Monday, January 28, 2008

Is There A Doctor In The House? - Part One

Monday, January 28, 2008

It was my intention to write about this whole sordid episode after some form of resolution had been reached, so I could put a happier spin on it. Unfortunately, at three months and counting, I am no closer to satisfaction than I was in the first three seconds. I am titling this as "Part 1", in hopes that at some point in the future I will be able to write a "Part 2", wherein I ride off into the surgery suite sunset and sexy nurses heal my broken body. Sigh, I am such a dork sometimes. While all that may never happen, I am cautiously optimistic that I will someday be able to write a finale to this. Hopefully, being optimistic doesn't equate to being a sucker, as is usually the case when TDCJ is involved.

It doesn't take very long to get jaded about the way we are treated around here. You sort of realign your way of thinking to accommodate the situation, so you don't lose it. One of my long-time neighbors, Lester Bower, quickly brought me up to speed on the medical care, shortly after my arrival. "Don't get hurt" was the summation of what he had to say on the topic. I was convinced that things couldn't be THAT bad. In the county jail, medical care is almost nonexistent, but for most people that doesn't matter much, as they are only in jail for short periods of time. It becomes a little more troublesome when you are there for eighteen months, like yours truly. You get used to it. Here at TDC, all medical care is provided by the University of Texas Medical Branch. If you are General Population inmate, and have a medical problem, you simply ask a guard for a sick-call form, which you turn in that evening for mail pick-up. The next day, you are called down to the medical building, which here at Polunsky Unit is labeled as 10-Building.

On Death Row (and the other ad-seg wings), the process is a little more complicated. In theory, the nurses are supposed to come around once a week to hand out sick-call forms. This doesn't happen, so you really try to stock up on them when you can. Lets say that you start feeling sick. You fill out a form, and then set it at your door (I've built a mailbox which is taped to the door, for example), for the officers to pick up the following morning at 5 AM. It usually takes about a week for a set of guards (called an "escort team") to come to your cell and accompany you (with your hands cuffed behind your back, like always) to the nurses office. This small office is located within the DR building, for convenience. If your problem is serious enough, they schedule you to see a doctor, which usually takes another week. In this way, the nurses are basically the gatekeepers, protecting the doctors from unnecessary visits. To get to 10 Building, you have to wear additional restraints, including leg irons, and a belt which is attached via chains to your legs and hand-cuffed wrists (this is only for DR). You learn to do the convict shuffle, a sort of quick-stepped hop, which is necessary because the chain connecting your two feet is only about 12 inches long. Anyways, once you get to 10 Building you wait to see a doctor. Well, that's the way it is supposed to work. My experiences over the past few months lead me to believe that UTMB is now using the Third Reich's version of Grays Anatomy (the book, not the show). The following information is all true; it is not dramatized in any way, and I have paperwork to back up most of it.

A little history before we begin. During the commission of the crime for which I am condemned, I was shot from a distance of three feet by a 9-millimetre hollow point round. Hollow points, for those of you who are not gun aficionados, basically open up like a flower when they hit something hard (in this case, my left bicep). This opening action prevents the pieces of the bullet from exiting the target, and produces massive internal injury. It basically hollowed out my arm, disintegrating the bone from my shoulder to my elbow. Doctors eventually inserted a titanium rod, which connects my shoulder to my elbow with pins. (To clarify, these were free-world doctors that did this). The fragments of the bone were supposed to migrate to the center of the arm, and reform around the rod. In an X-ray the pieces of bullet (which were in the left arm) glow white, ranging from just above my elbow to just below my shoulder. These pieces of broken bone would eventually be fused around the bone, which would prevent the metal from tearing my muscle every time I moved (though this took two years). During my time in Mexico, I had to be very careful with my motions, as my arm wasn't really a load-bearing structure. It wasn't until I was arrested that I was able to start working out, though this was tentative at best, mainly short sets of push-ups. It took 18 months of this before I was really able to begin an authentic work-out program. I was blessed, upon my arrival on the Row, to live next to a guy named C-lo, who is, for lack of a better word, a freak of nature. I swear he's only part human.

Anyway, he really pushed me to break past the tendinitis pain and the mental block that I was half way crippled. He introduced me to "smoke-outs". Even though inmates out on the rec yard are separated by metal gates and a mesh fence, you can still see the other person fairly well. We made it out together quite often. When I told him I was interested in putting on some mass, he smiled, and I should have run screaming, but I am an idiot. He told me to do 12 push-ups. I shrugged, not impressed, and did my 12. He immediately dropped and did 12, directly after I finished mine. I then followed him. OK, ok, 12 push-ups isn't much of anything, granted. Try doing this for ten minutes. Then do it for 45. The first time we finished our set, I couldn't decide whether I wanted to pass out or vomit first. The jerk happily hopped up and did a few million chin-ups (not really), but it might as well have been that many, the state I was in. After many months, I was up to 300 chin-ups after our smoke-out. On October 27th, I was working on these last sets when I heard a massive cracking sound from my left arm. I know my body, and the myriad sounds it makes, and this was not something I had ever heard before (or, frankly, want to hear again). Seconds later, I knew I had done something serious to myself, because waves of pain began to wash over me. I am no stranger to pain, but my body was telling me it wasn't happy, and it wasn't being bashful about it. Before nightfall, the upper bicep had swollen to about double its normal size, which would be pretty awesome under different circumstances, but not these.

And now we come to the problem. That evening, I filled out a sick-call form, and turned it in. That was a very painful night. I constructed a sling, which I used to suspend the arm, allowing me to lay on my bed without putting too much pressure on the elbow and shoulder. I waited several days for an answer, asking each guard that passed by to please call medical for me. None of them did, though some seemed to think it was pretty funny that my "arm was @#$%ed up, bro!" I finally did something that abnormal to get some attention, so I went to the day-room, sling and all. As soon as I was placed inside the cage, they took my hand-cuffs off (a rather painful process, to have your hands cuffed behind your back with a broken arm). I immediately told the officer that he had exactly two hours to get me some medical attention, or they were going to have to "suit up" to extricate me from the cage. What I meant by this, is that I had no intention of leaving, and that they would have to bring in the extraction team, body armor and all. This requires a bunch of paper-work, and I was betting it would seem easier to everyone just to get a nurse down to me. They did this, much to my relief, as I had no doubt my lack of an arm would greatly hinder my ability to defend myself, should the team come in on me. The nurse took one brief look at me, and said that I needed to see a doctor. She claimed that she was going to schedule me for an X-ray, though she never did this. I waited another three weeks, and sent several (4) sick-calls in before I was finally taken down to see the doctor (this was on November 24th). I will call this physician Dr. P. He looked at my arm, wrapped in chains as I was, and said that it was obvious that I had suffered some form of traumatic injury (well, duh. Sherlock). He never came out from behind his desk. On November 28th, I returned to 10-Building for my X-ray. For some reason, the x-ray was only ordered for my elbow, per Dr. P. Because the injury was obviously in the upper bicep (the bone is pressing against the skin), the radiologist tech took images of both the elbow and the shoulder/arm. She developed these as I waited, and as soon she put the images up on the light-screen, she exclaimed "Well, yeah, you broke your arm...looks like in multiple locations." She informed me that the X-rays needed to be sent to John Sealy hospital in Galveston, to be reviewed. She told me this would take about a week. It wasn't until exactly one month later (December 28th) that Dr. P. summoned me down to his office. (How apt that I instinctively use the word "down" instead of "to" if I were being called to a lower level of Hades or something). Anyways, once I was seated behind Dr. Goebbals, err, Dr. Ps desk, he informed that I had arthritis in my elbow. He did this with such a straight face, that I thought there had to be more to this statement coming. When he didn't say anything else, I told him that I didn't doubt that, but what about the rest of the arm? "There is no acute injury to the arm." He claimed. I sat there sort of stunned, "So...excuse me? Then your previous diagnosis was incorrect?"

"I made no such diagnosis."

"So, what you are telling me, Doctor, is that arthritis in the elbow is causing my bone to stick out against the skin, and for me to still not be able to use my shoulder."

At this point, he became extremely agitated, and told the escort team, led by officer Moss, to take me back to my cell. I was, apparently, dismissed. I told him to hold on, and asked for some pain medication. He told me no.

"So it is not important to you that my left arm is disabled, and after two months of pain, I still hurt. Fine. I want some medical release forms, I am getting a second opinion. These release forms are my right to ask for, but he began to shout at me that there could be no second opinion, and that, no, he didn't care, and yelled again for Moss to take me back to my cell. I looked at Moss, and asked him if he had witnessed all of this. He nodded. I told him on the way back to my cell that I would be calling him as a witness in the grievance process. He gave me a sad smile, and said, "sure, Whitaker." I didn't know what that smile meant then. I do now.

As soon as I was back in my cell, I gathered all copies of the sick-calls I had sent in, and made a file to send to my attorney. I have a habit of documenting everything and I had laid out the entire debacle for the grievance officer, trying to make it easier for him. I received my reply to this on January 14th, and immediately understood Mr. Moss' smile. It's all a joke to them, and they repeated Dr. Ps diagnosis back to me, word for word. I will admit, for all my calm and collected coolness, I got extremely angry. Pain, when you experience it for long periods of time, creates a sort of flaming ball of tension in your stomach. You begin to feel like a guitar string pulled too tight. You know, at some point, you are going to snap. Something I've noticed around here: when you follow all the rules, you get brushed off. If I had stabbed a guard, or set a fire in my cell, I would have gotten some medical attention immediately. But because I am quiet by nature, and have zero desire to engage in such nonsense, I was no closer to cessation of the pain than I was on October 27th. So I went over their heads. I sent a copy of what I had labeled "gross medical malpractice" to the UTMB Correctional Manager, Dr. Ben Raimer. I also sent another copy to the Texas State Medical Examiners Investigations Dept., which is supposed to regulate these physicians. I never received any response from either one of them. My attorney contacted the warden. Nothing was done. Finally, I asked some of the rank-and-file nurses if there was another doctor I could see. I started sending I60 forms directly to Dr. Z, instead of using sick-call forms. I was told by the nurse, who looked around conspiratorially before she muttered this under her breath, that Dr. Z was more likely to "actually pay attention to the words coming out of my mouth." Dr. Z actually came to my cell this week, and spent a few moments looking at my range movement (or lack thereof) and ordered some x-rays. I am still waiting on this. And lets be honest I don't expect they will ever be taken, unless I keep harassing them (which I am doing, believe me).

All in all, this has been an infuriating experience. I haven't been able to workout in three months, and my stress levels have gone up considerably as a result. I don't sleep well, because when I move, pain lances down my arm, waking me up. I know that I am just a convict. I know that I am no longer a citizen, that the social contract is different for me than it is for you. But, seriously, where are we living? Shouldn't medical care be granted to someone in need? To deny it...can we all agree that this constitutes a violation of every general conception of human rights? I've been told it wasn't always like this. In the Clinton era, there was such a thing as Federal oversight of state prisons, wherein Federal investigators made visits to state prisons twice a year, thus keeping the states in check. GW did away with this as soon as he took the oval office. I can't believe I voted for that idiot. Serves me right.

My case is not abnormal. The "arthritis" excuse is extremely common, given as an umbrella diagnosis for everything from a torn meniscus to the body tightness associated with the flu. Just this week, there was an article in the Houston Chronicle (January 15th, 2008 - "closer Look Sought Into Inmates Death") about the death of TDC inmate Larry Louis Cox. He got into a scuffle with the guards, who beat the tar out of him (two broken vertebrae among the injuries). His death was ruled "homicide by medical neglect". Even though he complained of severe pain in his back for two weeks, his x-ray sheet says his injuries were "unremarkable with no signs of fracture." Sound familiar? I remind you, this man is dead. The only difference between this case and hundreds of others is that the Chronicle got hold of it. I suspect this happened because of the furor surrounding the Harris County District Attorney, and his current fall from grace, which puts certain aspects of crime into the "hot issue" pile for a short time. Normally, prisoner rights are a verbal caltrop to politicians. It won't last.

Texas Prison Health Care: On The Brink of Unconstitutionality, Again

In conclusion, I guess I want to explain why even you hard-core Republicans should care about this (not about me, but rather about the horrid conditions here). I am never going to leave these walls, but the same statement does not apply to the vast majority of the 180,000 inmates in the TDCJ system. Most will be out, one day. I want you to think about that for a second. Let's take a look at some of the lessons these men are being taught, shall we? Rather than giving them drug education, they are taught absolutely nothing, except that they can't wait to get back out there, because street prices are quite a bit lower than prison dope prices. (GW killed nearly all the drug treatment programs when he was governor). Rather than teaching these men the value of a dollar, and about saving and making a financial plan, and giving them some vocational training and educational opportunities, they are simply shown how to "hustle". (TDCJ workers are not paid one cent for their hard labor, unlike other states. do you think they make money for commissary?) They are shown that they are subhuman animals, that they are different from YOU. They are shown that they are worthy of living in filth, and that the only way to make sure the "man" doesn't get them is to get him first. And people wonder why the recidivism rates in this country are 13 times higher than in Europe.

What do they do differently in Europe? Well, in general terms, they use the carrot, not the stick. They rehabilitate the offender, and treat him as if he were a human being. This does not mean you let him get away with anything. You simply grant him a small amount of respect. Amazing thing: they don't go back to prison! Imagine that. Sure, this type of penal environment costs more to operate than a purely punitive one, but do you honestly believe that the economic cost of putting programs back in prisons is higher than the economic and social cost of all the crimes repeat offenders commit? Tell that to the victims and families of victims of crimes which were committed by men who have been in prison 2, 3, 4 or more times. You would think that this stuff would be common sense. And yet...there is an entire political philosophy in this country predicated on the idea that criminals are not, technically, human beings. That once you delve into the world of crime, you are SOMETHING ELSE and must be banished for eternity from the world of the clean. If I am not human, I ask you, what am I?

"We are, I know not how, double within ourselves, with the result that we do not believe what we believe, and we cannot rid ourselves of what we condemn."
Michel de Montaigne Essay (11, 16 469C)

© Copyright 2008 by Thomas Bartlett Whitaker.
All rights reserved.