One year ago today, Robert Sillen toured San Quentin State Prison for the first time. He’d been put in charge of health care for all of California’s prisons by a San Francisco federal judge who was angry that state officials had done little to improve care.
What Sillen observed on that visit a year ago pushed him to launch sweeping reforms in prison health care. But has it done any good? To find out, KPCC’s Julie Small visited San Quentin - the penitentiary federal receiver Robert Sillen chose to be his laboratory for reform.
The buses that carry convicts to San Quentin rumble to a halt inside a chain-link fence looped with barbed wire. The inmates step off, and two guards unlock their leg chains and handcuffs and dump them into buckets.
“New arrivals get what’s called a fish kit with personal items,” said Lieutenant Eric Messick. “Toilet paper, tooth brush, razor...”
Messick says San Quentin processes about 350 prisoners a week for 17 counties. “And this is the pants we issue them, and they’re all inscribed 'CDC prisoner.' It’s orange with black lettering.”
After officers take prisoners’ mug shots, medical staff take their vitals.
Michael James McClure, from Vallejo, waits in a holding tank. “I have high blood pressure.” McClure’s been here before and had trouble getting his medicine.
California’s prisons keep paper medical records that take two weeks to arrive. “So there’s times when I didn’t get my medicine, I’m having headaches, dizzy spells.”
Federal receiver Robert Sillen toured the medical facilities at San Quentin on his second day on the job. “We discovered very quickly what a horrid place it is.”
Staff worked in a converted cell with no running water – except for the water mixed with soap and hair that streamed down the wall from the showers on the floor above. The prison’s trauma center nurses didn’t have gauze bandages or sutures. “You know this isn’t medical care in any shape or form that anybody would recognize it,” said Sillen.
Sillen put San Quentin under a microscope. No bandages or sutures? Sillen traced that to the Department of Corrections business office. “It has not been uncommon or unusual at all for people who know nothing about medicine to just take items off the requisition.”
Sillen bought supplies, then found out there wasn’t a warehouse for them – staff was stacking up stuff outside in a yard.
Sillen says it would be slapstick if it wasn’t so serious. How serious? Prison doctors waited eight weeks for X-ray results.
“The transcribed results were coming back and sitting in piles on the floor,” said Sillen. “Literally hundreds and hundreds of them. Because there was only one person to deal with them. She happened to be out sick.”
Those X-rays showed some inmates had active tuberculosis. Not that it mattered. San Quentin doctors routinely misdiagnosed illnesses.
“There are people practicing in prisons who have absolutely no business practicing anything medical,” said Sillen.
“Yeah, OK. We had some employees that were not good employees clinically or anything else,” said San Quentin Warden Robert Ayers.
Ayers says he credits the rest of his medical staff for providing the best care they can in dilapidated facilities. He says, try recruiting a doctor to work here.
“You know they’re going to come in here and see lead paint peeling – and asbestos coming down from the ceiling, flood water dripping down from the ceiling,” said Ayers.
Or, he says, they could work at modern, safe medical facility earning twice as much. “That’s a no-brainer,” said Ayers.
Sillen replaced San Quentin’s doctors with physicians from the University of California. He’s constructing a new medical building and computerizing records. Warden Ayers hopes it works. “My goal is to see Robert Sillen in an unemployment line.”
But Sillen says, if he left today, San Quentin medical care would revert to the way it was under Corrections officials. “Because they’re so entrenched in their culture and the way of doing things.
“The way of doing things is to not take good medical care of inmates,” said Sillen. “It is just that simple. There are far too many people in the system that believe whatever they get is more than they should in the first place.”
It’s been one full year since Robert Sillen took control of prison medical care. San Quentin inmate Michael James McClure sees a difference. “I just got here a few hours ago and all my medical care – blood tests, TB and everything – is taken care of. I got my medication. I should be getting it tonight or the morning.”
McClure’s still got a sentence to serve – but he figures at least he’ll be healthy when he gets out.