Whatever their crime or sentence, prisoners should not be legitimately fearful of choking to death on their own vomit every time they climb onto their prison bunks. But this is a daily worry for federal prisoner Paul Shook. The Federal Bureau of Prisons, known colloquially as the BOP, has devolved from its small, exclusive “Club Fed” country club reputation of 30 years ago to become the largest penal system in the country. Its size and the traditional governmental practice of funding bureaucracies over services leaves the Bureau of Prisons unable to provide even basic requirements daily living for many of its prisoners.
This disgraceful treatment has caused 49-year-old Mr. Shook, a former adjunct professor of computer science in his state's community college system and a first-time felon, to remark, “some nights I wish I would die (during one of my vomiting episodes).”
How did the system get so broken? There are just over 211,000 prisoners under the control of the BOP and this year they are receiving approximately $6.1 million of your hard-earned taxes to support these prisoners. That averages about $29,000 a year for a prisoner like Mr. Shook, or more than 50% over the poverty line for a family of four and over 20% more than his declared income the last year he was “free” — when his medical problems were properly handled.
Perhaps this is due to prison administrators such as Julia Heard, health services administrator at the Federal Correctional Complex in Tucson, Arizona. Under the watchful eyes of Ms. Heard — and the previous health services administrator who retired the same day a prisoner died in the medical unit, at least four physicians and many more physician’s assistants and nurses quit or transferred from the facility and at least one more doctor refused the job after completing the application process. Now there are no staff positions available to treat Mr. Shook or the over 2200 other prisoners housed in the complex. This is more ironic when noting that this complex is only one of three (out of almost 98 across the United States) designated solely as a “care level 3 medical facility” — specifically for prisoners needing serious care, just short of hospitalization.
Ms. Heard, however, has diligently kept all the administrative positions fully staffed. Perhaps she feels that pushing paperwork is more important than pushing pills — similar to food service which feeds the bureaucratic monster ahead of prisoners.
Unfortunately, her staff cannot even keep the paperwork straight. Four days ago, Mr. Shook visited the medical unit, hoping to update is “lower bunk pass” — which he requires so he doesn't fall out of bed during his multiple nightly trips to the toilet, vomiting the food his surgically damaged stomach cannot process. The physician's assistant (who controls care because she has no staff position to “assist”) instead, improperly updated the records of another prisoner, with a completely similar name, prisoner number, and even housing unit.
When Ms. Heard received a polite report of the mix up, rather than fix it, she challenged Mr. Shook, suggesting he was lying and that somehow, despite his multiple college degrees, he misread the paperwork. In response, she was told that Mr. Shook was the subject of this article, and she could read the truth in this paper.
Paperwork is not the only thing that was screwed up for Mr. Shook. Back in 2006, he was formally diagnosed sleep apnea — and the nightly use of a C-PAP breathing machine was prescribed. This was prior to Mr. Shook’s incarceration when he was free to visit Dr. Thomas Cotney of the Hendricks Medical Center. Since Ms. Heard did not believe Mr. Shook or his medical records, she wasted valuable government funds on an overnight oximetry study in February of this year. That too showed that Mr. Shook literally stop breathing several times a night. But this also was not sufficient for Ms. Heard.
On May 27, just before Memorial Day weekend, Ms. Heard spent over $3,000 of taxpayer money (I personally saw the bill) to send Mr. Shook to Northwest Medical Center in Tucson for yet another overnight “sleep study.” As Senior Correctional Specialist Pino and others watched, Mr. Shook not only stopped breathing in his sleep, he woke up from one episode gasping and choking. Perhaps Ms. Heard does not believe the medical results — or even the reports of her fellow staff members — as Mr. Shook still does not have a C-PAP machine or any other sleep accommodation.
Bureau of Prisons administrators have been quick to back up Ms. Heard — a former employee at their Washington DC “central office,” a place regarded by many as an ideal jobsite due to high salaries and isolation from actual prisoners. Written responses to complaints document their agreement with Mr. Shook’s lack of treatment and state that there is no concern on their part for the lack of on-site or staff physicians.
Mr. Shook's frequent vomiting stems from failed gastric (stomach stapling) surgery. The need for corrective surgery was documented also back in 2006 — when Mr. Shook could control his medical care — by Dr. Yogish Patel who actually put a scope down Mr. Shook’s throat and into his stomach.
Ms. Heard and her “utilization review committee” has made at least three consecutive decisions that Mr. Shook needed neither treatment nor even diagnostic tests for his problem — that external monitoring by a physician's assistant was sufficient. (Perhaps she believes that they, like Superman, have x-ray vision to see Mr. Shook’s stomach damage — because she also refused to order the x-rays that human doctors require.)
Until he is surgically fixed, Mr. Shook requires a highly specialized diet. He requires more protein and less carbohydrates than the typical prison diet. He must consume multiple very small meals (instead of the scheduled three large ones), and all food must be made small enough to pass through his damaged stomach opening — about the width of a pencil. Without this diet, his body causes him to vomit out the stomach contents instead of passing the food through his digestive system.
At present, his dietary needs are recognized, but not accommodated by staff. This violates not only the Americans with Disabilities Act, but also the Constitution's Eighth Amendment prohibition of cruel and unusual punishment.
Perhaps if he stops buying Commissary food — his only alternative to the unpalatable chow hall food — he can save enough money from his 45¢ per hour job as the lead in prison laundry to pay the $355 filing fee for a federal civil rights laws.
Until then, he you can comfort himself with is the hope that “the evolving standards of decency that mark the progress of a maturing society,” first mentioned by the US Supreme Court in 1958, will quickly come to the Federal Correctional Center in Tucson and he will be able to eat — and sleep — in peace.