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Friday, April 30, 2010

Medical Care at Stateville -- February 28, 2010

Years ago, I injured my back while lifting heavy weights. After the pain subsided, I continued to squat, dead lift, clean, and do many other exercises with weights, putting enormous pressure and strain on my lumbar spine. On the prison yard, there are not many alternative exercises one can do to vigorously work certain muscle groups without taxing the lower back. It was not like working out at Bally's Fitness Center. I used rusted scrap iron on very crude, and often broken, equipment, outside in the yard. Time and again, I reinjured my back until I had chronic lower back pain. Although I have since ceased power lifting, my pain has become more severe and I require medication on a regular basis.

Earlier today, I finally received several sheets of medications. I had been waiting since December of last year for my prescriptions to be refilled, and had been in a lot of pain. At last, I thought, I would have some relief. However, after looking at the medications given me, I realized the most effective pain reliever was missing. All I had was a sheet of Prilosec, Flexeril, and two sheets of extra strength generic Tylenol. Tylenol is something you take for a headache, or some minor injury, not a crushed or ruptured disk causing agonizing back and sciatic pain. I have been hobbling about my cell like an infirm old man, and I have lost part of the feeling in my left leg--and yet, I was sent Tylenol.

Last week, after writing several letters to doctors, the warden, and assistant warden, and after filing a medical grievance, I finally was taken to see a doctor. I told her about my medications not being refilled, and my need for stronger medications and a cortisone injection. I also asked about traction therapy. Last October, I saw a neurologist who recommended, like many specialists before him, that I receive regular cortisone injections and traction therapy before surgery is considered. Months went by and these treatments were never given to me. Instead, my prescription for an anti-inflammatory called Diclofenac had been allowed to expire.

The doctor I saw was one of three at Stateville. One serves as the medical director of Stateville, and is rarely seen by inmates. The other one is not officially a doctor at all, and is only qualified to address minor medical problems. She is often seen and comes to the cell houses once a week for in-house sick call passes. If an inmate is found to have a more serious medical problem, they are given an appointment to see Dr. Zhang, the doctor I was there to see. Dr. Zhang is an Asian doctor in her fifties. She is sometimes difficult to understand, and it is clear that she immigrated here. However, she is easier to understand than the medical director, who is of Pakistani descent. Besides the three doctors, Stateville has a handful of medical technicians and a number of nurses. Med techs and nurses have various responsibilities including collecting requests to see the doctor, giving diabetics their insulin, and caring for sick or disabled inmates at the infirmary.

Dr. Zhang could not tell me why my prescription was not refilled. However, she was able to answer why I had not received a cortisone injection or traction therapy. After searching through my medical file, which after 15 years looks like an enormous book, she found the medical director's latest entries. Dr. Ghosh had rejected the treatment plan of the neurosurgeon and other specialists before him. I was looking at the medical director's notes as Dr. Zhang reviewed them, but I could not make out his chicken scratch writing. Only the last word was legible--the word was "NO."

The medical director of Stateville is the only person who can authorize certain medical treatments, including the ones that were recommended for me. Several times before, I had spoken to Dr. Zhang about the inadequacy of the medicines I have been prescribed. Her hands were tied, however. She could not authorize a cortisone injection or stronger pain medications. She also could not authorize traction therapy. When I saw her last week and complained about the matter, she told me that even if Dr. Gosh had authorized the treatment plan of the neurosurgeon, the health care company, Waxford, probably would have rejected it. Waxford was attempting to control costs, and cortisone injections and physical therapy are very expensive. She went on to say that traction was not a fully accepted treatment and, furthermore, I could do traction therapy in my cell. With a bit of sarcasm, I said, "Oh, really?" Apparently, my skeptic tone was missed upon the Asian doctor, or fell flat because she continued to explain in some detail the various stretches which could achieve the same results. I did not interrupt her and allowed her to make a fool of herself before I said that I already do those stretches without results. The only minor and very temporary relief I get from stretching is a lessening of stiffness in my lower back. When I mentioned stiffness, the doctor quickly informed me she could prescribe a muscle relaxer, as if that would placate me. I have tried muscle relaxers before, and they have not helped, but I did not stop her from writing out an order for it.

In lieu of a cortisone injection, Dr. Zhang told me she could prescribe cortisone pills. I have never heard of such a thing and, thus, she got my "oh, really?" response again. Dr. Zhang has played games with me before, and I no longer believe what she tells me. For example, about a year ago, I saw her regarding my back injury. She told me she could administer a cortisone injection herself, and I did not need to go to an outside hospital. Although I knew only a trained specialist could give a cortisone injection to the spine, I went along with her claim. She told me to take off my shirt and show her where the source of my pain was. I did that, and she told me this was going to be painful, and involved using a large needle. Was I still certain that I wanted the injection? Yes, I told her. She told me to lie down on the examination table, and then went searching through various drawers and cabinets. Finally, she told me she could not find the necessary equipment. When Dr. Zhang told me about the cortisone pills, I speculated she was playing mind games with me again. Thus, I told her I was willing to take them despite the possible dangerous side affects. Just like the last time, however, she was only bluffing. She told me she will wait a few months to see how these medications worked before prescribing the cortisone pills. Did she really believe I would have some miraculous recovery from an anti-inflammatory I have been taking for years? or from Tylenol?

I can only speculate on Dr. Zhang's bluffing. Possibly, many inmates want to be sent out to the outside hospital for a procedure they do not need. Many men have been locked up for so long that they view a trip to the hospital like a field trip. I do not share this view. Contrarily, I hate having to go outside these prison walls. Any time a prisoner from Stateville is sent out, he is shackled, placed in painful boxed handcuffs that are secured to a chain wrapped around the waist, and led like a dog on a leash. Prisoners also must wear an ugly, uncomfortable bright yellow jumpsuit that I call the "banana suit." During the ride to and from the hospital, I usually must listen to some guard's concept of music, or a "bug" prisoner who will not stop talking (and usually stinks). In the hospital prisoner waiting room there is nothing to do and while guards have good times and eat pizza, steak sandwiches, or Chinese food, a few bags of bologna sandwiches are thrown to the prisoners. Even if I wanted, I could not eat the sandwiches because of the boxed handcuffs that are never taken off (unless you have to defecate). Yes, I have natural life and have been incarcerated 17 years, but I would rather never have to go on another "field trip."

During my talk with Dr. Zhang last week, she mentioned that part of my pain could be in my mind. She told me people who are depressed feel pain that is only psychologically based. I asked her what made her think I was depressed, and I was told she noticed in my file that I was prescribed a drug by the psychiatrist that is often given to people with depression or bipolar disorder. I told her she was mistaken to believe I was being treated for depression. I was seen by the mental health care doctors for Aspergers, or what is now defined as Autism Spectrum Disorder. This revelation apparently threw her a curve ball, and she abruptly quit trying to suggest that my pain was in my mind. Despite this, Dr. Zhang only prescribed me a mild muscle relaxer, and the anti-inflammatory I had previously been taking.

The anti-inflammatory is called Diclofenac, and it is a generic for Voltaren. Voltaren is basically the equivalent of Motrin, just more potent. Despite its greater potency, a person taking Voltaren gets no more relief because while Motrin comes in 500 mg. tablets, Voltaren only comes in 50 mg. doses. Both drugs help dull the pain, but are sometimes incredibly inadequate. At times I aggravate my back, and I will be unable to walk or move about. I have a high tolerance for pain, but the back pain I sometimes experience is the worst I have ever experienced.

Medical specialists at the University of Illinois in Chicago have repeatedly recommended I receive Tylenol #3 in combination with an anti-inflammatory. However, the medical director of Stateville refuses to prescribe this medication. Stateville has many drug addicts and people who would abuse any narcotic drug. There are also people who would sell their medications to drug addicts. Of course, I am not one of these people, but it seems Dr. Ghosh is not willing to take this chance. I can understand a policy of not giving prisoners, especially at Stateville, a sheet of narcotic pills. However, I do not understand why a nurse cannot give me one pill when she does her psychotropic drug rounds. Twice a day, nurses go through the cell houses giving people psychotropic medications that they are not trusted to keep in their cells. There is no reason why this cannot be done in regards to Tylenol #3 as well.

Many months ago, I wrote a prisoner advocate about the lack of medical treatment at Stateville. This man publishes a news pamphlet that may be known by readers, called "Stateville Speaks." He wrote me back telling me he referred my letter and documents to an organization called the "National Alliance Against Racist and Political Repression" or NAARPRA. I had no idea why an organization such as this would be interested in my medical issues and had forgotten about the matter. However, this week I received a letter from them stuffed with all types of information and forms. The forms included long questionnaires about medical treatments and a medical release form, and a long questionnaire about my criminal case. The letter enclosed was from a nice woman who oddly lives in Britain, and she was interested not only in medical malpractice and negligence, but my wrongful conviction. I do not agree with a number of this organization's political activism, and I will not be sending a donation. However, I filled out the forms and wrote the woman a nice thank you letter.

Stateville is well known within prison rights groups to have atrocious medical care. Numerous class action lawsuits have been filed and won, or settled, against the medical staff, health care company, and the wardens who are held responsible for the welfare of prisoners in their custody. As I write this journal entry, there are at least ten ongoing medical lawsuits that I am aware of against Stateville. The medical staff here are often negligent, lazy, indifferent, or incompetent, and a handful are guilty of some of most severe malpractices. Often I wonder how these people are ever hired or keep their jobs. Furthermore, Waxford, the health care management company of Stateville, is often pressuring or providing incentives to undercut medical care and its costs at the detriment of prisoners' health or lives.

A few years ago, I put in a medical request to see a doctor. I could barely walk and was in excruciating pain for weeks before I finally received a cell pass. With much difficulty, I finally made it down the stairs and to the office where in-house sick calls were conducted. Although I had basically crawled there, and I had sweat rolling down my face from the pain, the doctor said there was nothing wrong with me. In his choppy, heavy Asian accent, he told me, "You do not have herniated disk. If you had herniated disk, you could not tie shoes." I also saw this same doctor when I was having difficulty urinating. His diagnosis was, and I quote him: "You be jacking off too much." For a moment, I thought he was trying to be funny, but he was serious. Later, I learned that I most likely had an enlarged prostate, but not until many months later and seeing a different doctor. The Asian doctor no longer works at Stateville.

I have a neighbor who has had liver cancer for three years, and has only just recently begun treatment. In 2006, a routine physical and blood analysis was done. The doctor's aide happened to notice an alarming result in his blood test that demonstrated severe liver failure The doctor's aide told him she was going to notify the medical director about the matter and he should receive a cell pass soon to see him. Several months passed before Dr. Ghosh decided to meet with him. Dr. Ghosh informed him he was not exactly sure what the blood test results meant and therefore was ordering a biopsy. My neighbor waited and waited. Finally, half a year later, he was sent out to the hospital at the University of Illinois. The result of the biopsy was that he had stage 3 sclerosis of the liver. However, although the doctors at Stateville knew he had liver cancer, they did not begin any treatment until November of last year. A few days ago, he told me that he was given another blood test and the treatment was not working. The results were worse than before. Several other people I know at Stateville also were delayed treatment for years for various forms of cancer. One is now close to dying.

There is a large number of inmates here that must undergo dialysis. The Illinois Department of Corrections will not permit prisoners to have organ transplants whether that be for a heart, liver, or kidney. Even if a family member wants to donate one of their kidneys and offers to pay the full costs of the surgery, it will not be allowed. I did not become aware of this policy until last year when I thought it odd that every morning many prisoners went to the health care unit to have their blood run through a machine, and I asked one why he never was given a kidney transplant.

Four years ago, I had a cellmate who had a grotesque protrusion from his lower abdomen. It was almost as large as a basketball, and people would make fun of him. Inmates would say he was pregnant, he was incubating an alien baby that was about to burst out, or that he had an enormous tumor. However, the truth was he had a gigantic hernia, and his intestines had ruptured through his diaphragm. The man lived with this for years because the medical director refused to authorize the necessary surgery. Finally, after many grievances and the threat of a lawsuit, his hernia was repaired.

A few months ago when I was in the gym, I saw an old man walking around holding his testicles. The man is a weirdo, and as he passed by, I said to him, "Chuck! Cut that out." He approached me and explained he had a testicular hernia. I already knew this, and I cut him off by saying, "Get yourself some tighty-whities and quit walking around holding your nuts." The medical director of Stateville refuses to authorize his hernia to be repaired. Dr. Ghosh has told hm the procedure is cosmetic and he will just have to live with it. Although the man is probably a sexual deviant, a hernia is not merely cosmetic. Nevertheless, I figure I will continue to see this old man holding his privates for some time to come. Possibly, even when Dr. Ghosh is forced to give him the operation, he will continue to go around groping himself with the same crooked grin on his face.

Last summer, I noticed a man I knew who was formerly in good health walking about with a crutch in the yard of the health care unit. I asked him how he injured himself, and he told me he was not in the infirmary from an injury. He almost died from a blood clot in his leg. He saw a doctor when his leg swelled, but the doctor gave him Tylenol and sent him away. Not long after, his leg muscles began cramping and he was unable to walk. A med tech had to come with a stretcher to get him, and he was immediately sent to an outside hosp;ital. There he was told that he had a blood clot, and he underwent surgery. The doctor at the U of I told him that he could have died if they had not removed the clot when they did.

Routine health care is abysmally behind at Stateville. Inmates are supposed to see the dentist once a year, as well as get a physical. I have been here for over five years, and it was not until the fourth year here that I saw the dentist. The dentist merely looks at your teeth to see if you have any problems. If so, you are put on a waiting list for up to a year, even if just for a cleaning which does not include polishing of teeth. All dental care, other than a check-up, requires an inmate to fill out a money voucher for $2. Anytime an inmate sees a doctor at Stateville, he is supposed to pay a surcharge of $2, however, most prisoners are too poor to pay even this amount. A man I knew with an extremely painful tooth infection had to wait over a month to see a doctor. By the time he did, the infection spread throughout his gums and affected the entire right side of his face. This man filed a lawsuit which was settled out of court.

My cellmate noticed me writing about medical issues. He is not aware that I have this blog site and believes I am writing NAAPR. He wants me to mention to them that he has not seen an opthalmologist in several years, and his glasses are broken. I asked him if he wanted me to mention his G.I. problems and how the doctors refuse to give him a food allergy test, but he said "No." He is too embarrassed to grieve the issue. Little does he know that I have already written about his problem on my blog, and hundreds of people probably know about it. But, as I wrote in my last entry, what he does not know will not hurt him.

Health care has become the focus of national debate recently. President Barack Obama continues to pursue universal health care. Although I support better medical care for prisoners in IDOC, I oppose nationalized health care. Individuals, not government, should be responsible for their medical care. Costs can be brought down and medical care improved with greater free market competition, not government health care or more regulations. Enormous pharmaceutical and health care companies can be broken up and be put under anti-trust laws. The ability to buy health care from across state lines will also help. Tort reform is also necessary to keep costs of hospitals down as well as the ability of hospitals to turn away the noninsured or illegal immigrants. If Americans go along with Obama's plan, they may end up with the health care we have here at Stateville, and also have an enormous national debt that will bring down this nation. The public must understand that medicaid, medicare and social security must all be cut. As much as people don't like these ideas, it is better than having prison-like health care and being crippled by debt.