Lockdown on Rikers (25 page)

34

Despite my apprehensions about the Bing, I plodded on, doing my best as OBCC's sole Mental Health administrator, supervising every aspect of the operation—from monitoring referrals to figuring the payroll to compiling statistics.

There were also many, many meetings to attend: warden's meetings, unit chief meetings, quality assurance meetings, staff and clinic meetings. I barely had a moment to breathe, and at one unit chiefs meeting, the pressure shot up. Dr. Campbell outlined the upcoming summer audit schedule, emphasizing its importance. “The audits are our report card,” he said solemnly, “and we expect them to be perfect.” I scribbled the date for OBCC's audit, hoping Kelly would be back or that we'd at least have a clinical supervisor to spearhead the necessary chart reviews.

Next was the distribution of forms for staff to sign—everything from absentee policies, dress codes, and parking procedures to our relationship with DOC—plus countless forms on patient care. Taking a page from the Giuliani administration's touted policy of accountability, St. Barnabas was churning out the paperwork. If the audits were less than successful, then we, the unit chiefs, would be accountable. In turn, we were to make our staff accountable. When staff deviated from policy, they would be confronted with their signed understanding of that policy. Management, even of such an inherently complex situation, was reduced to
a simple maxim: everyone had a job to do, and if something went wrong, then the faulty link in the chain would be identified and corrective measures taken.

Although the accountability theory made sense in the abstract, its application was less than tidy. The premise that everyone had a job to do was turning a blind eye to the fact that many were doing more than one job. In my case, I was doing my job, Kelly's job, and the job of the clinical supervisor. The staffing levels in most of the jails were inadequate, yet we were treated as if we had reasonable workloads. But as a fresh stack of forms was distributed, we silently accepted them.

Campbell finished up with a dreaded announcement: “We're getting ready to fire all the limited license doctors. We've got enough fully licensed doctors, so we're going to move ahead on this. We'll let them go in waves. The transition should be completed by the end of summer.”

With this news, we all cringed. Most of us had worked side by side with our doctors for years and were rooting for them to pass their exams and stay. Besides, we suspected that all Central Office had in store was a fresh supply of moonlighters.

Defensively, the deputy director, Suzanne Harris (wearing civilian clothes), reminded us once again that this was a contractual obligation. “It's not going to be any surprise to these doctors—they know. But just in case, you're not to say anything about it. Not a word. We'll handle it!”

I suspected that all four of OBCC's doctors had limited licenses, but when Harris confirmed it, I felt sick. I tried to explain to the Central Office team that it would be no simple matter to place a new doctor in the Bing, but that was brushed off. They had no clue about the Bing, and my only hope was that Kelly would be back before any of this began.

But a week later, with no sign of Kelly, Hugh Kemper called. “Two new doctors are starting at OBCC next week. The first is Tarra Grant, and the second is Katherine Ketchum.”

“What about our own doctors?” I nervously asked.

“Well, just sit tight. We're not going to let them go just yet.”

The following Monday, Drs. Grant and Ketchum arrived on schedule. If our doctors suspected what was up, they didn't let on. They welcomed the women, perhaps assuming they were with us for training purposes. Despite my misgivings, on a personal level I found both new doctors quite likeable and was pleasantly surprised to learn that they weren't moonlighters but dedicated, interested physicians. Ketchum, a petite blonde in her fifties, was an eager perfectionist. But after a tour of the Bing, she was horrified and refused to return. Fortunately, she took an immediate interest in the Mental Observation Unit, where she assumed the role of primary psychiatrist.

Grant, a feisty younger woman with a short Afro, was obligated to work in an undesirable setting like jail for two years to satisfy the terms of her student loan. Grant was warm, affable, and competent. Unlike Ketchum, she was game for the punitive unit and began accompanying our doctors to the Bing.

Both new psychiatrists, unaware that they'd been hired to replace the team that was training them, quickly assimilated, and I tried to blot out what would happen next.

* * *

As we approached the Fourth of July weekend, we were heading into one of the hottest summers on record, and in no time the jails were stifling. The scorched rec yard, usually teeming with inmates, sat empty under the blazing afternoon sun. The clinic was slightly cooler but by no means comfortable. The COs lugged through the halls in their polyester uniforms, drenched in sweat. But at least officers and civilians could look forward to going home and cooling off; for the inmates, there was no relief. Of particular concern were the mentally ill, whose medications interfered with the body's ability to cool itself. Extreme heat could kill them. Each day the pharmacy cranked out lists of those on the questionable meds, and in the few cases where
they could be replaced by something more benign, our doctors did so. Besides that, there was little else to do besides push them to drink plenty of water and to take cool showers. Considering the health hazard, air-conditioning on all Mental Observation Units should have been mandatory, but this was jail—there would be no such indulgence. Instead, two oscillating floor fans stood at either end of the dorm. Since DOC relaxed the rules prohibiting bare chests, mostly everyone was shirtless. The lucky ones had shorts; the others lay very still on their cots in dark jeans. Although I offered to have the heavy pants cut into shorts, no one took me up on it. Owning only one pair of pants, they had to look ahead to the fall and winter, when they'd be needed for warmth. When I realized my well-meaning offer was more of a taunt than a realistic option, I dropped it.

As hot as it was on the MO and in GP, nowhere was hotter than in the Bing. Trapped inside sweltering cells, the only salvation for the punished was that each had a small sink and access to cool water. One afternoon when the mercury skyrocketed past 100 degrees, Pete and Grant called and asked me to come up to 2 Southwest.

By now, going over to the Bing was a regular part of my day. There was no avoiding it. The Leonard Putansk encounter was my introduction to a daily onslaught of suicide threats and gestures. To cope with these cell-door visits and the gut-wrenching decisions that ultimately rested on my shoulders, I started bumming a cigarette here and there. I would steal away to the restroom for a quick smoke to brace myself for the walk over to the punitive unit. Solitary confinement was far worse than I'd imagined. Behind so many of these doors were blood-smeared cells, makeshift nooses, and the agonized, shell-shocked faces of people begging for a reprieve. As I walked through the halls that afternoon, I rehearsed the mental drill that I'd started relying on to help me keep walking: I reminded myself that solitary confinement was standard punishment in jails and prisons across the country. Thousands of mental health workers were doing exactly what I was doing. It was legally sanctioned
and carried out in a nation that prohibits cruel and unusual punishment. Therefore, I told myself that none of this was really as bad as it seemed. Yet as I approached the big barred gate, my legs were wobbling anyway.

At the elevator, I bumped into Diaz. The sweat-drenched psychiatrist whipped his head to the side, throwing off a spray of droplets. “It's brutal in there,” he said. “I've got to get water.”

When I stepped into 2 Southwest, it was as though I'd stuck my head in an oven to remove a roast—and kept it there! As I made my way toward Pete and Grant, sweaty palms were slapping and sliding down the windows.
“We're dying in here, miss—we're dying!”

“
Shut the fuck up!”
the officers shouted.
“Shut up, motherfuckers!”

I kept going, aware of a growing stench. Midway down the floor, Pete and Grant were covering their mouths. The COs were darting away, pinching their noses. As I drew closer, I was also holding my hand to my mouth.

“Have a look,” said Pete, pointing to the open door.

I peered into the cell, where a young Black man was staring ahead blankly, all the while humming. Lathered in sweat, he was completely naked. With his cupped right palm, he raked his hand across his neck and chest, smearing himself with feces. The excrement was in his hair and slathered around his neck and ears.

“Send him out!”
the officers yelled.
“He's lost it! You gotta send him out!”

The three of us retreated down the floor.

“Oh, my God!” I said.

“Pretty bad,” said Pete.

“What do you think?” asked Grant. “MHAUII?”

“Sure,” said Pete. “But we know what MHAUII's going to say: that he's malingering, that this is just a ruse to get out, that it isn't life and death.”

Pete was right. This was not life and death, yet in accordance with anything decent and humane, we needed to provide this man with relief.

“Look,” I said, “as far as I'm concerned, a line's been crossed. This could be calculated, but even so, if you're willing to go to this length, then as far as I'm concerned, you win.”

“I'm with you,” said Pete.

“Me too,” said Grant. “Besides, the COs are going to lynch us if we don't get him out of here.”

“All right then,” I said. “Let me go down and call MHAUII.”

As I bolted from the floor, leaving behind the heat, the stench, and the anguished cries, I felt like I was departing the gates of hell. As I hurried through the halls, all my carefully crafted rationale about solitary confinement being okay because it was legally sanctioned went right out the window. This punishment was absolutely cruel! And anyone who said otherwise had obviously never set foot inside one of these horrific units.

Back at the clinic, I prepared to do battle with MHAUII. The removal of a Bing inmate came in two parts: our decision that he should come out, and MHAUII's agreement to accept him into one of their specialized cells. Since their small unit wasn't only for Bing inmates but also for high-profile and otherwise odd cases, their eight cells were never empty. The arrival of a Bing inmate meant that an occupant of one of these cells needed to be relocated. For the MHAUII staff, these bumps were disruptive and time-consuming.

Sure enough, when I reached the MHAUII chief, he had a different take on things. “Smearing feces is the oldest trick in the book. You can't let him manipulate you.”

“Listen,” I countered, “it's over 100 degrees in there, he's naked, and he's covered in shit. He needs to come out.”

“This isn't life and death. If you give in every time these Bing monsters act out, then you're going to wind up with five hundred empty cells.”

Bing monsters!
There it was again, and from our own staff! Though I heard these dehumanizing terms every day, I never got used to them. It seemed to me that when you can call someone a
monster,
or a
skel,
or a
body,
then it suddenly becomes okay to do whatever you want to them because they're not really human
beings. Yet the inmates I met with were not
bodies.
They were people. And when I stepped into these cells, what I saw was real blood, real thudding skulls, and actual human torment.

I didn't care what the MHAUII chief said. Not having seen this man, not having felt his desperation, it was so easy to peg him as a malingerer. In some ways, the MHAUII staff was as removed as the public, who learn about solitary confinement in the newspapers by reading how some convict is “locked down twenty-three hours a day” and then turn the page. People have no clue what solitary means. But one prominent American knows exactly what it means. Senator John McCain was famously held as a POW during the Vietnam War. During his five-and-a-half-year captivity, he was beaten regularly, sustaining broken arms and broken legs. Two of those years were spent in solitary. Despite the trauma of his limbs being deliberately broken, what McCain found
even worse
was solitary confinement. He said, “It crushes your spirit and weakens your resistance more effectively than any other form of mistreatment.” Worse than beatings and broken bones! We're horrified by what happened to McCain, yet somehow we don't equate it with the treatment that we mete out every day right here in the United States!

The MHAUII chief and I had reached an uncomfortable impasse. But I wasn't going to back down on this one. Even if they didn't keep him for long, I was determined to get him out, even if it was for nothing more than the lousy bus ride to the other side of the island—“bus therapy,” as we called it.

“Fine, fine!” he said abruptly. “I'll start the paperwork to bump somebody.”

“Thank you.”

When these conversations ended and my wishes prevailed, I always felt like a villain who'd just gotten away with something, and I resented being made to feel that way. Nonetheless, I was glad the call was over and the matter settled. Yet I knew my peace was short-lived and that within a day or two we'd rush to the cell of another desperate human being.

35

As the dog days of summer wore on, the suffering in the Bing weighed heavily on me, but I still needed to address practical concerns. Vacations had begun, and I had to scramble to maintain coverage by borrowing staff from other jails. But mostly I was worried about the audit. Ten days before the targeted audit date, I received a fax advising me to have thirty charts ready for review. Preparing for an audit involved a massive amount of detailed paperwork, and I called Hugh to see if it could be postponed until Kelly returned or at least until we had our clinical supervisor.

“Gee, Mary,” he said, “I'm sorry, but requesting a postponement sends the wrong message.”

“I'll do the best I can,” I sighed.

“The best you can? Mary—it
has
to be good . . . it has to be perfect.”

I knew Hugh felt bad that Kelly wasn't back, and although he offered to send an administrator from another jail to help me out, nothing came of it, and I was on my own in identifying thirty charts that could stand up to the scrutiny. For the next couple of weeks I stayed late into the night, studying charts, checking dates, reading written entries, looking for necessary signatures and required forms. The work was painstaking, but finally I had the files I needed.

On the appointed day, four hot and grumpy auditors showed up. Things immediately got off to a bad start when there was no place for them to sit. I never expected four of them, and I had
grabbed only two spots in the clinic. Since clinic space was scarce, I was lucky to get that. The head auditor, Leslie, solved the problem by plopping down at Kelly's desk and instructing her colleague to sit at the clinical supervisor's desk. I was uncomfortable with this arrangement, but there were no other options, and I began my day while they worked a few feet away.

For a few moments, all was quiet, save for the whirring of fans. Suddenly, Leslie began flipping rapidly through the charts, one after another. Something was wrong. She turned to me and said, “What we want are charts on inmates who've been here six months, so we can gauge continuity of care. Can you please get us a batch of charts that reflect six months of treatment?”

“No, I can't,” I said, surprised by my own abruptness. “No one said anything to me about this.”

“Well, we're telling you now,” Leslie said assertively.

“It's too late,” I said, just as assertively. Enough was enough.

Just then the phone rang. It was the Bing. Always the Bing. “You're needed up here—second floor.”

While I was relieved to be getting away from Leslie, the Bing was not an appealing alternative. I hurried to the bathroom and lit up a cigarette. I took a couple of hard drags, my muscles slackened, and I slumped against the wall where the cold cinderblock felt good on my warm cheek. I looked up at the mirror, caught my reflection, and for a moment searched for the traces of the idealistic intern I'd once been. So much had changed. But there was little time to think about that now. Another crisis awaited. I flushed the butt, splashed cold water on my face, and headed up.

A wild scene awaited outside the second floor elevator. Officers in riot gear, led by Dep Mancuso, were converging on a cell. “Pull him out!” Mancuso shouted. No longer looking confident and composed, the dep was bedraggled. “Get him out, and onto the goddammed bus!”

Later on, I would learn that the occupant of the cell was refusing to come out because the bus would take him to court, where he was to receive a sentence of life in prison.

I sidestepped the commotion and started down the hall to see Dr. Christian, who was talking through the crack in the cell door to the distraught person inside. Although Mancuso had kept his word with the daily escort, considering the hundreds of inmates needing medication, a single escort could only ensure that a small number of inmates could be met with privately. Of necessity, we fell back on the cell-to-cell method.

“It's going to be okay,” Christian shouted through the crack. “You're going to be all right, my friend.”

“I'm gonna die in here, I'm gonna die!” came the muffled sobs from within.

“No, you're not. We're starting you on medication right now and it'll calm you down. You'll see. We're just waiting for the nurse.”

“I'm going to take the cop-out! It'll get me off Rikers Island and out of here.”

“Don't make any big decisions. You've only got ten days in here—some people are in here for years—you're going to be fine. You're going to be fine.”

“I didn't even do anything to get a ticket! I swear, I didn't! I didn't do a thing.”

Christian stepped to the side of the cell and said, “It's okay, Mary, false alarm—I've got this one.”

A reprieve. But my mind was already racing. This inmate's protest,
I didn't do a thing!
made me wonder. Several days earlier, a friendly officer nicknamed Smitty had stopped by my office for a cup of water and a quick break. As he was leaving, he pulled out his infraction pad and revealed something stunning. “I've got to go write up tickets. The way they're loading up this island, they're scrambling for beds. With five hundred beds in the Bing, they can't afford to let one of them sit empty. Every time somebody goes into the hole, a GP bed opens up. We have our orders: ‘Write 'em up! Write 'em up!' Let me go find some poor schmo. See you later, Miss B!”

Now, I wondered if the person in this cell was one of those “poor schmos.”

Although we're led to believe that inmates in solitary confinement are the baddest of the bad, I found that claim to be highly exaggerated. In the beginning, I had actually hoped it was true as a means of helping me to justify this brutal punishment. But in the short time I'd been working in the Bing, I'd discovered that many of these cells' occupants suffered from impulse control disorders. It's not so much that they won't behave, it's that they
can't.
I wondered if someday we wouldn't look back at this primitive punishment and shake our heads. And then there are those in solitary like poor Keith Bargeman, who acted out in the hallway because his court suit had been stolen. Hardly the worst of the worst! And in terms of the most serious jailhouse infraction, “Assault on Staff,” after speaking with these offenders, I learned that the infraction usually came about when correctional personnel struck first and the inmate hit back. An unprovoked assault is rare, if for no other reason than there's no escaping the most violent retribution for such an act, and every inmate knows it.

And even in cases of the very worst sociopath held in solitary, the question still remained: How could it be that a punishment that drives
any human being
—criminal or otherwise—to attempt suicide to escape it not be considered cruel and unusual?

Years later, the United Nations Special Rapporteur on torture would state that solitary confinement beyond fifteen days should be absolutely prohibited. Yet instead of reducing or seeking alternatives to solitary confinement, the nation has been on a chilling march to build more. Supermax prisons, made up solely of isolation cells for supposedly high-risk prisoners, house human beings inside these cells—not for thirty, sixty, or ninety days, but indefinitely,
as a matter of routine.
In supermaxes, things have been designed very carefully. For instance, the cells are padded, so that an inmate in desperate need of relief could bang his head continuously without risk of injury. In these more sophisticated, sinister units, the “problem of head-banging” has been overcome. For twenty years, these specialized prisons have been cropping up across the United States, the morality of their use unquestioned, unchallenged.

I headed back down to the clinic, more confused and despondent than ever.

When I arrived, the auditors were packing up, the audit complete. With the Bing still fresh in my mind, the audit now seemed trivial. Leslie curtly informed me that Central Office would be getting the results in two weeks. I mumbled polite good-byes as they left. Two weeks came and went, and true to form, Central Office never disclosed the results. But operating under the old adage that no news is good news, I presumed we had done well.