Working in the Prison Unit

There is a special unit in my hospital for prisoners, complete with an officer for every inmate, a special code to get in (that most of the doctors don’t even know), and each patient cuffed to the bed at the ankles. When I arrive I try to knock on the door for one of the officers to let me in. The door is of course extra thick, so if my knock goes unheard I have to resort to waving my hands, hoping they’ll notice me through the small glass window. One of the officers then gets up, annoyed that my arrival has interrupted their focus on the crossword puzzle and types the code to let me in. I always check my name badge as the officer approaches to make sure that it’s visible, as if to say “See, I’m a doctor here, I’m not wearing the white coat to trick you into letting me in, I really do have a patient to see.” The hallway that opens into the patient rooms is lined with officers. The prisoners don’t get the prettiest or newest unit in the hospital and space is always an issue. From the patients to officers to doctors, nurses and staff it seems like everyone is cramped for space. I don’t know what the area was used for before it was the prisoners unit, but the layout is horrible, there isn’t much of a nurses station at all, each room has 3-4 beds and one small counter top with computer, sink, and patient charts, and there are passageways between the rooms that you have to turn sideways to get through.

The officers are very helpful and respectful for the most part, with the occasional one who obviously hates his job. The prisoners come in all types. Lots of them are very normal and respectable looking and you wonder what happened to them. I almost never know what they are in jail or prison for, nor do I ever want to. It’s completely irrelevant to my job. Of course I ask the same questions to prisoners that I ask non-prisoner such as IV drug use and sexual history, but no specifics on criminal activity! I’ve had a couple of patients tell me without being asked, but it wasn’t a big deal (I guess, in part, because they were not big crimes).

I had one patient where I heard all about his criminal background – mostly because a printout of the newspaper article reporting his sentence was actually in his medical chart! I don’t know how it got there or why, I should have ripped it out and thrown it away so as not to taint anyone else’s opinion of this individual. I must say it made the patient encounter different, and slightly awkward for me. This particular case was confounded by the fact that the crime was related to medicine. I guess the relation to the medical world made the story interesting and somewhat of a personal insult to us. In the end the patient was still a patient that required evaluation and treatment just like the patients on the newly remodeled 8th floor with private rooms, wood floors and flat screen TVs.