Harmful Health Care

The following article was originally published in Issue 1 of MEND, an annual journal for voices impacted by the criminal justice system, published by SURFACE at Syracuse University in 2023.

Every Monday, I complete a sick call request for chest pain. After filing a grievance and having two normal menstrual cycles, I get an appointment date. The day of the appointment, I awake to the usual sound of gunshots; every Texas prison has a gun range nearby. We hear them practicing and practicing, but for what? Best not to think about that. This is the Lone Star State: God, guns, and goons.

“Strip out!” the young female officer yells.

“Yes, ma’am,” I answer to this officer who is younger than my youngest. I quickly remove every clothing item, passing them to her through a shoebox-size open food slot in the door. Once I’m nude, I must raise my breasts, stomach, and arms; show her the bottoms of my feet; bend at the waist and spread my buttocks; tilt my nose up; expose the space behind my ears; open my mouth; lift my tongue; and run my fingers through my hair. She returns my clothing. She is only to strip me. There aren’t enough women officers to do much more.

I’m praying that I don’t get any of the CO’s we’ve secretly nicknamed The Weinstein Group. I wouldn’t be going to medical if it wasn’t urgent. I only need a normal, non-perverted guard to escort me downstairs to medical. Is that too much to ask?

I notice a pair of kids, barely legal men, horseplaying on the stairs. We’ve nicknamed them the Twin Toddlers. Their combined age doesn’t equal mine. The state gives them responsibility to write disciplinary infractions, resulting in longer prison stays, but they aren’t old enough to purchase cigarettes or beer. I’m glad it’s them. Although verbally abusive, they aren’t physically abusive. They handcuff me behind my back and, with each one holding an arm, we pass my mentally ill next-door neighbor. She is in her birthday suit, sitting on a table, masturbating with a tube of Colgate.

The toddler on my left cheers her on: “Keep going and sing ‘Jingle Bells’ to get the voices out of your head.”

“Then they’ll go away forever?” she asks.

“I promise,” replies the cruel one.

The occupant of the next cell comes to the door to wish me luck and to tell me that she’s praying for me. She has mismatched breasts: One is a DD cup, the other a B. She arrived at prison with breast implants with one malfunctioning. The system refuses to treat her, claiming it’s cosmetic, not reconstructive. This exacerbates her untreated mental illness and eating disorders.

Before I’m through the medical door, the physician assistant (PA) demands that I get on the scale. My escorts begin guessing my weight.

One comments, “It’s that donkey ass you Black girls got.”

“What’s your weight?” the PA asks. One of the Twin Toddlers answers for me, 186 pounds.

The PA pecks at his keyboard and informs me that at 5’ 7”, I am not overweight but obese. The adult children giggle. My vital signs are next. Usually my blood pressure is 110/70. This time, it’s 152/104.

“You people need to cut back on the salt,” the PA says.

I wonder, who are “you people”? Inmates? Women? Blacks? The obese?

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Researchers studying racial disparities in health ascribe them to toxic stress, which affects all systems of the body. Every time anyone experiences stress, their heart rate and blood pressure increase, their stress hormones increase, and their fight-or-flight (or freeze) instinct kicks in. The environment I live in is one of constant microaggressions and macroaggressions, overt sexism, and racism. This prolonged stress seeps into people’s biology, which accelerates aging. This is why Black Americans “live sicker and die quicker.”

A female med tech barges in to open a screened privacy divider six feet away and yells, “Call me when you’re ready!” The handcuffs are transferred to the front, and the twins go behind the screen. The PA continues typing with two fingers and instructs me, “Pull your panties down, your bra up, cover up.”

I obey. I exhale.

“Prisoners are the only group to have a constitutional right to health care. I misinterpreted that to mean their health should actually be cared about.”

Studies show that survivors of sexual violence may experience medical exams as traumatic, thus avoiding them altogether at their peril. Over 70% of incarcerated women have a history of sexual abuse. In society, a female is supposed to be in the room at all times during intimate exams. That courtesy does not extend to women in prison.

Two older male guards join the twins behind the screen. I can see the tops of their heads. They are there to relieve the younger pair for a break. I tense when I realize it’s Dawson (nicknamed after Richard Dawson from Family Feud) and Shadow (nicknamed because he imitates the beliefs, words, and actions of his coworkers). The PA is within spitting distance as he asks me about my medical history. The four officers are in the middle of a boisterous discussion about hog hunting when suddenly Dawson says, “I’m just ready to shoot something.” The PA yells over their voices a litany of questions: How many abortions? How many miscarriages? How many STI’s?

“None, none, none,” I reply.

“When was your last menstrual period?” he continues. “You’re no spring chicken. Are you having vaginal dryness?”

The men giggle.

“You’ve been complaining of chest pain on and off,” he says. “What’s your drug of choice?”

“I never used drugs,” I reply.

He repeats the question twice, and I repeat my answer twice. He begins to ask again; I interrupt and answer, “Ice cream, that’s my drug of choice.”

“You don’t have any drug convictions,” he persists. “That don’t mean nothing.”

Suddenly, someone says, “She just ain’t got caught.”

I’m prescribed to drink more water, and he offers me generic Tylenol, non-aspirin. “Does she have non-pain?” Shadow asks over the screen. They all laugh.

I don’t. I exhale.

A baked-in cynicism about what we say and complain about exists. The privilege of being believed rarely exists for Black women, and it is completely absent for incarcerated Black women. Prisoners are the only group to have a constitutional right to health care. I misinterpreted that to mean their health should actually be cared about.

The female pops in, and I’m relieved—someone to break up this testosterone convention. She appears at my side, rushing the PA. He begins with a breast exam, reminding me to do them daily. As he palpates, I’m on the verge of a panic attack. I’m nervous because my friend Trish’s experience is haunting me. She complained that he repeatedly lifted her breasts by the nipples, then released them, causing them to drop painfully. The tech looks at her watch and passes him a speculum.

“Nobody washed their hands,” I blurt out. “I don’t need a pelvic exam. I’m good.”

Both shrugged.

I remain silent as I dress. Self-advocacy can get me in trouble and denied medical care. Too many questions, and subsequent visits will be denied with the lie “inmate refused care.” Another blood pressure reading reveals 165/104. The oblivious PA says, “Let’s go with the first reading.” He is baffled as to why this reading is higher. I know: It’s because of my pervy escorts leering. My hands are cuffed behind my back. Shadow and Dawson are the remaining officers. Shadow is on my left, and Dawson is behind me, holding my right arm. He shifts as he walks. He rubs his genitals against my handcuffed hands.

The return trip feels longer. I don’t notice any girls in the cells I pass. Somehow, I make it to my cell. I’m grateful. As he removes my handcuffs and slams the cell door, I exhale.

In the U.S., women are the fastest-growing group of people locked up in state and federal prisons, county jails, and juvenile detention centers. This “fail care” the carceral system provides only serves to compound trauma.