I haven’t been keeping up with this situation as much as I should have. It’s a shame that this kind of rant is even necessary or has a reason to be written. You’re going to see me write a lot more of these. It’s not that I plan to permanently abandon the rants against corporate giants like Microsoft, Google, Apple, AT&T, etc. but this hitting so close to home means it kind of has to take priority for now.
Usually I’d split this into two posts. However, I don’t want any break of continuity, so it’s going to be one long one this time.
Two relatively recent articles in the Houston Press, entitled Jail Misery and Jail Hell (both by Randall Patterson) respectively, detail absolutely disgusting, despicable, inhumane, thoughtless, and unreasonable treatment by the Harris County Sheriff’s Department (HCSD) of some of its inmates.
The former article is what really got my blood boiling, and is the one I’m going to primarily focus on. The latter is kind of “more of the same” and can be classified as leisure reading for those whose blood isn’t boiling yet.
Anyway, on with the show. The first article is about Monte Killian, a 45-year-old offshore oil rig cook. According to police, Monte had a rock of crack in his mouth found during a traffic stop in Fourth Ward, and so he was arrested.
The second paragraph of the story is particularly alarming in and of itself, so is quoted here:
The U.S. Department of Justice had recently found that “certain conditions at the [Harris County Jail] violate the constitutional rights of detainees.” Justice officials were especially concerned with the jail’s health care system and “found specific deficiencies in the Jail’s provision of chronic care and follow-up treatment.” “Indeed,” they wrote, “the number of inmates’ deaths related to inadequate medical care…is alarming.”
And not surprisingly, HCSD denies it. Both county attorney Vince Ryan and the county’s media manager, Christina Garza, establish a horrifying and despicable pattern of denying wrongdoing and downplaying the very real and documented problems with the county’s medical care.
And Monte, who has AIDS along with other medical issues, definitely needs his medical care. Monte was without his medication for most of a week (July 31 to August 5) after his initial arrest, then was re-arrested for reporting late to a pre-trial drug testing on September 11. It is this, Monte’s latter stay in jail, where the really troubling part of this story begins.
Monte’s partner, Stephen Calmelet, began talking to the Houston Press when Monte was without medication for a week during the second stay. Finally, Monte gets his medication (it’s not clear from the story exactly when) from a “very apologetic” doctor. I’d like to think the doctor’s apology was genuine; the cynic in me seriously doubts the sincerity, however.
The story continues:
[Ms. Garza, the county’s media manager,] asserted by e-mail that “Mr. Killian has not been ignored, nor have his medical requests been denied.” More than that, Garza said, she couldn’t say about him, because of federal privacy laws. Can Killian waive his privacy rights and grant me his health records? Garza allowed ten days to pass before sending a brief e-mail: “Mr. Killian has stated that, in his best interest, he would like to withhold the release of his medical records and is satisfied with the care that he has received thus far here at the Harris County jail.”
Now, we’ll get back to this later. I apologize for any dizziness induced by that incredible spin job there at the end; were I a PR person, I’d never take such liberties with the truth.
If Monte really was happy with his medical care, that’s certainly not what he told his partner Stephen. We get to the part of Randall’s story where he interviews Monte, and we find out the truth (quoting the story again):
No, [Monte] certainly wasn’t satisfied with his medical care, he said. What happened was, he’d been taken alone into a room with a sergeant and “some officer in charge of media relations.” The media officer, who was male, had said to him, “You don’t really want your personal health information splashed all over the newspapers, do you?” And under those circumstances, “in fear for my safety,” Killian said he really did not, whereas now, he said, “I do think, out of civic responsibility, I should allow my situation to be publicized.”
It turns out the story gets deeper: everyone on a prescription who goes to jail has a break in their pill-taking regimen. What’s alarming, however, is that lapses in HIV treatment tend to be longer than the average. The jail clinic could easily call the inmate’s doctor and confirm the HIV claim. Instead of doing this, what do they do? They test the inmate all over again! Why? This makes no sense at all.
It’s all about the money. Monte was identified as having AIDS during his first trip to jail. He got his warfarin pills to treat the blood clots in his left leg almost immediately, without testing. Those cost $0.50 per pill. The Atripla for AIDS, on the other hand, costs $50 per pill, and Monte didn’t get those pills until September 19. (For those unfamiliar with HIV/AIDS medications, Atripla is actually three different drugs combined into one pill, part of the reason it’s so expensive.)
On September 22, Monte was found to be running a fever. He goes to the clinic. The first doctor to see him does something bordering on malpractice: he sends Monte back to his cell. Thankfully, the doctor on the next shift has a sense of humanity and medical awareness, calls Monte back to the clinic, and writes in his file: “Fever in a patient with AIDS. Transfer to LBJ [Hospital].”
A few hours later, Monte’s back from the hospital in his cell, a notation on his medical record for “strict ER precautions, return if worsening of symptoms/condition,” a prescription of a higher dose of warfarin (15 milligrams instead of the 10 milligram “subtherapeutic” dosage he was getting), and a new prescription for the antibiotic azithromycin. Thankfully they know what they’re doing at LBJ. Of course, sadly, that does not matter as much as it should…
On September 28, Monte has to tell a clinic doctor that the orders from the hospital are still being ignored. The doctor orders the higher dosage of warfarin in an underlined, circled, all capitals “NOW.” On October 1, he gets his azithromycin, but is still only getting the 10 milligram dosage of warfarin. Apparently, an underlined, circled, all capitals “NOW” was beyond the grasp of whatever idiots were working the pharmacy. The records end with October 7 so it is not clear if the warfarin dosage was ever increased.
On October 18, Monte runs out of his Atripla, the expensive AIDS medication. He’s without it for three days, on top of the week he was without it after being re-arrested, and the week without it after the initial arrest. That’s 17 days out of about three months.
Quoting the story once again, we come to a truly frightening turn of events:
Calmelet noticed that he began looking pale, “that internal-sickness kind of pale.” Killian himself wrote that he was having not just fever with “a great amount of sweat” but also chills, “severe headaches, nausea, blurry vision.” Believing that many of his symptoms were caused by an overdosage of Dapsone, another antibiotic he was taking, Killian tried to change the dosage, and when he couldn’t, stopped taking the Dapsone. Knowing the state of his immune system, he also stopped eating from the trays that were brought him, which he said were dirty, and instead, bought food from the commissary and drank only from sealed containers.
Now, let me explain something, and unfortunately, this is from my own personal experience as a former inmate. Lest anyone try to imply otherwise, I’m not proud of that in the least, but I put that out there in the hope what I say next is a bit more credible as a result.
When one becomes an inmate in an institution, whether it be a county jail, state penitentiary, or what have you, one’s needs become the responsibility of the agency running that institution. This includes food, shelter, and medical care. The mealtime trays are paid for by the agency (HCSD), and served to every inmate. Due to his compromised immune system, caused by the county’s Monte spent his own money just to eat. As an inmate, there is no way to land a paying job, so Monte is at the mercy of generosity of others and/or any money he may have earned in the free world. The food prices are ridiculously inflated, as well. A package of ramen noodles which costs maybe $0.15 at a grocery store sold for $0.50 as of the last time I checked years ago, and is probably higher now. Other items have similar markups; some are actually close to not being a ripoff.
Monte originally planned to take his case to trial, and rejected an offer of two years’ probation. By October 28, Monte pleads guilty. Not necessarily because he was guilty, but because it was the only way he knew to save his life.
And that part is what I believe to be absolutely, positively, unmistakably wrong. Even if the charges are true and the evidence is irrefutable, it is absolutely, positively wrong to deny medical care to a human being with a terminal disease, just to coerce that person into pleading guilty to a crime.
After being released the next morning, Stephen takes Monte to see his regular doctor. In the span of less than two months, Monte’s blood pressure went from 130 over 74 to 96 over 66, he had lost 20 pounds, and was jaundiced with blood in his nose and his stool.
Monte’s condition was so bad that the doctor immediately sent him to the emergency room less than one day after his release from jail.
At the hospital, tests reveal Monte has two forms of cancer (liver cancer and Hodgkin’s lymphoma), almost certainly not helped by the precarious state of Monte’s immune system during his time in jail.
Not surprisingly, Ms. Garza, the county’s media manager was less than thrilled with the journalism of Randall Patterson, and she lobs back this e-mail: “Mr. Killian’s medical issues were always promptly addressed by the physicians… Overall, our medical care professionals believe there are no indications of adverse outcomes and no indication that Mr. Killian was in a life-threatening situation.”
Liar, liar, pants on fire! I’ve never seen such a blatant lie. Shame on you, Ms. Garza! It’s people like you make the entire profession of public and media relations look bad. I’m horrified that my tax dollars pay your salary. The truth, the documented truth, is the exact opposite of this dollop of bovine excrement that frankly isn’t even worthy of the label “spin-job.” The vital signs alone between the two doctor visits are enough to completely discredit any notion that Monte’s medical issues were anything close to properly and promptly addressed. If HCSD’s medical staff took such great care of Monte, why was he in the emergency room the day after his release?
I’m being realistic here. I’m not expecting the jailhouse to become a taxpayer-funded imitation of the Hotel Zaza, or for that matter, even Motel 6. But to me, it is painfully obvious that HCSD either wilfully or negligently fails to respect the dignity of the human beings it is responsible for as inmates of its jail system.
I don’t care what kind of slick PR job Ms. Garza thinks she’s pulling here; this is the kind of spin that makes weaker men vomit from dizziness. The right thing to do in this situation is apologize. Apologize profusely, and communicate with the people one is apologizing for to be sure future incidents are being prevented. The rules of PR relations do not change when working for a government agency. They don’t!
I find HCSD’s intimidation tactics and loaded questions from its media officers (such as “You don’t really want your personal health information splashed all over the newspapers, do you?”) to be distasteful and obviously self-serving of its own best interests as opposed to the people’s. I find it horrifying we have sociopaths in charge of the care and custody of Harris County’s jail inmates, many of whom have not been found guilty of a crime and are merely awaiting trial.
I’m glad we have good people like Randall Patterson that cut through the crap and report the truth. I’m glad we still have the First Amendment in the USA; I probably could never post a similar piece about local jails as a resident of, say, China.
And Monte… I’m glad you’re alive, and I hope you make a full recovery. Your suffering was and is not in vain. Not on my watch.