The mother lifts up her son's left arm and releases.
It flops lifelessly down to the hospital bed.
"It's his whole left side," she explains.
"He can't use it." Carefully, she folds back a portion of the beige blanket
to reveal a thin left leg dotted with sores. "He can move this leg a little,"
she says, pushing the foot slightly with her hand. "But he can't stand on it."
She basically has been living in local hospital
rooms since her son was admitted early last month several hours after being
released from Orleans Parish Prison (OPP). Her son was infected with HIV but
fairly healthy when he was arrested and taken to OPP last December, she says.
Most family members still don't know about his HIV status, and her voice automatically
lowers to a whisper whenever she speaks about his medical care, even inside
his own hospital room. In this story, her son will be called Robert, not his
real name. On Nov. 7, when Robert was released from OPP after an 11-month stay,
it took a deputy and a wheelchair to get him to the release area, she says.
Her son, still lying flat on his pillow, tries to enter the conversation. His
mother bends over the bed and listens closely. "He says that it was a lady deputy
who pushed the wheelchair," she says, adjusting his pillow.
Robert's mother says her son has told her
that when he was released, he was feeling weak and could barely stand up. One
inmate had looked at the thin prison-issue slippers on Robert's feet and said,
"You can't leave in those." He took Robert's slippers and gave Robert his expensive
tennis shoes.
According to Robert and his mother, when Robert
"rolled out" -- completed the paperwork to be released -- prison staff told
him that he would have to give up the wheelchair. He stood up, but was only
able to stand for a minute or two before falling down.
Another newly released inmate walked up. "It
was a guy I knew," says Robert in a weak voice. "He said, 'You don't look so
sturdy. I'm going to help you get out of here." The guy had Robert put his working
arm around his shoulder and they walked out. OPP officially records Robert's
release at 12:56 a.m.
What happened next is a muddle. "He wasn't
in his right mind," says his mother. She spent that night sitting in the living
room with the door unlatched, waiting for Robert to walk into the house. Her
other child, a daughter eight years older, would see Robert first. Just before
8 a.m., the daughter was driving along Tulane Avenue to Charity Hospital. Not
far from the main Charity entrance, she saw someone on the sidewalk, stumbling
a few steps, then falling down. She realized it was her brother.
She hit the brakes, stopped the car in the
middle of the road, and ignored the horns of the cars and buses while she ran
over to her brother and dragged him into the car. "Probably the first thing
people thought is that he was drunk," she says. Her brother, she says, was "out
of his mind." For the first 10 minutes or so, he didn't even know his sister's
voice, didn't recognize who she was.
Robert had mentioned to them, via telephone,
that the guys in the tier thought that he'd had a stroke. But Robert's family
was not prepared for the severity of what they would see. "Look at this boy.
He done had a full-blown stroke," screamed the daughter as she arrived at her
mother's house. Robert's mother changed his clothing while her daughter called
the paramedics, who arrived almost immediately and took him straight to Baptist
Hospital.
Robert's mom says that Orleans Parish Prison
staff should have intervened. They should've called a family member or used
some of his leftover OPP account money to put him in a cab. If she had had even
an inkling about his actual condition, she says, she would've waited there all
night until he got out.
"To push him out the door and say, 'You get
home the best you can' -- that's cold-blooded. You don't do a dog like that."
Orleans Parish Sheriff Charles Foti says that
Robert brought everything on himself. "I am truly sorry that anybody has a stroke
or that anybody becomes powerless," he says. "But that is because of his lifestyle,
not because of us."
Foti estimates that, of the 70,000 or so people
booked at OPP each year, 1,000 or so are infected with HIV.
"I'm not a doctor and I have 6,000 people
in this facility," says Foti in regard to Robert's release. "But he [Robert]
wasn't infirm for most of his stay. He was seen while he was here, 30 times
by a physician, 12 times by the HIV specialist. He was taken five times to HOP
(Charity Hospital's HIV Outpatient Program). He was given very good care."
He was not, however, a perfect inmate, says
Foti. Within the past several years, he had come through OPP more than a dozen
times on different charges. On several occasions he had to be moved to different
tiers for his own protection; he was a firesetter and he had tried to infect
others with HIV while in custody.
Robert's family says that they never heard
anything about the other incidents. They say that they've heard that it's not
unusual for HIV-AIDS inmates to transfer tiers frequently, because they are
often singled out for mistreatment by other inmates.
The HIV-AIDS epidemic began in the United
States in 1981, when the Centers for Disease Control and Prevention (CDC) first
identified AIDS. Prisons have been hit harder than almost anywhere else, says
Nick Freudenberg, professor of public health at Hunter College in New York and
the founder in 1987 of the college's Center on AIDS, Drugs, and Community.
"Some studies show that about a quarter of
the people with HIV infection in the United States pass through a jail or prison
in any given year," says Freudenberg. "That to my mind is just a staggering
figure."
Freudenberg says that the rates differ for
men and women, but that overall, the rates of HIV infections in jails and prisons
are about 10 times higher than the general population. "The larger proportion
of that is related to injecting drug use. That's because of our policies on
drugs and who gets arrested," he says. "Also, compared to the general population,
jails and prisons have high proportions of men who have sex with men, and women
who are heterosexually infected."
In 1995, according to the Bureau of Justice
Statistics, nearly one-third of inmate deaths in state prisons were attributed
to AIDS. As new medication has been developed and put into use, that has dropped
dramatically, to the point where only six percent of deaths in 2000 were from
AIDS-related causes. That means that, like on the outside, inmates with HIV-AIDS
are living longer and requiring ongoing medical attention for more extended
lengths of time.
Like other prisons of its size, OPP now has
HIV experts on its medical staff. There also is a separate AIDS hospice within
the prison facility. Inmates with HIV-AIDS are transported for appointments,
to the HIV Outpatient Program (HOP) at Charity Hospital and are also treated
there when they are released.
Significant improvements in OPP's medical
care came about because of an ongoing piece of litigation, Hamilton vs. Morial,
the longest-running lawsuit over prison conditions in the United States. Mohamedu
Jones is a lawyer for the National Prison Project of the American Civil Liberties
Union, which filed this lawsuit in 1969. Health care is one of the main points
of contention within the suit.
"There's no way that whatever (health care)
improvements are being made would have been obtained without this lawsuit,"
says Jones. "It took this suit to bring in HIV specialists, gynecologists, psychiatrists
and fully trained nursing staff."
OPP has made significant progress, says Jones,
but it still has work to do, particularly regarding discharge planning for people
with HIV. "There is no discharge planning," says Jones. "That's a failure of
the sheriff and of the HIV advocates in the community," he says.
Jackie Walker, the Prison Project's coordinator
of AIDS information, says that OPP is "clearly behind" in this area. Facilities
that do this right, says Walker, release prisoners with HIV-AIDS prisoners with
two weeks of medication and arrange for housing and transportation for people
who are being released.
On a statewide level, the Louisiana Office
of Public Health (OPH) is implementing this type of model with state facilities,
says Beth Scalco, the HIV-AIDS director within the OPH. The city HIV-AIDS office
is said to be considering such a model for Orleans Parish, but did not return
phone calls for this story.
Discharge planning at OPP definitely could
use some help, says Deidre Peterson, a local criminal defense attorney who works
with defendants with HIV and AIDS. "I think they're trying to make an effort,"
she says. "But I think they're very clumsy sometimes. They just don't know what
to do with these people. I don't think they're trying to be indifferent. I think
they just don't know what to do." They need to learn soon, she says, "because
people with HIV and AIDS are going to make up a good portion of the prison population
in the next few years."
Foti says that inmates who are released currently
have an appointment the very next day at the HOP clinic. He notes that most
hospitals won't even let you walk to the door. "They wheel you out," he says.
But what about Robert's case, in which his
mother and sister say he could barely stand up without the wheelchair? "I'll
find out whether he [Robert] was unable to walk," he says.
Foti calls back a few minutes later and says
that he checked with his staff and that Robert was fine when he was released.
"There is no indication," says Foti, "that he had suffered any sort of stroke."
If Robert had been in any sort of distress, says the sheriff, he would have
been immediately taken to Charity Hospital.
Octavia Henry can tell you what Robert did
for those first several hours after his release. "He sat right there all night,"
she says, pointing at a booth not far from the kitchen in this 24-hour restaurant,
the East Pavilion. As you walk onto Charity's grounds from Tulane Avenue, the
Pavilion is on the left, in the area that was once the blacks-only waiting room
and then was the K through Z patient waiting room before it became a restaurant
in 1985. It's a long skinny space filled with two rows of small, hard booths.
Every night, Henry can be found at the Pavilion,
cooking and waiting tables during the night shift. Tonight, most of her customers
wear the white pants and white shoes of hospital workers. She also sees a lot
of newly released OPP inmates. "Every day," she says. "They must tell them to
come here."
She remembers Robert well. "He kept falling
on the floor," she says. "He told me that his equilibrium or something like
that was off. I thought he was drunk."
Robert had come in around 2 a.m. or so, she
guesses. The guy who brought him in ordered chicken for the two of them and
explained that Robert had just come from the prison. At some point, the man
left. Robert stayed on, often falling off the slick booths onto the ground before
being picked up by other customers. "He didn't talk to nobody," she says. "He
just sat there and looked."
"He should've told me that he'd had a stroke,"
Henry says. "I would have gotten him some help from the hospital."
Instead, she told him, around 4:30 or 5 a.m.,
that he couldn't loiter any longer in the Pavilion. "I put everybody out if
they're acting drunk," she says.
Two officers from the hospital helped Robert
out to the street. Henry then watched while he held onto Charity's outside fence
with his arms and slowly moved himself toward that corner's bus stop. "The last
time I saw him, it was around 7:30 or 8 o'clock," she says. "I was on my way
home. He was on the ground inside the bus stop and a couple of ladies were picking
him up."
Robert seems uncomfortable. He has been tossing
and turning and flailing, often grabbing the bed rail with his right arm and
turning over. But as the last ray of sun comes across his hospital room, he
finally goes to sleep and his body is still.
His mother adjusts his blanket and tries to
recall when she first knew that he was HIV positive. The staff at the HOP clinic
had urged him to tell his mother, she says.
"I don't know when he first started going
there because he didn't tell me," she says, whispering. "But one day he broke
down and wanted to talk. He told me and he started crying." As to how he contracted
HIV, she has no idea. "We never discussed it," she says, wiping her eyes. He
never told anyone else about his diagnosis, she says. But from that day forward,
she would accompany him to his appointments at the clinic. "To give him support,"
she says.
She looks at the young man with the hollow
cheeks who stares blankly from the bed. "This is a short-term facility," she
says, a tear running down her cheek. "Two or three people die here every day."
She would have never pictured Robert, her baby boy, in here.
"He loved school," says his mom. He played
the drums, was on the newspaper staff. "His senior year," she says, "he was
senior class president. He always had a lot of friends. He was voted best dressed,
most popular. He would escort a lot of the girls to the homecoming, if they
needed a date. He was a happy-go-lucky guy.
"I never had to go to school for him. One
of his teachers called me to tell me what a good student he was. He used to
get Ebony and JET magazine, was always in good spirits, always
neat, well-dressed. He had several drawers just of socks and underthings. Ties
galore -- beaucoup ties."
She always appreciated that her son was so
well-behaved, she says. "When he was young and growing up, I would tell him,
'I sure thank you for not bringing me through no changes.' I never had to get
him out of trouble. Some parents have to do that through life, you know."
After graduation, Robert headed to the University
of New Orleans. He lived on campus, but stayed in close touch with his mother
and sister. Then, after three years, he quit. As he got older, into his early
thirties, he started getting in trouble. "I never could figure any of it out,"
says his mother.
Robert's first arrest, in December 1998, seems
to have coincided closely with his first visit to the HIV clinic. Maybe that
was on his mind, says his mother. She says that she thinks it was around this
time that he probably started smoking crack. He was arrested on too many occasions
for things like public drunkenness and criminal trespassing. "It was never no
big thing." she says. "But I couldn't understand any of it myself. He had never
been in trouble before."
A crack-possession conviction landed him in
the state correctional system for a year. In December 2001, a five-dollar shoplifting
incident, which he pled guilty to, and another crack-possession charge landed
him back in OPP as a parole violator. His mother says that he continued to call
her two or three times a day while he was in OPP and that she and his sister
saw him on visitation days.
A few weeks before he was to be released,
she says, he called and said that the guys on the tier said that he was slurring
and stumbling. They told him he'd had a stroke. He was having trouble carrying
his food tray without tipping it, so the other men on the tier would get it
for him.
He got along fine with people, she says, but
he had told her he "wasn't a great mixer" in OPP. "He didn't play cards, didn't
play dominoes. The other guys like to watch Cops, wrestling matches.
He liked movies. Most of the time he was just up in his little bunk, reading
something," she says.
She had seen him in mid-October and he had
been fine. Toward the end of his most recent stay at OPP, it became more difficult
to see him because he was transferred to a different tier that had different
visiting hours, she says. He still sounded upbeat, she said, although he began
to call a bit less because he said he was getting tired standing up. She had
no idea what shape he was in, she says.
A hospital worker opens the door and brings
a waft of gravy with her as she enters with a mauve-colored plastic dish.
Robert stirs in his bed. He puts his right
arm up on the bed rail again and tries to pull himself into a position to watch
TV. His sister, just off work from Charity, walks in the door. She and his mother
talk about his upcoming 38th birthday. He had been looking forward to lots of
home-cooked food and a big celebration. Now, the party has been moved to this
room at Mercy Baptist, with a few balloons, some cake, and his immediate family.
