Women were the ambulance, the caretakers and the providers

    Stories about prison health care focus on the deadly inadequacies — but there is another side to story: the way incarcerated women care for each other.
    An artistic illustration of prison health care. (Flickr/MichelleKarshan)

    When Gloria Rubero suffered a stroke in a New York State prison, it was the women around her, not the medical staff, who cared for her. “They used to bathe me, feed me, everything,” she recalled at a recent roundtable about aging in prison.

    When another woman fell and was unable to walk, staff refused to assist her in walking down the stairs to the medical clinic. Instead, eight women carried her to the medical unit so that she could receive medical attention. “The women were the ambulance, the caretakers, the providers for each other,” Rubero said.

    Articles about prison health care are filled with stories about long waits, dismissive or hostile staff, accusations of faking illness or pain, refusal to prescribe medications or order needed treatments and preventable deaths. Very rarely do stories about prison health care have a happy ending.

    These stories often leave out another side — the ways in which women have taken care of each other through these grueling ordeals. It’s a form of resistance to the dehumanizing and often life-threatening “care” (or lack of care) that draws little to no attention. And this care isn’t limited to one or two women’s prisons. While interviewing several formerly incarcerated women about conditions inside, I was reminded that this self-organized care seems to happen wherever women are imprisoned.

    Sandra, one of the women I interviewed, had a lot to say about conditions inside the federal prison in Danbury, Conn., where she served her sentence. Among her many recollections of atrocious medical care was the story of a woman named Foxy who had broken her leg. Foxy was transported to an outside hospital for medical care. There, doctors instructed her not to stand or get up for five days, a near impossible instruction for someone who is incarcerated. “The hospital wasn’t aware of prison conditions,” Sandra surmised.

    The women around Foxy did their best to make sure that Foxy could stay off her leg. One woman donated the bowl that she had bought at the prison’s commissary for use as a bed pan. The women took turns emptying the makeshift bedpan while also advocating that the prison provide Foxy with a real one. Two days later, they were successful. But the struggle for a bed pan wasn’t the only hurdle Foxy faced. Prison policy dictates that each woman stand up during count, which occurred several times a day. “If you don’t stand up for count, you’re in trouble,” Sandra remembered. The women approached the officer on duty about exempting Foxy from standing. Then they approached the physician’s assistant, who finally issued Foxy a pass. In the meantime, however, Foxy was forced to disobey the doctor’s orders and stand for every count. “The women take care of each other because the staff doesn’t,” Sandra recalled.

    Lynne Stewart remembers the ways in which women formed communities of care as well from the time she spent at the Federal Medical Center at Carswell in Fort Worth, Texas. She told me about Kiki, a woman on the chronic care unit where Stewart was housed. Kiki, she recalled, was constantly helping other women. “If you threw up in the hallway at midnight,” Stewart said, “Kiki would come out of her room and help you clean it up. If somebody had an accident with her bowels and messed up the whole bathroom, it would be Kiki who would come in and help clean up. And she always did it with a sense of ‘Well, I’m glad to help you out because someday you may be able to help me out.'”

    Unfortunately, the women around her were unable to help her when Kiki most needed it. After falling, Kiki complained that she was in pain. She was taken to the medical clinic where she was given an X-ray. Medical staff told her that they saw no sprain, strain or break and refused to prescribe pain medication. Kiki was returned to her cell, where she continued to complain about being in pain. The women around her tried to help in the limited ways they were able. They gave her Tylenol purchased from the prison’s commissary. They attempted to comfort her. Then, prison staff told the women that they were no longer allowed to stop and talk to Kiki outside her cell. “She was off-limits,” Stewart recalled. In the meantime, prison staff continued to accuse Kiki, who continued to complain loudly, of faking her pain.

    One night, two prison staff, including a lieutenant who Stewart described as “the meanest man alive,” stood outside Kiki’s door and yelled at her, accusing her again of faking her pain. They then moved her from the chronic care unit to the mental health unit, where she was placed in a single cell. Later, the other women on the unit told Stewart that Kiki continued to complain about pain, but that the nurse on duty simply laughed and ignored her. The women reported that they heard Kiki complaining until two or three in the morning. Then they heard nothing from that isolated room. The following morning, Kiki was found dead.

    The Bureau of Prisons, which runs the federal prison system where Sandra, Foxy, Lynne Stewart and, until her death, Kiki, were incarcerated, has regulations stating that if a person age 65 or older has served half of her sentence and has a serious or chronic medical condition, she is eligible for early release. If she is 65 or older but does not have a serious or chronic condition, she must serve either 10 years or 75 percent of her sentence — whichever is longer — before being considered. For people in state prisons, 36 states have compassionate release laws, which can be applied to incarcerated people with terminal illnesses or severe medical issues. But in both state and federal prisons, these early release programs are very rarely applied. In New York, for instance, of the 2,730 requests for compassionate release filed between 1992 and April 2012, only 381 were granted release. A full 950 people died in prison while their applications were pending.

    Women behind bars do their damnedest to help those who need care. But, as Stewart’s story illustrates, their efforts do not compensate for the lack of medical attention needed. What would really help, all of the women agree, is releasing people from prison so that they can get the care they need.

    Lynne Stewart was granted compassionate release, returning home to New York City on January 1, 2014. Now receiving care at Memorial Sloan Kettering Cancer Center, she notes the extreme difference between Sloan Kettering, where she receives not only “complete care, but instant complete care,” and the prison medical system. But Stewart’s victory is exceptional — many remain in prison despite their increasing age and declining health. In contrast, 71-year-old Phyllis Hardy, affectionately known as “Grandma” to the women at Danbury, has numerous health issues yet remains in prison. Last November prison officials told Hardy, who has spent more than 20 years behind bars, that she had been approved for early release and would be home by Christmas. A federal probation officer inspected her son’s home, where Hardy was to live after release. Instead, Hardy was transferred to the federal medical prison at Carswell in Texas instead. But the women who formed Hardy’s community of care haven’t given up. Those who are now out of prison are helping to advocate for her release, circulating petitions and raising awareness about her case wherever they go.

    “She could have gotten excellent care and the help she needed from doctors on the outside,” said Beatrice Codianni, who spent years at Danbury with Hardy. “It’s costing so much money to keep her there — and to provide her with substandard medical care. She could be home instead.”

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