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A Day in the Life of a Mental Health Team in a Solitary Confinement Unit

2/28/2017

 

 

This excerpt from “Lockdown on Rikers,” recalls an incident that occurred during my first week as an Assistant Mental Health Chief in the Rikers Island 500-cell Punitive Segregation Unit.

***********************

 

        On my second day at the Otis Bantum Correctional Center, I was in my office in the clinic when I received a call from one of our psychiatrists, Dr. Diaz. He requested that I come up to the 4th floor of the Central Punitive Segregation Unit, otherwise known as “the Bing.” My being called up to this unit meant there was a decision to be made, and as I walked through the jail, I was nervous.  I’d heard many stories about this infamous unit when I’d worked at other jails on Rikers, never imagining that someday, this is where I would be working. After I’d passed the gate that separates the main jail from the five-story Bing, I proceeded to an elevator bank and stepped into an empty car. Since I was going to the fourth floor, I held up four fingers to a corner camera, waiting to be spotted on a TV monitor.  As the car lifted, the errant cries of punished inmates echoed throughout the cavernous tower, and I winced at the sound of a particularly piercing howl.  When the door rattled open, a swarm of officers were hovering around a captain who was pressing a radio to his ear.  From what I could glean, an inmate had set fire to his mattress.  The captain shouted some orders and they poured into a stairwell and pounded up the stairs to put the fire out.  The inmate would be “extracted” from his cell and “arrested” for arson.  Despite the heat, despite the additional legal charge – despite the possibility of death – I was already learning that fire-setting is a common ploy to gain relief from the torment of solitary.

 

        My arrival at this fourth floor wing was met with ferocious noise as the occupants of the cells were railing violently against their confinement. Bodies thumped against the doors. Faces – dark skinned and young -- were pressed into the small windows, and sweaty palms slid down the plexiglass.  As I walked past, they cried out to me, “Miss! Help!  Please, Miss!! Please!!  Fighting my natural urge to rush to their aid, I reminded myself that they’d done something to warrant this punishment – hurt another inmate, perhaps – maybe cut someone.

 

        I kept my eyes trained on Dr. Diaz and Pete, one of our therapists, who were standing in front of a cell at the far end, with its door slightly ajar.  

 

        “Welcome,” Pete smiled, wryly.

 

        Dr. Diaz motioned me to the side of the cell.  “His name’s Leonard Putansk -- he’s been going downhill for a while – we’ve done the usual -- upped his meds, talked to him, but we’ve got to make a decision here.”

 

        Although the Mental Health Department could authorize a temporary reprieve for inmates in solitary, we were under fierce pressure not to do so – “If you let everyone out who threatens suicide or injures themselves, you’ll wind up with 500 empty cells,” was the advice I was given. But of course, we were also to ensure that the suicidal gestures did not result in death. It was a fine tightrope that we were expected to walk.

 

        “I don’t think he’s ready to come out yet,” said Diaz, “but we’re getting close -- there’s a lot of blood.  I think you need to take a look and then we’ll decide.  You ready?”

 

        No, I wasn’t!  But I steeled myself and nodded.

 

        The officer pulled the door open to reveal a claustrophobic cell, the cement walls smeared with crimson stains.  A burly young man in a sweat-soaked T-shirt sat on the cot and sobbed, his back to me.  But he turned around quickly, his forearms slathered with blood.

 

        “Please, Miss! Please!  Help me!  My family -- they’re in Kosovo – I don’t know if they’re dead or alive with all the fighting going on over there!”

 

        “I’m sorry about your family,” I said, softly.  “That must be very hard.”

 

        “It is -- it is!  I’ve already been in here for three months now – they’ve got me down for another six!  They wouldn’t do this to a dog!  I’m going to kill myself!  You gotta get me out of here!  I can’t take this anymore -- I can’t!  I’m telling you, I can’t.”

 

        “Okay, just a minute now,” I managed, stepping back out.

 

        Dr. Diaz motioned me out of Putansk’s earshot.  “It looks worse than it is,” he said.  

 

        “He’s picking at his skin -- it’s superficial.  He’s trying to make it as dramatic as he can so we’ll pull him out.”

 

        “He’s doing a pretty good job,” I said.  “So, why don’t we pull him out for a while?”

       

        “It’s not that simple,” said Pete.  “He’s desperate, but they all are -- we can’t pull them out just because they’re miserable – that’s the whole idea.  We only intervene if we think his life is at stake, and at this point, I don’t think it is – although he’s going to up the ante.”

 

        “Well, if we know he’s going to do something more drastic, why wait?”

 

        “Because we can’t give in,” Dr. Diaz replied.  “If we do -- they’ll all start cutting themselves and threatening suicide.  It’s a tug of war, Mary -- welcome to the Bing.”

 

        “But he’s already been in there for three months!  With six more to go!”

 

        “That’s nothing,” said Pete.  “In these Super Maxes they’re building all over the country --- they throw people in that cell for the rest of their lives – ‘Here’s your life – a square box.’”

 

        I shuddered at the thought.  A human life – relegated to a box – how could this be happening in the United States – a country progressive on human rights?  

 

        Since Dr. Diaz and Ron were both disinclined to pull him out, I deferred to their experience and the three of us went back to the cell and informed him of our decision.  In response, Putansk howled and beat the walls with his fists.  “We’ll get someone from medical to take care of those cuts,” said Pete.  Dr. Diaz nodded to the C.O., who shut the door and locked it up.  As we made our way out, Leonard Putansk’s agonized wails seemed to follow us.

 

        As the day wore on, I tried to focus on other matters, but I kept thinking about Putansk.  I hoped he was doing a little better.  When we didn’t hear anything more, I relaxed a little.  But the following afternoon, the call came:  “They’re cutting someone down – a Leonard Putansk.”

 

        My stomach knotted at the words:  “cutting someone down.” I pushed my paperwork aside and put my head in my hands.  I was not cut out for this. The phone rang again, and this time it was Dr. Campbell, the Rikers Island Director of Mental Health. Somehow, the news had already reached him. "Find out if he's dead or alive and call me back," Campbell snapped.

 

        I forced myself out into the clinic where a swarm of officers, keys jangling at their sides, were running the gurney down the main aisle.  In the examining room, Putansk was quickly surrounded by a sea of white lab coats.  In the thick of things was Dr. Diaz, who waved me in from the doorway.  As I reluctantly approached the table, Diaz put his big arm around my shoulders and ushered me up to the semi-conscious inmate, pointing to the thick pink welt where the sheet had dug into his neck.  

 

        "He's OK," Dr. Diaz smiled.  "Don't worry -- he's going to be fine.  I knew he was going to do something, but he timed it for when a C.O. would be walking by.  We'll send him to the hospital and he’ll get a little breather."

 

        “He’s going to be okay,” Diaz reiterated, in response to what must have been my ashen face.  For him, this was everyday stuff, but for me it was all new – and all horrifying.  As Leonard Putansk was stabilized with a neck brace and wheeled out to a waiting ambulance, I didn’t see how I could possibly come to terms with my new post in the solitary confinement unit.  

 

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