Incarceration Is a Deadly Health Risk: Former Chief Medical Officer of NYC Jails Speaks Out
This is democracy now I'm, Amy Goodman his. Name is synonymous with all that's wrong with the prison system kalief, Browder, police. Spent three years at, Rikers Island jail in New York without charge who was a 16, year old high school sophomore, when, he was detained, on suspicion. Of stealing. A backpack, Browder. Never, pleaded, guilty was, never convicted, he, maintained, his innocence, and requested, a trial but, was only offered plea, deals then, while the trial was, repeatedly. Delayed. He. Was held Rikers. Island jail, for. Three, years, beaten. By guards. And prisoners alike. After. Enduring nearly, 800. Days in solitary, confinement and. Abuses. Browder. Was only, released when, the case was dismissed. He. Committed suicide on June 6, 2015. At his home in the Bronx he, was 22, years old, nearly. Four years later the question remains, why did Khalif have to die is. There something, inherently wrong, with incarceration. That, makes it a health risk sometimes, with. Deadly, consequences, well. A remarkable, new book attempts, to answer those, questions, as it shines a light on the health risks, of imprisonment, the book is titled life, and death in Rikers Island its author dr., Homer Venters, the former. Chief medical, officer, of New York City jails he. Offers unprecedented, insight. Into what happens, inside prison, walls to create new health risks, for incarcerated, men and women including neglect, blocked access to care physical, and sexual violence, and brutality by. Corrections, officers, Venters. Further reveals. That when prisoners, become, ill or injured or even die in custody, the facts of the incident are often obscured. He. Writes quote we, work in settings that are designed, and operated, to keep the truth hidden detainees. Are beaten and threatened to prevent them from telling the truth about how their injured health staff are pressured to lie or omit details in their own documentation, and Families, experience, systemic. Abuse and humiliation during, the visit station process, unquote, the, risk of jail are disproportionately. Harmful, for people with behavioral health, problems and for people of color Venters, explains, he, concludes, Rikers, Island must, close and suggests. How that should be done well, dr. Homer Venters joins us now physician. And former chief medical officer for New York City's correctional, health services, again. His book life and death in Rikers Island he's, currently senior health and justice fellow at Community Oriented correctional. Health services, associate, professor at New York University's, College of global. Public Health also. With us Jennifer Gunn ermine staff writer for The New Yorker magazine her, most recent piece as a review, of dr..
Venters. Book it's. Called life. And death and Rikers Island do jails, kill, people, is the name of her, article. Welcome you both, to Democracy, Now, okay. Dr. Venters start, off talking. About why you wrote this book and how kalief Browder z', death relates, to all of this well. Early. On in my time overseeing. The health system in, New, York City jails it became clear that our job was not just to take care of people who were injured or address. The medical problems, people had but, that this system was conferring, new health risks to our patients, so our patients, were getting hurt because of the way that jails were set up and run and so, it, was clear to my team and I that part of our mission had, to be to, use our, tools. As public, health and epidemiology, folks. As well as doctors and nurses to document. Just what these health risks were and to report those out and one of the things that over the years became clear is that those health risks as you, just stated aren't, meted out in a uniform ashen fashion. People with baby or health problems people, of color our data, show were more likely to find themselves on the wrong end of, these health risks talk. About why prisons, are lethal. Talk about Rikers Island for example well, we, can start with the first and most serious health risk which is death it's, clear, that there, are many. Preventable. Or what we would call Jail, attributable. Deaths that, happen we, worked hard to document those while I was leading, service in the New York City jails but, there are many others so for. Instance, people that we know who. Are coming in with very serious health problems diabetes or, hepatitis. C or needing. Dialysis, who, then are denied those services, despite the fact that we have them available, people. Who are exposed to solitary, confinement not. Just, isolation. But the brutality and violence associated, with it who do take, extreme, measures to get away from the. Distress that that setting causes, those are things that were conferred. To those people tell. Us the story of Carlos marcado and on, how Ramirez, so. Those are two patients. Who. As have, been publicly reported, entered. Into the jail system with. Clearly, identified. Health. Problems, one with diabetes, and. One undergoing, withdrawal, and as has been reported in the press, they. Both despite, having clearly. Communicated. Their problems and even having their problems, elicited. And understood by quite, a few people in the jail's received. A punishment response, and a neglect, response, that led to their death even. Though they were in the system that was able. To provide them the health care they needed so what happens, to a prisoner, when, they're sick you, also talk. About the tension between the. Doctors. The nurses the. Health professionals. And the guards, in. The best of circumstances the. Correctional, officers who are with our patients, all the time they have you know they see and interact with people much more than we do in the health service they. Determined. That somebody is ill and they need help or somebody. Just reports, I don't feel well then they're taken, to medical, care and they. Get the appropriate level of medical care they're transferred, to the hospital if they need something that the journal's can't provide in, the worst circumstance, and there are some, situations. That actually. Hardwired. In this, this. Less ideal response people. Aren't able to say, that they're sick or that they feel well or what they do they're not believed and so they're kept in a chaotic, intake, Panwar there solitary. Confinement cell, even though they're saying clearly, I need insulin, or I'm you, know I'm, sick or I've just swallowed, something that could kill me and then, they're denied access to healthcare and then finally I would say that, because of the pressure of dual loyalty and is really crushing, and very. Omnipresent. Ethical. Problem human rights problem in correctional health that, even when they do make it to the health service sometimes, the doctor or nurse or social worker in front of them is acting, more there's an agent of the security, service then as a health care provider talk. About your own experiences. You entered, the jail's and what 2008, I've got a decade, ago yes what did you find there what shocked you most I. Believe. That one. Of the things that shocked me the most was the high level of injury, and injury, associated, with violence, certainly.
All Physicians and, health care people our work we. Have experience taking care of injuries but so many of our patients were coming to us with injuries and so many of them we're, saying that these injuries were from things called slip and falls so, you, know patients that come with a fracture. To the jaw a very, you know very serious, injury or, a fracture. Of the upper, arm or the leg and then, saying that they had slipped and fallen things that just did not you. Know we, didn't believe but also it was clear when you interacted, with these patients that they were terrified, and that they actually in that moment we're, thinking very clearly about their survival, and their preservation and, so it, makes a very difficult, proposition for, a doctor a nurse so, you set, up an injury, surveillance. System, that's, right, shortly. Before I arrived, Christopher. Robinson another, young, man who died in that same jail. The kalief Browder was held in he. Had been beaten to death and so when. I did arrive and started, with the correctional Health Service we, said about understanding, how many other people were injured especially, adolescents and, we saw saw lots of jaw fractures, and hand fractures, and so at, first we were dealing with paper records, but then we quickly implemented, in. The, New York City jail system an electronic, medical record but we were able to modify that in really major ways so, that we could capture data, and not just about the type of injury people had but, whether or not it was intentional, did it happen during a use-of-force was, there a blow to the head then. We could use that data, to report out to others not just in the Correctional, Service, or the city but, outside, parties, that might be interested, what, the rates of injury were so, that we had empirical, data to show the brutality and injury, was in fact a, real. Crisis, for our patients, describe, what would happen, when you would send, an email to the, do see to the Department, of Corrections, to upgrade. An injury. To. Upgrade, what you saw well. The injury, reporting, system on the health side as I mentioned we built a pretty sophisticated electronic. Medical record system on the security side it required. Paper. Pieces. Of paper injury, reports, to, be, updated. And amended actually on an individual, piece of paper so when, I would find a patient as, I often would who had an injury that was more serious than initially. Reported, or that the circumstances. Of the injury were different, than was originally reported. Unlike. In healthcare where we want all set you know all information, to lead us to the quickest. Best. Outcome for the patient these, paper forms, then, would, be put back in my face and people would say listen you have to find the original doctor or go to the original jail go find this piece of paper that nobody can find that's, the proper way to get this address not simply to tell us that that just, because you're a doctor or a health administrator, that you think something else happened why is there, so little. Transparency. Talk about the silent, complicity. You describe you, know these are paramilitaries. Settings, and so the, health service in most of these places even when we have an independent Health Authority we still rely on the correctional, staff for our safety and security and so as such. Because, there isn't a lot of mandated, transparency.
About Health, outcomes, about the true characteristics. Of injuries, for instance at the time we were doing this work there's. Most, of the system is designed to keep you information on the inside so, that anybody who wants to change the original account whether. It's a patient or a doctor or a nurse faces, a real gauntlet, of challenges. That not, only are bureaucratic. And administrative. But actually could put their own personal safety at risk I wouldn't, turn to kalief, Browder in, his own words kalief, Browder of. Course is the sick. Well was 16, when, he was arrested, and sent to Rikers Island he. Ended up being there for three years much, of that time in solitary. Confinement, without. Charge. He, was arrested when he was a high school sophomore. Police. Believed. They said that he stole a backpack. But could never come up with a person who made the accusation who, they drove around a neighborhood and, the, person, pointed out Khalif walking, on the street and then that person just disappeared. Khalif, would not plead, in prison, because he said he was taught not to lie and he said he was innocent held. For three years. Much. Of that time in solitary, confinement he. Said that while, he was in solitary confinement at, Rikers the guards often refused to give him his meals, if. You see anything that can take them or for any type of way some. Of them which, is a lot of them what, they do is they starve you ate it won't feed you and it's, already hard in there because if you get the three trays that you get every day you're still hungry because I guess that's part of the punishment so and they start with one tray that that, could really make an impact on you and how, much were you starved. Almost. All the lot can't even I can't even count, so. That, was kalief Browder speaking. On half, Poe live, when. It was around. He. Died within, two years after this interview he took his own life he, went on to say he was once star four times, in a row no breakfast, lunch dinner or breakfast, again after. Enduring nearly, 800, days in solitary, Browder, was only, released when the case was dismissed. Browder. Took. His own life jun, 6 2015. At, his home in the bronx he was 22, years old, he was a student at Bronx Community College. Jenifer, gonner man wrote. A lot about his case for The New Yorker and exposed, videos, that, were gotten from the inside, of Rikers showing, him being be. By, guards, and prisoners alike. Jennifer. You've covered the prison system a lot and. You were really. Taken, with this book life and death and Rikers Island II wrote a review of it for The New Yorker yeah, I know I saw an early copy of this book in, December, and a lot of books come in you know as a reporter you get a lot of often. Get a lot of books and people who want publicity I started reading this book and I really couldn't put it down I thought it was so important. Crucially. Important and I feel like it, covers one of the most overlooked, aspects, of mass incarceration I, mean mass incarceration has gotten a lot of attention in recent years but, what the health risks, that folks endure when they go inside is something that I feel needs much more attention and. I think as a society we've sort of grown numb to these headlines like an individual died in prison or jail and we don't really follow up with the necessary questions, and what dr. Venters book does is really pushes us to ask those harder questions like did this death have to happen was, it preventable. Did something happen in the jail that led to this individual's death and those are the kind of questions the public and journalists, in particular really, need to be asking tell us the case of Ronald Speer. Ronald. Speirs is one of the gentlemen in the book he. Was, in Rikers Island he was in his 50s, he was a kidney dialysis, patient, in. 2012. One, night he, felt very, ill and tried to get the attention of the doctor he was housed in the infirmary on Rikers Island there was a medical office next door to his dorm he snuck, out of the door me to, get into the hall to get to the medical office and the doctor told him you, know a guard stopped him and the doctor said, you had to keep waiting he's been waiting for hours the.
Officer, The correction officer and mr.. Spears got spear got into an altercation which, ended with two other guards. Coming in and, restraining. Him on the floor and that, would have been the end of the. Situation. But then the the first officer's, name was Brian Cole came, in and kicked mr. spear in the head repeatedly and he died right there on the floor this. Case was covered, up lied. About for, years until finally federal, prosecutors, in the Southern District in Manhattan. Brought, a prosecution, against the officer, and he went on trial in 2016, so I sat through the trial and obviously, the focus on, what this officer did and didn't do but, one of the subtext. Of that of that court, case was what the medical staff was doing at the time so this this. Crime, took place in the hallway right outside the medical offices and the nurse got on the stand and said when she heard the altercation of the hallway she opened her door and then she shut her door and. That she had sort of been taught to do that it's almost like an unofficial rule on Rikers Island the AH the doctor, who was on duty and here's all of this commotion, going on in the hallway he was sitting in his office and never looked out the window never opened the door, testified. To all of this and only, open his door after the whole thing was over and somebody knocked on the door I believe was a captain, and say can you come out here and you. Know help and at that point mr. Spears on the floor in handcuffs, face down and no pulse and. So essentially, this homicide took place you, know within feet of the, medical staff and that. Always stuck with me and and you know this this idea of an unofficial rule of averting your eyes when, there's an altercation, between. Correction. Officers and inmates is something that actually shows, up in dr. Venters book also you, say that. 112. People died, in New York City jails between, 2010. And 2016. That's like almost what twenty, a year. More. Probably in sub years right yeah. Some, years yes. So. What, is society's. Responsibility, here, I. Think. That there are really. Very. Large. Policy, decisions that have been made to keep these, deaths and injuries hidden and so to undo, these problems, it's not simply a matter of a, little, bit of training for one group of staff for another it, is that we have to establish.
Medical. Systems, that work not only to, care for the patients, and their health problems but also to collect the data we do in the rest of the country and report, it out we, also need to independent oversight we're fortunate in New York City to have the board of Correction, an, incredibly, vital institution. That really doesn't exist in most of the other 3,000. Counties in the states but, they need to be supported in the independence, to make sure that the health service, and the. Correctional service adhere, to rules dr., ventures you also say wreckers should be closed absolutely. Is it happening fast enough well. So. The mayor's office of Criminal Justice led, by Liz, Glaser is doing, an amazing I'm. Of work to come up with the, actual, planning that, could make it happen but this is a political, question to, close Rikers Island, how. Many people does it imprison. The. Jail system today has about, as under, 9,000, but we really need to get down to 5,000, or so which means building at least another borough jail you, right mmm. The. Health risks, that are faced. Particularly. By people, with behavioral problems. In prison. Talk. About that yeah. I think that the the most extreme, example, that it's really a an. Obscenity is the notion that people who exhibit symptoms. Of mental health problems would, be then put into solitary confinement where, we know that they'll get worse and and often. Die and so the. Idea that we had a solid. Terry confinement, unit, for, people with mental illness in the New York City jails until 2014. Is is. Horrific it's, not that's not a lack of resources that's not a lack of a thought, thought went into it and so we're jason echeverria and others died, you. Know they that, was an affirmative, decision so undoing, those bad. Decisions, coming. Up with a more clinically, appropriate and a therapeutic model in. Most cases means not having people in jail means having people in a community. Setting that's an actual health care so we built, alternative, models in the New York City jails these units the caps and pace units these very therapeutic units but, they're incredibly expensive, a couple of million dollars a year for 20 patients and, every. Aspect of those units would be more effective if they were not in the jails mass. Incarceration, in, this country. Has. Been taken on bay by. Grassroots. Activists. Now for years, and it's certainly, reading, I think a reaching. A tipping point where, you have people across the political spectrum, saying. We have. The largest, prison, population in. The world how, can this be changed I think, that one, of there's an important, voice that needs to be brought to this which is health, care systems, health insurance, companies, because keep, in mind that while most people don't die in.
Jail Or prison many. People are coming home with physical. And psychological, damage. From these settings and the, care they need which they may have struggled, to access but the care they need is going to be provided by community hospitals just, take the example of traumatic brain injury we documented all of the hidden traumatic, brain injury in just, in the New York City Jail systems that, increases, the risk of those people for dementia, and CTE, down the road that is incredibly, costly to them and their families, how do people on the outside get access, to these this, information, on the inside particularly, families, of people who are in prison so. I think that it is these systems are designed to keep the truth from certainly. From families, who are you know lie to all the time and from, but I think that it's. Incredibly important to have aggressive, journalism but. Also I think that some of the structures that exist in New York City should, be replicated, elsewhere so, having a board of Correction or an oversight agency, that demands, data having. Investigative. Journalists, that dig into individual, deaths is incredibly. Important, Steve Cohen just wrote a new piece in The New Yorker the jail healthcare, crisis, talking about the opioid, epidemic among. Other things yeah. I think that that's a that is also a very good example that most, jails and prisons, people. Don't have access to evidence-based, addiction, care so many people end up incarcerated because, of an addiction problem then, because they're denied access to buprenorphine and methadone they. Leave and we know we have documented, here in New York City their risk of death when they leave is much higher now in New York City we have a methadone program and a buprenorphine program, for people who are incarcerated but, very. Few jails around the country have that and. Jennifer, gundermen what gives you the most hope as you continue, to cover the prison, industrial complex. Well. As you are mentioning there's a lot of activists have taken up this cause which is fantastic, because you know back. In the 90s the 2000s, you just didn't see that level of interest. Of enthusiasm activism, for taking on these really challenging topics that, gives me hope and also folks. Like dr. Venters, people who have been on the inside who have a witness horrific, things and then have the wherewithal, and the courage and take, the time to really record them so the rest of us can really truly get a much, better understanding of, what's going on behind bars and. The. Access, to information you as a journalist, have getting, for, example, you leak these, of what was taking place with Khalif being, beaten videos, that are taken the surveillance system, within prison, you, know that was very unusual you, know there's very little, video, footage that has come out of from, prisons around the country despite there being a number of surveillance cameras you. Know like dr. venture said the truth is, hidden it's intentionally, hidden it's very difficult on, what's going inside in jails or prisons is very difficult but obviously the more journalists, who are taking on the challenge the. More we're going to get to the heart, of what the truth is I want. To thank you both for being with us dr. Homer, Venters, former, chief medical officer for New York City's correctional, health services. His, new book life in death and Rikers Island and Jennifer Garner and staff writer for The New Yorker magazine will. Link to her piece do, jails, kill, people, and that does it for our show. Democracy. Now is produced by Mike Burke Dina Guster nermeen Shaikh Carla, wills Tammy Warren of Sam al Kahf John Hamilton Ravi Karen honey, Massoud Trina Anna Dorota, Murray a studio, and Libby Rainey Mike DeFilippo and, Miguel de Guerra our engineer, special, thanks to Becca Staley Julie, Crosby, Hugh Grant David prude Arielle, Boone Festa guitars and Karl Marx ER and to our camera crew John Randolph Karen Berg Meadows and up goes Becca and Matt helix if you'd like to see our video and audio podcasts. Read, the transcripts, go to democracynow.org. You've. Got to sign up for our daily digest text, the word democracy now to six, six eight six six I mean a good. You.