Kites and other Prisonisms

When you have to go through a metal detector and three electrically bolted doors to get to work, you know you're in prison.

I am quickly becoming acquainted with the fascinating culture of the correctional system...and trying not to break any rules I don't know about. Today I got scolded by one of the nurses for telling a patient when her consultation with the GI doctor was scheduled. What I should have told her was that her appointment would be "very soon." (Like that's a satisfying answer to someone who can't even swallow liquids without choking and regurgitating...) Apparently, if the inmates know when their outside appointments are, it could be an escape risk and "you could get fired for that sort of thing." Being a contractor, I didn't get to partake in the month long "academy" that all correctional employees go through. This where they learn the cardinal rules of prison, like not telling inmates when their appointments are, while reading books called Games Prisoners Play. Employees also take a pressure point training class so they can subdue a threatening inmate with a single finger to the Mandibular Angle, or other sensitive areas. (I also saw an email for an "interesting" Spontaneous Knife class...I can only imagine the pearls they pick up there!)

But until I become a real DOC employee, I have to learn my prison survival skills on the fly.

Other prison idiosyncrasies include:
-Officers checking to make sure all the car doors in the parking lot are locked several times a day...otherwise they will lock them for you. Another escape prevention precaution I guess...

-Walking to the clinic in the morning and and hearing "Offender so and so, please report for your 7:30 cosmetology appointment" over the PA. (Need a manicure at a discount at sunrise? There's a cosmetology school in prison, and acrylic nails are very popular among the medical staff.)

-Having to ask permission from an insurance company for every imaging study or specialist consultation...and the answer is usually is no. (I have a template for my appeal letter :)

One of most charming prisonisms is the newly created communication system where inmates write their appointment and refill requests on a small piece of paper called a kite, which the nurses have to log daily. Sometimes I have to review the kites and "kite them back." Have a dental problem? Better kite dental. Want a refill on your psych meds? Kite mental health. (Did I mention medical and mental health are totally separate in prison? No psych here for me.) Then at the end of the visit, I have to "close the kite out" in the computer tracking system. I love how kite is both a noun and a verb, and a major pain to the nurses. I think it's very poetic to think of the inmates writing and sending kites. They could at least make them diamond shaped.

More prisonisms, including lockdowns and excerpts from the hilarious prison emails I receive, coming soon.

The Baader-Meinhof Phenomenon

Since I started working in prison, I have become highly attuned to stories of prisons and prisoners on the radio and in the news. On my daily drive, my ears perk up for any NPR story on the prisoners of Guantanamo...China...South America. Seems like prison stories are everywhere, even inundating me on my [fabulous] 3 day weekends...or maybe it's the Baader-Meinhof phenomenon. Ever learn a new word or topic (usually obscure) and then start noticing it all around you? (Like when I went to the Nuggets v. Suns game last weekend and noticed the Suns' point guard Steve Nash...then Monday I heard his name in the lyrics of a Nelly Furtado song...oh, Canadians...) Anyway, you think it must be an amazing coincidence that the new information is suddenly everywhere! How did you never notice it before?! (One theory is that the brain has a bias for recognizing recently acquired information and patterns, termed the "recency effect.")

Such has been my experience since working in prison. And not always in a good way.

I really try to avoid knowing the legal history of my patients. It seldom has anything to do with why they are in my exam room, and I don't want it affecting how I treat them. I think a lot of the women may be there on drug charges, but others have convictions for sexual offenses and murder. Anyway, imagine my surprise while reading the newspaper last weekend to find a big article about of of my patients. Cringe. Then moments later, there was story on tv about a prisoner who escaped from Colorado Department of Corrections 7 times, which I had heard about briefly at work. The tv story described him building a huge copper ladder and climbing over the electrically charged "kill fence" before being apprehended by the escape recovery team.

And now that you know about Baader-Meinhof, you will probably notice it. Everywhere.

http://www.9news.com/news/article.aspx?storyid=165313&catid=339

Chocolate Heart

Prisoners have been known to be manipulative in the medical clinic, and I have been known to be on the naive, trusting side of the spectrum. (While on rounds as an intern, I presented a patient with the history of being chased all night by "meth heads." Incidentally, his legs looked like they were covered in tree bark. This tale caused my program director's mustache to twitch into a sly smirk during my presentation...Later, when the patient claimed the meth heads pulled up to his hospital window in a tanker truck and that the nurses were in a meth ring, I became suspicious.)

In prison they call my type the "chocolate heart," chocolate for short, or "don't go all chocolatey on us!" The last doc in my position was the opposite of chocolate, and I don't mean vanilla. Perhaps sour grape?

In medicine, the doctor who gives out the narcotics is the "candy man." Fortunately for me, there isn't a lot of candy to give out in prison. No one is on chronic narcotics, and even drugs like neurontin require approval by special committee. (Apparently, there are all kinds of meds you can get high on, and all sorts of ways to procure your meds, despite having an officer shine a flash light in your mouth after you swallow.) Of course, many inmates have "burning, tingling nerve pain" and it's hard for this chocolate heart to separate the wheat from the chaff. I'll just go back to eating tootsie rolls in my office.

Bringing it back

I've been inspired lately by the resurrected blogs of my residency pals and my ample free time in Pueblo hotel rooms to bring the Kenya blog back. This time there won't be any accompanying slides shows of cute animals...I work in a prison and cameras aren't allowed. Let me summarize the past few months and then we'll get back to prison.

I finished residency in June and was off all of July. Post graduation, I enjoyed a fabulous cruise with my family to Alaska (complete with several nights in the cruise dance club--Skywalkers--with my sisters, Matt and even Granny!) I also spent a lovely week in Mexico with Alyson (want to try the best guacamole and salsa ever in Puerto Vallarta? look me up...) Finally, I managed to pass the boards, check out some fab hikes with The Hiking Club, and having happy hour prn before starting work as a faculty for my residency in August. When I wasn't fending off the questions of super smart residents, I was tackling items on my Seattle to do list like full moon kayaking, enjoying the Seattle arts scene, and taking a few last laps around Green Lake.

At the end of September, Chelsea, Matt, & I shoved all my worldly possessions into a 6x7x8 "Relocube" and drove to Denver. All that stuff about 300+ days of sunshine is true! I acclimated well to the gray skies and mizzle of Seattle, but the sunny rays sure are nice! No more "I-should-go-outside-since-it's the only-sunny-day-all-week-but-would-rather-sleep-in" Seattle guilt --it's always gloriously sunny in Denver!

October brought a month of unemployment, interviews, and travel while trying to settle in to my new digs. My Seattle treehouse has been replaced with a 3rd floor Congress Park "penthouse" (Being on the 3rd floor and having a dishwasher are the main luxuries...storage and quiet are not the penthouse's forte...I may re-dub it the "Icebox" until my heat is fixed and my Raynaud's improves.) Which about catches us up to the present day: Room 316, La Quinta, Pueblo, CO.

Yes, Pueblo is 2 hrs south of Denver, and I recently moved cross country to be closer to Matt. However, I'm doing locums work (which has the flexibility I wanted), have a 4 day work week, and actually am really enjoying correctional medicine at the women's prison. More to come about life beyond the razor wire fence...just don't bring in a camera or cell phone!