In all my previous thirty years of practising medicine, before working in prisons, I had never had to attend a Coroner’s Court. But in the seven years I had been at the Scrubs, I had been required to attend on four occasions.
Somehow, rather than becoming less daunting, each time I attended I found it more and more stressful.
The shine had been taken off the Scrubs.
I dreaded having to attend another Coroner’s Court, and became almost paranoid about writing even more meticulous notes on everybody that I saw.
The fear of missing something was almost crippling.
I worried that someone was going to find fault with me. I’d been told to walk with confidence when in prison. Now I felt like I was walking on eggshells all the time.
The situation became worse not long after the court case, as a vicious batch of spice was doing the rounds.
The effects were extreme, and the men that used it either became zombie-like or wild and very aggressive. Some were having fits and losing consciousness.
I was terrified for the men’s safety, and I feared that sooner or later someone might die as a result of smoking spice.
It was so bad that alarm bells were going off everywhere, and I spent my time going from one wing to another, seeing prisoners who were either recovering from the effects of it, or who were having to be restrained by officers.
As doctors we were helpless to do anything. Sometimes we would send them to hospital, only for the doctors there to send them straight back to prison, saying they couldn’t help; the drug needed to work its way out of their system.
The fear of further deaths took away the fun from a job I had once loved.
The final straw came one afternoon when I was called to C Wing for an emergency.
The nurses had helped one of the prisoners into the consultation room, after he had collapsed on the landing. They managed to get him onto the examination couch so that he could lie down.
He was skinny and pale, his face covered in blemishes with a nasty weeping cold sore on his bottom lip. He looked undernourished and as if he hadn’t slept for weeks.
Sylvie was already by his side, waiting to fill me in on what had happened.
‘Thank God you’re here,’ she said. ‘Today has been a nightmare. It’s one thing after another. What’s happening to this place?’ She shook her head, sagging with exhaustion.
‘We found Alex having a fit on the landing. His notes are on the screen for you.’ As I scanned the records, I could see Alex wasn’t a stranger to prison. He’d been in and out since he was 15 years of age, and had some complex medical issues.
I initially suspected he might have suffered an epileptic fit, but he had no previous history of epilepsy.
‘I think he’s been on the old . . .’ Sylvie rolled her eyes to the ceiling, in frustration. I instinctively knew she was referring to spice.
‘I’ll never use it again, Doc,’ he murmured, then started retching violently. ‘I feel so sick.’
He clutched his stomach, a thick string of saliva trailing between his mouth and the couch.
His hair was bright ginger. His face was so white he looked like a corpse. Even his lips were drained of colour.
In the ruthless world of prison drug dealing, it was usually the most vulnerable who suffered. Dealers sometimes wanted to test their merchandise, to see what effects it would have. They would often offer a ‘free’ sample to those with learning difficulties, or other vulnerabilities. Or they would simply force them to take the drug, to see what happened.
I wondered if the young man had been cherry-picked to be a guinea pig.
With anxiety in his voice, he explained. ‘I couldn’t sleep one night. Someone offered me a joint and it got me to sleep. The next night I thought it was a good idea, and that’s how I got hooked.’
He stared at me with desperate eyes, looking for sympathy.
‘When you can’t sleep it’s like you’re doing double time.’
I’d heard the term ‘double time’ on many occasions over the years, usually when the prisoners were desperately hoping that I would be able to prescribe them sleeping pills. I could imagine it must have been like having a double sentence, if the nights lasted as long as the days. Probably even more painful for those in the Seg.
‘When I do drugs, I don’t feel nothing. I don’t see nothing. That’s why I use; it makes me forget I’m here. It blocks everything out. I shut my eyes. I feel calm and relaxed. I can’t even move. It takes over, and the time flies, it absolutely flies,’ Alex said, before he started retching again. ‘But I’ve never used spice before, and I’m never going to use it again. Never!’
There was nothing I could do for him. I didn’t know how the drug had reacted, and the last thing I wanted to do was give him another drug that could make things worse. He just had to let it work itself out of his system.
I appreciated his honesty in admitting that he had used illicit drugs, as he knew that he could be punished for it. By telling me the truth he had spared me a lot of time considering alternative causes for his collapse, and possibly from sending him to hospital for further investigation and monitoring.
That day I realised that the frighteningly rapid rise of the use of spice throughout the prison was out of control, and that I could no longer continue to work there.
My time was up.
*
I had loved working in the Scrubs. I loved the banter, the noise, the excitement. I loved belonging somewhere. I loved the fact that the officers and a lot of the prisoners knew me. I was such a familiar sight around the prison that I felt like part of the fixtures and fittings. It was a really hard decision to make, but one that I knew was right. After seven years in the notorious Victorian prison, I decided it was time to leave.
I don’t like big goodbyes because I get very emotional. So I didn’t let many people know I was going. Only my very closest friends at the Scrubs knew that the August bank holiday of 2016 was going to be my last day there.
As always, David was fully supportive of my leaving, and of my decision to not give up working behind bars. Instead I had decided to face my biggest fear of all – working in a women’s prison.
Many officers and medical staff had warned me not to do so, saying that female prisoners could be much more challenging, with a very high rate of self-harm. Governor Frake had given me some hard truths, having worked in the infamous Holloway for sixteen years. She said she much preferred dealing with men, and that I’d have my work cut out for me. But it was time to try something new.
So I signed up for some shifts in HMP Bronzefield, a closed female prison in Ashford. It is now the largest high-security female prison in Europe, since the closure of HMP Holloway.
Female prisons are not categorised in the same way as male prisons, and are referred to instead as either Closed or Open.
Opened in 2004, the modern building is a huge contrast to the Scrubs. The prison is divided into four house blocks, each housing up to 135 women. It also has a twelve-bed Mother and Baby Unit, accommodating children up to eighteen months old. Unlike in the Scrubs, the Number One Governor is referred to as the Director, the prisoners as residents, and the Seg as Separation and Care.
*
As I took my last steps on my final shift in the Scrubs I felt incredibly sad. It was the end of an era, but I had made my decision and was looking forward to the next chapter in my life.
I was walking down the grated metal steps to the ground floor of B Wing, my bag slung over my shoulder, my feet weary from another long day, when all of a sudden the place exploded with bangs and shouts from every direction. It sounded like a riot had broken out.
‘You fucking blinder!’ from my right.
‘Get in!’ from my left.
‘Eeeeengland!’ from above.
It was the explosive sound that I had become so used to whenever there was a football match on TV. When a goal was scored the place erupted and the noise was deafening. It always made me smile. In that moment, there were a lot of happy people in the Scrubs.
As I approached the exit gates, one of the prison officers was grinning.
‘England just scored!’ he said. ‘Worst thing about being on duty is I don’t get to watch the game.’
‘Bad luck,’ I replied as I reached for my keys, but kindly he stepped forward.
‘Here, let me.’ The keys rattling in that old lock. It would be the last time I heard it.
‘Night, Doc,’ he said. ‘Safe journey home.’
I smiled back, but the smile didn’t reach inside. ‘Goodnight.’
I disappeared from the prison. Whether I had left a mark I didn’t know. But I hoped I had, in my own small way, helped some of those men.