The Prison Doctor

by Dr Amanda Brown

  Unlike adult prisons, which are categorised by letters, from A to D, depending on the seriousness of the crimes of the prisoners locked up, a young offenders’ institute has no grade. That didn’t reassure me though.

  I’m not frightened easily, but I was filled with self-doubt as I read up about the crimes some of these teenagers had committed. It wasn’t just theft and burglary but also murder and rape.

  I turned to David for advice.

  ‘Do you think I can do it?’ I asked

  He was peeling the spuds for dinner and laughed. ‘Don’t be ridiculous, of course you can, you’re more than capable.’ He smiled. ‘You always are.’

  I loved the fact that he was so supportive of both me and my career. God knows how many evenings he’d spent alone, looking after the boys while I’d worked very long days or been called out in the middle of the night. He understood my drive and my need to help others. He understood I had worked too hard for my career to give it up.

  ‘I’m going to be treating teenagers who have committed some very serious crimes!’

  It was hard to comprehend that boys my sons’ age could have killed someone, raped someone, abused a young child.

  ‘But they need a doctor, too. And I can’t think of a better person for the job,’ David said.

  He was right. I wasn’t there to judge; my job was to try to make people better.

  ‘But it’s a prison. Have I got the guts to handle it?’

  I heard the plop of another peeled potato being dropped into the saucepan of water, then David turned around and looked me in the eye.

  ‘Do I have to remind you of some of the brave things you’ve done in the past? Do you remember that bloke who had a knife to his throat . . .?’

  Chapter Three

  Four years earlier . . .

  Buckinghamshire

  July 2000

  It was a scorching summer’s day and I was sipping on an ice cold drink and having a quick bite to eat at my desk in my lunch break.

  A gentle breeze lifted the curtains as it blew into my consultation room, tickling the back of my neck.

  I battled to keep my eyes open; in that heat I could easily have dozed off for a few minutes. Suddenly the peace was broken by screaming and the sound of footsteps hurtling down the corridor.

  My door burst wide open. One of my patients, Jenny Scott, was standing in front of me, breathless, panic stricken.

  ‘Amanda, you have to come with me now,’ she screeched.

  Her normally perfectly styled hair was windswept and tangled. Her usual composure was shattered.

  ‘It’s Jonathan – he’s got a knife and he says he’s going to kill himself. I don’t know what to do. He’s at home . . . please come.’

  Jonathan was Jenny’s husband, an alcoholic who suffered from severe mood swings. I’d been treating both of them for years. Without a second thought, I grabbed my bag, filled with all the equipment and medicines I carry to my home visits, and chased after her into the surgery car park.

  She sped off in her car, but I knew exactly where to go. I’d been to their house on many home visits in the past.

  It was less than five minutes from the surgery, in a pretty lane with beautiful houses on either side. Large homes, with large gardens and expensive cars parked in the driveways. Many people would look at the area and think that the people who lived there surely had to be happy. But, from my experience, inside many of those magnificent houses, behind the seemingly perfect façades, there lurked a lot of anguish and unhappiness. A significant proportion of the medical problems I treated were brought on by stress and financial pressures. I learned early on in my career that money very often doesn’t buy happiness

  Turning into their road, the dappled sunlight trickling through the trees was replaced with the blue and white flashing lights of several police cars. They were parked outside the Scotts’ home. Half a dozen armed police officers wearing protective vests surrounded the house. I parked and got out of my car. What had I walked into? It looked like a hostage negotiation scene from a film.

  Jenny was standing behind one of the police cars. She beckoned me over. A police officer stepped into my path, his hand outstretched, ready to stop me.

  ‘It’s okay, I’m his doctor,’ I explained.

  The police officer moved aside and Jenny ran forward, a look of relief washing across her face.

  ‘Thank God you’re here, Amanda.’

  Her whole body was trembling, but she wasn’t crying. Jenny was a tough, resilient woman, and could cope with a great deal. Goodness knows she’d had to over the years. It wasn’t uncommon for Jonathan to lose his temper, but I never thought I’d see the day when police cars were parked outside their house.

  ‘So, what’s happened?’ I asked.

  ‘I don’t know, I don’t understand, one minute he was fine and the next . . .’ Jenny paused to compose herself. ‘We were having lunch together. I got up to get the salad cream out of the fridge and noticed three of the wine bottles were missing. Three!

  ‘I know he likes to drink, Amanda, but three bottles by lunch was a lot even by his standards. I was tired, I was angry, and I asked him where they had gone.’

  Her voice started to tremble and, knowing Jenny, she was blaming herself for whatever happened next.

  ‘He started shouting that I shouldn’t have asked him, and the next thing I knew he’d pulled the carving knife out of the drawer and was holding it against his neck. He was telling me he didn’t deserve me, and he was going to kill himself.’

  She looked to me for reassurance. ‘This is my fault, isn’t it?’

  I squeezed her arm. ‘No, Jenny,’ I stressed, not for the first time. ‘This is not your fault.’

  I felt deeply sorry for her. I couldn’t imagine what she had suffered over the years. And being the strong, independent woman that she was, I imagine she had kept a lot of her pain locked up inside. I also felt deeply sorry for Jonathan, living with anxiety and depression, turning to alcohol to numb his pain.

  ‘I tried to get him to put down the knife,’ she said. ‘But that only made him hold it closer to his neck. I was terrified, so I ran. He listens to you, Amanda, please will you talk to him?’

  I felt the pressure building.

  I turned to one of the police officers and asked if they had approached Jonathan.

  ‘Not yet. We have to wait for legal authority to enter. Won’t take long but right now . . .’ He shrugged. ‘Well, we’re stuck here.’

  ‘What about me?’ I asked. ‘Can I go in?’

  ‘Legally? Yes, you’re his doctor, and have reason to assume he may be hurt.’ He looked at me and the fear in his eyes, the concern for my safety, nearly changed my mind. ‘You shouldn’t, though. You should wait for us to get clearance and then we’ll all go in together.’

  But that was no good, was it? Jonathan needed me. Jenny needed me. It was my job to help and I was obliged to carry out my duties.

  I walked up the driveway.

  The Scotts’ house was very beautiful, with a large weeping willow in the middle of the lawn, and flowerbeds filled with stunning roses and brightly coloured summer flowers. Rectangular flowerboxes hung along the wall by the front door, and flowerpots filled with pansies and lavender lined the driveway.

  My heart pounded as I drew closer to the porch. I was nervous about what to expect on the other side of the door. There was a chance Jonathan could turn the knife on me.

  It felt like one of the longest walks of my life. I turned back to see everyone’s eyes watching me. Jenny’s hand was clutched over her mouth and the police officers were poised, their hands hovering over their weapons, ready to jump in at any moment.

  I took one last look back and then plunged in.

  The front door was ajar. I pushed it open with my fingertips, stepping into the hallway. The house was eerily quiet, my shoes sounding far too loud on the wooden floor.

  I called out. ‘Jonathan?’

  Silence.

 
‘Jonathan, it’s Doctor Brown.’

  There was still no reply but I kept moving, into the kitchen, bracing myself for what I was about to see.

  But he wasn’t in the kitchen any more.

  I called out, again. ‘Jonathan? It’s Doctor Brown. I’ve come to see if you’re okay.’

  I heard a noise coming from the living room.

  The nervousness I’d felt had left me now. I needed to find him as quickly as possible. I moved into the living room.

  ‘Oh, Jonathan!’ I gasped as I turned the corner.

  He was standing in front of their leather sofa, his slim frame outlined by the sun streaming through the skylights. The knife, pressed hard against his throat, was glinting. He was swaying slightly, drunk, a sweat glistening on his forehead, his lips wet.

  He stared at me, not saying a word.

  I was shocked. I knew him well, as he had confided in me over the years about his problems, and I’d come to regard him more as a friend than a patient. My heart went out to him that he felt so desperate he wanted to kill himself.

  His lips were white, his face drained of colour. His eyes were agitated, his whole body tense. But still he didn’t speak; he just kept the knife clamped to his throat.

  I didn’t have any choice but to try to take it from him.

  I started to gently walk towards him. My voice was soft as I said, ‘Please, please, Jonathan, give me the knife.’

  He was frozen to the spot.

  ‘Let me have the knife, it’s going to be fine.’

  Still no reply, as I softly, slowly moved forward. What was going through his mind? Was he about to cut his own throat? Was he about to turn the knife on me?

  The sound of police radios and talking were coming from outside the window.

  I couldn’t see any lacerations on his neck, but the tip of the knife was pressing hard against his skin. Any trigger could set him off.

  ‘Jonathan—’ I started, but didn’t finish my sentence. Suddenly, he lurched towards me, the knife in his right hand.

  It all happened so quickly. I froze, suddenly certain that I’d made a terrible mistake, that I was going to die, there in that opulent living room. Blood spilling onto a carpet few could afford. I’d gone there to help but Jonathan was too far gone, too lost to see clearly. His arms stretching out towards me, the knife shining, looking sharp enough to cut a slit in the air itself.

  Yes. I was about to die.

  He flung his arms around my neck and flopped onto my shoulders, letting go of his grasp of the large carving knife. It made a small thunk as it dropped onto the living room floor behind me. Part of my brain heard it fall, recognised that the danger was past; the rest of me was occupied with the sobbing Jonathan. I stood there, holding him up, as he sobbed and sobbed and sobbed.

  ‘It’s going to be okay,’ I said, stroking his back as I would a child who desperately needed a hug and reassurance.

  When his breathing had calmed a little I told him we needed to go outside, that Jenny was waiting for him.

  His voice was thick with tears. ‘How can she ever forgive me?’

  ‘She loves you, we all care about you. Jenny would be distraught if anything happened to you,’ I said.

  I led him out of the living room and towards the front door.

  He was wobbling still, drunk and disorientated, and I propped him up as we walked into the sunshine together.

  I was relieved to see the flashing lights of an ambulance.

  ‘I want you to go to the hospital for me,’ I said. ‘They’ll help. Can you do that for me?’

  He nodded.

  Jenny ran towards us, taking her sobbing husband into her arms. I was so thankful that he was safe. I looked at the two of them, unable to shake the thought that one – or both – of them could have died today if things had gone differently. Ultimately, while I may have helped to ground him, Jonathan had held on to enough strength – just enough – to stop himself from doing something that would have torn their lives apart.

  I stood back as the paramedics helped him into the ambulance, to take him to the psychiatric ward of the local hospital. Jenny followed in her car. He was in need of expert help, more help than I could give him.

  I watched as they disappeared from view and then got back into my car and drove slowly back to work. I had other patients to see.

  Chapter Four

  November 2004

  HMP Huntercombe

  I remembered those nerve-racking steps towards Jonathan and Jenny’s house, as I walked towards the entrance of HMP Huntercombe. My heart was pounding just as much, my palms moist with anticipation as to what was around the corner.

  And then suddenly, just as it had all those years ago, courage kicked in.

  I straightened my back and walked on with confidence and purpose.

  It was daunting but exciting. I was reinventing myself.

  My thoughts were broken by the noise of a large white van rolling up to the prison gates. It had the distinctive tiny blacked-out windows running along the sides, the ones the paparazzi try to reach their cameras up to when high-profile prisoners leave court. I wondered who was inside it.

  As the huge metal gates opened, I was able to get a brief glimpse of what lay on the other side. A concrete yard, some more fencing, half a dozen prison officers . . . and then it all vanished from view as the gates slammed shut.

  The intimidating façade of the prison wall, with its barbed wire twisting over the top, was a stark reminder of what life held in store for those being dropped off.

  I arrived at the gatehouse, where a thick glass screen separated me from the officers who kept a close eye on the monitors to see who was coming and going.

  It was like being at passport control at the airport, slowly being given the once-over.

  ‘What’s your name?’ asked a small stocky man with a thick Essex accent.

  ‘Doctor Amanda Brown,’ I replied, loudly, just in case he might not hear me through the thick glass screen.

  ‘Have you got your ID with you?’

  I pulled out my passport and driver’s licence from my bag, and passed them through the hatch that he clicked open.

  There was a long pause as he checked my ID, and then I heard the rumble of a big heavy metal door sliding open.

  I stepped forward, taking another half-step to make sure the monstrous door didn’t clip me as it closed.

  I was now on the other side, standing in a narrow corridor. An officer spoke through another glass screen, and told me that someone from Healthcare would come along soon to meet me. I moved along the corridor slightly, to a small room lined from floor to ceiling with lockers. This, presumably, would be where my belongings would be stored, the things I could take inside being limited for safety reasons. Straightaway, a reminder of what I was facing: a job where the contents of my pockets could get someone killed unless I was careful.

  The head of Healthcare arrived, greeting me with a friendly smile and a handshake. I hadn’t seen Dawn Kendall since my interview, six months previously – the process of getting security clearance and having contracts drawn up for the job had taken that long.

  She had a clipboard in one hand and a large set of keys in the other, which clinked as she rolled them between her fingers. She looked like she meant business, with her black trouser suit and white blouse.

  I was given a locker in which to store my phone, bag and coat, then she unlocked another large solid metal door, and I followed her through. That was locked behind us, the sound heavy and horribly final. A large metal gate followed; again keys jangled, locks turned. Then – finally – we were in the prison grounds.

  ‘Once you have your key training you’ll be able to do this yourself.’

  She turned around and grinned at me. ‘But for now, you’re stuck with me escorting you.’

  I’d liked Dawn from the moment I met her. She was a large lady with a big personality to match. I got the sense she wanted to mother the boys because, somewhere, deep down, I’m
sure she felt sorry for them.

  I believed that most of the staff genuinely wanted to make a difference, and I hoped I was also going to be able to.

  We walked across the courtyard, then through another metal door and another gate, and finally we were in the Healthcare department of the prison.

  The walls were brightly coloured and there were a variety of drawings and paintings stuck on them. ‘All done by the boys,’ Dawn proudly announced.

  She walked briskly ahead, filling me in on some facts that belied the innocent-looking appearance of the place.

  ‘Huntercombe is home to 360 of the country’s most troubled teenagers. Sadly, many of the kids inside here have come from troubled families. Violence is all they’ve known.’

  We turned a corner and I skipped to keep up.

  ‘The UK has the most juveniles locked up behind bars in Europe. This age group, 15–18-year-olds, has the worst reoffending rate of all: 82 percent are likely to commit another crime within two years of being released.

  ‘You’re not shocked easily are you, Amanda?’ she asked as she unlocked the door to the clinical room.

  I shook my head.

  ‘Good, because these boys can be rude, they can be aggressive, particularly when they don’t get the medication they want.

  ‘Some of them will have had drug addictions, and will want you to prescribe them strong painkillers and sleeping pills. These need to be avoided at all costs; they’re highly addictive and can sometimes be used as currency, to trade for cigarettes or items of clothing. Some of the boys can also be bullied, attacked for them. Drugs are a commodity here; we need to be careful.’

  In the twenty years I’d worked as a GP I’d only looked after one patient who was addicted to any medication. My experience wasn’t going to be much use to me. I had so much to learn.

  The Healthcare department was where the prison GPs ran their clinics, alongside other healthcare professionals, including the dentist, psychiatrist, optician and GUM consultant – a doctor specialising in sexual health.

  Dawn informed me that there were a lot of self-harmers in Huntercombe, and to prepare myself for seeing some horrific scars and shocking wounds.