Next to Evans, Teddy Gibson smiled shyly. Barely out of his teens, he was lying on his cot, jiggling his legs to the tune on his Walkman. Gibson’s forearms were covered with pink crisscross scars. Kelly told me he was highly impulsive and that, after suffering chronic sexual abuse as a child, the undercarriage of his personality was so fragile that the slightest negative nuance sent him into a self-destructive tirade, as his cut-up arms attested.
As we toured the dorm, we’d acquired a quiet tag-along in the form of George LaRoche, who spoke like someone who was well educated. Wearing canary-colored sweat pants that draped from his thin frame, he became our unofficial guide. Ushering us up and down the rows of cots, he introduced me to Victor, a plump thirtyish fellow in a New York Mets baseball cap and a pair of oversized, jail-issued eyeglasses. When Victor looked up, his eyes went off in different directions. Mentally limited, he’d emptied out a bag of potato chips on a patch of smoothed bedding. “I don’t think they gave me the right amount,” he explained. As he lined up the chips, he told me about himself. “My mom got shot in the belly when she was pregnant with me. The bullet went right through my head. Yeah—that’s what happened. Well, I have to count my chips now. Bye.”
Kelly said that Victor had been arrested on a drug charge, either as a lookout during a drug deal or as an unsuspecting courier. It wasn’t unusual for drug dealers to exploit those with limited mental faculties for various low-level tasks.
George steered us to Ruben, another pal of his with a Jamaican accent. Ruben jumped up to show off his inside-out jacket, its Ralph Lauren label barely clinging to the collar. “You see this?” he said, twirling around. “When I’m here, I wear it like this. But when I go to court,” he said, removing the garment, turning it right side out and slipping into it, “I’m all ready for the judge.”
“Very nice!” I applauded.
“He even wears that jacket to sleep,” chirped the patient next to him.
In any other setting, I would have attributed this jacket routine to an eccentric aspect of Ruben’s mental illness, but in here, I had to admit it was a creative solution to the problem of holding on to one’s court clothes.
Off to the side were two small interview rooms cluttered with old furniture. “I don’t know how they got to be so junked up,” said Kelly, “but they need to be cleaned out so we can use them for sessions—if for no other reason than confidentiality. Right now, the sessions are taking place in the corners of the dorm—no good!”
Kelly also mentioned that group therapy had fallen by the wayside, and patients were only being seen individually. We agreed that we needed to get therapeutic groups back up and running as quickly as possible.
On our way out, we stopped by the bubble to visit the MO officers, a big, sandy-haired CO and his smaller, freckle-faced sidekick. Not exactly hard-nosed officers, Hartman and Burns came off more like a Laurel and Hardy comedy act.
“Welcome to the nuthouse!” Hartman grinned.
Burns, with one hand tickling the top of his head, and the other patting his stomach, hopped around the bubble. “Hooh, hooh, hooh.”
“Meet our steady officers,” Kelly said wryly.
“Sooo,” said Hartman, “you just met a few of our nuts?”
“I prefer to think of them as our patients,” I countered.
“You say potahto—we say potato!” joked Burns, with Hartman slapping his knee in laughter.
Although their sentiments were no surprise—the same as their correctional brethren—these two were essentially good-hearted and well-meaning, a very good sign for us.
As we departed the dorm, I figured managing these fifty beds would be a breeze compared to the 350-bed Mental Health Center. Of course, the tradeoff was that I’d be administering services to general population. And then, of course, there was the matter of the Bing.
I was anxious to finally see the infamous jail within jail, and after a meeting was coordinated with the punitive unit’s newly installed deputy warden, Kelly and I set out for the five-story tower, which was structurally attached to OBCC.
“I’m glad we’re meeting with him,” said Kelly. “It’s really important that we have a good relationship with the dep. I hate to tell you this, Mary, but our biggest challenge in here isn’t the mentally ill or the guys in GP. Far and away, it’s the Bing. Those five hundred cells are always full, and most of these guys are on psych meds—for hallucinating, crying, talking to themselves, defecating, refusing to eat.”
“That bad?”
“I’m afraid so. All four of our psychiatrists carry heavy Bing caseloads. Thank God for the meds. But even with them, a lot of times they reach a point where they can’t hang on anymore, especially if they have long solitary sentences. They get to the end of their rope and start banging their heads, cutting their arms, and trying to hang themselves.”
“And then what?” I asked uneasily.
“Well, obviously, we try to calm them down, talk to them, maybe change the meds. But if we think somebody’s really going to die, then we pull him out and send him over to MHAUII.”
“Sounds like a tropical island.”
“Yeah, hardly. More like ‘Mental Health Assessment Unit for Infracted Inmates.’ Sort of an MO for Bing inmates. All it really is is eight cells in another one of the jails, but it’s smaller and closely monitored by Mental Health staff. It gives them a little relief. But once they’re better, they’re bused right back here to finish the sentence. We’re under a lot of pressure to keep them in, though, because once we send one out, they all start threatening suicide. On the other hand, we can’t have anyone dying. It gets tricky—you’ll see.”
I got the feeling there was a lot I was going to see that I might have preferred not to.
At the end of a long corridor, a lone officer sat in an elevated Plexiglas booth. Heavy black lettering along the wall spelled out the words central punitive segregation unit. We held up our ID badges and the officer inspected them closely. He nodded and the heavy black gate started moving open on its track. We stepped inside, turned a quick corner, and came to an elevator bank.
“They connect to the higher floors,” Kelly explained. “We have a few minutes before our meeting, so let’s peek in at the first floor.”
Kelly rapped on a long tinted window positioned between two plain doors. “The door on the left is 1 South,” she said. “The one on the right is 1 Southwest—fifty cells on each side. It’s the same layout on all five floors.” A CO thrust out a logbook and we signed in. Kelly told the officer that we wanted to go into 1 Southwest. A loud buzz followed, and we pulled open the door on the right.
Cavernous and dimly lit, 1 Southwest was nothing more than rows of sulfur-colored steel doors, one after the next. At the top were little windows, and on the bottom a narrow flap for food trays. The windows were all empty. “They may look empty,” Kelly whispered, “but it’s full capacity in here—they’re still sleeping. This is the only time it’s quiet in here—the only time there’s peace. They’re in these cells twenty-three hours a day—no TV, no radio. They’re entitled to one hour of rec, but most don’t bother with it. They’ve got to be cuffed, shackled, and taken to an outside cage to stand alone and ‘recreate.’ It’s a joke.”
Along the walls, cameras were conspicuously mounted. All Bing activity was carefully monitored, the fallout from a class action suit brought against the city for brutality in the punitive unit when it was located in the House of Detention for Men, the original Rikers jail. Among other horrors, Bing officers had routinely inflicted “welcome beatings” as inmates arrived to serve their sentences. Reports of fractured skulls and perforated eardrums were rampant. As a result, the punitive unit in the old, decrepit jail was shut down and the infracted were transferred to this modern tower, where all activity was monitored by camera.
A set of stairs led down to a processing desk and shower area
. At an empty shower stall, Kelly made a glum announcement. “This—is the Mental Health Office.”
“A shower stall?”
“Yup. Pretty pathetic, huh? Up until recently, we’ve been seeing these inmates by going from cell to cell and talking through the doors, but Legal Aid’s complaining that yelling through doors violates confidentiality. And they’re right, but it’s not an easy fix. So, the solution DOC came up with is to give us an escort to take these guys out of their cells and bring them down here for privacy. Problem is, we’re not always getting this escort. That’s what I want to bring up with the dep. Then maybe I can work on getting us a real office in here.”
Kelly looked at her watch. “Let’s go.” We departed the eerie 1 Southwest, ducked into a side stairwell, and walked up to the second floor to the dep’s office.
I don’t know what I expected of someone in charge of a punitive segregation unit, but I definitely didn’t expect the warm and friendly deputy warden Alfred Mancuso. Seated behind mountains of paperwork, a trail of cigarette smoke curling up from his ashtray, Dep Mancuso jumped up to shake our hands. “Hello!” he smiled. In his mid-forties, he was of medium build, sported a dark crew cut, and was well educated, as his framed master’s diploma attested. Beside the diploma were citations, certificates, and ribboned medals for completed marathons; Mancuso was a dedicated runner. On the wall adjacent to his desk, five long rows of TV screens captured the activities on each floor of the Bing.
Pushing papers aside, he issued directives to a couple of captains who’d followed us in and motioned for us to sit down. “So, Mary,” he said after we were introduced, “what do you think of the CPSU so far?”
“Kind of quiet,” I replied.
“Quiet! Hah! It’s still early. As soon as the meals start, the mayhem begins. Just as soon as we unlock the slots to put food trays through, out come the arms—swiping, hitting, grabbing. And lately it’s been really bad. They all know I’m new here, so I’m being tested. We’re getting a big increase in use of force. At the beginning I expect it, but once these guys see I’m consistent and mean what I say, the numbers should come down. That’s what usually happens when there’s a change of guard—least that’s what I’m hoping. I’ve been with the department for close to twenty years, and nothing prepares you for this. But there’s no getting around this post if you want to become a full warden. You first have to prove yourself in the Bing. Let’s see if I survive it,” he smiled.
He paused as a scene on a monitor caught his attention. His eyes narrowed and he dragged hard on his cigarette, watching as a handcuffed inmate was led out of his cell. Satisfied with how it was being handled, he returned to us. “Okay, where were we?”
“Well,” said Kelly, “our immediate problem concerns confidentiality.” She outlined our dilemma and explained that the warden had promised us an escort. “The thing is, the escort isn’t always showing up.”
“Well, now, I can see how the cell-to-cell arrangement would work well for the department. It’s a hassle to pull these guys out—they’ve got to be searched, cuffed . . . but if the warden’s made that commitment, then I guess that’s how it’s got to be.” He thought for a moment and said, “How’s this: I’ll make sure you get an escort every morning. If nobody shows up, call me immediately.”
“That’s great,” Kelly said with a note of relief.
“Happy to help. After all, it’s the psych meds that make this place even slightly manageable. Plus, I’d really, really like to avoid suicides. So, if you have any issues in here—anything at all—my door is always open.”
“Thank you,” we said.
With business concluded, Mancuso dared us to sample some of the hot peppers he kept in colorful jars on his desk and told us a couple of corny jokes. As we laughed, I was uncomfortably aware that just outside his office, hundreds of human beings were awakening to another day of grim isolation.
32
Shortly after my arrival at OBCC, Kelly took a weeklong vacation, leaving me to run things alone. Given my administrative experience at the Mental Health Center, I felt okay with it, and things started off smoothly. The office coffeepot was the early morning gathering place, and I enjoyed chatting with the crew before the day began. Theresa and Kathy prepared to assess the morning GP referrals while Lynn Cosgrove, wearing a taboo Montefiore lab coat, would start off on the MO. While we sipped coffee, Dr. Diaz, keeping one ear attuned to the early morning chatter, puttered with the plants that sat atop the file cabinets. Pete Majors, the primary Bing clinician, had the longest commute, and he and Dr. Christian were the last ones to rush in and join us before things got under way.
After everyone had cleared out, my first order of business was the basket of referrals. I logged each one in, careful to ensure they’d be evaluated within the seventy-two-hour mandatory timeframe. Toward the bottom, one referral puzzled me. A Bing inmate named Rafael Ramirez was complaining of numbness and tingling, which struck me as a medical issue. I pulled his chart and was surprised to see that he’d recently been evaluated by Mental Health three times, with chart notes indicating nothing more than irritability and anxiety. The attending psychiatrists must have considered even that to be mild because they’d prescribed no medication. I took it up with the chief physician, who was also baffled as to why the referral was given to mental health, and he agreed that medical should check him out.
The following day, Dr. Sackett informed me that the medical team’s efforts had been thwarted because Ramirez was in court. On Wednesday morning, he’d completed his Bing sentence and was transferred out of OBCC.
By Thursday morning, I’d forgotten all about Ramirez when I got a disturbing call from Janet. “Mary, did you hear the news? There was a suicide, a hanging at AMKC, general population.” I sat up straight. While suicide attempts were an everyday occurrence on Rikers, completed suicides were infrequent and, for the Mental Health Department, particularly upsetting. Although our interventions kept suicides down to a handful a year, we could not prevent them all.
“And I hate to tell you this,” she added, “but he was just transferred from the Bing.”
“The Bing! What was his name?”
“Rafael Ramirez.”
Rafael Ramirez! How in the world did numbness and tingling translate to suicide? I got off the phone with Janet and started pacing the room. This was terrible. What happened when he’d gone to court? Maybe he’d been given a stiff sentence. I just didn’t know.
Even though I’d never met Ramirez and he’d killed himself in another jail, this was the closest I’d come to a suicide. When I’d been a clinician, I was fortunate that, of the hundreds of depressed inmates I’d worked with, none had killed themselves. But when it had happened to others, Montefiore Hospital, our former employer, was always supportive, bringing staff together, allowing us to talk and grieve. But it was a new day, and the phone had yet to ring with a call from St. Barnabas.
As the day wore on, I learned through the grapevine that his chart had been found in proper order, with all protocol followed. This brought a certain relief, but of course it would not bring the dead young man back. I kept reviewing the sequence of events, wondering if there might have been a different outcome if I hadn’t referred him back to medical. But even if I’d scheduled him for another evaluation, his appointment wouldn’t have been until the tail end of the seventy-two hours, at which point he would already have been gone from OBCC. It would have made no difference. Still, I felt I needed to talk this out with my superiors, so I stayed close to the phone. But by Friday afternoon, when there was still no call from Central Office, I realized that the support we’d been afforded by Montefiore was a thing of the past. Instead, I simply said a quiet prayer for the soul of Rafael Ramirez.
The following Monday Kelly returned, to my great relief. The suicide had unnerved me, and I didn’t want to run things alone anymore. But it wasn’t to be. Just as
George had sat me down when I started at the Mental Health Center, Kelly did the same. No, she wasn’t quitting, but she was taking time off for a surgical procedure. Recovery would be anywhere from two to eight weeks.
Kelly’s announcement hit hard and, in hindsight, was my strongest cue to get out. But I didn’t see it. What I saw was that we had a great staff, a manageable building, and with it the potential for high-quality work. If this was the final hurdle before things settled down, I could do it—especially if Kelly was only gone for two weeks, although in my heart I knew that was unlikely. Kelly had already had several run-ins with St. Barnabas and wouldn’t be rushing back anytime soon. Realistically, I was looking at the full eight weeks—if she returned at all. In a phone conversation with Hugh Kemper, he tried to be encouraging. “Kelly’ll be back before you know it. And don’t forget, I’m interviewing for a clinical supervisor, so that spot could be filled before she even returns. Let’s think positive, Mary!”
I wanted to believe him, but when we hung up, I knew I was in for a long, hot summer.
33
On Monday, June 14, 1999, I took over as acting chief of Mental Health at the Otis Bantum Correctional Center. Despite my nervousness, I was buoyed by the staff; they rallied around me and even pitched in with some of my administrative tasks.
In some ways, things got off to a promising start. I was especially pleased with developments on the MO, where Theresa tackled the problem of the dorm’s unused interview rooms. Since cleaning them out required DOC’s assistance, and because DOC dragged its heels with anything beyond its own security concerns, I wasn’t overly optimistic. But when Theresa approached the MO captain, he responded favorably. Captain Catalano, an eager young man, agreed to have the junk removed and the rooms painted. Although Theresa explained that a cheerful environment would be beneficial to the patients, I think he was far more interested in Theresa than the mentally ill. Regardless, he fulfilled his promise, and we now had two usable rooms for individual sessions. Building on this, with Catalano’s permission, Theresa and Kathy brought in plants and old paperbacks for the patients to read.
Lockdown on Rikers Page 24