The Prison Doctor

by Dr Amanda Brown

  She sighed. ‘It’s very sad, but often it’s an outlet for these boys. They are lonely, depressed, some just want to die. They turn to self-harming as a way of offsetting the pain and stress they’re feeling inside their heads.

  ‘A lot of these lads don’t want anyone to see their wounds, or the scars from cigarette burns, the scalds made with boiling water.’

  I felt a huge pang of pity. It was awful to think boys the same age as my sons felt so desperate and helpless that they needed to self-harm in such a way. No one should suffer like that.

  Again, I hadn’t seen many patients who self-harmed while I worked at my surgery. More to learn.

  I wouldn’t be dealing directly with mental-health issues; they would be handled by the psychiatrist. However, I might have to tend to their wounds, particularly if they had become infected and needed antibiotics. I might also have to represcribe antidepressants if the psychiatrist wasn’t in.

  I had been expecting to deal with the common complaints that teenagers usually present with, such as acne, asthma, skin infections and rashes, etc – conditions I’d seen hundreds of times over the years in my old practice. But now the type of patient would be very different.

  A couple of nurses were popping in and out of rooms along the corridor, and Dawn called them over to introduce me. I was given a lovely warm welcome by both.

  ‘The turnover rate of doctors is high in prisons,’ Dawn explained, ‘so everyone is hoping you’ll stay with us. We need some consistency here.

  ‘Apparently, working with the 18-to-21 age group can be the most challenging of all. They’re the most notoriously difficult. Too much testosterone in too confined an area. They’re always fighting, with each other mostly, but sometimes with the prison officers as well.

  ‘That’s why I like working here.’ She stopped outside a pale green painted door. ‘Despite the government statistics on reoffenders, I feel like we still have a chance with boys this age, to help put them on the right path in life.’

  Dawn unlocked the door and pushed it open.

  ‘And this is where you will be working.’ She stood back to let me pass.

  It was a far cry from what I was used to, but it wasn’t as bad as I had expected. It was small, clean, and had the essentials. There was a desk and shelves, all compact and well designed, as if it had come straight out of IKEA. There was also an examination couch on the other side of the room, with blue tissue paper placed on top, ready for my first patient.

  The lovely thing about the little room though, was that there was a window – even if there were big metal bars in front of it! I wasn’t expecting to have natural sunlight, so although the view wasn’t up to much I was grateful. I peered out on to the tarmac yard outside.

  ‘Can get a bit noisy when the boys are walking across the yard,’ said Dawn. ‘Silence is a luxury in this place!’

  She was standing on the opposite side of the room, stroking her top lip with her forefinger as she tried to remember any details she may have forgotten. I had so many questions but I decided it was better to just get on with the job and save them for later. It seemed to me that this was the kind of place that you learn as you go along; sink or swim.

  ‘A nurse will run the clinic with you, she will let the boys in and out and tend to all the minor things through there.’ Dawn pointed to an adjoining room.

  ‘Ah speak of the devil.’ Dawn took a step backwards to make way for a petite, pretty lady, in her early sixties, wearing blue trousers and a long blue tunic top. A biro was peeping out of the top of her breast pocket.

  She may have been five foot nothing, but I could tell I wouldn’t want to get on her wrong side. Nobody would. She had an authoritative air about her.

  Dawn introduced her.

  ‘Amanda, this is Wendy – or Matron, as the boys like to call her.’

  Wendy stared up at me through her thick dark fringe. She had a blunt bob cut which was striped with grey hairs. Her face was stern, but she had kind eyes.

  ‘Wendy must be one of our longest-serving staff. Thirty years now.’

  ‘Thirty-two next May,’ Wendy corrected her, as she busied about doing her things, darting in and out of the room.

  ‘If you have any questions, she’ll be able to help you.’

  Just as Dawn was leaving, she spun around and looked me straight in the eye. Her voice was hard now.

  ‘One last thing. Make sure you do not reveal anything personal about yourself to the boys. Keep where you live, any details of your family, private.’

  The words were chilling.

  I nodded obediently.

  ‘It’s not permitted for any prison or medical staff to have any sort of communication with inmates after their release.’

  I nodded again. Things suddenly seemed to get a lot more serious. I’d been so used to being entwined in my patients’ lives at the surgery. I had followed their journeys over the years, visited them at their homes, watched their lives evolve. This was a completely different way of approaching medicine. I would be seeing prisoners in my clinic who I might never see again.

  Dawn softened as she saw my flash of concern. ‘You’ll be fine. It’ll be a challenge.’

  With that, she disappeared along the corridor.

  *

  My thoughts were interrupted by a thud on my desk. I looked up to see Wendy had given me a large plastic box of files. Inside were orange A4 folders, of varying thickness, each marked with a number – the prison number of the boys I would be seeing that morning. It was wrong to make the assumption that the thicker files would be the more demanding patients, but from everything I’d heard that morning, I couldn’t help but jump to that conclusion.

  ‘Doesn’t make for light reading,’ Wendy grimaced. ‘And here’s the list of boys you will be seeing.’ She placed a sheet of paper on the desk.

  ‘Thank you,’ I smiled, grateful for her help. I knew I could do with having Wendy on my side.

  She carried on whizzing back and forth between rooms, making the final preparations. I glanced at my watch.

  ‘What happens now?’ I asked, as she reappeared.

  Wendy explained that the officers from the various wings were collecting the boys, who had either put in a request to see me, or who one of the nurses had decided needed to be seen.

  ‘They then wait in the communal area until I call them in,’ she explained.

  I peered out of the door to look at the waiting area, which had approximately twenty plastic chairs set out in neat rows.

  ‘Everything is plastic here,’ Wendy explained. ‘From the chairs to the cutlery.’

  ‘Oh?’

  ‘To try to prevent them from self-harming,’ she said.

  And again, I was forced to face the reality that some of these young people felt so desperate that harming themselves seemed the only escape.

  ‘You’d better get set up, they’ll be arriving any minute.’ Wendy nodded, and left the office again.

  I returned to my desk and glanced over the names of the boys I was about to see. What had they done? I couldn’t know about their crimes, that was a detail not recorded on their medical notes. Besides, I would have hoped that knowing about the severity of their crimes wouldn’t have affected my ability to help them. Yes, I would hope that . . . but it was a relief not to have to prove as much. Who were they? What were they coming to see me for? Of course, it was no different to any new patient, not really . . .

  By the time I’d read to the end of the list, the noise from the waiting room had swelled into loud chatter and raucous laughter.

  An authoritative voice bellowed, ‘Oi, keep it down in here!’ That must have been the prison officer in the waiting room.

  Which only led to more sniggers.

  And to the prison officer becoming even more irate.

  ‘Keep it down in here, I said!’ he shouted, banging his fist on the door.

  ‘Ah, you can fuck off an’ all!’ came the reply.

  Then, in a flash, chairs were scre
eching across the floor, more shouting, more swearing, scuffling, threats, then silence.

  I nearly jumped out of my skin when Wendy knocked on my door.

  ‘That’s what happens if you put a bunch of rowdy teenagers in a small room together,’ she said, poking her head inside and rolling her eyes. ‘I’ve got Jerome Scott here.’

  I pulled Jerome’s file from the plastic box. It was as thick as a book.

  ‘Come in!’ I called out.

  I prepared myself to meet my first patient in prison.

  Chapter Five

  Jerome was tall, skinny, and wore his grey prison tracksuit bottoms low enough to show off his boxer shorts. He was pale, spotty and had a diamanté stud in both ears. His hair was shaved along the sides and spiked with gel on top. He looked like every other teenager who had spent too many hours indoors playing video games.

  It was only his eyes that told a different story. They were bloodshot, puffy, hollowed out by the shadowy purple circles underneath. He looked as if he hadn’t slept in months, and I prepared myself for his request for sleeping tablets.

  ‘Come on in, take a seat.’ I welcomed the teenager in the usual friendly manner I’d always greeted my patients with, in my old surgery.

  Jerome swaggered across the room and slumped into the chair opposite. He automatically slipped into a slouch with his left leg outstretched and his right elbow hooked over the top of the chair.

  ‘How can I help you?’ I asked, leafing through his most recent medical notes to familiarise myself. Antidepressants, medication for anxiety. Bruising to ribs and left cheek and cuts to forehead, following a fight with his cellmate. I looked up to check how well the wounds on his face had healed.

  ‘It’s my feet, Miss.’

  I was taken aback a little. After such a build-up, and a complex history, I wasn’t expecting such a seemingly minor complaint.

  ‘Oh dear. What’s wrong with your feet?’

  ‘They hurt when I walk. It’s these shoes, innit.’

  Jerome lifted one of his black trainers into the air, which I assumed must be part of the prison uniform. He then returned to his slouch and started biting his nails, or the little bits of nail he had left. I noticed a tattoo of a snake wrapped around a sword on his left wrist, the tip of the blade peeping out from under the cuff of his jumper.

  ‘What sort of pain are you feeling, and whereabouts on your feet?’ I could believe those shoes weren’t the most comfortable.

  ‘I’ve got blisters everywhere, Miss. I can barely walk, it’s so painful. I can’t be doing with these trainers.’

  It was strange to be called Miss, but I suppose Jerome saw me as an authoritative figure, like a teacher – unlike my previous patients who, on the whole, had viewed me as a friend. Did I want that responsibility? Could I take it?

  I moved around to the other side of the desk to take a closer look, asking Jerome to remove his socks and shoes. He waved his slightly smelly bare foot in the air to reveal the tiniest of blisters on his right heel.

  His eyes looked sheepishly to the ground.

  ‘It’s killing me. I can barely walk!’

  He didn’t seem to have any problems swaggering into my office a moment ago, I thought. I started to wonder if there was a bit more to his complaint.

  ‘Why don’t you pop next door, and the nurse can give you some plasters for your blisters.’

  The words had barely left my mouth when Jerome fired back with his own diagnosis and cure.

  ‘Can you just write me a note saying I can wear my own trainers? That way I won’t get blisters no more.’

  I suddenly cottoned on to what was going on. There must be some sort of loophole whereby the prisoners could wear their own shoes on medical grounds. Whether the trainers would be sent in by his family, I didn’t know, but I was pretty sure that’s what Jerome was after.

  It was my first day on the job and I needed to be careful not to break any rules.

  Turning a little firmer with my tone, I suggested, ‘Let’s try out the plasters first and see how that goes.’

  Jerome huffed loudly.

  ‘But Miss,’ he whined.

  He sat there for a moment, sulking, waiting for me to come around to his way of thinking. Nibbling on his nails.

  I thought about what I would say to my boys if they were trying to get their way.

  I smiled and explained it was my first day in the prison and that he needed to use the plasters first, but I promised I would find out the rules and regulations surrounding the boys wearing their own trainers instead of prison-issue shoes.

  After more huffing and puffing Jerome reluctantly agreed to try the plasters, and as he walked off to see Wendy in the next room he turned back and flashed me a mischievous grin.

  ‘See you next week then, Miss.’

  *

  The rest of my morning surgery was a succession of minor ailments, with at least three more trainer requests, all with similarly feeble excuses.

  Two of the boys complained of achy feet, the other of painful toenails. It seemed ludicrous that a doctor’s time was taken up by dealing with kids wanting their own footwear. It was something I would have to take up with Dawn, but first I needed to tell Wendy about the massive faux pas I’d made with one of the other boys.

  ‘I told him I liked the orange jumpsuit he was wearing. That it was a bit more bright and colourful than the grey tracksuit. He said “Thanks, Miss, I get to wear orange because I tried to escape!”’

  Wendy howled with laughter.

  ‘I suppose he won’t be making a run for it again in that jumpsuit. He’ll stick out like a sore thumb!’ I laughed along with her.

  For a moment I looked at the severe Wendy, and she looked at me, and I felt reassured. Yes, we were going to get along just fine.

  It was funny, but it was also strange to think that someone I was treating for something as routine as a minor ear infection had tried to break out of a high-security prison, maybe hours earlier. I was dealing with the ordinary in what was otherwise an extraordinary foreign world.

  I turned to Wendy and asked, ‘So what’s with these boys wanting trainers?’

  If anyone would know what tricks the boys were up to, Wendy would.

  She chuckled. ‘It’s not “cool” to wear prison shoes, and they’ll do anything to try and wear their own trainers. It allows them to maintain some sort of identity in here.’

  Wendy looked me in the eye. ‘You’ve just got to be firm with them, or they’ll run rings around you.’

  I’d worked that out pretty quickly. If I gave into one, they would all be queuing up – kids demanding trainers all week long.

  ‘These boys are crafty. If they see you’re a soft touch, they’ll immediately take advantage,’ she warned me. ‘They’re constantly testing you, pushing you to the limit. Like most teenagers. But don’t forget some of them are very experienced at lying and manipulating. It’s easy to forget they’re in here because they’ve committed a crime.’

  Wendy was right. It was easy to blot out the fact that the boys were criminals, when I was treating them for very run-of-the-mill medical problems. Apart from their bad language, on the whole, they seemed quite well-behaved.

  After three weeks in Huntercombe, apart from getting thoroughly irritated by the trainer requests, I realised I was having an invigorating time in my new world. It was different and challenging and I felt like I’d been given a new lease of life. The cloud that had hung over me when I left my practice was rapidly lifting. I was beginning to feel accepted and to enjoy feeling worthwhile again. Might I even be making a difference?

  I was living in a bit of a bubble in the Healthcare department. I knew little about the other areas of the prison, what went on in the wings, even what the cells looked like. I knew nothing about the boys outside the fifteen-minute consultations they had with me. I’d only run into the governor once or twice. I was in and out, twice a week, now with my own set of keys, treating seemingly ordinary spotty teenagers, with or
dinary medical complaints. I was even liking my new name: Miss.

  But as with every bubble, it had to burst at some point. And Wendy’s words of warning came true sooner than expected.

  I blamed the waiting-room system. There was a high likelihood that putting a lot of teenage boys together in a confined space could lead to trouble.

  My Wednesday-morning surgery had started like all the others so far. A big pile of files on my desk, and a list of the boys I would be seeing over the next few hours. As usual, I had no idea beforehand of what they were coming in for.

  I knew they were a rowdy lot, though, as there had been a great deal more laughter and shouting coming from the waiting area than usual. The prison officer had screamed at them to shut up a number of times, but I was too far away to hear what they had been saying, other than a load of effing and blinding.

  When Wendy knocked on my door, her face said a thousand words. Her mouth twisted into a grimace as she wished me luck.

  ‘Thanks, Wen,’ I said, before taking a large sip of coffee from my mug. A caffeine hit before I started my clinic.

  There were only nine boys on the list that day, and the first one, Danny Farr, had been to see a doctor three weeks ago about his feet. Three guesses what he’s come back for, I thought, as the 17-year-old made his way into my room.

  Short, stocky, and wearing his own clothes, Danny sank down into the chair opposite me. He had strikingly chiselled features, with high cheekbones and a shaved head. His legs were spread wide apart, his arms dangling by his side as he assumed a relaxed pose.

  I started things off.

  ‘Morning, Danny, how are you today?’

  ‘I’m okay, Miss.’ He coughed loudly. ‘Apart from, I got this problem.’

  ‘Go on?’ I encouraged him.

  ‘Well, it’s a bit embarrassing, Miss.’

  I smiled, trying to put him at ease. I knew boys could feel awkward confiding in a woman. ‘Don’t worry, there’s nothing I haven’t seen or heard before.’

  ‘It’s my . . .’ he dropped his gaze to his crotch. ‘I think I’ve got a . . . a spot on my . . .’