The Prison Doctor

by Dr Amanda Brown

  ‘Nah, let him face the music tomorrow,’ she growled. She then turned and marched off in the opposite direction, switching the alarm bell off on her way.

  Chapter Nine

  I had barely placed my bag down in the doctor’s office when I was immediately summoned to an emergency on D Wing.

  All the prisoners were locked in their cells, but there was a crowd of officers gathered outside a ground-floor cell.

  ‘It’s not good, Doc,’ one of the officers muttered as I walked past.

  I took a deep breath and entered the cell.

  Lying in the half-dark, in a crumpled heap on the concrete floor, was a man in his seventies. His wrinkly, sinewy body was covered in blood and bruises. There looked to be a discrepancy in the length of his legs; I imagined he had a fractured femur. His internal injuries could – in fact probably would – be considerably worse, possibly life threatening.

  ‘There’s an ambulance on the way,’ said one of the officers.

  The old man coughed violently, blood spraying out of his mouth.

  I touched his shoulder lightly.

  ‘Please don’t try to move,’ I said.

  His skin was turning purple with bruising. His wispy white hair was soaked in sweat and blood.

  I asked the officer if he knew why the man had been attacked.

  ‘They found out what he was in for, Doc,’ he said, giving me a knowing look. ‘He’s a nonce.’

  The old man was a paedophile, I had suspected as much.

  Some crimes and acts of brutality are so beyond my comprehension that the only way I can cope is to block off all thoughts of them. All I could allow myself to see was an old man who had been brutally beaten up. He must have been terrified when they came at him, herded into a corner where the security cameras would be blind to them, surrounded by a group of men he couldn’t possibly defend himself against. He must have thought he was about to die. Perhaps he had been right.

  I sorted out some painkillers for him and waited for the ambulance to arrive.

  ‘Stand back,’ one of the officers yelled. The paramedics were finally there. ‘You need to go, Doc,’ he said to me. ‘Some sort of panic on B Wing.’

  I didn’t even have time to oversee the old man being carried off. I slung my medical bag over my shoulder and marched out.

  *

  It was only early afternoon and I was already feeling exhausted. The morning had been hectic, with a lot of prisoners kicking off, causing drama and adrenaline levels to rise. I peeled off my surgical gloves and tossed them onto the growing pile of medical waste in the pedal bin. I’d just stitched up a man who had taken a razor to his legs. Cuts like screaming mouths from knee to ankle. It was so heartrending seeing someone self-harm, and I wished I could do more than just patch them up.

  I let out a sigh and made my way back to the gates of the Healthcare wing. Time for a coffee and a snack – I had worked through lunch again.

  As I walked along, I heard someone behind me. I turned round, and to my utter disbelief, shuffling my way was the last man I’d ever expected to see again.

  With the huge gash across his neck held together by staples, there was no mistaking the Spanish man whose throat I’d held together with my hands.

  It was association time and so most of the prisoners were milling around. Some were waiting their turn to play pool on the small table while they watched the others play.

  He was trying to catch up with me but he was a bit short of breath. Perhaps he was still a bit anaemic, so I took his arm and gently steered him towards a chair where he could rest.

  He looked up at me with his big dark eyes, longing to say something but lacking the breath.

  I couldn’t help but stare at the huge gash. It was a miracle he was alive. He’d wear the scar tissue like a scarf for the rest of his life.

  I rubbed his arm. ‘It’s okay,’ I smiled, trying to calm him.

  He closed his eyes for a moment, just as he had done when I thought I was losing him, and then opened them wide, staring intensely into mine. Clutching his throat with his left hand, he mouthed, ‘Thank you.’

  My heart filled with joy. There’s always a worry, when you save someone who has tried to kill themselves, that they’ll hate you for it. I speak from sad experience.

  I squeezed his hand and smiled – a universal expression that wouldn’t be lost in translation. All the ups and downs and exhaustion of the day were suddenly worth it.

  I held his words close as I walked away. They would be armour to throw on whenever feelings of self-doubt crept in.

  ‘You need help with that, Doc?’ Sylvie spotted me waiting for someone with a key. I nodded, overjoyed to see a friendly face.

  I glanced at my watch. I had ten minutes before I needed to be at my security training meeting, where I was hopefully going to be handed my own set of keys. I was still new and yet these last few weeks had been the most traumatic, but also some of the most rewarding, of my life.

  *

  My ears were ringing with all the information that had been passed on to me over the previous two hours. All the new staff and agency workers, like me, had been cooped up in a room, learning about prison security. I’d discovered that a seemingly innocent piece of chewing gum could be used by the more ingenious prisoners as a means of escape – by taking impressions of an officer’s keys. Under no circumstances was I allowed to bring it into the prison. Same went for Blu Tack – which explained why some cells smelt minty, as some of the prisoners used toothpaste as an alternative to stick their pictures on the walls.

  Also on the banned list were spiral-bound notebooks. If the spiral fell into the wrong hands, a prisoner could use it to pick a lock.

  Obviously, mobile phones were forbidden.

  ‘They may look harmless enough,’ the officer presenting the security talk said. ‘But don’t be fooled. Phones can be as lethal as the drugs that are smuggled in. They can be used to carry out criminal activity, to harass victims, to set up drug deals, and they can also be used as currency in the prison. An old Nokia mobile would go for £300 to £400!’

  A little gasp of astonishment was let out by everyone.

  After a fascinating talk, during which I learned all about contraband and all of the strict security rules I needed to obey, I was finally going to be allowed to draw keys.

  I would be given a black circular piece of plastic with a number on it, called a tally, which I would hand in at the gatehouse in the mornings, in exchange for the exact combination of keys I would need to pass in and out of the clinical rooms and the wings. I wasn’t allowed keys for the cells. If I needed to visit a prisoner in their room, for whatever reason, I would have to ask an officer to assist me.

  But the really important message was left until last.

  The officer took a deep breath before hammering home the point. ‘Under no circumstances, and I mean no circumstances’ – he raised his finger – ‘are you to inform the prisoners who have been given hospital appointments, when their appointment is or where.’

  A few of the nurses gave a knowing nod, while the rest of us were looking sideways at each other, a little perplexed.

  He cleared his throat. ‘As some of you know, last year what should have been a simple transfer to Hammersmith Hospital, ended in tragedy.’

  Those whispering at the back of the room suddenly fell silent.

  ‘A prisoner inside for armed robbery convinced one of the doctors that he was so poorly he needed to be referred to hospital to see a specialist. Unfortunately, he managed to find out the date, time and location of the appointment, and then tipped off his mates. Three of our officers were ambushed outside the hospital by men wearing balaclavas, pointing guns at their heads.’

  The room was now deathly quiet as we all tuned in to the story.

  The officer paused for a moment, rubbing his forefinger above his eyebrow, as if he was struggling a bit to come out with the next part of his story. We were hanging on to his every word.

  �
��The men told our officers that they would shoot them, unless they released their friend. Obviously our boys took the cuffs off, because no one is worth dying for.’

  Everyone murmured in agreement.

  ‘We caught the guy after a couple of days on the run, and he got a few years added on to his twelve-year sentence. The police found one of the ambushers, but not the other.’

  Someone from the back asked, ‘What about the prison officers, were they unharmed?’

  The officer telling the story paused for even longer this time, and I had a terrible feeling the answer wasn’t going to be a ‘happily ever after’ ending, otherwise he wouldn’t be telling it.

  The officer reached for his glass of water behind him on the desk, which had stood untouched until then. He took a careful sip. ‘Unfortunately the incident ended the careers of those involved, and we lost three excellent officers. Tragically, one of them became so depressed and anxious he even attempted suicide.’

  A silence fell. I was just as lost for words as anyone else.

  ‘So that, ladies and gents, is why we don’t like to send anyone to hospital, unless it’s a life-or-death situation – especially on a Saturday or Sunday when we are more likely to be short-staffed. And if they do have a hospital appointment, they must never be told of the date or location in advance.’

  The warning was heavily directed at me and all the other healthcare workers in the room. It was unsettling to think that our decisions could come at such a high price.

  ‘So please, make sure that you keep any information regarding hospital appointments under your hat, right up until the last minute. That way there will be no time to plan an ambush.’

  And just as he was concluding his talk the alarm sounded.

  Chairs screeched as everyone got up and dispersed. I went straight over to the gatehouse to get the tally, so that I could exchange it for the same numbered set of keys, but the keys I was given felt heavily loaded with responsibility. I couldn’t even begin to imagine what it must have felt like for those officers to be held at gunpoint. To see their lives flashing before their eyes. Choosing whether to let a prisoner escape, or risk being killed, was a million miles away from the kind of decisions I used to make in my cosy GP practice.

  It was going to take more than a horror story to put me off though. I attached the keys to the chain and tucked them in the leather pouch on my belt, and decided that the best way to get through life in a prison was not to think about it too much, not until I really had to.

  Chapter Ten

  It was a sorry sight, watching the new prisoners arrive at the Scrubs, dragging their large see-through plastic bags filled with all their possessions.

  Sitting in the doctor’s room in Reception, I could hear the bags sweeping along the corridor outside. They shuffled into the large holding cell opposite, the heavy sound of the door locking behind them. There, they’d wait to be screened by the nurses. The diversity of people coming from the Crown and magistrates’ courts into prison varied enormously. It was like the A&E department of a hospital. I didn’t know who was coming through those doors, nor what state they would be arriving in. I had to brace myself for everything. It could be rude, aggressive men, who were withdrawing from drugs and alcohol, many of whom were frequent attenders, or people who had never been in prison before, who could be nervous and shell-shocked. People from all ethnicities and walks of life, from wealthy, high-profile people to the homeless. Many of them shared the same shock and horror of being in prison – apart from some of the homeless men, who were happy to be in prison, just so that they would have food and shelter. The majority however, were very anxious. Occasionally some of them broke down and cried when they sat with me, knowing they were out of sight of the other men.

  The new arrivals were screened by the nurses first, and there were usually two, sometimes three working the evening shift.

  At 8 p.m. everyone had to move from Reception on the ground floor, to the First Night Centre on the fourth floor, to continue screening the new arrivals. So, along with everyone else that evening, I went up to the FNC until my shift finished at 10 p.m.

  As usual, I had no idea what crimes the prisoners had committed, though the nurses would let me know, should the prisoner be accused of something particularly savage: murder, or a crime of extreme violence, as these prisoners would also need referring for a mental-health assessment.

  I was warned about Azar by my dear friend Haj – one of the nurses – not because of the nature of his crime but because he was clearly in shock at being in custody.

  I was reading through the Dubai man’s notes when he was shown in.

  I was a little taken aback by his presence. Despite being very unsure of his surroundings, the young man still carried himself with grace and elegance. He was tall, slim, with striking looks. I could immediately tell he came from money by the quality of his clothes. He was wearing a cashmere jumper and perfectly pressed chinos. His shoes looked of the finest quality leather.

  His voice was soft and educated. ‘Shall I sit here?’ He pointed to the plastic chair adjacent to my desk.

  His big brown eyes were wide, like a rabbit caught in headlights.

  I smiled. ‘Yes, come and sit down.’

  I’d been warned that I should always leave my door open, and be the one sitting closest to it. That way I could escape quickly if I ever needed to. On the wall to my left was a big red alarm button in case of an emergency.

  The room was small but clean. The thick, cloying smell of detergent hung in the air, a precursor to the cells the prisoners would be moved to next.

  Azar looked around, nervously.

  ‘I shouldn’t be here,’ he said trembling.

  ‘Are you okay?’

  He started shaking his head in disbelief.

  ‘What am I doing here? I shouldn’t be here!’

  At that moment there was an almighty crash outside my room, followed by shouting and an ear-piercing scream.

  ‘Get off me, get the fuck off me!’

  Azar froze as he watched a man being dragged along the corridor by three burly officers, his legs kicking in all directions, his T-shirt yanked up around his neck, exposing his pale hairy body.

  ‘Oh, Jesus!’ Azar whispered.

  I wished I could close my door to drown out the drama, to keep him calm, but I knew that wouldn’t have been a good idea.

  Instead, I offered him the only thing I had to hand – my reassurance.

  ‘You’ll be okay, try not to panic,’ I said.

  Prisoners who were withdrawing from drugs, or who were on long-term medication for something like HIV, hypertension, or mental-health problems, would be given priority, as they would need to be seen before the end of the shift, so that their essential medication could be written up. I had the challenge of filling in the gaps until the prisoners’ medical records were faxed through to the Scrubs, which usually took around twenty-four hours. That is, if they were registered with a surgery. Many of the homeless men were not.

  From the notes that Haj had quickly made, I knew Azar was a diabetic on insulin. I didn’t have much time, and I needed to get his medication sorted before he was shown to his cell.

  ‘I’m going to be seeing a lot of you,’ I smiled. ‘The prison is very strict about not allowing inmates to administer their own injections.’

  Azar looked even more horrified and panic-stricken, if that were possible.

  ‘But don’t worry, you will eventually have an in-possession risk assessment, and you will then be able to self-medicate and keep all your medication in your room. But initially the nurses have to administer it for you.’

  ‘Okay,’ he mouthed.

  I went on to explain that all medication, except creams for any skin condition, and inhalers, had to be given out by the nurses on the wing until it was clear that a prisoner was going to take his medication regularly and reliably, and also that they were not at risk of overdose, nor of using the needles to attack another prisoner.


  All colour had now drained from his face.

  Azar suddenly stood up, only to wobble and fall back down into his chair.

  ‘I know this must all seem very frightening, but you will be well looked after, I’ll make sure your diabetes is under control,’ I promised.

  It must have been so shocking to be suddenly wrenched from his life of luxury and detained in custody. And then to be told that, on top of that, he no longer had control over his illness and medication. He must have been terrified; his world turned upside down.

  I tried to keep him talking, to take his thoughts away from the brutal reality of the situation.

  I looked him in the eye. ‘Azar, you will be okay. Are you here on remand?’

  He lifted his gaze.

  ‘Twelve months on remand, but I might be extradited.’ He quickly added, ‘But I didn’t do it.’

  ‘It’s okay, you don’t need to tell me, I’m here to help you, not judge you. I don’t have access to your prison records, just the medical ones, and that’s the way I like it,’ I explained.

  ‘But I want you to know, they are accusing me of fraud but I’m innocent.’

  That catchphrase ‘everyone is innocent in jail’ was now ringing in my ears.

  ‘Any history of mental illness?’ I continued.

  ‘No.’ He shook his head.

  I softened my voice. ‘Any history of self-harm? Do you feel like you might want to hurt yourself?’

  He shook his head again. His perfectly styled black hair falling back into place each time.

  Silence filled the room as I completed my entry on the computer. The medical records had recently been computerised, and I was still feeling my way around the system. Azar’s eyes were transfixed on my hands, tapping away at the keyboard with my embarrassing one-finger-typing skills.

  I was coming to the end of my shift, but despite feeling tired I wanted to find out more about Azar. He was clearly struggling so much to come to terms with being in prison.

  ‘Do you have any family who you can turn to?’ I asked.

  He sighed deeply.