Lockdown on Rikers

by Ms. Mary E. Buser

  “I thought so,” I smiled.

  When we stood up to say good-bye, we hugged. “Thank you, Miss Buser. God bless you. Thank you for caring about me.”

  And then Jerome Mathis was gone, headed back down to his job in the kitchen.

  25

  On a September morning, it became official: the city had awarded the contract to St. Barnabas Hospital. Few of us had even heard of this small Bronx-based outfit. The media immediately pounced on this low bidder, underscoring its glaring lack of experience in a correctional setting. Regardless, the city was touting St. Barnabas as efficient and up-and-coming, with a reputation for being streamlined and aggressive.

  Once the contract was finally settled, we were thrown into a new kind of chaos: the managerial transfer from Montefiore to St. Barnabas. Since the city was so late in making its decision, St. Barnabas was in a pinch to be up and running for its January 1 takeover. Setting up camp in a local motel, they frantically interviewed and hired hundreds of Montefiore staff. Layoffs did not appear to be imminent. As deals were cut, word spread that St. Barnabas was giving wild increases and placing unlikely people into key positions. The effect was a sense of giddy uneasiness. Weren’t they supposed to be cutting costs? The terms of the three-year contract were no secret; they’d been the low bidder for a contract designed to put money into their pockets for every dollar they didn’t spend. Yet judging by the way things were going, it seemed like the ax was never going to fall.

  But it did.

  One afternoon while Charley was at the motel, St. Barnabas signed him on in his existing position, assistant chief at GMDC, with a generous raise. Thrilled, Charley raced back and urged Pat to go right over. She grabbed her jacket and they both shot out the door.

  But as the afternoon dragged on and Pat and Charley did not return, we became concerned. The following morning we gathered in Pat’s office where she announced the unthinkable—she was leaving. Apparently, St. Barnabas’s generosity wasn’t meant for everyone. Their strategy was to target each jail’s second in command by luring them with hefty pay raises to engender their loyalty while snubbing the chiefs themselves, who, it was assumed, were deeply tied to Montefiore.

  “My last day will be December 31,” Pat said resolutely.

  We begged and pleaded with her to talk with them again, but she would have none of it. Shock waves rippled across the island as news of Pat’s impending departure spread. Within the week, Charley Simms was bumped up to take over, and Janet Waters was promoted to second in command. In the midst of the commotion, our beloved chief began saying her good-byes.

  By late November, with the managerial end of hiring complete, St. Barnabas hurriedly focused on the union. On a cold and blowy afternoon, a group of us trudged down to the river and onto a drab barge that had replaced the motel as St. Barnabas’s recruiting base. One by one we sat for brief interviews. Since we were to be paid union scale wages, there was no haggling about salaries. The interviews were nothing more than a formality, and we left the barge in downcast silence, new employees of St. Barnabas Hospital.

  On January 1, 1998, riding high on the crest of their improbable victory, St. Barnabas Hospital arrived on Rikers Island. Although this was their first foray into correctional health care, they were already brimming with plans to peddle their services to jails and prisons across the country. Rikers Island was just the beginning.

  In the first few months of their tenure, sweeping changes were put on hold while they settled in. Although initially content to coast along with the program they’d inherited, a few changes were implemented, the first being a moratorium on bottled water. The plan was to have the tap water analyzed, and if there was nothing radically wrong with it, then jug water would be a thing of the past. Needless to say, this was poorly received, as was their second change—the installation of time clocks.

  In an effort to calm fears and dampen lingering affection for Montefiore, St. Barnabas held a town hall meeting. Regarding the time clocks, they insisted this was normal procedure at their flagship hospital where everyone, from clerks and janitors to surgeons and administrators, not only carried a time card, but were happy to do so! Punching a time clock, they told us, was an integral part of their innovative, no-nonsense philosophy, a philosophy that was landing lucrative contracts and garnering wide acclaim. And as St. Barnabas flourished, so would we all flourish. It was just a matter of “rolling up your sleeves and getting the job done!” They finished up by telling us how lucky we were to be part of the team.

  But the crowd, not quite convinced of its good fortune, remained glum. When the forum was opened up for questions, only one was asked: “Why won’t you let us have water?”

  That was our first and last town hall meeting.

  Oblivious to the hospital changeover uproar, the inmates, consumed with their own misery, continued to stream into the clinic, and by early 1998 we were busier than ever. I didn’t mind though, as it distracted me from nagging misgivings about our new employer—and, of course, from the aching absence of Pat. Although Charley was a competent leader and Janet was second to none, things just weren’t the same without the chief I’d always known. Nonetheless, the drumbeat kept up: we evaluated the referrals, placed the mentally fragile in our Mental Observation Units, transferred those who didn’t respond to treatment over to the Mental Health Center, and tried to otherwise stabilize and support everyone else in emotional crisis. Weeks slipped into months, and another harsh winter gave way to spring. We welcomed the warmer months but dreaded summer’s heat. Air-conditioning on Rikers was spotty to nonexistent, and with summer’s arrival the jails quickly turned into cement saunas.

  One morning, at the start of another scorcher, I received a phone call that would lead to one of the most devastating situations I would encounter at Rikers. The caller was an officer from the Mental Observation Unit. “It’s Peter Ortiz,” she said. “He’s asking for you. I think you need to come down now.”

  She said nothing more than that, and as I made my way down the stairwell I was concerned. Peter Ortiz was a Vietnam veteran suffering from bipolar disorder. When he’d arrived at GMDC, he was initially housed in GP. Preoccupied with religion, he began proselytizing to his fellow inmates, sitting on their cots and cornering them in the showers. He quickly became a glaring problem and was brought to the clinic, with the referral handed to me.

  Peter was in his early forties, although his jet black hair and boyish face gave him a more youthful appearance. Pacing the waiting room floor, in the throes of mania, he was crying out to his fellow inmates, “Are you believers?” At my session booth, he was quiet for a moment, politely insisting that I be seated first. But after that, the interview went nowhere. Questions about his history, his charges, and his life were mere cues for his religious diatribe. While he ranted, I flipped through his chart and learned that it was in Vietnam that he’d acquired a heroin addiction; and heroin was undoubtedly related to his arrest. The emergency contact person was his mother, whose address was listed as “California.” At this stage of his life I figured he was pretty much on his own. As I filled out the paperwork to transfer him to the MO, Peter rattled off psalms.

  Once he was situated on the MO, the challenge was to get him to start taking a mood-stabilizing medication. Because of his nuisance-like behavior, I was concerned for his safety. Of all the forms of mental illness, I found that those in the manic stage of bipolar disorder are the most vulnerable in the jail setting. Because of their inflated behavior, these inmates aren’t always properly responsive to DOC’s orders. Instead of attributing this behavior to mental illness, it is viewed as an affront to authority, and these inmates become prime targets for abuse.

  Thankfully, Peter had begun the medication regime and his mood was starting to even out.

  But not fast enough.

  When I arrived at the MO, I spotted Peter quietly looking out a window, his back toward
me. But when he turned around, I was shocked to see that both of his eyes had been blackened; they were not just purplish, but the color of coal. His nose, now crooked and broken, was pushed to one side of his face. And when he opened his mouth to speak, his front teeth were gone.

  “Peter, what happened? Who did this to you?”

  “The COs. They did it,” he whispered. “They did it. I was coming back from court last night, and when we got back to the jail, a CO was walking me down the hall. When he saw his buddies, he pointed at me and smiled. Then he disappeared and the two of them came over and pushed me in a corner. I didn’t know what was happening, and then they just started punching me. They were laughing. And you wanna know what they were saying to each other? You wanna know what they were saying while they were beating me?”

  I shook my head.

  “They said, ‘Did you get his nose? Did you hear it snap? Did you get his nose yet?’ Other COs walked by, including a captain, but they just kept on going. Nobody helped me, nobody.”

  Tears were streaming from his blackened eyes, and my own eyes were stinging.

  “Oh, my God, Peter, oh, my God!”

  “My teeth are gone, Miss Buser—my teeth are gone. My nose was broken—and for what? This was a joke to them—a joke!”

  Looking at this poor man’s pulverized face, I wasn’t going to stand by any longer. Suddenly I knew exactly what needed to be done. “Peter, listen to me, we’re going to do something. We’re going to do something here. Let me help you. I’m going to find a way to reach Al Sharpton.”

  “What? Nooooohhh!!”

  “But why not, Peter, why not?”

  “Don’t do anything like that. Please! Don’t you see, they’ll kill me.”

  As he stood trembling, I realized that despite my best intentions, I was actually making this poor man worse. I backed off immediately. Once again, I couldn’t do a damn thing.

  “Promise me you won’t say anything,” he said. “Promise.”

  “I promise you, Peter. You have my word.”

  Back upstairs, I returned to the office and sat at my desk, dazed. Peter Ortiz, a Vietnam veteran, a heroin addict with bipolar disorder, didn’t have a mean bone in his body. The ugliness of this might have been a little easier to bear had he been a heinous criminal, but like so many at Rikers, he was simply a lost soul.

  I continued meeting with Peter in the weeks that followed, helping him with his meds, and just being someone in his life who cared. About a month after the attack, he told me he’d worked up his nerve and told his lawyer what had happened. I praised him for his courage.

  * * *

  I would never know how things ultimately turned out for Peter Ortiz. Like so many of my relationships at Rikers, this one would end abruptly. But it was not because Peter was going upstate or being transferred to another jail. This time, I was the one who would be leaving.

  By the fall of 1998, I’d been at GMDC for three and a half years. My moments with these inmates were rich and poignant—but never were they easy. I don’t think I realized how badly I needed a break from the front lines until I received a call from the unit chief at the Mental Health Center. He had an opening for an assistant chief, and I’d been recommended for the spot. Was I interested?

  I was more stunned than anything else. I had not thought of myself as an administrator. Recalling my years at the Samaritans hotline, and my ultimate discontent as a director, my initial reaction was to decline. Yet something had to give. There are no happy stories in jail, and some days I felt like I couldn’t bear to hear one more account of childhood beatings, of police and jailhouse brutality, or of courtroom injustice.

  Although this promotion would mean that my close personal contact with the inmates would end, I started to consider that a position in management would still enable me to provide our valuable mental health care, but just in a different way. At GMDC I’d come to appreciate strong leaders and recognized that my effectiveness as a clinician was due in large part to the support I’d been afforded. Since I was now a seasoned therapist and also had prior administrative experience, I reasoned that I was in a position to teach and support the newer staff.

  I looked to Janet, who had successfully made the transition to management. “I think you should go for it, Mary Mac,” she said. “I’m proud of you.”

  I would miss my mentor and friend, but I sensed that it was time to move on.

  While I waited for the necessary interviews to be arranged, I went about my daily routine, and one morning, a nice surprise was in store. Out in the hallway, I bumped into my first case at GMDC, Antwan Williams.

  “Antwan—I thought you were gone!”

  “Hey, Miss B! They just transferred me back to GMDC. I’ve been on the island all this time. My case just wrapped up! Can you believe it? Over three years here.”

  A far different person than the desperate man I’d originally met, he calmly brought me up to date. He’d abandoned hopes for trial and accepted a plea bargain of eight years. “No way I’d go to trial with that woman! I’ve got five more to do upstate. But at least that’s better than twenty!” When I asked about his family, he shook his head. “My wife and I split up a year ago. I told her to move on. I can’t take care of them. The most you can make in here is ten bucks a week. What’ll that do? It was hard, but it had to be done,” he said softly. “My sister still brings the kids for visits. They don’t cry anymore. It’s all very different. Pretty soon I’m going to tell my oldest why I’m in here. I told him that when he turned twelve, I would tell him why Papi went to jail. I still love my children, Miss Buser. It hurts—it really hurts. They’ll be pretty grown up by the time I get out. I never knew how horrible this could be. Never.”

  “I hope the next five years go by quickly for you,” I said.

  “You and me both,” he smiled. And then we shook hands and Antwan Williams headed down the corridor, a decent man who’d made a horrible mistake.

  A few days later I was called to the office of the new deputy director of Mental Health, part of the St. Barnabas regime. A sandy-haired woman with thick glasses and a wide girth, Suzanne Harris took a hard drag on her cigarette as she scanned my resume. While she looked it over, I glanced at her desk, which was covered in Yankee baseball paraphernalia: bobbleheads, bat-shaped pens, and, along the wall, pennants and team pictures. Apparently she was a big fan. She put the resume down and asked a few predictable questions.

  A week later I was called back to her office, where I accepted the promotion.

  26

  It was with a renewed sense of spirit that I arrived at the Mental Health Center, home to the city jail system’s most severely mentally ill inmates. This facility was based in a large wing of the Anna M. Kross Center (AMKC), Rikers’ largest jail. Though it was only across the road from GMDC, as I sat in my new boss’s office I already felt like I was in another world. Unit Chief George Davis was a balding, serious man. Joining us was the chipper Karen Doyle, one of two clinical supervisors. An oversized bulletin board listed the staff, over two dozen psychiatrists and clinicians. The place was huge! Karen smiled and pointed to my name, which she had inked in underneath George’s. I felt a flush of pride at the words: “Assistant Unit Chief.”

  “We’re something of a MASH unit,” George explained. “We treat the sickest of the sick—that’s all we do, Mary. Buses pull up at all hours of the day and night from the other jails, and they come across the bridge from the borough houses. It’s our job to get them stabilized and returned to their own Mental Observation Units.”

  “And as quickly as possible,” added Karen. “A big part of our job is to make space for incoming patients. We have 350 beds, which may seem like a lot, but it’s never enough.”

  George suggested a tour, and as Karen resumed her paperwork, we stepped out into the wing that housed most of the Mental Health Center’s patien
ts. “We operate a total of seven houses,” George explained. “Three dorms, four cellblocks. Five houses are in this wing; the other two are in the main jail. We even have our own clinic here, just for our patients.”

  The clinic, known as Hart’s Island, was our first stop. “Believe it or not,” said George, “it was named for Hart Island.” Located a little farther up the river from Rikers, the mile-long Hart Island serves as New York City’s potter’s field. “There’s a lot of folklore on Rikers, but no one knows who named our little clinic and why it stuck, but it has.”

  Inside the curiously named clinic was a battered and clouded Plexiglas “waiting room” where a huddle of raggedy patients coughed and shivered. Since it was count time, a CO stood in front of the window, ticking them off on her fingers. “I got nine bodies in here!” Even though the Mental Health Center was home to the “sickest of the sick,” it was still jail, and with misery etched on their faces, these patients sat passively, seemingly inured to the indignity of being counted like cattle.

  A second, smaller pen served as the psychiatric waiting room, with three patients inside. “They were just bused in,” George explained. One man was singing and rapping his hand against the window, while a rumpled older man paced back and forth. The third was curled up on the floor.

  Next to the pen was the “on call” office, which was staffed twenty-four hours a day by a psychiatrist. The presiding doctor that morning was Dr. John Toussant. “Welcome aboard,” Toussant smiled when George introduced me. “Three new arrivals,” he said, pointing to the pen. “The older guy who’s pacing, I just gave him a shot of Haldol. He should start calming down pretty soon, and then we’ll get him over to the new admissions dorm.”

  “Sounds good,” said George.

  “Aaagghh, nothing wrong with that guy!” said a dour officer seated at a nearby desk.

  “Putney!” George smiled. “Mary, I’d like you to meet Officer Putney. Not much happens around here without Putney!”