The Prison Doctor

by Dr Amanda Brown

  I suppose I was expecting to read a list of chaotic thoughts. The ramblings of a confused teenage boy wanting to offload his mind before bed.

  But as I quietly read the lines, and between the lines, I was moved to tears: Jared had written the most beautiful poem about his childhood.

  It was sad. It was moving. It was tragic.

  It was also very well-written. Yes, it had a few spelling mistakes, and letters jumbled back to front, but Jared clearly had a talent, an ability to express himself.

  ‘That’s beautiful,’ I said, sweeping my tears away with my forefinger.

  Jared stared at me, I think in disbelief that something he had written could have had such an effect on me.

  And then I broke my first prison rule: I gave him a hug!

  I just felt so overwhelmed with the desire to show him someone did care. He wasn’t alone. I wanted to encourage him to continue with his writing. I knew it meant an awful lot to him that I’d taken the time to bother to read it, to know that I believed in him when perhaps no one had believed in him before.

  I suspect it may have been the first hug he’d had in a long time.

  ‘I’m glad you liked it, Miss. I’m going to write another poem and show it to you,’ he said, filled with enthusiasm. His big eyes sparkled with excitement.

  Jared clearly wanted to better himself, and I instinctively wanted to help. I couldn’t wait until the next instalment.

  I had the pleasure of reading two more of Jared’s poems. They described why he had trouble sleeping. They told of the memories that came to haunt him in the night. But what was just as pleasing as seeing his efforts was hearing that the writing did help a little with his sleep.

  I could see he struggled a bit with vocabulary, and the mother in me wanted to help him improve it, so one afternoon, after work, I swung past WHSmith. I knew exactly what I was looking for: a dictionary and thesaurus.

  I showed it to David when I got home.

  ‘I just want to give him something to help him with his writing. I can tell that he wants to learn, and I know it’s only small, but small changes could go a long way. If Jared starts believing he’s good at something, it might give him the confidence to make something of his life.’

  Throughout our marriage David has always been the calm, steady, rational one, whereas I’m much more hotheaded and emotional. We balance each other out that way.

  ‘Just remember these boys are troubled,’ he said. ‘I don’t want you to get too disappointed if you don’t see the changes you hope for.’

  I gave him a giant hug, putting my arms around his waist.

  ‘What’s that for?’ he said, wrapping his arms around me.

  I snuggled into him and smiled up at him. ‘Just for listening to me and being wonderful. You don’t need to worry. I won’t be disappointed. Even if Jared only looks at the book once, it will have been worth it.’

  *

  I had a spring in my step as I walked towards the formidable prison walls the following morning. I knew Jared had a matter of weeks left before his move to the next prison. I was pleased to think that he would now have something with him to help take his mind off things, if he struggled to sleep in his new cell.

  I hugged the large book into my chest as I waited for the thick metal door to slide back. My heart was skipping with excitement as I imagined Jared’s face when it was handed to him.

  ‘Morning, Doc,’ said Joey, one of the prison officers, as he stuffed his bag into the locker.

  A huge smile spread across my face. ‘Just the man I wanted to see!’

  ‘Uh-oh, what have I done?’ Joey winked at me.

  He was a big guy. His white shirt clung tightly to his belly, revealing tiny squares of his skin and hair where the fabric stretched apart at the buttons.

  I asked him if he would be able to pass on a present from me to one of the boys on his wing, to Jared Keane.

  ‘Keane?!’ he exclaimed. ‘The lad who’s moving in a few weeks?’

  I held out the book, still smiling.

  Joey blinked a few times, lost for words.

  ‘It’s not the most exciting of presents, I know,’ I giggled.

  Joey continued to stare at it, then sighed deeply as he ran his hands backwards and forwards over his head.

  ‘I don’t know how to tell you this, Doc, but I can’t give him the book. It’s against the rules.’

  I stared at Joey, crestfallen.

  ‘But . . . why?’

  Joey explained that giving Jared a present could be seen as conditioning, a term used to describe when inmates corrupt staff members and persuade them to smuggle things into the prison for them, including drugs and other banned items such as phones. My gift could be seen as a potential precursor to more serious contraband.

  I snapped. ‘Oh, for goodness’ sake! It’s just a book.’

  ‘Rules are rules, Doc,’ Joey shrugged. ‘He’ll have to wait until he’s released to have it.’

  ‘From the next prison?’

  ‘Afraid so.’

  I was so disappointed. I felt so deflated. The book would remain unopened amongst Jared’s possessions for another three years. I wanted him to know that I believed in him, and cared about him.

  I had to accept the rules of the prison, even though I found it very disheartening. I wanted to help him, but sometimes it was impossible to help people in prison.

  The blocking of the book also highlighted another problem – trying to stop myself from getting too attached. Unlike in my old practice, where I would see the same faces, day in and day out, over the years, and could follow their progress to find out what happened to them, I had to wave goodbye to these teenagers with no idea of how the rest of their lives would pan out.

  It mattered a lot to me to know whether I’d helped people. But being a prison doctor often meant that I’d never know.

  I couldn’t forget Jared. Every so often I thought of him, and of the choices he might have made, as I continued with my regular sessions in Huntercombe.

  Did he continue with his poetry?

  Did he find peace at night?

  I carried on working there, and also became involved in a project working for the Primary Care Trust to try to improve end-of-life care.

  One day it was announced that the prison was due to close. There were rumours that it might reopen as an adult Cat C prison, but nothing was confirmed, and so my time there came to an end.

  However, I realised that I was in need of a bigger challenge. I wanted to entrench myself deeper within the prison system – to do the best I could within the limitations I had. I wanted to see if I could have more of an impact on the people I was dealing with. I suppose I was still searching for a purpose.

  So, at the age of 55, when I could have been curling up on the sofa with a glass of wine and a nice book every evening, I applied to work as a doctor in one of the oldest and most notorious prisons in the UK.

  PART TWO

  The Scrubs

  2009–2016

  Chapter Seven

  A stampede of prison officers crashed past my door. Their radios blasting ‘Code Blue on A Wing’.

  When Code Blue was called, everyone went: nurses, prison officers, doctors – a train of people racing along the landings.

  Just in case I hadn’t heard – though I could hardly miss the noise – nurse Sylvie banged on my door. ‘Doc, Code Blue.’ I grabbed my bag, shoved a pair of surgical gloves into my key pouch and joined the stream of staff flocking to A Wing.

  A couple of weeks had passed and I was still finding my feet in the huge Victorian men’s prison, Wormwood Scrubs, famously known as ‘the Scrubs’, with its five wings, A to E, each spread over four floors in West London. I was also adapting to the rude shock of coming from a relatively sedate institution, dealing with teenagers with minor medical ailments, to running between wings in a vast building that housed some very violent criminals.

  I was overwhelmed with the size, the noise, the throbbing life of the pla
ce. A Code Blue was called for the most serious and often life-threatening emergencies, possibly a suicide.

  I followed the stampede past the counselling rooms, as more radios crackled and more nurses and prison officers boarded our train.

  ‘All out, all out, all stations. Code Blue on A Wing.’

  I don’t think any of us had a clue what we could expect to see at the other end.

  Sylvie glanced back to check that I was keeping up.

  I was familiar with the double gates that needed to be unlocked and locked to get from one area of the prison to the other. There were four gates that needed to be passed through in order to reach A Wing. Luckily, the person in front held the gates open for the next person to speed things up.

  Clang! I heard the gates slam shut as I arrived onto the second floor of the massive four-storey wing

  The stench of sweat lingered in the air from the prisoners who had been walking the landings minutes earlier. It was association time – the hour in the day when the prisoners are let out of their cells to mingle on the wing. But they’d been locked up prematurely to contain the Code Blue, and they weren’t happy about it. Hundreds of fists pounding against the metal doors, exploding across the four floors.

  I followed the human train along the landing, avoiding the stares of the prisoners leering out of the hatches in their green doors.

  ‘Oi, let us out!’

  ‘You’re having a fucking laugh,’ another man cried from across the wing.

  I carried on marching to the beat of their fists, their eyes boring into me.

  A deep voice, gravelly from cigarettes: ‘I like the look of you, Doc.’

  ‘Shut it!’ barked the prison officer behind me, thumping the door for good measure. I was already ten strides ahead, focused on the crowd standing outside a cell. By the looks of sheer horror on their faces, whatever I was about to see must be truly shocking.

  I pushed my way through them into what I can only describe as a bloodbath. There was blood everywhere – splattered across the walls, on the bed sheets. On the concrete floor, writhing in a pool of his own blood, was a young man with a massive slit across his throat.

  Fortunately, a very competent young doctor called Mark was already there, trying to stop the haemorrhaging. He had been working in the doctors’ room nearby when the alarm sounded. The ambulance was on its way.

  Mark was on his knees, crouched over the man, blood spurting onto his white shirt as he pressed both hands over the gaping wound.

  What had the prisoner used to cause such a wound? A smuggled knife or razor? In that moment it hardly mattered.

  I pulled on my surgical gloves and crouched opposite Mark. We both had our hands wrapped across the prisoner’s throat, desperately trying apply enough pressure to stop the bleeding but not so much that we strangled him, as we were also having to press on his wind pipe.

  It didn’t help that he kept twisting and turning, spluttering words in a language I couldn’t quite catch.

  ‘I think he’s Spanish,’ Mark said. ‘Can’t speak a word of English.’

  The prisoner started squirming again, my hands slipping from his throat.

  ‘Goddammit, can’t we get anyone to hold him!’ I shouted.

  The cell was already too small with the three of us inside. Two prison officers in the doorway grabbed his legs in an attempt to pin him down.

  The pool of blood was growing by the second, spreading across the floor, creeping under my shoes towards the walls. Despite the amount of it, he must have narrowly missed an artery, otherwise he would already have been dead.

  He suddenly stopped fighting us. The colour of his face faded to white, his eyes rolled to the back of his head.

  Mark yelled, ‘Where’s that ambulance?’

  It seemed to take for ever for the paramedics to arrive. With someone’s life literally in our hands every minute dragged impossibly on, with both of us wondering whether he was going to die in that hateful little room.

  I kept pressing on the wound. It looked like raw meat. The blood bubbled up around my fingers, streaming into the man’s long dark hair, matting it in clumps. He was about 25 years old. Trying to end his own life when he’d barely lived, it was tragic. I didn’t even know his name. All I could do was keep talking to him, trying to reassure him.

  ‘You’re going to be fine, we’re going to look after you,’ I said as I continued to plug the wound. I don’t think he could understand what I was saying, I just hoped the tone of my voice would soothe him.

  Suddenly, he jolted back to life and started thrashing around again. It was like trying to catch a slippery frog – there was so much blood everywhere.

  ‘Will someone please hold him down?’ Mark shouted. He knew it was no one’s fault the cell was so small, but we were feeling the pressure, the enormous strain to keep this young man alive.

  ‘Clear the decks, stretcher coming through!’

  At last! Help had arrived, and relief washed over me. We had literally been fighting to hold on to a man’s life. The weight of that, the pressure . . . The knowledge that we were about to pass that responsibility on, and to people with the space and facilities to manage the burden more easily, made me light-headed.

  The people hovering outside parted to make way for the paramedics. There was so much blood on the floor now, the two men had to be careful not to slip.

  The prisoner was completely still again as the paramedics prepared to move him on to the stretcher.

  His head rolled to the side, his eyes were opening, closing, opening . . . and then staying closed for longer each time. He was fading. The paramedics counted down the lift on to the stretcher.

  ‘One, two, three!’ They heaved the prisoner sideways while I continued to press on the wound.

  Just when I thought he had finally died, his eyelids opened. He looked directly into my eyes, staring at me with the most intense gaze. The only thing I could think was Poor bugger, the last thing you’re going to see is me!

  He clearly had other ideas, as he started struggling again like a caged wild animal. I wasn’t sure if he was attempting to make a run for it, or if he was trying to stop us from saving him.

  We pinned him down as the paramedics tightened the straps around his arms and legs. I wanted to scream. ‘We’ve tried so hard to keep you alive, and you’re killing yourself with every movement. Just lie still!’

  But I had to remind myself: dying was, it would seem, exactly what he had wanted. I watched the paramedics carry him off along the landing, hoping for the best. They continued to apply pressure to the wound and get him to hospital as quick as possible. The wound was far too deep and extensive for a quick patch-up. He would almost certainly need a blood transfusion, that’s if he even survived the journey to the hospital.

  The banging from the prisoners was louder than ever, but a deathly silence had fallen across the crowd in and outside the cell. We all looked at each other, stunned.

  Finally, Mark spoke, quietly thanking everyone for doing the best job we could have possibly done. We all shared the same sense of overwhelming relief that we had managed to keep the young man alive.

  We then began to try to find out more about him . . . Who was he? How long had he been in prison? What was his story? Was he on an ACCT book, or was his act of self-harm completely unexpected?

  Nobody knew the answers. He had only been in the Scrubs for a few days. He hadn’t needed to see a doctor, and as far as the staff knew, he was a foreign national on remand for burglary, waiting for sentencing.

  The prisoner’s cell mate, who had raised the alarm, was in just as much shock as everyone else.

  He was a half-Asian guy, with a goatee beard and a shaved head. He must have been on remand, too, because he was wearing his own clothes rather than the grey prison tracksuit handed out to those who had been sentenced for their crime. Just over 60 per cent of the prisoners at the Scrubs were on remand – waiting to hear how much time they would have to spend behind bars. He had a thick coc
kney accent.

  ‘I’ve been coming here for years and years. I’ve been in and out of prison since I was 17, but oh my days, I have never seen anything like that,’ he said, staring in disbelief at the blood.

  ‘Did he seem distressed or agitated?’ I asked. I was still struggling to get my head around the idea that someone could suddenly just turn and slit their own throat.

  His cell mate shrugged, kicking his foot against the wall. ‘Nah, he was quiet, kept himself to himself, hadn’t been causing me any problems. But then I wouldn’t know because I couldn’t understand what he was saying, anyways.’ He coughed harshly. ‘So who’s going to clear this up then? ’Cos I ain’t touching that blood.’

  One of the prison guards stepped in. ‘All right, all right, the Doc doesn’t have time to hear about this,’ he said and ushered him along the landing.

  As everyone dispersed, I asked Sylvie if I could go to the loo. I was still being chaperoned everywhere until I had my own set of keys, which meant I needed someone to unlock the bathroom every time I needed to go.

  We both walked in silence back towards the Healthcare block, still digesting what had happened. I didn’t really need the loo, I just had this overwhelming urge to clean my hands. Even though I’d been wearing protective latex gloves, I could still envisage the blood on my fingers, hard to forget the feeling of its warmth and stickiness as it began to congeal.

  I’d been in the ladies for a while when Sylvie called out.

  ‘Are you all right in there, Doc?’

  I’d slipped into a bit of a trance, letting the cold water wash over my hands, watching it swirl down the grimy plughole. My mind flashing back to the blood spurting out of the man’s throat.

  I was still a million miles away, trying to process what had happened, when Sylvie called out to me again.

  ‘Doc?’

  ‘Just coming,’ I replied.

  I looked up at my reflection in the mirror. My complexion was almost as ghostly white as the prisoner who slit his throat. My shirt was smeared with blood. On my face, splatters of blood! I rubbed furiously at the specks on my cheek with my forefinger.