The campus of the prison was a fairly large and open area on a slope with five housing units, administrative areas, facility and factory areas, and our medical facility, called a hospital but more of a clinic with a handful of overnight/observation beds. Regarding the factories, the Federal Prison System maintains a widespread industrial and manufacturing operation that, for example at Ray Brook, produced gloves for the military. Most convicts were employed (and paid small amounts), which curiously had a major impact on medical services, to be discussed later. Even though the pay was little, if you were some lowly crew member caught smuggling drugs out of Columbia, did your in-prison job regularly and saved your money, at the end of your sentence you could have a few thousand dollars in your pocket when you were deported back to your village.

The routine at the hospital included “sick call” Mon-Fri (no inmate could be refused an appointment), with most of the patients being seen in the morning but often spilled into the afternoon. Staff included six PAs, a physician (often a young person doing payback for medical school government grants), a psychiatrist, pharmacist, dentist, and several support staff. There was a regular, four times a day “pill line” in which prescriptions were dispensed or convicts received their meds directly, either controlled substances or when they were viewed to be unreliable- in this case they were required to open their mouths to confirm the med was swallowed (there were ingenious ways to “tongue” the drugs for resale in the living units).

As with anything in life, no one can claim any given demographic always believes this or does that, but convicted criminals are kind of self-filtering and do tend to share similar characteristics. In general a criminal acts out of selfishness, covetousness, greed, or an inability to delay gratification. A prison is an excellent place to witness this in action on a daily basis. There is a type of person- a sociopath- who exhibits all these characteristics, but additionally feel absolutely no remorse for their actions. A non-sociopath criminal might murder someone during a robbery and feel bad about it, whereas a sociopath would justify the killing and even blame their victim. By no means are all convicts sociopaths, but they are certainly well represented in the prison population. One thing to remember about sociopaths is that they will do absolutely anything to satisfy whatever desire they might have, including acting like the nicest, most compassionate person you’ve ever known.

In the prison population lying is about as common as breathing: lying about anything at anytime and often without consideration of consequences or even believability. I received a call from a living unit that a convict was in so much pain he could barely walk, though he thought he could make it to the hospital on his own. I said to send him down and watched out the window. The living unit door opened and a young man, who was the only person out on the compound, jogged down the hill without hesitation, but as he approached the hospital he began limping and showing evidence of great pain. I let him in the hospital and mentioned what I had observed. His response was not, “okay you caught me” or even “the pain went away for a moment so I was able to run here,” but a flat out denial: “it wasn’t me!” I clarified that out of 800 convicts he was the only person on the compound, and he stuck by the “it wasn’t me” story. Why do people do these things? Who knows, but type of behavior was non-stop.

Are there innocent people sent to prison, a perpetual question in the world of criminal justice? I can say of the 100s of convicts I knew everyone was guilty. Nevertheless, on rare occasions justice was not served. Convict JP was a mildly retarded black guy from Georgia doing Federal time for counterfeiting. What?! He was a mandatory “open your mouth at the pill line” patient, and once he refused to do so, which meant a trip to segregation. He cried and begged me not to send him to “seg,” but I did: there was no option and I actually- the only time- shed a few tears in doing so. Supposedly his “counterfeiting” involved trying to pass off a black and white photo copy of a $20 bill. Indeed it was a crime, but you have to wonder what kind of moron the prosecutor had to be, and what kind of idiocy effected the system, to send this hapless person to prison.

In a similar occurrence, but on the other side of the social spectrum of convicts, was an inmate who refused to open his mouth a the pill line and became mouthy, protesting , “I have rights!” This was a white guy from a wealthy family. I politely asked him to step aside, and at one point he threatened me with “I’m going to call my mother at the country club!” For real. As he was waiting for me to finish the pill line it dawned on him that he was shortly to be placed in segregation, and he declared, “Okay, I’ll open my mouth.” Perhaps it reflected poorly on me, but I enjoyed sending that privileged weasel to segregation.

While convicts could do the darndest things, staff were not immune. One weekend day our aforementioned psychiatrist appeared and invited me to look through a window to the visiting room. He pointed out a woman who was not unattractive but clearly had made some bad choices in life that were evident in her appearance. Our distinguished healer asked, “Fitz, doesn’t she drive you f...ing crazy?!” How does a lowly staff PA respond to such a statement? I meekly replied, “I guess she’s kind of pretty.” It ended up our man of letters was exchanging sex on the outside with this convict’s girlfriend for supplying drugs to her inmate paramour. As far as I recall, this psychiatrist was bundled off to Philadelphia, where he was to use his healing powers in service to the Dept. of the Navy.

A pleasant enough black inmate showed up on sick call with a sore throat, which proved to be gonorrhea. Public health concerns prompted me to ask if he was a homosexual, to which he responded, “I ain’t no faggot!” I rephrased the question and asked if he engaged in oral sex with any of his fellow inmates, to which he clarified, “Well yeah, but I ain’t no faggot.” I believe that little outbreak of gonorrhea was quickly contained.

An older and hard-lived street guy- I don’t recall his crime but it wasn’t violent- gave me some advice. He said, “when you see a homeless guy begging for money to get something to eat, he ain’t going to spend the money on food, he’s going to use it to buy another bottle of Thunderbird.”

As I mentioned, most convicts were assigned jobs; some were skilled and some were givens factory labor type positions. We had inmates assigned to the hospital for cleaning, and at various times included an older Cuban gentleman who did something illegal trying to overthrow Fidel Castro, an older low-level Mafia guy (not too bright), and a young guy who truly took pride in his work. For the most part the convicts went off to their jobs without complaint, but a good number, lacking a work ethic (they weren’t criminals for nothing), spent much time and effort in trying to be excused from work for medical reasons so they could lay about in their housing units. This was a huge challenge from a medical standpoint: separating them from truly ill. Lots of convicts are not intellectuals nor deep thinkers, and their pretensions at being sick could be both humorous and absurd. On the other hand, there were some impressive actors, with well researched and rehearsed presentations of pathology (“I am experiencing acute substernal crushing chest pain radiating to my left arm with shortness of breath”). For the most part we- the medical staff- did not want to miss something real so we were probably BS’d more than we should have been.

One evening shift a young Afghani convict (heroin trafficking if I recall) came to the hospital for an EKG- some kind of abnormality had been found on his admission exam. He didn’t speak a word of English and, despite my reassuring gestures, was terrified. As we laid him down and attached the electrodes his lips quivered and tears leaked. It was evident he thought he was being executed, and as we finished the procedure and unstrapped him, he had a look of relief I’ve rarely seen in life. I kind of admired the guy for his stoicism.

Once in a while a CO (correctional officer) would suspect a convict of receiving contraband (mostly drugs) from a visitor and secreting them in clever places, most commonly the rectum. One of the less enviable tasks of the PA’s were resultant “cavity searches.” One such case was brought to the clinic, where I was eventually able to extract a baggie of dope from his ass despite his bucking and kicking out at me. A while later I saw him on sick call and asked him why he kicked me. His response was obvious: “I didn’t want you to find the weed.”

At the literal other end of the gastrointestinal tract, I was called one evening shift to a unit with the CO reporting an inmate having a seizure. There was quite a bit of blood when I arrived and the convict was repeatedly jabbing a pen into the back of his throat. What had happened was he swallowed some cocaine balloons, felt they were rupturing, and he was aggressively trying to make himself vomit. In a bit of irony, ultimately all the balloons were recovered intact, so he kind of ratted out himself.

There are jobs and life experiences that aren’t fertile ground for interesting recollections, but the prison world is very fertile indeed; people who spent longer than me in that environment undoubtedly could fill volumes. It was an excellent place to gain an insight into human nature, albeit mostly the darker side. 40 years later many lessons have remained, with me, and some are increasingly pertinent today:

1) There are truly bad people in the world, people who can generically be termed “sociopaths.” Certainly a higher concentration of them can be found in the convict population, but there is no shortage of them in any human endeavor (think politics), people who will do anything to get what they want- lie, cheat, steal, kill- and feel no remorse whatsoever. Similarly, plenty of sociopaths will go the other way, eg/ be charming, polite, solicitous, friendly...”he seemed like the nicest guy in the world,” but it’s all to obtain a selfish end, and they may well turn on you in a flash if the good guy approach doesn’t work. It’s okay to be trusting, but be smart.

2) There seems to be a disturbing cultural fad at the moment where a number of things, including medical care, are encouraged to be prioritized based upon skin color, ethnicity, sexual predilection, and other various demographics. This is antithetical to the practice of medicine, something seen where tyrants rule. Never did we- the prison medical staff- provide favorable (or lower quality care) to an inmate due to such factors, including the crime for which he was incarcerated. There was no, “he’s a murderer (or drug dealer or rapist, etc), so I’m not going to order an otherwise necessary test or not give him a medication he needs.”

3) Another cultural fad is described as criminal justice reform or something similar, with a dose of “equity” thrown in. In looking at the tenets of these proposals- essentially an end to the traditional bail system, “defunding” police, redefining crimes so as to turn formerly significant crimes into trivial ones- it’s almost as if the activists and supporters of such “reforms” have never actually met a criminal, let alone have a clue as to what is going on in their minds. While not claiming that criminals want to be incarcerated (though some certainly do), they generally know the score and play the odds. This idea, for example, that if they steal items less than $1,000 in value it won’t be prosecuted, is like an invitation to an open bar to an alcoholic.

Now, as in my prison time 40 years ago, black people (more specifically, young black males) make up a disproportionate number of convicts. The reason for this is obvious: they commit a disproportionate number of crimes. The “activists” claim this is due to a nefarious and ubiquitous “racism,” and probably there has been historically a discrepancy in, for example, sentencing: Winthrop Winchester, III of Andover whose father is a lawyer and political donor, might well get off on a charge of drug possession while Leroy Deshawn Robinson of the projects, whose father took off before he was born, might well do time for the same crime. Yet crying “racism” is a superficial anodyne, a means to deflect why Leroy’s father abandoned him. It has been a long time since Martin Luther King actually talked about right and wrong and responsibility; the vacuum created by his murder was quickly filled with race hustlers under the guise of “civil rights leaders” who found fame and fortune by casting criminals as victims, and passively, if not actively, justifying criminal behavior. The irony is, of course, that by far most of the victims of young black criminals are black people, with the greater irony that “criminal justice reform” measures are often the brainchildren of insulated elite white people and are not typically supported by the black population they pretend to embrace and defend.

I suspect there will always be employment opportunities in the world of jails and prisons. Perhaps “equity” will mandate there be less black convicts and more white ones, perhaps legalizing drugs and redefining other crimes will lead to a transitory reduction in the number of convicts, but a combination of societal factors- our great societal wealth not leading to altruism but to increased greed, constant yearning for more of and the latest in material items, endlessly flexible standards of right and wrong, the decline of any meaningful counterweight to abject selfishness and ego-centrism, disdain for the concept of personal responsibility- will inevitably lead to more crime. Either the people will react to it and insist the pendulum swing back to “law and order, or we’ll dissolve into anarchy. If the latter happens, just sing to yourself the old REM song, It’s The End Of The World As We Know It (And I Feel Fine).