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An incarcerated physician describes his
chilling experiences with healthcare at
Lompoc Prison.
The medical staff was rumored
to be staffed by Doctors Mengele and Kevorkian, recruited from Africa after
their clitorectomy practice dried up. They supposedly emerged at Lompoc where
they learned they would be inoculated against civil litigation. When you enter
prison, the world leaves you behind. You quickly realize that your life is
inconsequential, and your medical problems are of little import. In my case, I
needed a prostate pill that I had taken for years which was not on the
formulary of drugs provided by the clinic. The formulary held a grand total of
about one hundred types of pills to cover a gamut of medical illnesses. As long
as your condition could be treated by one of those few pills, you were in good
shape. If not, you had to request an appointment to see Dr. Khan. Her English
vocabulary consisted of the same number of words as drugs available in the
formulary. Her staff was irredeemably cruel, syphilitic, grim, and burnt out.
When I stood in line to request my medication, I listened intently to the
assistants interact with the other beleaguered inmates. A sepulchral scent
wafted towards me as I braced myself for the worst.
Every interaction in the
clinic was contentious, accusatory, and truculent. What the staff lacked in
compassion, they made up for with lightning
quickness. Speed was valued over accuracy. After being informed that my
prostate pill was not available, I was given an opportunity to meet with the
physician on “an urgent basis.” A mere two months later, I met with the venerated physician. She was a graduate of
Pakistan’s one hundred and fifty third best medical school and could not have
been more callused or disinterested in seeing me. She stood five feet tall and
weighed ninety pounds. She was between 40 and 110 years old. I explained my
situation and was told it “should be available in a day or two.” I sat and
watched her submit the request. She fiercely typed using two fingers like a
nine-year-old who hasn’t been taught how to type yet. When I went to pick up my
medication at the drug line the next day, I was informed that Regional had
disapproved the request. I explained that there must be some type of confusion
since the doctor had approved the medication.
“Make another appointment with
the doctor.”
A month later, I was finally
granted access to see Dr. Khan again. She was annoyed by my presence. I
explained to her my frustration, confident that she would fix the problem. She
warmly replied, “What do you want me
to do about it? They disapproved
it.”
I explained to her that I
realized it wasn’t an emergency for her
personal health, but a lot of doctors here in America might consider urinary
retention an emergency condition. Finally, she showed evidence of having a
pulse. As a well-seasoned medical professional, she had just the prescription:
She got up out of her chair and ordered me out of her office.
After 7 months in prison, 22 visits to the clinic, and a surfeit of administrative remedy applications, I eventually got my medicine. Most inmates are not that persistent. The prison spent
lavishly on needless overtime, but they knew where to save a buck. They
bristled at sending inmates for outside consultation and other medical care
that was desperately needed. Sam was a seventy-year-old, enfeebled sex offender
with a history of coronary artery disease and two prior myocardial infarctions.
He came into the clinic with chest pain, something which might arouse the
suspicion of any healthcare worker in any facility, including the cashier in a
hospital cafeteria. Rather than perform any type of test, such as an EKG, the
provider relied on her clinical insight, garnered from weeks in the BOP. Sam was
told to drink water, the favored panacea of the clinic.
Eager to comply, poor Sam did
as he was told. Amazingly, his compromised coronary arteries failed to respond
to their groundbreaking treatment and his angina persisted. He returned later
that evening to the clinic. The provider was determined to get to the bottom of
this perplexing enigma.
“Was there ice in the water?”
“No, it was from the tap.”
Satisfied that her diligence
had unroofed the solution, the nurse impatiently replied, “You have to use
really cold water.” The next morning, Sam’s carcass was removed from the
dormitory. His sad, inexcusable case would be scrutinized by nobody.
The inmates may not have been
aware as to just how bad their care was, but they could certainly tell that the
staff was vacant and mean. Dr. Mike, the plastic surgeon from Anchorage, knew
better. Although he was successful in getting an evaluation by a “real doctor,
off the compound,” a cardiologist, none of the physician’s recommendations were
followed. He contacted the Board of Medical Quality Assurance for the State of
California, a legitimate regulatory organization. Tragically, he was informed
that BOMQA had no jurisdiction within the BOP. The doctors who worked here were
immune from regulatory insight. Similarly, they were personally shielded from
civil actions. When I couldn’t get the prostate medication that I required, the
only administrative remedy that was available was to ask the Warden to
intervene. I was only able to get my medicine by being obsessively persistent,
and eventually I found a provider with a modicum of interest.
When Dr. Mike tried my tact,
he was not so lucky. The Warden decided that Mike needed diesel therapy. He was
put on a bus, in handcuffs, and sent to another facility. Transport within the
BOP is brutal. Inmates have their hands shackled in a box, have minimal access
to bathrooms and must try to eat while
shackled. Their journeys can take days, with intermittent stopovers at sundry
austere detention facilities.
Dead Bob complained at sick
call for six months to a heavily tattooed paramedic/guard about hematuria
(blood in the urine). Paramedic and
guard empirically seem like an unlikely combination of responsibilities. A
skeptical and accusatory attitude is not compatible with providing good health
care. Bob’s complaint triggered the guard to order a urinalysis. This is a test
that costs about twenty-five cents and takes thirty seconds to run. Incredibly,
the test was not scheduled for four
months. After the test was finally done, the results were lost, and Bob needed
to reschedule. It would be like going to Burger King for a Whopper and being
told to come back in several months. Six months later, Bob had gross blood
clots coming out of his penis when he tried to empty his bladder. Later that
day, he was unable to urinate at all. He passed out and was carried to
the clinic. Rather than accept his word, he was told
to drink water so that he could produce a sample. Except he couldn’t urinate no
matter how much he drank because the blood clots had obstructed his
urethra. By the time he was finally
allowed to see a specialist—someone who knew more than nothing—he was diagnosed
with advanced bladder cancer. He died three weeks later. His tragic death resulted
in zero investigation.
The BOP was required to
perform a TB test on all inmates, every year. It is a simple test which
requires a simple injection just below the skin. Instead, the medical staff
delivered the injections deeply into the muscle, guaranteeing that none of the
tests would be positive, ever. The
test was a charade and guaranteed that the staff wouldn’t have to waste neither
time nor resources treating tuberculosis.
Sex Offender Bob had the
misfortune of having a transurethral resection of the prostate performed by an
outside urologist. Unfortunately, the operation was botched, and he had
problems with heavy bleeding and clots following surgery. His problem was never
addressed, and he was sent home from the hospital with a catheter that was
clogged. His urine was trapped in his bladder, which filled further as his
kidneys continued to produce urine. Eventually, the urine had nowhere to go and
he was screaming in pain. He banged his head against the wall, literally, in a
desperate attempt to knock himself out. When this measure failed, he pleaded
his case to the Lieutenant. The Lieutenant had a solution. “Walk or go to the
hole.” Sex Offender Bob thought about his options. Neither seemed to provide
him the positive outcome that he had hoped for, so he walked away.
To have an institution such as
the BOP, which perceives itself as fundamentally having a punitive role, also
be responsible for providing healthcare, and not held accountable to impartial,
outside review, is an opprobrium. The mayhem that I personally witnessed was
cruel, unusual, and arguably unconstitutional. Learn more here.
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