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Sunday, August 8, 2010

Insomnia -- June 25, 2010

In the last five nights, I have only slept about 10 hours. Sleeping is very difficult at Stateville Correctional for many prisoners. The cell houses are very noisy, and this noise reverberates off the concrete and steel into our cages easily. Noise on the other side of the cell house or many floors above or below does not dissipate easily. Some prisoners will cover their heads with pillows when trying to sleep. Others will listen to music with earbuds in their ears. My cellmate has started to use the whirl of his fan to block out noise. I have a pair of earplugs I use which do not block out all the sound, but muffle the noise.

Sleep is much more important and difficult for me than most other inmates. I have autism, which makes sleep essential for me to be able to cope and function. Stateville is incredibly volatile, crowded, and full of distractions. The environment is incessantly disturbing, and I have no ability to escape or remove myself. Even while in my cell, I am bothered by noise and events outside. Cellmates, even good ones, are disruptive and can prevent me from relaxing. Serving time in a maximum-security prison is not nice for anyone, but for those with autism, it can cause deep anguish.

On Sunday, I met with a new psychiatrist. Her name is Usha Kartan, and she is a very petite Eastern Indian. She is not attractive, but has a friendly personality. Dr. Kartan works at Stateville's Northern Receiving Center, or NRC. The NRC is beyond the walls of the prison, but not far outside them. IDOC is attempting to save money and has eliminated Stateville's full time psychiatrist. Now, Dr. Kartan will work both institutions, mostly working weekdays at the NRC unit and weekends at Stateville. Enormous cuts can and should be made to the IDOC. However, I do not believe the focus should be prisoners' health care, which is already severely deficient.

Dr. Kartan has an enormous list of clients she must attend to. I do not know the exact number, but I estimate she determines the medications of a couple of hundred inmates. Psychiatrists should be well acquainted with all their patients' backgrounds and mental health issues. However, I have found that at Stateville, they do not even know why you are there until you tell them, or they glance at your file.

I have been incarcerated over 17 years, and my medical file is several inches thick. The file contains not only psychologist reports, but all medical reports, and not in any order. Every time I have been to sick call, had my blood pressure checked, been prescribed a medication, been tested for TB, or had a dental check-up, there is a written record. The various documents and notes of doctors, nurses or dentists are often scribbled in almost illegible script. Thus, I was not surprised the new psychiatrist did not even bother to look in my folder.

Dr. Kartan asked me how I was doing. I hate ambiguous questions like this, and I do not know how to answer. I assume she wants to know how my medications are working, but the possibilities are almost indefinite. I asked her if she could be more specific in her question, whereupon I was given a long speech about what her job entails and how it is important for her patients to communicate with her. I admit that I am not the most social person, however, I was just seeking clarification of her question. I could have answered in a multitude of ways, many of which she would probably not have been interested in hearing.

She was apparently unaware that I had been diagnosed with autism. She had no idea about the problems I experience living here. I doubt she even had much knowledge, except the most rudimentary, of autism spectrum disorders. Without asking me for any background, the doctor asked me if the former doctor's prescriptions were effective. I said "No," and explained that I was continuing to have difficulty sleeping. I also told her I continued to experience high levels of anxiety, aggravation, and exhaustion from various and almost unrelenting disturbing environmental stimuli. She did not inquire about the specifics of my anguish, but gave me a general empathetic response about how she knew how bad conditions were at Stateville. She then expressed, in a very nice and sincere tone, how she would like to help me. Despite her tone, I was skeptical.

Since my former medications were not working well, Dr. Kartan suggested discontinuing them and trying something new. "How do you feel about that?" she asked. I am not sure, but I certainly saw no point in continuing to take inappropriate medications that did little to help me. The former psychiatrist, Dr. Tinwallay, also had no understanding of my problems and did not care. He had prescribed two medications that boost serotonin levels. One was taken at night to help me sleep, and the other was taken in the morning to help me cope during the day. Both drugs are psychotropics used to treat people with bipolar disorders, a condition I do not have. The medication at night helped me sleep a little, but seemed to oppress me physically and mentally. It reduced cognitive sharpness, caused lethargy, and even shortness of breath. The morning pill served no purpose except to make me feel nauseous, and I had stopped taking that a long time ago.

Instead of prescribing bipolar medications, Dr. Kartan's brilliant plan was to give me allergy and "happy" pills. She said Benadryl will help me sleep, and Zoloft will cure my depression! I told her that I was not depressed, and I do not need any happy pills. For almost ten minutes, she went on and on, persistently trying to convince me that I was depressed. Yes, I have a natural life sentence, and, yes, I will probably die in prison. I have even contemplated suicide, but, no, I do not need to be treated for depression. I must give the impression that I am unhappy, bitter, or sad, because the doctor insisted that I take Zoloft (an antidepressant). It was almost comical how she continued to try to convince me that I was depressed, despite how I repeatedly denied being so.

The night my prescriptions were changed, I only slept two hours. I tried to sleep at the usual time, but I did not even feel sleepy, and after a few hours lying there, I got up and read the newspaper. I was up when breakfast was passed out at 3 a.m. I ate the two small self-contained bowls of generic rice crispies with some commissary trail mix, brushed my teeth and then tried to sleep again. It was not until about 5 a.m. that I fell asleep, and I awoke two hours later.

Normally, I fall asleep with little problem. My problem is typically staying asleep. I wake up repeatedly during the night, and without medication, I will wake up 50 or more times. Although I usually fall quickly back to sleep, I almost never get a deep sleep, and the repeated disruptions cause problems for me during my waking hours.

My sleep troubles did not just begin with my arrival at Stateville--they just got worse. My parents tell me that I slept very little as a baby, and as a child, I recall lying in bed for hours before falling asleep. Although I had an early bedtime, I sometimes stayed awake long into the night. I would watch the moon rise and fall from my window, and daydream. No, counting sheep did not work.

During high school, I slept in two shifts. I went to sleep between 3 and 4 a.m. to arise for school around 7. After school, or any sporting events, I fell asleep for four more hours. My mother was sometimes incredulous to discover me in a full sweat lifting weights and exercising at 2 or 3 in the morning. Once, I remember her finding me cooking a full meal in the middle of the night.

If you knew me in high school, you may have found me sleeping in class. Sometimes I had not slept at all the following night. I was a night owl, and I often preferred to sleep during the day. The day was bright, noisy and full of distractions; often I felt irritable and lethargic. The night was tranquil, quiet and beautiful. I would much rather be alone under a vast night sky than the crowded, loud, hallways of school.

In Cook County Jail, I did not go to sleep until after eating breakfast around 5 a.m. I slept the entire first shift until about 3 p.m. There were no cell bars and I had a solid steel door to keep noise and distractions at bay. The only days I awoke early were visitation days. On Saturdays, I received numerous visitors. My parents, relatives, friends, and former girlfriends would come to see me. Although visits were limited to a half hour, I often spent most of the day in a visiting booth.

The county jail had a day room where I could have watched TV, played games, socialized, or just walked about. However, I preferred to stay in my cell, and detainees typically did not see me until mid or late afternoon. Cook County Jail was dangerous, and people may be surprised that I slept all day. However, I had the guards keep my cell locked during the first shift. I slept fairly well there, except it took me some time to get used to sleeping on a narrow bunk. I would toss and turn, and I often rolled off my bunk onto the floor.

Initially upon arriving at Pontiac Correctional after my conviction, I had a terrible time sleeping. I had never experienced so much chaos, noise and people living on top of each other. However, after orientation, I found a permanent cellmate and discovered the cells could be made comfortable. My cell had thick curtains in the front of the cell that blocked out noise and provided some privacy. My cell was furnished with carpeting, furniture, paintings, a stereo system, and even a hammock. Plus, I quickly purchased stereo headphones and earplugs. I did not have much problem sleeping, although I did go back to sleeping in two shifts as I did during my high school years. Maximum-security has changed enormously, however, since I first came to the penitentiary, and not for the better.

Tuesday night, I slept possibly two hours. Again, I tried to sleep, but to no avail. I was given 200 mg. of Benadryl, but I do not think 1,000 mg. would have made a difference. I suspect the only result would be my tongue stuck to the roof of my mouth and a nosebleed. After lying in bed awhile, I turned on my TV only to turn it off after seeing CNN's Anderson Cooper continue to rant against British Petroleum. Cooper says he has repeatedly asked officials at BP to come on his show, but they refuse. Imagine that. The company you have been trying to demonize for two months does not want to come on your show. I would not go on your show to be crucified either.

Wednesday morning, I had an appointment with Dr. Tolley, the prison psychologist. She is an intelligent Asian woman of about 50 years old. She is not very well acquainted with autism, but she is one of the more competent doctors here. Dr. Tolley typically tries to give me practical advice, and social or behavioral feedback. I am now 35 years old, and there is little insight I can gain, but I appreciate her attempts to be helpful. When I saw her Wednesday I must have clearly looked miserable, and she asked what was wrong. She also noticed that I had hand tremors. I told her the new psychiatrist ceased my prior medications in exchange for Benadryl and Zoloft. I went on to say that I had only slept a few hours since Sunday.

Dr. Tolley was alarmed that a psychotropic medication was abruptly discontinued, and she was baffled by the new prescriptions. She asked me if the new psychiatrist understood my medical issues. I told her that I did not know what her understanding was, but I had made it clear to her that I was not depressed and could use a sleeping aid--not a drug for allergies. Doctors often prescribe medications for ailments they are not specifically designed to treat. Usually, doctors do this wisely and because they know it is the best prescription to help their patient. However, in prison this is often not the case. I am given Benadryl and previously other antihistamines, or even psychotropics to treat insomnia instead of much more effective medications like Ambien, Lunesta or Melatonin that are sleeping aids and have less detrimental side effects. Doctors get away with this because we are prisoners. However, I must add, and as Dr. Tolley correctly pointed out, Stateville doctors often have their hands tied because the managed health care agency, Waxford, will only permit certain drugs. These prescriptions are generally generics ordered in bulk to save them money.

Dr. Tolley notified me that my father filed a complaint against the medical department. I have filed numerous complaints as well, and was not surprised my father contacted a supervisory agency. Many of the doctors here are incompetent and negligent. Just this week another man died at the prison due to the malpractice of medical staff. The 21-year-old man died of Crohn's disease, a chronic inflammation of the GI tract, not known to be fatal. This is not the first time the attending doctor has been negligent in an inmate's death, and I have heard many complaints about Dr. Zhang as well as the medical director, Dr. Ghosh. Dr. Tolley informed me she will be sending the new psychiatrist a memorandum, and I should see her again over the weekend.

Later on Wednesday, I received a visit. I did not want to go. The visiting room at Stateville is incredibly loud and very crowded. After having only a few hours of sleep since Sunday, I just wanted to go to my cell and hide away if possible. My mother said I did not look too bad for having so little sleep, but she noticed I had hand tremors. She opined it was withdrawal from the psychotropic medication, and I bitterly agreed. I was angry that doctors prescribed me these inappropriate medications. I would probably be fine with just an over-the-counter melatonin supplement. I was irritable during our visit, and when visits were declared over, I was quick to say a hasty goodbye.

Last week, a man asked me to write a letter on his behalf to the Prisoner Review Board. I was not certain of the man's innocence, but he had been incarcerated for 20 years, and I thought he was an intelligent and industrious person. I did not agree with his natural life sentence without a chance of parole, and believed he could be an asset to society. However, I did not believe the Board would care to have my opinion. In the last several days though, various people approached me with messages that this man would really value my letter. Hence, yesterday I wrote with great difficulty, a 3-page letter on his behalf. After having virtually no sleep, it was difficult for me to focus. This journal entry is difficult for me as well to write. It is now 4 a.m., and I intentionally waited for it to be so late so I would not be disturbed by cell house noises and commotion.

Thursday night, I was determined to get some sleep. I laid down early and put my earplugs in. After tossing and turning, I gave up trying. Instead, as I did when I was a child, I daydreamed. Initially, I brooded about my co-defendant who sought to pin the Palatine Massacre on me, and has had no sympathy for the 17 years I have been in prison. Then I thought about the lying cop who interrogated me, and my incompetent trial lawyer who refused to contest his testimony. These broodings were not going to help me sleep and, thus, I turned to more pleasant thoughts.

I reminisced about my life before my arrest. I doubt people who I knew back then realize how much I appreciate the memories of them. Even grade school friends will always mean more to me than any of the people I have met at Stateville. This life means little or nothing to me. I then fantasized about what my life could have been if I was not convicted. Finally, I thought about all the pretty girls I used to know. I especially thought about the girl I had to let go last year because of the futility of our relationship. I miss her very much, and in sadness, I finally fell asleep.

July 4, 2010

Last night I had my first full night's sleep in weeks. Yesterday, I met with the psychiatrist again, and she prescribed me Klonopin. I had tried to persuade her to ask Waxford for special permission to order me a true sleeping medication like Ambien or Lunesta. I even said I would be happy with melatonin. However, she told me that even if I paid for the brand name, Waxford would not agree.

Dr. Kartan ceased my prescription for Zoloft, which I never took anyway. When the nurse came to my cell in the mornings, I would just tell her to go away. I also ceased taking the allergy pills. They were worthless. My psychiatrist now realizes that Zoloft was inappropriate, but for some reason wanted me to continue taking Benadryl. She even insisted the nurse bring me both Benadryl and Klonopin. In a few weeks, I will see the doctor again to report how the medicine is working. From this first night, however, I noticed a remarkable difference. I fell asleep at 10 p.m., and awoke a little past 7 a.m. only awaking a few times during the night. I feel much better today, and hopefully this will continue. I was quite miserable the last couple of weeks.


  1. i have insomnia aswell so i really sympathize with you there

  2. 200 mg of benadryl??? Doesn't it make your heart race?

    1. I am no longer taking Benadryl, but it never made my heart race. Recently, I was prescribed Melatonin which works well to deepen my sleep.

    2. Glad they finally gave you melatonin. I take it occasionally though it stops working after about a week then I have to be off of it for a week. One week on, one off. Do you find it loses it's effectiveness after a week or so?

      It gives my teenage son nightmares!

    3. I do not feel that I am building a tolerance for melatonin It works very well after 2 months of taking it rather consistently. As for nightmares, my nightmare is upon waking, not during my sleep.

    4. Does the melatonin still work well? Have they increased your dose?

  3. Cure for insomnia? Find boring books to read, stay off prescription drugs, exercise, help others, throw yourself into creative outlets like writing, I don't trust any drug sold or made by a corporation. No good can come of it. Best wishes and massive respect to you Paul.

  4. I have severe allergy symptoms in the spring months and I take 50mg of Benadryl twice a day.Not only does it keep the allergy symptoms at bay but it makes me extremely drowsy almost to the point of falling asleep at my desk during work hours if I am idle for even a few minutes. 200 mg and you do not get sleepy? That would put me on my back. I continue to pray for you Paul. God's speed to you.

  5. Receba gratuitamente no seu email este e-book fantástico.

  6. Some antianxiety medications can help you sleep.


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