When Security Trumps Care: What Prison Medicine Gets Wrong

The alarms we hear in this conversation aren’t sirens—they’re missed test results, canceled consults, and doors that won’t open after midnight. We pull back the curtain on federal prison healthcare through first‑hand accounts of delayed diagnoses, security protocols that override treatment, and the grinding bureaucracy that turns a simple appointment into a six‑month wait. You’ll hear how a man’s PSA rose from seven to twenty‑four while no one explained what it meant, why biopsies and MRIs require multiple layers of approval and armed escorts, and how even federal medical centers can become places where crises are contained rather than health restored.

We talk candidly about culture: custody officers as first responders deciding whether someone is “faking it,” nurses and PAs carrying physician‑level load without the authority to cut through red tape, and lockdowns that freeze sick call when care is needed most. We unpack the staffing crisis—one doctor stretched across multiple facilities, transport teams that don’t materialize, and consults routinely booked half a year out. Through stories of infections ignored, bones healing crooked, and a pillbox that became a labyrinth, we show how policies meant to prevent escapes end up preventing medicine.

This isn’t just a catalog of failures; it’s a map to change. We highlight the pressure points that work—direct outreach to the right Bureau of Prisons contacts, documentation that frames delays as liability risks, and legal strategies that move people to treatment faster. We also outline practical reforms: guaranteed access to lab results, medical triage led by clinicians rather than custody, protected staffing for healthcare roles, and performance metrics tied to medically indicated timelines. If you care about public safety, you should care about the care people receive inside; the health that returns home is shaped by what happens behind those walls.

Subscribe to stay with us as we amplify voices from inside, share this with someone who thinks delays are harmless, and leave a review with the one reform you’d prioritize first. Your feedback helps push this conversation—and real change—forward.

Follow this podcast so you'll be informed when new episodes are uploaded (twice a month). Meanwhile, read more stories and learn how you can contribute to reform; visit MoreThanOurCrimes.

Chapters

• 0:00 Why Prison Healthcare Matters
• 1:33 Brian Rogers And The Missing PSA Results
• 5:16 From Seven To Twenty-Four: Cancer Delays
• 6:43 Forcing Action Through External Pressure
• 7:36 Lived Stories Of Denied Care
• 10:24 Lockdowns And Midnight Medical Barriers
• 11:19 Security First Culture Explained
• 14:07 Six-Month Consults And Staffing Gaps
• 16:32 Medical Centers Aren’t Always A Safe Harbor
• 19:07 CO Gatekeeping And Deadly Assumptions
• 23:16 Violence Protocols Over Patient Safety
• 26:23 A Pillbox Becomes A Battle
• 29:10 Why Reform Is Hard And Urgent
• 33:19 Closing And How To Help

Transcript

PAM BAILEY: Hi, I'm Pam Bailey. I am a host of Voices Unlocked, which is produced by More Than Our Crimes, which advocates for people in federal prison. And the co-founder of More Than Our Crimes and the co-host of Voices Unlocked... Hi everyone, I'm back again.... is Robert Barton.

ROBERT BARTON: Yes, I'm Robert Barton. Thank you.

PAM: The purpose of Voices Unlocked is to allow you to hear directly from people in federal prison so you understand what's going on behind the walls. And why is that important to you? It's because these are individuals we're sending to federal prisons sometimes for decades and they're going to be shaped by what happens there. And how they're shaped will determine who comes home and lives next door to you. And that's why you should care. The focus of this episode is medical care, which is the number one concern I hear from when I talk to family members.

ROB: Yeah. And that's because the family and the guys in prison is not getting the care or the attention that they need when it comes to their medical conditions or issues. And so they're calling their family members and basically just pleading and begging with them to call the institution because they feel as though some outside pressure will make the doctors or the nurses or the medical staff move faster because they're not getting the attention that they need. And so that's why you hear that all the time.

PAM: And it's also a life-and-death issue. The first interview...we're going to start with a portion of an interview with a man named Brian Rogers. I met him when he had arrived at FCI Sheridan, which is a medium-security federal prison in Oregon. You're going to hear him talk about how he learned about his PSA levels. PSA, in case you don't know, is a test that's done to determine your risk for or whether you have prostate cancer. Now he's going to be talking about how...

ROB: What's the normal PSA level?

PAM: The normal level would be around four. You're going to hear him talk about when he finally hears about it. They've been testing him from facility to facility and not telling him the results. And he finally gets to Sheridan and he finds out just how high it is and you're going to hear him talk about that.

BRIAN ROGERS: Well, it actually started when I got to the holding facility for the US Marshals in...

This call is from a federal prison.

....Fayette County, Tennessee. And they said that I had an elevated PSA of seven. They didn't tell me what it was about or anything. They just said, "PSA is elevated." So from there, I went to Tallahatchie, Mississippi, another holding facility. And they again informed me that it was a little elevated. From there, I went to-

PAM: And let me ask you something. At that point, did you know anything about PSA levels and what numbers meant? 

BRIAN: I didn't know anything about it.

PAM: And they didn't explain it, I take it?

BRIAN: No, they didn't explain anything. I mean, I was like, "Okay, my PSA levels are raised. So what?" Then from there, I went to Grady County. I was there for 28 days and then I got to SeaTac. SeaTac came and told me, "Hey, your PSA's pretty high, but we're not going to do anything about it here. We're going to wait until you get to your final destination." And I think it was like a 13 or something, and that was November of last year [2024]. When I got to Sheridan, it was 14.5 in December. And from that point on, they told me, "You've got an elevated PSA. We're going to see about sending you to a urologist and figure this out, blah, blah, blah." I didn't get sent to a urologist, I think, until March, when the urologist came in and said, "Hey, these are strong indicators that you might have prostate cancer and we're going to need to do a biopsy." That got scheduled for July.

And in July when they did the biopsy, they did 12 snips and 10 of them were positive for cancer. The whole left side of my prostate was covered with a cancer mass. I was constantly in conversation with the warden, the assistant warden, the assistant warden over medical and Grasley was just ... He ignored me. And he told me at one point in time when I confronted him on the sidewalk and said, "Hey, this is my life that we're dealing with here and I don't know anything that's going on." And he said, "Well, maybe you should have thought about that before you committed the crime that got you here."

PAM: Oh my God. You're kidding me. You're kidding me.

BRIAN: So when I got here, my PSA was a 24, over a 24. So within a year's time, it went from a seven to a 24.

PAM: So we just heard Brian talk about how he found out finally about his PSA. It was extremely high. Now, in the community, if you were out here, this is what should have happened: You get a PSA test, it's abnormal. You repeat the PSA test to make sure it wasn't a fluke. And of course, he had had a number of PSA tests at this point.

ROB: He just never got the results.

PAM: And it keeps going up higher. Yeah. It keeps going up every time. So what should have happened when he got to Sheridan was he should have immediately gotten a biopsy so they could confirm his cancer and then start with treatment. Now, I'm going to talk later about why all these kinds of things happen and it took so long for him, but he didn't get a biopsy until July. And at that point, he found out that he had advanced prostate cancer, which is life-threatening. You can die from that. Now, I'm going to tell you that fortunately More Than Our Crimes partners with the federal Prison Education and Reform Alliance, which is staffed by former BOP people, and we intervened for him and we helped get him to a prison hospital, which is where he needed to go to actually get treatment for his cancer.

ROB: And how did y'all get to that stage where y'all can do that? Because a lot of times people don't understand the work that we, specifically you, do, because a lot of times it's you that's directly talking to and dealing with the network of guys that's in, outside of me doing a lot of the other types of work. And so how did you get to the point where you could affect the BOP and have them move to help him in those ways?

PAM: Well, so in this case, a lot of times what people don't know is because grievances....for a prisoner to file a formal complaint really doesn't...it takes a long time and doesn't work, right? So what happened is people at PERA, the Prison Education Reform Alliance, knew the right people within the BOP to send emails to, putting them on notice. Because listen, this is liability risk for the BOP. Here you have a man who has a diagnosis that could be fatal and he's not getting the care he needs. So there are people who understand that. And if you go to the right people at different levels-

ROB: Sometimes it works.

PAM: It sometimes works. And so we actually got him transferred probably sooner than he would have otherwise.

I want to ask you, Rob, what was your.. you were in for 30 years, at a number of different prisons. You're healthy. You came out healthy. So I don't know if..Did you have problems with medical care yourself?

ROB: I mean, I didn't really have problems per se. Well, a lot of people look at my thumb and see I lost my thumbnail. And for those of y'all that know me, I have a problem with biting my fingernails. One time I bit my fingernail, like a hangnail, and it got infected. So, like every time my heart beat, it was the most excruciating pain that I have ever experienced in my life. And for those that have been through that, you know what I'm talking about. And I kept going to Medical or trying to get to Medical and they would just give me Tylenol and send me back downstairs. And this went on for like two, three weeks. I didn't see anybody to the point that, I mean, I could never sleep anyway, but I just kept pressing, pressing, pressing [for help].

And eventually I caught a doctor who lanced it and he told me that if it swelled back up that I would have to go to the hospital. And I did end up having to go back to the hospital because it did swell back up. It was infected and I had to get an IV for a week in my thumb. And if they hadn't put me on the IV, there was a possibility that I would have lost my whole finger and it could have spread to my hand. And luckily I just lost my thumbnail. So that's one of the experiences that I had with Medical. But I've seen guys,, especially on the midnight shift, spit up blood or defecate blood and they tell staff at nighttime they need to go to Medical and staff don't want to do nothing on the midnight shift.

It's against the rules for them to open the slide [slot for food] after midnight so they don't have keys, there's no doctor there and all those type of things. So it's hard to get to Medical at those times, so that's when a person can die because they can't get to Medical. I've seen a guy splitting up blood and they just... Medical come gets them and they got to call somebody in from the street and then they take them up there and then they send them right back. And so to a person that's on this side and you're looking at it, it's like, damn, you're going to let them die? Y'all don't have no means, no way, no means to help this guy? And so those are like some of the things that I've seen that was drastic with Medical for me.

PAM: And what about, I've done interviews...

ROB: It happens a lot with broken bones and stuff like that too. So say like you break a bone, but can't get to the doctor. A lot of times, it ends up the bone just heals broken because you're doing things to try to fix it on your own. Maybe you break the bone back on your own and then you make your own sling and all those things. And then by the time you get to Medical or you get to see a doctor six months later, your bone is healed in that way. So now you got crooked fingers and all those types of things. So I did see those type of things happen a lot.

ROB: I assume, during lockdowns, which we've talked about before, I mean, at Coleman, you were locked down like half the time at the federal prison in Florida. So what happens in terms of access to medical care during lockdowns?

It's pretty much the same thing that would happen at midnight. It's limited. There's no sick call. The nurses that come around early in the morning, they don't want to stop for you for real. So they sneak past the door and you may miss sick call. And then the people that's running the institution, they got to ... So they got like what they call compound officers and those are the officers that's tasked with coming to get the inmates from the housing units and taking them to Medical. It's a process: They might do this block one day, that block the next day. And so it just makes the process, andit's already long, longer.

PAM: I'm going to mention...You might be wondering at this point, why on earth does it take like six months to get care? And recently I had the opportunity to talk to a BOP clinical director. She was a clinical director at one of the federal prisons. She has just left because she was actually a whistleblower, but she explained that to me. And it revolves around two things. One is the No. 1 orientation at a prison. The No. 1 concern is not your wellbeing.

ROB: It's security. Security. You don't have to tell me that. I already know that.

PAM: Yeah. And because of that, if you have to take somebody outside of the prison, and let's face it, they cannot have all the medical specialists that they need at the prison. I mean, they have a doctor, but they often are stretched across many different-

ROB: Like say, for instance, Coleman. Coleman is the largest institution I believe -- I'm almost 99% sure about this -- in the BOP. You might have one doctor that works each jail. So, Coleman has two FCIs, two penitentiaries, a women's facility, a low, and a camp. And [the doctors] work in all of them. And so you can imagine how strapped and stressed they are with time.

PAM: Yeah. So basically what people are mostly seeing are nurses or physicians assistants. So if somebody has a problem that needs more specialty care, which is for a lot of things, they have to go outside of the prison to an external hospital. Now, that poses, as far as the prison's concerned, a security risk

Because you're taking this prisoner to the hospital. It could be an escape, right? They could escape. So let's take a high-security prison like you were at. I'm told that they need to have three people to take you. 

ROB: And then it's short of staff all the time. So that's going to make the jail be ... the institution be locked down. They got to pull [officers' from certain places and a lot of times they just don't want to go through the process of doing all that.

PAM: And they've got other prisoners besides that one who need to go out.

And then they got to sit with the prisoner the whole time and they got to pay overtime and all those types of things. So three people to go to the hospital. They stay there the entire time for however long that takes. And then another three people, or the same three have to bring them back. So in order to schedule that, there's this very elaborate process... first they have to get approval to ... The clinical director can't just say, "This person needs this care. They're going to get it." She has to get approval from like a regional and medical staff that has

ROB: I ain't know that.

PAM: ... their own opinions about whether or not something's medically necessary or not. And then after she gets that approval, it's got to go to all these different people within the prison to schedule it. That's why they actually routinely will schedule consults, outside consults, six months out, because they know that's how long it will take. Yeah. And then of course, think about this, if the day comes and something's happened, like staff don't show up and they don't have three people, you don't go. And then this is what's crazy. So you go out, you have a consult, the specialist says, "Oh, now I need an MRI."

ROB: Now you got to wait another six months to go through the whole process all over again.

PAM: So it's insane. And to skip all that, you have to be almost dying before get emergency care and go out without all that. In fact, they consider almost everything else elective. But anyway, in fact, I talked to ... There's another member of our network named Cory Perry, who is currently in a medium-security prison in New Jersey called Fairton, but before that he was at a high-security prison in Tucson and pretty much the same. He has multiple medical problems that keep getting worse because they're not treating them and he doesn't get it. And I asked him, he makes a comment right now about what this sort of security orientation means. So let's listen to him.

CORY PERRY: See, the medical staff in the BOP, they're not just medical staff. They're trained to work security as well. So they have to qualify in the gun range, the whole nine yards. They're all certified correctional officers, and that's what the BOP pushes in their heads: "These are not people. These are things, and these things will destroy you if you give them an inch. They will lie to you, they will con you, they will bullshit you, they're trash. They are the shit that comes out of the butthole of humanity. And if you treat them any differently than that, it's going to cost you in the long run." And they see that they don't have to treat you well, and they just blow you off. "Hey, I don't have to do anything. I'll get to it. Yeah. If it happens to be convenient, I'll take care of it."

PAM: Now you might think...There are seven ... The Bureau of Prisons has seven federal medical centers, which are basically prison-run hospitals. So you might think that, "Okay, once you get there, like Brian did, now you're going to get good care because it's priority." That's actually often not the case. Now, Brian, I will tell you, has a good end to his story. He got to a federal medical center with our assistance, he got the radiation, etc. that he needed. There were some other medical problems that they didn't deal with. They just wanted to deal with the cancer and then get him out because he was close to release. So he actually is out now in a halfway house.

ROB: That's wonderful. 

PAM: And hopefully he'll stay cancer free. But in this next interview bite you're going to hear, he talks about other people he saw at the federal medical center. He went to one in Butner, North Carolina. And you may recall, you might have caught that NPR did a series on Butner because it's known as being one of the best places to go if you have serious medical issues. And they actually did an expose saying, "No, there's a particular floor there that's where people go to die." And this is what he talks about in this next bit.

BRIAN: I mean, they hype it up a lot around here, but there's a floor called fifth floor and everybody here says if they send you to the fifth floor, you're going to die or you're on the verge of dying and I've seen it happen. My bunkie has multiple myeloma, he has degenerative lung disease, he has so many different things and he'll tell them, he'll go in there and say, "Hey, listen, my breathing is bad and I think my lungs are filling up, my stomach's filling up with fluid." And they'll be like, "Oh no, just go lay down." And he's been rushed to the hospital. He also is onto dialysis and has a port in his arm and the port got, it started leaking in his arm and it was filled with blood. And when they finally got him to the hospital, they said that he was within hours of that thing bursting and it would've killed him.

And they just kept blowing it off. Every time he told them about it, they were like, "Well, no." And that was one time and then another time he ran a fever of 104. By the time they got him to the hospital, they said, "If you didn't get here, you'd probably have been dead by morning." 

PAM: And when you think about why this is all happening, why is medical care so bad in the BOP? We've already talked about one problem, which is the fact that security is the No. 1 concern and not the inmates' best interests.

ROB: Every time.

PAM: And so that's the culture that pervades. Now, another problem that's increasingly happening is that non-clinical people or people who are not as highly trained as a physician and are basically just taking orders from other people who are higher, are increasingly given more authority and power. In fact, the doctor that I mentioned that I talked to who had just left the BOP, that's one reason why she left and she says she predicts an increasing number are going to leave. And what you are already seeing as a result is that nurses and physicians assistants are making more decisions. Now, not to say that PAs can't make a lot and do really good care, but there are some decisions that should be made by a doctor. 

ROB: Then outside of that, just the system and the places that they work in, the conditions that they working under, is running a lot of the nurses off and the doctors off because they got to work as officers and work extra time because of a shortage of staff and all those type of things. And so they can't even do the job that they was hired for. And so in a lot of those ways, this is also affecting Medical because you just don't have the staff and medical staff there who want to work in these institutions. So that's another problem.

PAM: And they're leaving. And the lower you go in terms of your level, the less likely you'll be strong enough to push back when you're told that, "Hey, this is not necessary." So we have a little bit of a bite, a short bite from Brian where he talked about the fact that, yes, that's what he's been seeing, he saw at Butner in terms of just more and more PAs were in charge. So listen to this.

BRIAN: PAs are pretty much running the show as far as diagnosing and all this other stuff, and you see your MD very rarely, maybe, not even once every six months like they used to do it for chronic care. So it's shoddy at best.

PAM: And what's sort of like pervading all of this, what ties it all together in terms of what is causing the problems, is culture. In this next little bit from Brian, he talks about how the front lines of health care actually are the COs, what you call the cops. because when a medical emergency or a problem happens in the cell...

ROB: They're the ones that go through first.

PAM: Yeah. And they have to decide, is this guy faking it? Is he really high? And I mean, I've heard lots of stories of people having an epileptic seizure.

ROB: And they say they're high on K2 and all that type of stuff, so they don't-

PAM: So they don't take it seriously. Yeah. So Brian describes an instance where, and this is at the federal medical center, where everybody there is ill, somebody was very, very sick and refused to take a breathalyzer, which means the staff thought that he was actually drinking homemade the alcohol. So hear his story.

BRIAN: The guys fear going to the fifth floor here because people end up dying up there. We had one guy that got here, his name was David Parker, and he had kidney failure. Well, he got really sick and was unable to take a breathalyzer, so they put him on AD status, administrative discipline. They lock you down in your room. When he came out, he was yellow, I mean a bright yellow. And within three days he ended up in the hospital and within seven days after that, he died. It's stuff like that that could be avoided. And they send guys out to Duke or the other hospital here, I can't remember what its name is, but by the time they get there, they're just too far gone that they can't do anything to treat them. They stick them on the fourth floor and they make them comfortable. And everybody says, "Well, what about compassionate release and all that stuff?" Man, it's so hard to get a compassionate release. It's ridiculous.

PAM: So that illustrates the culture.That officer that Brian talked about assumed, "Oh, you're not sick. You've been drinking alcohol or something." What do you want to say about prison culture and the assumption that the staff make?

ROB: Outside of just the assumption that the staff make, they always make assumptions. So everything has to do with, "you're lying." I mean, they're trained that way. They're trained to believe that we are being manipulative all the time, that they shouldn't fraternize with us, not to believe us and all those types of things. And so that's the first thing they resort to every time, but you're playing with people's lives. And so what should happen is that even if you think a person is lying, you should still give them the medical treatment that they deserve or need or they're asking for because they may not be lying and it's not your job to determine whether or not I'm lying. Your job is to keep me safe. And so the culture plays a part in that because one.. because there's this big divide between officers and residents, then it makes me see you as an other or somebody that I'm against.

We're at war, we're at odds, all those type of things. And so I can't help a person that I'm at odds with, unless I'm really forced to do so or I really take my job seriously. And so the culture deems that I don't help inmates. And so one of the prime examples of this is that one of my homies, Ootz, that's his nickname, I don't know his real name, was killed at Pollock. And during this stabbing, he was stabbed kind of like severely. He died. So of course he was stabbed bad. They made him walk to Medical. So, Medical from his unit was probably like 200 yards. It's probably one of the reasons why he died. He didn't get the attention that he needed. Why are you making a man that you know [is seriously injured], and you're putting handcuffs on him? All that's got to do with the culture. I can remember being in the SMU, Special Management Unit, in Lewisburg.

PAM: And what is a SMU?

ROB: A SMU is basically a place that you are sent to when you've been bad for lack of a better word, for punishment. And it's like a 12-month program where you're doing 12 months to 18 months, where you do and 23 [hours] and 1 in the cell daily. And so I've seen where two people, because they'll put you in the cell with just anybody, and two people are in the cell fighting and they come to the door and one man might be damn bad, but they're not going to open the door up until both people are laying down and they are able to come in there and put the handcuffs on you. So, just imagine if a person is stabbed up in the room and he can't get up to get to the door to cuff up because they ain't coming in the room until you get up and you put cuffs on. That's life threatening.

And at the same time, they're shooting paintball...gas... in the room and all those types of things to try to stop the fight, which is exacerbating the problems. This has all got to do with the culture. It's all about their security and what they deem they should do to corral the situation. And so that's why all this stuff is just bad because the culture says that it's security first and that we got to move in these forms. I got to do X, Y, and Z, and ain't nobody willing enough to think outside the box. And so as I think about it, George Jackson got a quote, and I don't know it verbatim, but basically what he says is that you can't try to reason with an officer. What you need to do is you need to kick him in the back pocket where that little black book is at, because that's where his brain is at.

PAM: Well, let me ask you something. I'll give an adversarial point of view. I'm trying to think of what staff might say. You often hear, and this is one reason why officers don't, people don't, want to work in prisons. It's a very stressful, often dangerous environment. So I suppose in some of the situations you're describing, you're, yes, somebody's in need of medical care, but you're worried about, could I be attacked at any time? I mean, I don't know. I mean, put yourself ... Is there a real danger, do you think, that's going to complicate their decisions?

ROB: No, because a lot of times they are exacerbating the situation once they get you in the handcuffs. And so it used to be that they didn't go through all these protocols like when I first came to the federal system in early 2000s. They would just tell you to get down or they'll shoot, you get down. Now they actually run and they're tackling people or they beat you up while you got the cuffs on and all those type of things. And so if I'm doing all those type of things and I'm not worrying about my security, I'm just worrying about taking care of the situation or getting it under my control, not control. Yeah.

PAM: Yeah. So the only thing they're thinking about is security,

They should be thinking about yes, just like I told the police officer, they need to be thinking about protecting everybody, but they also need to be thinking about the health of that person. And that really doesn't matter.

ROB: I mean, that should be paramount and that's just like ... So that's like what their law is about or their rules about when a guy just got killed in Coleman.

I mean, you can explain a little bit more, but like two guys were fighting on the compound and the [officer in the] tower killed one of the guys. And so the rule I believe was that if you see one inmate striking another inmate with a weapon or something and they deem the person's life is in imminent danger, then they can kill the aggressor.

PAM: Well, my understanding is they have to do a sound bomb first, and if they still fight after, then they can do it. Which they did.

ROB: They continued to fight. But my thing is, my point was that you are telling me that you're trying to protect one person's life from being taken by taking another life or stopping the other person, but you don't care about the other person's life when it's just a fight and you are intervening in the fight and all those type of things. And that's the point or the mentality that I'm telling you about security.

PAM: Right. Yeah, good point. We have one final interview section I want to share with you from Cory, the one who is in FCI Fairton in New Jersey. And we've been talking about serious things like cancer and stabbings, etc. He describes a very small, a little thing. All he was trying to do is get a ... And there was a nice staff member he talks about who was trying to help him because he's taking so many medications, he couldn't keep them straight. And it was important for him to remember to take them and in the right order, otherwise he'd mess up his system. So this staff member says, "You need to get a plastic pill box." And so he describes what he had to go through to get that. And I think his comment at the end It sort of sums up the theme of what we're talking about. So listen to this.

CORY: Okay. I did a sick call thing and I went in and I saw Mr. Knowles. He's the certified registered nurse, right underneath the doctor. ARNP is what he is. And he said, "Okay, yeah, you're on 12 different medications. So we do need to get you one of those things where you put all your pills in for the day." He said, "Go to the pharmacist and tell him." I said, "Okay." So I went to the pharmacy and this lady just cusses at me. I don't have anything to fucking do with that. You need to talk to him. I said, "I just went." She said, "You need to go to sick call." I said, "I just came from sick call. He told me to come over and tell you. " "Well, I'll look into it. Check back." So, I came back like a week later. It wasn't like I came back the next day.

I waited a week or almost two weeks. And she's like, "You need to go to sick call." I said, "Ma'am, I did go to sick call. Remember, I talked to you before? I talked to Mr. Knowles and he told me to come over here." "Well, he has to tell us. We have nothing to do with that." So when I went to the dentist like a week and a half ago, I didn't leave until 11 and that's when they opened the pill line. The head pharmacist was over there with the same lady. She's there too. And I went to her and she did the same thing. She said, "You've got to go to sick call." I said, "Ma'am, we've talked about this twice. I've been to sick call. I've seen Mr. Knowles. He told me to tell you," the big guy that was sitting right there.

And he goes, "Yeah, but he never said anything to me and they have to order those." And I know that's a lie because Mr. Knowles told me, "They have them in the pharmacy and I'll let them know to give you one." But they make a huge issue out of it. It's a plastic pill container for Christ's sake. But he's laying back in his chair just completely stretched out and they're in there talking about God knows what and they just don't want to be bothered and you're an inmate. You don't matter. And like the one nurse told me one time when I said, "How come you're here? You're really good. Why are you here?" And he said, "Because in a hospital, I can't tell you to go fuck yourself, but in here I can." That is the problem.

PAM: Well, so it's a lot to cover. I mean, there's so much more we could say about medical care. And it's one reason why you see all these advocacy groups that are tackling different things like solitary confinement that's sort of a simple thing to focus on. Medical care is harder because there's a variety of causes. It's lack of funding, for instance. They don't pay these doctors enough to make them want to come and work in prisons.

ROB: And then they don't want to pay the hospital. They don't want to spend the taxpayers' dollars on the inmates getting services they don't feel they need.

PAM: Yeah. And so one thing I've heard from a couple of the people that sometimes the outside hospitals want to get them out as soon as possible because they're not being paid or they're not paying their bills. It's lack of staffing. There's a whole variety of factors that contribute to really poor medical care. So it's harder one to tackle, but it is so important. It needs to be. It needs to be like a top concern. And we need more attorneys who maybe do class action lawsuits so that it'll force that kind of attention because unfortunately it seems like that's what it takes sometimes. But thank you for listening.

ROB: Thank y'all for listening.

PAM: This is Voices Unlocked. Please subscribe so you'll be notified of future episodes. We hope you share this with your family and friends and tune in next time.

ROB: Bye everyone. Thanks for tuning in.