachel’s ever seeing a physician.

I’m not sure exactly what she paid for two other inmates’ Haldol and Thorazine pills to keep her knocked out all day so insanity-making idleness couldn’t reach her. Whatever the price, Rachel got more than she bartered for after bingeing on anti-psychotics at abortifacient doses. At first blood, she asked to go to the medical unit where nurses told her that the doctor was out and was the only person who knew how to use the ultrasound machine. So they let her bleed. To quell her rising anxiety, Rachel took more Haldol and Thorazine, spotted tablets, tye-dyed by another woman’s saliva.

This upsets the usual paradigm of correctness in corrections, namely that the state is always right and the prisoner is always wrong. Unless you ask one of us, in which case, we are always right and the oppressor is wrong. The seesaw evened out on this one, though. Here, the nurses and Rachel all contributed to her misfortune of having to wait for large doses of Motrin to deal with her pain and continued bleeding.

“What should I do?” she asked Terry.

ADVANCE ONE STEP

“When you get out, get a lawyer and sue these motherfuckers! They let your baby die! Whadya think, Bunkie? She’s got a good case, right?”

“I don’t know. Maybe one of those pro-life groups will help you,” I said, looking straight ahead. We’re not supposed to talk in line.

“I didn’t get a fuckin’ abortion!” Rachel cried.

“Yo! Quiet in the common area!” a C/O shouted.

“No, you had a miscarriage, a spontaneous abortion. You’re thinking of induced abortions. Pro-lifers don’t like either one,” I explained quietly, still looking straight ahead like I was talking to an imaginary person.  “The enemy of my enemy is my friend.”

ADVANCE ONE STEP

I feel sorry for Rachel but, quite frankly, not that much. It might be that I’ve been here for five and a half years, watching heartache on repeat.  Or maybe I’ve refined my understanding of cause and effect in the House of Consequence. Should they have transported a pregnant, bleeding woman outside of the prison for a full exam? Of course. Is it their fault this woman took another person’s psych meds while pregnant? That’s on Rachel. Actually, on second thought, that’s their fault too, because they run Med-line, where the pills that probably caused this event were spirited away and sold to Rachel.

One of the worst parts of needing medical attention and/or medication in prison is Med-line. In the morning and at night, a guard escorts two nurses (their names are ‘A through L’ and ‘M through Z’) to each housing unit to dispense all pills that could somehow be abused. All psych meds, anything that can be stockpiled sufficiently for suicide attempts, gets dropped into the palms of the begging inmate who then swallows it and opens widely for a mouth check. Of all the degrading aspects of prison life, this has to come in, at least, in my top three. I’m getting over shitting as a spectator sport, bleeding all over my hirsute self, negotiating for a maxi-pad like its NAFTA, but this: lining up to be infantilized, like it’s something worth waiting for, is one of the biggest tortures for me. I’d do two weeks in seg in exchange for the chance to be trusted with my own healthcare. 

ADVANCE ONE STEP

When I first got here, ‘A through L’ went all Johnnie Cochran and told me:

“I peek so you can’t cheek.” 

They used to make me bob my head in all different directions to do these mouth checks.

“Head back!”

“Lift your tongue!

“Bow forward!”

ADVANCE ONE STEP

One even gloved up felt up the insides of my cheeks, mouth-fisted me like we were in some kind of German porno.

But they’re obviously not doing that to everyone if Rachel was able to put herself in such a fix that she’s just spent the rec period curled up on the floor, hugging her knees, and crying about her child, one who will never be.

Allowing this woman to take someone else’s Med-line pills and inadvertently erasing her child while no one in the medical unit rushed her to a local hospital for an ultrasound pointed out who was wrong. The nurses who failed to secure a timely sonogram are the same stiffs who’re monitoring me like I’m a medication magician but seem not to catch on when other Med-line diversionary tactics unfold – inmates pretending to drop pills, feigning choking, jumping down the nurses’ throats with insipid questions like the woman in front of me who’s asking:

“Is this pill pink or peach?” as she puts it up to the nurse’s face as she hides another pill under her finger around her water cup. The nurse knows the deal; the inmate’s hiding something but she plays along as if the color of the pill matters. It’s not like the inmate would even know if she’s getting the wrong med.

From my place in the Med-line, I can see that inmates are not always the ones in error. In fact, it’s not a case of prisoners being right or the staff being right, black and white.  As backwards as it sounds, prisoners and staff work together very well to be wrong. Our hijinks – like trying to get high off pills that were in someone else’s mouth, prescribed for them – work in tandem to cover up and augment the incompetence and neglect in this place. We know victimization so well that we take it over and do it to ourselves. And they let us. 

When it’s my chance to present myself to “A though L’ like an imbecile, I step forward and announce woodenly to both the nurse and the cheeky inmate as she steps away with some sedating drug under her forefinger, about to be placed on the prison black market so it can ruin another life:

“You’re both dead wrong.”

*Names have been changed

THREE IDEAS IN CRIMINAL JUSTICE FROM MAY 1 – 7, 2017

desiree-fairooz-e1493782132232

CODEPINK activist Desiree Fairooz, a woman who laughed during a Senate hearing to confirm Jeff Sessions as Attorney General and then caused a scene as she was being escorted out, was convicted by a jury on Wednesday ofdisorderly or disruptive conduct.”  Unlike many media reports that say she may go to jail for laughing, the foreperson of the jury was very clear that Fairooz wasn’t convicted of laughing, but for her conduct when Capitol Police tried to remove her from the hearing room. According to jurors, the way the law is written means “there’s almost no way that you can find them not guilty.” Lesson here: use your Fifth Amendment right not to speak around police at all. Even die-hard justice reformers talk to police, argue with them, ask why they’re being arrested. But, as you can see, even that can be a crime under our country’s ever-loosening laws. Fairooz’s crime was asking: “Why am I being taken out of here?” and then saying: “I was going to be quiet, and now you’re going to have me arrested? For what?”  If she hadn’t said anything she would never have been tried, much less convicted. I know she has a right to question why she’s being taken into custody, but in an era when police don’t follow procedure and respect rights, maybe it’s wise to fall back on the Fifth. Jail time is unlikely for this woman but still, take notes on this one: SAY NOTHING TO COPS.

The decision was rendered earlier, but it hit the news this week. Even though a defense lawyer was seven minutes late for trial after a court-imposed lunch break and the trial court started without him, the 11th U.S. Circuit Court of Appeals held that the defendant, a man named Alexander Roy, was not deprived of assistance of counsel.  In the United States, a court can try you if your lawyer is in the bathroom, passed out drunk or just running late and you will get no relief from an appellate court because of our “harmless error” doctrine, which basically admits that a defendant’s rights were violated but says that, because the person is so guilty, it doesn’t matter. The problem with the harmless error doctrine is that it forgets that everyone in the middle of a trial is innocent so any violation of rights, in theory, can harm them. By law, a defendant being tried can’t be guilty but we always think they are.  Roy was being tried for possession of child pornography so people will say that he’s not the most sympathetic case to make this point. That attitude shows how much we presume guilt in our defendants. That’s what he was accused of doing. And what if he didn’t do it?

The Sentencing Project released a study this week showing that a record 206,268 American prisoners are serving the equivalent of a life sentence. That’s almost 10 percent of all incarcerated people. And approximately 17,000 of them are serving those sentences for nonviolent crimes. Chew on that for the next 1400+ days of the Trump presidency.

And, because we’re talking about drugs here, note that anti-drug Trump cut the funding for the Office of Drug Control Policy by 95%. That’s the office that’s in charge of trafficked drugs, i.e. ones that cross the borders illegally.

SHARING IS CARINGShare on FacebookTweet about this on TwitterShare on LinkedInEmail this to someonePin on PinterestShare on TumblrPrint this page
12 December 2016

Broken Sorter

SHARING IS CARINGShare on FacebookTweet about this on TwitterShare on LinkedInEmail this to someonePin on PinterestShare on TumblrPrint this page

hospital

I cringe when I hear post-Sandy Hook plans, plots and promises about mental health treatment: expanding access’ and ‘removing barriers’ and ‘stricter laws involuntary commitment.’ I shudder at the phrase ‘treatment-based approach.’ That’s the worst. That shit scares me.

My parents have committed me involuntarily to psychiatric hospitals on seven occasions. Each time I was admitted, I posed no danger to myself or others. My parents even concede this now even though they pushed for the admissions at the time. They were trying to wring out a mental health defense from my situation – one I never wanted.

On the one occasion I was a danger to myself – the despair of fighting the charges made me so despondent that I wanted to die – no one referred me for any treatment.

bfscorridorI didn’t really understand how broken the psychiatric sorter was until Selly moved into my room. She was serving an 18-year sentence for stabbing her boyfriend 38 times after being released from a psychiatric hospital – over her parents’ objections that she wasn’t safe to leave.

The requirement for someone to be hospitalized involuntarily is dangerousness – to oneself or to others – and clinicians’ ability to assess it is notoriously bad, as my and Selly’s experiences demonstrate. Even the Supreme Court of the United States has acknowledged shrinks’ inability to know who’s dangerous.  In 1983, in Barefoot v. Estelle, the Court wrote  that even the American Psychiatric Association hadn’t conceded  “that psychiatrists are always wrong with respect to future dangerousness, only most of the time.”

Hospitalization isn’t about medicine and care; it’s about power. How else can anyone explain a system where people who want treatment don’t get it and people who get it don’t want it?

psychiatric-hospitals-or-wards_230_160_100On those occasions that I sat in the Yale-New Haven Hospital’s emergency room as a vestibule to the locked hallway of the hospital, New Haven’s most esteemed psychiatrists unlocked the doors for others – usually men – who days later would appear on the news for some violent altercation, usually a robbery. From the hospital, I would recognize their mug shots, their necklines decorated with different collars and colors than the pale blue, patterned gowns we all wore after we were forced to fork over our clothes. I had to keep my gown, whereas others who traded their johnny-coats for sweatshirts and jeans left to hurt people who ended up in the same ER that had just certified their assailants as safe.

A bearded man whom I watched walk out of the psychiatric emergency room holding area ended up seated on the couch next to me, finally admitted as a danger to himself after he tried to slit his own throat. A choker of black, spiny sutures spanned his neck in an area that ER nurses had shaved to free the surgical field for doctors to save his life.

Until he actually hurts someone else, a patient’s propensity for violence relies mostly on self-report or someone else’s telling on them. People who report others for potential violence might have an agenda in seeking someone’s psychiatric admission. My parents ratcheted up my ‘symptoms’ with little to no regard to how these experienes would traumatize their daughter and invite scorn for the rest of her life.

Others fear stigma so much – Nancy Lanza might fall into this category – that they actually become reasonably wary of psychiatry. They minimize and downplay symptoms – I can just see what would have happened to me if I refused to leave my bedroom for weeks and asked for a gun for my birthday – and these people don’t see the inside of a psych ward…and then they go off and hurt someone else.

img_0689Besides, who’s going to believe someone who walks into a hospital and says he’s planning on mowing down some second graders? I’ve watched these clinicians. They would have sent Adam Lanza home with a diagnosis of histrionic personality disorder and attention seeking behavior. No one who’s going to do these dastardly deeds announces it beforehand. They con the nurses and the docs into buying their stories of stability so they open those sliding glass doors leading to the sidewalk and opportunities to explode.

Increasing the number of psychiatric admissions, either through passing new laws or striking fear in the hearts of psychiatrists will likely increase the number of people like me whose doctors hear amped up reports of illness and we will take up space in hospitals, edging out the entry or stay of patients whom doctors really need to keep against their will in order to prevent violence.

teenage-psych-ward_art-300x225We try to medicalize violence after these national tragedies as I have taken special notice since I’ve been here – the Tuczon Safeway supermarket shooting or the Aurora, Colorado movie theater massacre because gun laws’ loopholes circle, curl and coil around reality. The only thing that ‘expanding access’ will do is return to us the mirage of control, the illusion that these doctors who can’t sort the sick from the silly, the dangerous from the slightly damaged are going to keep us safe. They can’t even keep the right ones in the building.

Since December 14, 2012, I’ve wondered what the psychiatrists would have done if Adam Lanza appeared in the ER beside me. Would I have watched his back as he walked out, clad in the colors of death while I remained?

psychiatric-hospital

THREE IDEAS IN CRIMINAL JUSTICE FROM DECEMBER 5 – 11, 2016

override

He’s back in their arms again: Dylann Roof decides he wants counsel for the guilt phase of his trial for shooting and killing which included the introduction of a videotape where he straight-out confessed to police. Probably could have handled this part himself.

I don’t know which is worse: the fact that it took 13 minutes to kill someone who coughed and heaved in what is supposed to be a fast and painless death or the fact that the state of Alabama allows its judges to overrule juries that decide on life in prison without parole. That’s what happened last week.

The New York Times ran a great piece inspired by a new report released Friday by the Brennan Center for Justice at NYU School of Law on how decarceration efforts will never work unless they embrace people convicted of violent crimes  – ones who are rehabilitated, of course. The piece examines the sentences of four real crimes and has an interactive component where you can weigh in on how much time you think a particular defendant/prisoner should get and see how many respondents agreed with you. Try it here.

 

 

 

SHARING IS CARINGShare on FacebookTweet about this on TwitterShare on LinkedInEmail this to someonePin on PinterestShare on TumblrPrint this page
10 October 2016

P-Word

SHARING IS CARINGShare on FacebookTweet about this on TwitterShare on LinkedInEmail this to someonePin on PinterestShare on TumblrPrint this page

vagina-flower-photo_burned-2The word “bitch” has lost all its sting in a prison.   Even “cunt” doesn’t cut it anymore. The verbal gauntlet for me?  The P-word:  “pussy.”

I’ve always hated the word “pu**y” – along with its wrapper, the word “panties.” They always sounded like something an aging, perverted chiropractor would say to a female patient as he convinced her to don a paper gown for an adjustment that could be done through her cable-knit J. Crew sweater. I doubt many chiropractors used the word to patients since it isn’t the target of treatment, but the image endures. To me, the words “pu**y” and “panties” are used only by people who shouldn’t be allowed inside either one.

In here there’s no other word for vagina except “pu**y.” Even when the C/O’s taunt an inmate that her “man” is probably cheating on her, they don’t say he’s getting laid, they say he’s getting pu**y. I think everyone in here’s been convinced that it’s a clinical term.

In the hallway of the medical building, Dr. Fetal Pig was instructing someone who works in Food Prep with me to avoid using commissary soap to wash her private parts – HIPAA and any common law respect for medical privacy be damned – when I walked past.

“It’s a self-cleaning oven,” the physician advised. “You don’t need more than water.”

“If you think that, then your pu**y must really stink,” the inmate said, thinking she was a polite patient.

“Can you not use that word?” I asked her when we got back to Food Prep.

“What word?”

“The P-word. You know…” I looked around. “Pu**y.”

“What’s wrong with pu**y?” She looked at me like I asked her not to say “is.”

“It’s, you know, derogatory.” Ever heard of another P-word? Propriety?

“What the fuck is that?” she asked.

“Never mind.”  I let it go.

I can run any number of theories on why inmates talk about their genitals so much and use the word “pu**y” to do it. They’re undereducated so they don’t know the difference between slang and acceptable language. High school science programs are on the wane so they’ve never heard biological terms. They like sounding irreverent.

They use “pu**y” because they’ve internalized the misogyny around them along with the most common word they’ve heard to reference their genitals. They become obsessed with what’s between their legs from living in here where a shower is never guaranteed.  When you haven’t washed and you start to waft, the essence of your femininity becomes your problem, not what you did or what was done to you. Your hole becomes your Achilles heel.

Of course, that’s how it is for many women, whether they bear an inmate number or not. But women on the outside aren’t psychotic about washing away their scent. Anyone who thinks cats dislike and avoid water should head in here, where someone’s constantly dunking one and trying to drown it.

Women on the inside go to great lengths to make sure they have no smell at all, which is impossible. They pour empty Fluff containers filled with soapy water on themselves on the toilet to wash after they’ve showered. Rub solid deodorant on between their legs. It isn’t primping. It’s pathology, in response to feeling dirty, being called dirty, being dirtied by men in the past.

I like to be clean, too and I have never smelled as bad or as often as I have in here. But I also like to exist. Sometimes the only way I’m sure I still do is my filth.

“I hate being a woman!” my roommate shouted from the toilet. She actually asked one of the inmate janitors for contraband bleach to use on her vagina. I motioned to the janitor from behind her to ignore the request.

“You know your scent is how you attract men. It’s called pheromones,” I tell her. Another P-word. Explain to her how Napoleon wrote to Josephine to tell her to stop bathing before he got home.

“Who’s Josephine? She on this tier?” she asks in all seriousness, furiously scouring her crotch. “I wish I could wash away my pu**y!” She almost has.

“You’re wasting your time washing away what makes you human, a woman,” I advise her. “This place will do a bang up job on that without your help.” Another P-word: punishment.

Pussy. Panties. Perverted. Pig. Privacy. Polite. Patient. Propriety. Problem. Psychotic. Primping. Pathology. Pheromones. Place. Punishment.

PRISON.

misogynist-01

THREE IDEAS IN JUSTICE REFORM FROM OCTOBER 3 – 9, 2016

13th-documentary-netflix-1474990378-640x345

HUGE BUST: Eighty people took a collar – including 18 guards and 35 inmates – in a corruption probe into a Maryland prison that found C/O’s were arranging to smuggle contraband like opiate-substitute Suboxone and cell phones from outside. The C/O’s then tried to get inmates to stab other inmates who reported the ring. I am floored.  – Only 80 people?

HUGE LIST: 102 more sentence commutations by President Barack Obama. It fits. First black president frees the second largest number of people in history, after Abraham Lincoln.

HUGE HIT: Ava DuVernay’s documentary “13th” premiered to the public on Friday on Netflix. Two things I learned from the film: 1) the Ku Klux Klan never used burning crosses until the movie “Birth of a Nation” used one as a cinematic device; and 2) getting arrested at civil rights rallies was never a by-product or accident of the protest. It was the purpose, black people’s meeting their worst fear: being arrested by white people. It’s a worthy watch. I thought I knew most of the history of incarceration but I don’t. Also, the juxtaposition of clips of Trump supporters beating black protesters with clips from years ago of mobs beating up black men says too much about this election.

SHARING IS CARINGShare on FacebookTweet about this on TwitterShare on LinkedInEmail this to someonePin on PinterestShare on TumblrPrint this page
23 May 2016

Rehabit

SHARING IS CARINGShare on FacebookTweet about this on TwitterShare on LinkedInEmail this to someonePin on PinterestShare on TumblrPrint this page

 

6889837884_068b95b2b4_o

I thought it was a truism only for free people:  you find things in the last place you should look.  But it happens in a prison, too.

The last place anyone should expect to find caches and stashes of illicit drugs is in a drug-treatment program, particularly one in a maximum-security prison, the home base of women who ruined their lives – at least temporarily – with bad choices brought on by drugs.  But this facility’s highly-touted Marilyn Baker Program, in its colonial-style brick manor, makes this place less like a prison and more like a Pi-Phi house because it’s the place where inmates party the most.

house
This is the Pi Phi house at University of Oklahoma. It could pass as the Davis Building at York CI.

I once wondered why the drug program’s housing unit, the Davis Building, was the only one on the prison compound still awaiting the installation of security cameras.  But after one inmate took enough Xanax to make her slur her words and tell people she was screwing a member of the staff, I know why there aren’t cameras.  Not only would the crimes of drug dealing and statutory rape be revealed, all the good stuff might be missed with a stationary surveillance lens. The building’s better suited to the roving cameras of Girls Gone Wild.  I don’t think they’re still making those videos which is too bad because the drug program here would have provided some good footage.

Wardens once hailed prison drug treatment programs as revolutionary in that they acknowledged how deeply entrenched addiction had become in criminal behavior.  Treating addicts while they did time honored victims’ wishes, deferred to the state’s punishment and deterrence goals and promised to rehabilitate offenders whose real problems were less character-based and more drug-induced.  Approaches like Marilyn Baker Program were supposed to hit multiple jailbirds with one stone.

reg_293.joe.ggw.cm.22813
This could pass as the Davis Building, too.

But participants attend supportive  “groups” where they sell, swallow, sniff and space out. Drug users hone their manipulation and hustling skills and play them thoroughly when they land in Marilyn Baker’s group settings, passing around as much weight as I bet you see in a season Breaking Bad. I don’t really know. I haven’t seen it yet. The last time I watched cable Girls Gone Wild was still in production.

Recent research suggests that these group settings don’t and won’t work. For one, the community, not just the patient, has to be sober, not doing dirt but staying clean, for treatment to work.  Anne Fletcher’s new book, Inside Rehab, reveals that group settings like the Marilyn Baker Program also won’t work if they are too dedicated to the ‘confrontational model’ of Alcoholics Anonymous, which Marilyn Baker is.

Much of Alcoholics Anonymous is very philosophical. I mean, it’s actually called a philosophy. When you try to spoon feed theory or a “medical model” to people whose cognition has been chipped away by drug use, you’re likely to get it spit back at you, unless the inmate’s using it to wash down her smuggled Ativan. Many members just aren’t intellectually capable of handling the content of group addiction therapy.

This statement may sound harsh but it was actually reported in the book The Farm, which is a kind of ethnography of this very prison.  The author, a journalist named Andi Rierden, interviewed two inmates who left the Marilyn Baker program back in the nineties when the in-prison rehab was new. “During the A.A. meetings they’d talk about Bill’s story and I couldn’t fucking understand it,” one told Rierden. Another prisoner told the reporter: “I didn’t know what the hell was going on either.” At least those two got out of a situation they didn’t comprehend. The ones who stay just wreck any progress they might have made in spite of themselves by popping a Percoset and blowing a C/O.

It’s totally unkind and politically incorrect to suggest that prisoners may have – on average, average, calm down –  lower intelligence than the general public but it would be a conclusion I can make knowing the population in here. Women have endured years of drug use and trauma (elevated levels of cortisol are associated with cognitive decrements) and, to top that structural damage, they suffer from undereducation. I think people expect to find cunning criminal geniuses when they look inside a prison, but here’s the last place they should look. Try the Pi Phi house instead.

DrugI asked my sister to google “prisoners and I.Q.” and she sent me a copy of a seventy-five year old article that would never have been indulged with publisher’s ink today. The study reported that 42.2 percent of prisoners’ intelligence was below average versus 20% of the general population. The average inmate I.Q. in the study was about 90. Of course, I.Q. tests include questions on acquired knowledge so they aren’t a completely accurate picture of someone’s native mental abilities. But it points out a truth no one wants to say: one of the reasons that it seems impossible to rehabilitate prisoners is that many aren’t intellectually capable of the type of insight and judgment needed to cut the shit.

Academics and journalists who know rehab say that individual psychotherapy is more “evidence-based” – meaning it actually works – to treat addiction. It makes perfect sense. Not only is the therapist is less likely to deal to patients, individual therapy doesn’t require the patient to understand the theory of analysis or cognitive behavioral therapy for it to work on her.

003_baseball_field
Looks about right.

I can’t say any of this in here, one place where the most outrageous things are uttered. They’ll scream and me and tell me that I’m calling everyone stupid, which I’m not. I just think that drug habits aren’t a game, but we treat them like they are and our strategy to win this showdown is to hit ’em where they ain’t. The pervasive low self-esteem in here requires that everyone be built up just so they can function. You have to tell every inmate that she’s smart to boost her confidence in decision-making skills she might not have rather than dealing directly with the skill set she actually does have.

I think the reason why prisoners in a drug rehab program get high is that they don’t understand the program and they seek some way to stimulate their brains out of the boredom and fog, even though drugs are the last place they should look to do that.

THREE IDEAS IN CRIMINAL JUSTICE FROM MAY 16 – 22, 2016

GOP Senate Candidate Tom Cotton Greets Voters On Election Day In Little Rock

The look, the feel of Cotton. The idiot of our lives.

Senator Tom Cotton (R-AR) said we have an “under-incarceration” problem in the United States.    He told the Hudson Institute, a conservative think tank, that:”For the vast majority of crimes, a perpetrator is never identified or arrested, let alone prosecuted, convicted and jailed.” Law enforcement arrests someone from only 19% of property crimes and 47% of violent crimes, according to Cotton. If half of people in state prisons (766,750 or half of 1,533,500 according to the Bureau of  Justice Statistics for 2013) are serving time for violent crimes and they constitute only 47% of violent perps, we need to add at least another 864,633 violent offenders to see Cotton’s vision come to fruition.

Donald Trump hired a convicted felon as one of his press people in Alaska. It was revealed last December that Trump once employed another “returning citizen” – this one mob-linked. He made a big deal on Friday that we wants to lock people up but it’s possible that Trump has the best record on folding people who did time back into society. Message to Hillary and Bernie: step it up. Hire some cons for your campaigns.

Did you know that we don’t know: 1) how many people have a criminal record; 2) how many people have served time in prison or jail; 3) how many children are on some type of supervision or probation; or 4) how many juvenile offenders graduate to become adult offenders, among other holes. Next to no idea. That’s how little we know about our criminal justice system according to a report from the Marshall Project.

 

 

 

SHARING IS CARINGShare on FacebookTweet about this on TwitterShare on LinkedInEmail this to someonePin on PinterestShare on TumblrPrint this page
29 February 2016

Black Mold Matters

SHARING IS CARINGShare on FacebookTweet about this on TwitterShare on LinkedInEmail this to someonePin on PinterestShare on TumblrPrint this page

“Bozelko, were you here when they did the construction on these buildings?” the C/O asked me on the walkway. He was staring at the housing units, almost wistfully.

“You mean last year when they forced us to sit in the gym all day while they replaced the brickface or last year when they let us sit in our cells while they replaced the brickface and their drills were like buzzsaws in our ears?”

“Neither.”

“Oh. Then no.”

“No, not that,” he explained.

“Years ago, when the construction experts came in on buses and they took a face off the cinderblock on each building, you know, to look underneath to see how much the buildings sank? It looked like fur. Like the buildings were covered in fur underneath the cinderblock,” 

“Am I to assume that this was the real thing? No faux fur?” I kidded him.

“Real thing.  Mold like fur on the walls.

When they tried to clean it up,

it

                                       blew

                           

                                                                                  everywhere.”

 

“CT, you finished opening all those cans?” I asked another worker in Food Prep. She answered me sounding like Beaker from the Muppets.

“Meep. Eep. Ip.”

“What?” I leaned closer to her to hear.

“Ost. I. Ois.”

“Oh, you lost your voice again?” I asked and she nodded.

“Ge. Bah. Lay.”

 

 

 

“You’ll get it back later? Well, yeah, I doubt it’s gone forever,” I assured her. She waved over another inmate to translate.

“I’m on her tier,” the other woman said by way of introduction and explanation of how she knew CT’s situation and what she was trying to say.

“Her voice comes and goes. It’ll be fine one hour and gone the next. She thinks it’s the mold on the tier.”

“I’m sick, one counselor went home early and the other counselor had her third sinus infection in two months,” the CTO told the officer behind the desk. “I think it’s all the bacteria from the leak in the ceiling. You saw the whole ceiling fell in? There’s a big hole and all this black water came down…”

“I know. I saw it,” the officer said without looking up from logging in the recent housing moves.

“The water’s so dirty…”

 

 

 

“It’s not dirty. It’s mold,” the officer was trying to let the CTO down gently.

“No, it’s…. you think?”

 “You don’t see me going in there do you? That’s black mold,” the officer continued with regret. And the CTO blew her nose again.

“I’ve never done this before, so I’m not really sure what to do with these,” I confessed to Merc as she dropped four little packets of powder on the counter before me. Marc is here for sticking up convenience stores to fund her addiction.

“Do you know what I went through to get this for you? I was standing on my counter wearing one of them masks they use in the spice cage (the prison’s spice rack), all gloved up, scraping that shit off the walls with a fuckin’ spork.”

“I know. I know it’s not easy to get. But I don’t know how else we’re gonna prove that it’s making people sick unless we can send some out. I can’t reach it in my cell,” I said.

“Yo, you see that mold up there? You gonna do anything about that?” shouted a woman from her cell to the Operations Captain with his double-barred lapel who was conducting a rare tour through squalid housing units; usually he just runs the place.

“Well, something’s gotta kill you,” he said as he and his double bars walked, jackbooted, under the mold and out of the building.

THREE IDEAS IN CRIMINAL JUSTICE FROM FEBRUARY 22-28, 2016

130608223636-pkg-feyerick-whitey-bulger-arrest-trial-00024427-story-top

The Vera Institute of Justice revealed that 12 million people are admitted to jails every year, 20 times more admissions than to state and federal prisons combined. Since there are only 2.3 million inmates remaining in custody, this would mean one of three things: 1) a bunch of people who leave jail are skipping court and not showing up to get sentenced; 2) judges are sentencing many, many people to punishments other than incarceration; 3) tons of charges get dropped, either because the defendant was innocent or the government didn’t have enough evidence. I don’t know whether any of the options is good.

President Obama announced plans to close Guantanamo Bay where each inmate costs a whopping $3 million per year to incarcerate. There are at least 60 left from the 242 in custody when Obama’s first term commenced. Who needs $180 million?

It was revealed that James “Whitey” Bulger allegedly masturbated in his cell last summer and got caught and sent to solitary confinement, where he would have even more free time and privacy to finish the job. He says it’s not true, that he was just powdering his testicles. I can’t make this stuff up.

SHARING IS CARINGShare on FacebookTweet about this on TwitterShare on LinkedInEmail this to someonePin on PinterestShare on TumblrPrint this page
30 November 2015

Illin’

SHARING IS CARINGShare on FacebookTweet about this on TwitterShare on LinkedInEmail this to someonePin on PinterestShare on TumblrPrint this page

 

image

When I would get sick at home, the local CVS/Pharmacy made bank.  I bought NyQuil, DayQuil, ZZZQuil, Advil, Benadryl.  I bought every -il in the store including Cetaphil, Massengill and Enfamil if I thought it would make me feel better.  I purchased every tablet, caplet, gelcap, capsule and pellet – plus a new cherry Chapstick – each time I fell ill.  It just wasn’t a cold or flu without a long, curling receipt detailing my score of home remedies, even if none of the medicines helped the virus worm its way out of me.

imageIn hindsight, I see that it wasn’t any cold remedy or anti-congestive pills that made me feel better; it was all of the choices that the drugstore aisle afforded me.  There were so many choices that I never even made one.  I brought all the Robitussin’s and Coricidin’s home with me.

When that watery warning tickled the back of my throat one Saturday, I knew I was going to be illin’ without all of my –ils to soothe me.  To buy any supplies in prison, an inmate must bubble in a Scan-tron order form.  Then the commissary has one week to process the order and pack the purchases ready for pick-up.  If my housing unit’s day for ordering commissary is Tuesday and I get sick on Wednesday and need cough syrup, I wait for the next Tuesday to order the medicine and another week to retrieve it.  Whatever remedy I get my feverish little hands on today was ordered at least one week – maybe two – ago.  I have no choice but to accept this system; it’s the only legitimate commerce in here.

imageThe inmates’ Code of Penal Discipline outlaws bartering so trading something I have for something I need is, technically speaking, misconduct, so I try to stockpile medical supplies as do all Future Savers among us.  The Future Spenders here at York liquidate their inmate accounts on consumables like honey buns and squeeze cheese, fuel that enables their trips to my cell door to beg for Tylenol and bacitracin to heal their nostrils after our third world toilet paper abrades them in the absence of  Kleenex or Puffs.  Once I saw what the toilet paper did to my nose when I was sick, I worried about what it did to our assholes; it must be killing them.

Usually after the other inmates raid me, I need the supplies I gifted out so I turn to other inmates, arrive at their cell doors to suss out some tussin cough syrup or allergy tabs.  It would be nice if each inmate accumulated what she might need when cold and flu season dips in, but that’s a fantasy.  Each of us gives out cold remedies to other inmates because none of us have much of a choice in controlling symptoms.  Medical essentials pass around the compound, pushed on by each inmate’s individual emergencies.

imageFor the most part, the prison health service sees patients on an emergency basis.  “Sick Call” they call it, borrowing from the military but it makes it sound too much like what it is:  a cattle call, permission granted to herds of women who sniffle, sneeze and sleep away their fevers to corral themselves into the outpatient medical unit and wait for the medical advice to RICE – rest, ice, constrict and elevate – everything.

“Emergency medical care is available 24 hours a day” announce signs in all housing units.  Just like the words “obscene,” “reasonable” or “humorous” open themselves to a number of interpretations, emergency is in the eye of the toilet-bowl holder. Since it is what kicks in any regimen of care, everything hinges on that definition in prison.

“The difference between life and death,” a guard answers when I ask what an emergency is.  But in a place with no strategy of preventive and spotty acute care, life moves closer and closer to a prisoner’s day of demise.  Because inmates often don’t receive the care they need, everything is an emergency.

And even though my friend had been bleeding, spotting for months.  When she sought emergency care, the guards denied her.

image“Write to medical,” they ordered her, which meant to complete a “Request Form” and place it in the institutional mail system which is like sending a letter to 911.  Nicole wrote and doctors told her it was nothing, probably stress.  Then cancer riddled her uterus, her cervix, her ovaries; no health care provider had examined behind her ovaries where the cancer started in order to catch it in Stages One, Two or Three.  When it reached Stage Four, Nicole survived total evisceration, chemotherapy, a hysterectomy and other surgeries but she eventually succumbed in the prison’s hospice on October 7, 2011.

Just a year before, another friend of mine, Deb Czarneski, dropped dead of a heart attack in the lobby of the outpatient medical unit.  Her death resulted not from a lack of preventive cardiac care, but the fact that undiagnosed carcinomas in her lungs had metastasized so extensively that the metastases caused organ  failure.  Deb complained for months of such severe shortness of breath that she could no longer climb to her top bunk; guards threatened her with tickets for interfering with safety and security when she put her mattress on the floor to sleep.  All of her written “Request Forms” had the same misdiagnoses scribbled at the bottom:  asthma or walking pneumonia; no one ordered the proper scans or x-rays to reveal the tumors burgeoning in her lungs.

Nicole actually faced capital punishment for her crimes of killing jewelry store owners during robberies but the court punished Deb Czarneski for a larceny.  For stealing something,  she received the death penalty.  When Nicole asked for “sick call” to call her for her spotting, her symptoms constituted an emergency, fitting in that spot between life and death.  The same was true about Deb’s breathing; she lived in an emergency state for months.

imageThe problems with correctional health care encompass more than woefully low funding or sub-par practitioners; ultimately, it is the lack of choice.  In prison, when it comes to health care, inmates take what they get.  Second opinions rarely await inmates in the Department of Correction’s examination rooms.

Incarceration must include giving up some choice because rehabilitation repays bad choices.  But when punishment perverts prevention and incarceration immerses inmates in illness, we have only on choice:  to expand service so as to protect all prisoners’ health.  Denying options to inmates kills them.

imageI refused to accept the lack of choice and I was not facing a life-threatening illness.  When pain in my right foot persisted for six months, APRN’s – Advanced Practice Registered Nurses, the poor man’s physicians – advised me that, as arthritis, it was untreatable and something I just needed to accept.  When my walking suffered, I filed a health Services Review form which is a grievance against medical treatment and/or diagnoses.  Because I grieved the fact that I needed treatment for something more than arthritis, the Health Services Review was my attempt to forge my own choice, to create options where they did not appear to exist.

The Health Services Review Coordinator nurse, a model of preventive and public health who cannot work for 30 minutes without a smoke break, met with me and said “We don’t do this,” not referring to some procedure I requested but to the fact that few people in the medical unit questioned others’ medical conclusions. She confirmed my suspicion that employees in the medical unit align themselves very tightly, at least in the face of questions and complaints from inmates and guards.  I think she believed that her four words would make me go away, to limp out of her office defeated.

“Well, there’s a form and a procedure for me to question the adequacy of my treatment, so I think that you do,” I retorted to a stunned expression.  I don’t speak like the other inmates.  So much of what I say stuns the people who work here.

Eventually, I saw two physicians who diagnosed a neuroma in my foot which was treated with cortisone and alcohol injections.  It took eight months for me to get those shots.  If my foot’s neuroma squeezed into the emergency space between life and death, a toe-tag would have decorated my future.

imageThe lack of choice for inmates’ medical care causes more than just physical distress; it also creates rancor between medical personnel and “custody staff” – guards, lieutenants, captains and the wardens.  When custody staff wants to send an inmate for emergency care, nurses sometimes send her back, deciding that symptoms are not serious enough, maybe even faked.  Other times, inmates appear in the medical unit with conditions so advanced that nurses pick up the phone and yell at a member of the custody corps for not dispatching the prisoner over for treatment sooner.  The internal power struggle leaves medical needs unexamined and inmates like me have no choice but to stand as silent witnesses to the duels.

“I can’t believe they let her die!” cried one female guard after Deb died, a clear accusation that it was the medical staff’s fault, not the guards who might not have referred her properly or with enough priority for effective care.

image“I don’t know what’s happening in that unit, but you waited too long to send her here,” a nurse was telling a C/O over the phone in a conspicious way – on the phone in the lobby of the medical unit. It makes me think it;s more theatre than concern when one of us croaks.

When that watery warning developed into a full flu crisis, I thought of asking a guard to call the medical unit for me, if only to collect another bottle of Tylenol for my fever, something it would take two weeks for me to receive from the commissary, but I didn’t.  The nurses advice would do as much as all of those over-the-counter pills I used to buy, which was close to nothing.  I decided I had no choice but to ride it out if it isn’t serious.

THREE IDEAS in JUSTICE REFORM FROM NOVEMBER 23-30, 2015

image

From Fluvanna Review: Lawsuit Spotlights Inadequate Health Care At Fluvanna Prison

“Capitated compensation” – a contract between a private healthcare provider and a correctional system whereby the provider is paid a fee for each resident of the facility and no more – can be the unofficial cause of death for prisoners.

From Vice.com: What It’s Like to Celebrate Thanksgiving in a High-Security Prison

All the fixin’s. And food in people’s pants.

From the Chicago Sun-Times: Prison “Reform” Can’t Be Revolving Door

The State of Illinois spent $69 million in fiscal year 2014, $67 million in fiscal year 2015 on prisoner re-entry services. Since July 1 of this year, the state has spent only $418,000 on services. Is Illinois headed toward more recidivism?

SHARING IS CARINGShare on FacebookTweet about this on TwitterShare on LinkedInEmail this to someonePin on PinterestShare on TumblrPrint this page
24 August 2015

Not Unusual Enough

SHARING IS CARINGShare on FacebookTweet about this on TwitterShare on LinkedInEmail this to someonePin on PinterestShare on TumblrPrint this page

 

image
“The Healing of the Woman with Issue of Blood”

“I mean, I’m basically biblical at this point,” I said, referencing the hemorrhaging woman cured by Jesus in the Gospel of Mark. Like her, I had been bleeding for years at this point and I was begging for help from the OB-GYN, Dr. Fetal Pig, who is far from divine, and I couldn’t have grabbed the edge of her lab coat without being re-arrested.

No one can convince me that Fetal Pig doesn’t drive home – to the closest high school biology laboratory – in a jar of formaldehyde. I have no place to criticize anyone else’s looks, but F. Pig, MD is an appropriate name for the prison’s rug doctor because she is a chauvinist, blindly loyal to her own, to the establishment and clearly unconcerned about female inmates’ health. If I hadn’t made advance plans for procreation years ago, I would have been so scared about my reproductive future that I would have dissected her myself even though I am not given to violence, especially against scholastic subjects.

“Everything is fine,” she said peering through a microscope at my crotch samples. “You must be spotting from stress.”

image
Good day, doctor.

“For two years? I’m spotting from stress for two years?”

“How long have you been here?”

“Five years.”

“See? That’s why. It’s a stressful, stressful place.”

“I mean…shouldn’t I have been spotting for five years then? Why did it start after three? It’s not like regular menstrual blood. It’s more dilute.”

“It’s just spotting,” she announced after she turned from the microscope. “Nothing to worry about.”

I left her office and continued to diaper myself as I had been for almost 24 months. Whipping the adhesive backing off sanitary pads and liners, leaving wrappers everywhere, I wondered why any man would ever want to be a woman, remembering how another prisoner, Bradley Manning, the army private sentenced to 35 years in Fort Leavenworth for leaking classified government files, had been calling himself Chelsea lately, saying that Manning is no man at all, but transgendered male.

imageFrom prison, the only place where such a statement like “She’s a boy” is easily understood, a place where gender and biological sex run away from each other, Manning says he has been “a woman since he was a little boy.” I read in the paper that the private sought to receive hormone therapy to bud Chelsea’s new private parts and may eventually seek gender reassignment surgery. Chelsea can refuse to provide the crotch samples I had so willingly surrendered but rather tell them: “Take it all!” And the weird part, I thought, as I papered up my private parts, was that Chelsea might actually get the the hormone therapy while she’s incarcerated.

Federal courts have held that the Eighth Amendment prohibition against cruel and unusual punishment requires individualized assessment of whether a prisoner needs specialized medical treatment. For transgender inmates, men who aspire to bleed like I do, and others diagnosed with gender dysphoria, assessment and treatment might include the hormone therapy that Chelsea wants because, according to the courts, lack of such therapy for the transgendered male causes depression, self-mutilation and suicide attempts.

imageThe idea that Chelsea Manning might get hormone therapy and a whole new chasse wouldn’t twist my panties at all if other prisoners saw their Eighth Amendment rights protected. I’m bleeding to death but I get nary an extra maxi-pad. My roommate’s femur juts out from her hip at a 45 degree angle; then her tibia angles in at 45 degrees because her knee needs replacing.  Her surgery has been cancelled because she was supposed to parole but then she didn’t parole so she hobbles down the prison walkway. Doctors cut every nerve in the shoulder of an inmate here who underwent surgery at UCONN Medical Center for a rotator cuff injury.

But Chelsea Manning might get bigger boobs than mine because of hormone therapy when I might be dying? The framers of the Bill of Rights are flipping in their graves and grabbing their balls as I list the examples of real Eighth Amendment violations that will continue to be ignored because they don’t have Wikileaks case or a politically-charged condition like gender dysphoria. I don’t begrudge her the hormones at all but I think this is improper correctional triage.

During a meeting with one of the facility docs to review recent lab results on my thyroid function, Dr. Crayfish scrolled up and down the computer profile for inmate lab results and asked me:

“Do you know there’s been blood in your urine since September 2011?”

“No.… It’s 2014.”

“I know but each urine since then has big, big hemoglobin in it.”

“Well, I’ve been spotting. Fetal Pig has examined me several times and she said…”image

“When did you start spotting?”

“Two years ago.”

“No, the blood in your urine started before the spotting.”

“Is the blood in my urine the spotting itself? Is that what you’re saying?”

“I’m saying that this needs to be checked before you leave [the facility].”

“Why hasn’t Fetal Pig informed me of this?”

“Oh,” he said as if his answer was easy and rational. “Urinalysis is always at the bottom of the lab profile. You have to scroll down, like forever, to get to yours because you’ve been here so long.” I knew what he meant: no one bothered to look. To him, this was normal and acceptable.

When one considers what constitutes an Eighth Amendment violation it’s a wonder that anyone even bothers to make a claim of cruel and unusual punishment. The legal standard is deliberate indifference. It’s like an intentional accident, calculated coincidence or a planned fluke; even in theory, the standard isn’t real.

imageTo prove that allowing me to bleed like this violated my constitutional rights, first I would have had to prove an objective element of my claim “the serious medical need” that went untreated – which is next to impossible because Fetal Pig was downplaying whatever was wrong with me and writing in my chart that I was fine. I could never provide evidence that whatever I’m suffering from now is anything in particular.

Second, I would have to prove that Fetal Pig knew about the blood in my urine and consciously disregarded it. I know that Dr. Pig didn’t know about the blood in my urine because, as Crayfish said, it was way at the bottom of my lab profile. This means that my claim of cruel and unusual punishment would fail. But Chelsea’s claim has a chance.

imageThe fact that Fetal Pig should have known, should have used her tiny hoof on her mouse to scroll through all of my lab results but failed to do so, would not matter in an claim of cruel and unusual punishment. The fact that I was later diagnosed with a urinary tract infection that they could have found and treated earlier is not an Eighth Amendment violation by itself; it’s only malpractice.  And that’s okay because this is a prison; correctional medicine expert Michael Puisis said that prisons hire doctors who “would not be acceptable to practice in a free-world civilian sector.”

image
An inmate tombstone.

Deliberately indifferent is how correctional medicine is practiced; it’s the norm. In fact, the apathy infects so much of correctional health care that proving it in civil court is almost impossible since evidence in litigation usually points up the digressions, departures from the norm, not the norm itself. There’s no deviation from the standard of care here because there is no standard of care. Malpractice is so pervasive that it doesn’t exist in a correctional setting.

I guess the lesson still awaits Chelsea that something else leads to the cruel and unusual badness of depression and self-loathing: incarceration itself, especially the mundane medical mishaps that happen apart from sex changes. No matter how badly they handle Chelsea’s unique medical concerns, it will never be an Eighth Amendment violation that can free her from confinement. Even getting the hormone therapy won’t be a divine cure. She – like the rest of us – will still live in cruel circumstances that are not unusual enough.

image

 READER POLL

image

 

From the Guardian: Chelsea Manning Found Guilty but Spared Solitary Confinement

Chelsea Manning was written up and received a 21 day sanction of loss of recreation privileges for possessing contraband and allegedly disrespecting a guard, along with tossing a mustard packet.

Was her sanction fair?

View Results

Loading ... Loading ...

SHARING IS CARINGShare on FacebookTweet about this on TwitterShare on LinkedInEmail this to someonePin on PinterestShare on TumblrPrint this page
13 July 2015

Perennial Bush

SHARING IS CARINGShare on FacebookTweet about this on TwitterShare on LinkedInEmail this to someonePin on PinterestShare on TumblrPrint this page

 

image

“George Bush was president the last time I shaved my legs,” I announced from the shower.

“Thousand points of light,” said Diane, an older woman doing time for abusing her corporate credit card to buy household essentials as she waited for me to get out.

“George W., not the father; I’m not some kind of pig,” I schooled her.

imageI started shaving when I was ten years old, pilfering my mother’s yellow-handled metal razor from her shower.  Amateur that I was, I harvested a slice of skin worthy of grafting.  When my mother discovered my wound, she provided the few tips needed to qualify me for authorized use of a razor by a minor.  I used my new license to shave every day for almost 30 years, until I met York CI where the warden considers all tools of hair removal to be weapons – aside from factory-reject electric razors and Nair bottled in 1999.

The act of shaving was never a nuisance or a preference for me; it was automatic.  Neither a triangle of bristle near my ankles nor a strip of stubble on my shin ever appeared.  I never imagined a day when I would be prevented from my daily grooming routine.

image
No cameras allowed inside York CI…but this could have been me.

I didn’t shave when I first arrived at prison; I never thought I would be here long enough to need a shave.   About six weeks into my stay, I sudsed up my washcloth, started to scrub and wondered how a Greek sailor got into the shower with me and left his toupée under my arm. My basement window wasn’t obscured by bushes; I had grown full hedges. All of this hair can’t be mine, I thought.  I didn’t even recognize myself.

Panicked, I purchased the electric razor from the prison commissary which barely removed any hair.  The rotating blades pressed against such cheap mesh guards that the lattice tore, leaving razor-tipped metal edges digging into my skin.  Scabs dotted my legs and when I tried switching methods, the Nair set the abrasions on fire.

Then, on top of these scabs, I developed a rash.  Prisons are the capitals of infectious disease; more than just the bad attitudes are contagious.  The prison doctor said he saw one red skin inflammation every year that defied diagnosis.  I won the completely- unidentifiable-irritation-award for three years running.

image
I hated having to hike up my pantlegs during mini-searches to see if I was stowing contraband in my socks.

“Shaving or the clobetasol,” the doctor told me, holding out his hands like the competing sides of a scale, meaning that if I continued to shave with the razor that minced my skin into ground chuck, then he would stop prescribing the steroid cream that stopped the rash.  I pitched the razor and haven’t attempted hair removal since.

Women never consider the possibility that we may, at some point, be unable to groom ourselves or control how we look.  If we do, we usually associate that inability to primp with death, not living in tight quarters, undergoing daily scrutiny and surveillance.  Sure, my new hirsute identity elected not to shave but, as for most prisoners’ actions, conditions compelled my choice; in prison, restriction always anchors one’s free will.

Being unable to control our appearances can be traumatic, harrowing.  That’s the real punishment for women in prison – the powerlessness to look the way we choose.  Women’s magazines succeed because we like learning what else we can do to change, enhance or delete from our appearance so that we’re not always stuck with what occurs naturally.  Proving that appearance is no minor concern, the mere chance to change our own attributes spurred a 90 billion dollar a year cosmetics industry, a multi-billion dollar plastic surgery industry and Adobe Photoshop.  Private enterprise loves to make money off prisoners; the decision not to allow makeup or other image enhancers in women’s prisons is not because no one on the inside would buy the products.  We would.  I suppose that denying these products is part of correction, an imposition of humility on incarcerated women.

image
This is the machine Kafka envisioned for carving your judgment into your skin. Wear it, honey.

Sentences of mere confinement were too easy in Franz Kafka’s short story In the Penal Colony, where guilt was “never to be doubted.”  In the colony, wardens carved prisoners’ punishments into their backs with needles over and over again until the carvings lacerated their bodies to the point of death.  The executioner required onlookers to watch the visible demarcations of punishment.  Beheading or poisoning the prisoner would have been more efficient yet it would have been insufficient.  It is never enough that someone suffers punishment; a prisoner has to wear it before he dies.

External manifestations of punishment are hardly new.  From Hester Prynne’s crimson vowel to the six-pointed yellow stars worn by Jews in Nazi Germany, few can deny the connection between reckoning and appearance.  Your just desserts have to be spilled down the front of your shirt.  Revisitation of karma must lay track marks.  Even Jesus Christ who rose from the dead couldn’t shake his stigmata.  Prevention, people will tell you, is why these brandings are necessary; prevention of escape, prevention of another offense.  Everyone must know you did wrong just from looking at you.  Knowing that you are helpless – that you’re not ready for your close up when you’re ready for your cuff up – to control how you look is the real penalty.  The real rebuke is ugliness.

image
I’m pretty sure she wore black stockings because she didn’t shave her legs.

Nowhere is this lesson more apparent than in how we criticized Lindsay Lohan in her court appearances last year when she was accused of stealing a necklace from jeweler Kamofie and Co. in Los Angeles.  Of course, in this country, no defendant is actually considered innocent until proven guilty.  We suspect someone is guilty until she looks terrible, and when she does look bad, we know she’s guilty for sure.

Lohan appeared in court on March 10, 2011 in an awkwardly adjusted, Raquel Allegra buff-colored leather dress and a Judith Ripka diamond pendant that few others can afford.  Was it really the fit of the dress or the cost of the diamond that offended us, or its function?  Lindsay used the dress and the diamond to look good, so different from all of the other defendants in court that day.  Lindsay denied those people who remain unaccused of wrongdoing the right to look better than those people who face accusations.  How dare she?

Even as my own trial unfolded in the local newspaper, reporting inaccuracies and the names the press called me bothered me but not enough; I was just glad that Connecticut courtrooms disallow cameras.  Because of this rule, no reporters carried cameras with them to snap photos of me outside the courthouse.  They had no chance to see the hair on my legs because it wasn’t even there yet, so that was not the cause of my trepidation.  Readers of the local press drew incorrect conclusions about my character and the evidence against me.  But my overall appearance was still inconclusive to them and I was OK with that because no one could assess my case based on whether someone though I looked good or bad.  Think about every trial you’ve seen on TV and try to deny that the defendant’s appearance did not affect your evaluation of the evidence and the verdict.

imageI must admit that not shaving, or not grooming myself, has caused a new form of self-rejection.  I never look down or to the sides when I dress.  Nightmares of strapless dresses and shorts recur weekly.  I shower with one eye closed so I can’t see the locks on or between my legs.  I refuse to wear shorts in deference to the public aesthetic.  As a result, I am so alien to my own body that I don’t even know if I’m bleeding.  So unfamiliar am I that I discovered a days-old cut on my leg after I parted the hair to see why a minor knock hurt so much.  I don’t know how I got it; it had already begun to heal.

imageWomen rarely shave in Europe, other inmates remind me, as if they have been there.  I never shaved to fit in.  I shaved because the activity revealed my body to me.  I knew the slopes and scars, curves and craters.  Admittedly, I never liked terrain; it was always too something, fat, short, wide or white.  Through shaving, though, I understood the condition of my skin, the largest organ I have, even with the imperfections I have inventoried.  When I shaved, I accepted myself more even though I was conforming to an external beauty standard.  I sound overly trite when I say this, but I bared myself to myself.  It’s a hard thing for me to do physically or emotionally after being society’s rejects for so long.

Psychologists say that women experiencing emotional pain tend to cover up to protect themselves and to prevent scrutiny.  They do it with fat, baggy clothes, or whatever works.  I sprout a thick enough coat to do the same with hair except I enjoy the added benefit of fending off lesbian suitors silently when they sneak a peek through the shower curtain.  I never thought I would miss the flaws of my short little legs so much that I would want to bare my body more, both to myself and to others but I do.  I doubt that is a bad thing.  More than just to get rid of the hair, I cannot wait to shave so I can know what I really look like again.  I wonder if it will be before Obama leaves office.

READER POLL

image

 

From solitarywatch.com: Kafka and the Debate over Solitary Confinement

Franz Kafka’s story “In the Penal Colony” celebrated its 100th birthday last week. One law professor believes that the story shows the dangers of solitary confinement specifically and unchecked prison management generally.

Which state is the new Kafkaesque penal colony?

View Results

Loading ... Loading ...

 

SHARING IS CARINGShare on FacebookTweet about this on TwitterShare on LinkedInEmail this to someonePin on PinterestShare on TumblrPrint this page