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Authors: Ms. Mary E. Buser

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16

The next morning, I was ready to begin. With a couple of referrals in hand, I settled in at my session booth and took a deep breath. The first referral simply said “Anxious,” and the second one read “First incarceration—evaluate for depression.”

There was little time for first-day jitters as Miss Edwards shouted, “Miss Buser!
you got one!

I stepped out to the waiting area where Hector Rodriquez, the “anxious” inmate, was pacing the floor. “Sit down, Mr. Rodriquez—sit down!” yelled Edwards. I introduced myself, and he stood still long enough to shake my hand, but as soon as we were seated, his legs jiggled wildly. “Can you get me out of here, miss? Can you get me back to the Brooklyn House? They brought me out here to Rikers last night. I don't know why. My mother's very sick—she'll never be able to make the trip out here. We don't have a car. She could die! My bail's only a few hundred bucks, but we don't have it. At least let me see my family.
Please, miss! Please! Can you help me?

Overhearing him, Janet, who was engrossed in paperwork nearby, leaned out and beckoned me, and I excused myself briefly. “You're going to see a lot of this,” she whispered. “Most of the boroughs have their own jailhouse, but because of the huge numbers of people arrested, most are held here on Rikers. The thing is, the smaller jails are closer to home, easier for family visits. They all want to go back, and you can't blame them, but this is a DOC
matter. Don't get pulled into this. You have to tell him there's nothing Mental Health can do. We can help him with the anxiety, but not a transfer.”

I returned to Rodriquez and repeated what Janet had told me. “I'm so sorry,” I said. “Maybe you could speak to a captain or someone in DOC.”

“Yeah, I should do that,” he said, with a glimmer of hope. “Maybe this is just temporary. I'll talk to a captain—yeah, that's what I'll do! Maybe they'll send me back.”

He declined any further mental health support, and as he stood trembling at Edwards's desk, waiting for a hall pass, I wished I could have done more. But more than that, I was confused. Hector Rodriquez had been arrested and charged with a crime that he may or may not have committed. He had yet to have his day in court. But in the interim, because he couldn't make bail—for lack of a few hundred dollars—not only could he not remain at home with his family, he was remanded to an inaccessible island. His pretrial incarceration was not a question of guilt or innocence—it was a question of money!

But I couldn't dwell on it. My next referral was already signing the logbook. I walked him to my booth, noticing that the lanky Antwan Williams was fighting back tears. As soon as we were seated, he doubled over and began rocking,
“Oh, God, miss! They want to give me twenty years! Jesus Christ! They got me on a drug sale.”

Putting my intake questionnaire aside, I listened as the thirty-year-old Williams told me what had happened. “It started out like nothing,” he whispered. “I'm not a bad guy—I was just desperate. That's why I did it.” He explained that he was the center of an immigrant family from Jamaica, a hard-working clan that had scraped and borrowed to open a small bodega in Brooklyn. But despite their best efforts, the store struggled. Antwan had a younger brother, Tariq, a twenty-two-year-old with no interest in shopkeeping. Instead, Tariq sold drugs. But Tariq's life in the fast lane came to a violent end when rival drug dealers shot him dead on a street corner. “It was horrible,” Antwan whispered. “After Tariq was
killed, everything changed. Things were going bad at the bodega to begin with, but after that, it went downhill fast and I was borrowing money everywhere I could. And then Tariq's friends came by and told me Tariq was owed a lot of money, and they thought it should go to his family. I didn't ask questions—I just said, ‘Give it to me!' But they said if I wanted it, there was a few things I had to do. I was desperate, and out of my mind over my brother's murder. Everyone was looking to me for answers—it was too much. So I said okay, and I started carrying duffel bags to different drop-offs. Small stuff—and these guys gave me a
lot
of money for doing practically nothing. It was so easy.
Just so easy.
And my wife was saying, ‘What are you doing?—look what happened to Tariq!' I told her I was only going to do it a few more times—just enough to recover from the store and get out.”

But it was too late. While parked in his car one afternoon, Antwan Williams was surrounded by police. “They put a gun to my head and told me to get out. Then they put me in handcuffs, took me to a precinct, and played back a tape—one of the guys I was dealing with was wired.
They had me red-handed!
I've never been in jail before—I can't eat, I can't sleep, I can't think. I swear to God, miss, if it wasn't for my kids, I'd string up a sheet and end it—I swear to God I would!”

“Okay,” I said, feeling slightly overwhelmed. “Okay, now. I know this is all a terrible shock, but we're going to help you get through this, okay?”

He bit his lip and nodded.

Given his reference to suicide, I wanted to transfer him to the MO. But when I proposed it, he gripped the edge of the desk. “
No! Please!
I can't take any more changes. Don't move me! I'm not gonna do anything—I wouldn't do anything to hurt my kids! I swear!”

As desperate as he was, I believed him. I set the MO aside for the moment. But I did want him to meet with a psychiatrist for medication. Although a pill couldn't undo the damage, at least it would help calm him down, and to this he agreed. “But can I talk
to you again?” he asked. “You've been very nice to me. You can't trust anyone in here, and I really need someone to talk to.”

I pulled out my calendar, and we scheduled our next appointment.

“Thank you,” he whispered.

When Miss Edwards announced that the morning session was over, Antwan Williams, my first case, got up and returned to the cement cell that was part of his new and horrible world.

After he was gone, my thoughts were racing. Antwan Williams seemed like a decent person who'd made a terrible error in judgment, yet the price for it could be twenty years—a huge number in a human lifespan. My mind flashed back to Sister Marion and the mules at Rose Singer who faced fifteen- and twenty-five-year sentences for similar transgressions. Once again, I didn't understand how a nonviolent drug sale could be placed on par with murder. If Williams got the maximum, this father of three would leave prison in his early fifties. His children would be grown and the prime of his life over.

17

As the days progressed, I grew accustomed to the rhythm of the men's jail—the quieter halls, the long silent lines headed to chow. At mealtimes, white-shirted captains stood at the mess hall entryway and scrutinized the arriving lines, watching as the inmates removed their belts and passed through metal detectors. After refastening them, the men were hustled in to eat—and just as quickly hustled back out. With an allotted “feeding” time of five to seven minutes, there wasn't a moment to spare.

I began each day with a stack of referrals and a morning of assessment interviews. Through these interviews, I found that the male inmates shared the same sad profile as the women: poor, minority, drug-addicted, products of foster care or group homes. Most were high school dropouts, with tenth grade seemingly the universal dropout grade. Many were illiterate; many more had spent their early school years in “special ed.” Whenever I asked what took place in special ed, the answer was always “Nothing.”

But when it came to criminal charges, men and women differed radically. No longer was I sitting across from people charged with drug possession, prostitution, and shoplifting—now it was drug sales, rape, assault, arson, and murder. Although these men were detainees and innocent until proven guilty, I knew very well that many were guilty as charged. But just as I had done all along, I resolved to leave judgments to the courts and keep my focus on their mental status.

Despite the more serious charges, the work itself, as Janet had promised, was the same. I settled into a comfortable groove, transferring the mentally ill onto a Mental Observation Unit and scheduling clinic-based follow-ups for everyone else. I was just starting to feel confident in my ability to work with male inmates when I began making mistakes. The first occurred during the evaluation of a forty-year-old referred for possible mental retardation. When I questioned him, he was mute and appeared lost and disoriented. I decided it best to transfer him to the MO for his own protection and further evaluation. My next referral was a twenty-three-year-old brought to the clinic by two officers who'd spotted him fashioning a noose out of bedsheets. I wasn't going to take any chances here and immediately transferred him to the MO.

On the face of it, these two situations seemed straightforward and my response to them appropriate. In both cases I'd been duped. The “suicidal” inmate began extorting the mentally ill, and within days of his arrival on the unit, the “mentally retarded” inmate was hailed as the house chess champ! Both were promptly discharged back to population, and I landed in Pat's office, feeling a little chagrined.

“Don't worry,” said the chief. “It happens to all the rookies.”

“Happens to the veterans too!” Charley piped in. “These guys are good, Mary—they know exactly how to play us. Welcome to the wonderful world of malingerers!”

Malingerer,
I learned, is the psychiatric word for a faker, and a big buzzword behind bars.

Charley and Pat explained that, for a variety of reasons, the island's Mental Observation Units are coveted houses. Terrified first-timers in jail often fudged mental illness because they figured that with the Mental Health staff's regular presence on the unit, the MO was a safer haven. Others thought it might help their legal case. Unfortunately, others viewed the mentally ill as perfect prey for extortion. But the biggest motivation for feigning mental illness and exacting a transfer to the MO was a key policy clause: “Any inmate housed on a Mental Observation Unit is considered
too fragile for solitary confinement.” What this meant was that someone who'd been issued a “ticket” was apt to appear at our door prior to his transport to the Bing. If he could convince us that he was suicidal or mentally ill, he'd be transferred to the protected house, safe from harsh punishment.

“The two guys you put on the MO, Mary, they'd both been issued Bing tickets the night before,” Charley said.

Now it all made sense.

“You can't blame them for trying,” Pat said. “They're scared to death of solitary—but on the other hand, we can't allow our units to become havens for Bing beaters.”

Armed with this new information, I conducted my evaluations with a little more savvy. As a gatekeeper for our Mental Observation Units, I needed to protect the mentally ill. If someone told me he felt like killing himself, I didn't automatically believe it. I assessed his energy level and body language. Did it add up? Or was he joking around in the waiting area just prior to telling me about his death plan? When I asked myself these questions, many claims did not pan out. If I still had doubts, I checked with DOC to see if there was an outstanding Bing ticket at play. In many cases, the answer was yes.

With a little more experience, I began recognizing ruses and staged maladies. Some were quite sophisticated and convincing, while others were so obvious they were almost comical. One young man, outfitted in designer jeans and gold chains, who'd been holding court in the waiting area, claimed to be hearing voices. “When did you start hearing these voices?” I asked.

“The other day—just like that!”

“And how often do you hear them?”

“All the time!” he insisted. “All the time . . . you better transfer me to the MO.”

“And what do these voices talk to you about?”

He thought about it for a moment before making his fatal mistake—“Sports!”

I tried not to burst out laughing, but I did smile, and when he realized it wasn't going to work, so did he.

While frustrating, situations like these actually provided a little levity, and in some ways they were a welcome diversion from the more complicated decisions that I was starting to face. Although many would take a broad brush to malingerers, attributing their chicanery to the “criminal mentality,” I was finding that most jailhouse malingering was driven by sheer terror.

It was through Curtis Bellows, one of my earliest cases, that I came face-to-face with the dire straits the detainee is up against. A thoughtful thirty-three-year-old, Bellows was battling drug addiction and depression. In and out of jail most of his adult life, he'd endured a horrific childhood at the hands of a sadistic foster mother. Belt-buckle beatings and near drownings at bath time made for a man who functioned with great difficulty. But he and I were forming a solid therapeutic alliance, and I wanted to help him find some peace in his life. Although he'd be going upstate for a few years, we were working on a postprison game plan. But one afternoon he arrived for his session with eyes downcast and lower lip quivering. He told me he was in grave danger. Apparently, he'd borrowed a pack of cigarettes from a housemate through the jailhouse practice of “juggling.” The repayment terms were steep: twice the amount loaned is due back on an agreed-upon date. For each day it isn't repaid, the owed quantity doubles. Curtis had juggled the cigarettes with the promise of payback later in the week when he received money from his sister. But things took a bad turn when his sister, usually faithful about sending him ten bucks a month, was unable to do so. With the owed cigarettes rapidly multiplying, he'd never be able to pay off his “creditors.”

Janet told me that DOC would not make housing transfers based on these everyday squabbles, and that an inmate who owes money to a housemate is a sitting duck for violent retribution.

In one case that occurred before I arrived, a young man's desperation led to ultimate tragedy. My cube mate, Ellie, told me how he'd juggled cigarettes and candy, knowing his grandmother would
be visiting and bringing the money he'd use for payback. But when she wasn't up to making the trip out to Rikers that week, he panicked. Instead of pretending to be suicidal or psychotic, and possibly being pegged by us as a malingerer, he devised a risky plan for getting out of his house. The idea was to step into a bedsheet noose while a pal of his, who “happened to be walking by,” would then yell out for a CO. With such a dramatic act, he'd be a shoo-in for the MO. However, the plan went awry when the timing of the rescue was off. By the time the COs arrived, he'd already hanged for too long. Although an ambulance was quickly summoned, this twenty-one-year-old was dead on arrival at the hospital.

Curtis Bellows's situation was similar, and I tried to help him figure some way out of it. “Maybe you could call your sister again—explain things to her.”

“No,” he said. “She has her own health issues and barely has enough money for herself. If she had it, she'd have sent it.”

We were quiet for a moment before he shook his head, tears rolling down his cheeks. “I hate fighting, but I'm gonna to have to. I don't know when I'm going to get jumped . . . at night . . . in the showers . . . I just don't know. But they're coming for me.”

I was half-tempted to give him the money, to put it in his commissary account and end the whole thing. But to do so was taboo, both from a therapy standpoint and because giving
anything
to an inmate was strictly prohibited. Theoretically, I wasn't supposed to get pulled into these situations. As a therapist, it was my job to stick to mental health concerns. But I had to do something. And what I had in mind was a transfer out of his house and onto one of our Mental Observation Units. The only problem was that he wasn't mentally ill. A move like this would require Pat's approval. “Wait here,” I told Curtis.

I went back to the office where I hashed it over with the chief. Her response was exactly what I'd hoped for. “Get him out of that house. Go ahead and put him on the MO. We're always trying to make sure we don't get played that sometimes we lose our hearts. He's in emotional distress—I think that qualifies him for the MO,
don't you? You don't ever want to lose your heart, Mary,” she winked.

In that moment I felt a stab of love for Pat. While it would have been much easier for her to default to a bureaucratic template, Pat hadn't lost her own heart, and even if I were duped by a malingerer here or there, I wasn't going to lose mine either!

I practically skipped back to the clinic to deliver the good news. Bellows was ecstatic. “Thank God! Oh, thank God! Thank you, Miss B, thank you!”

I filled out the transfer form and within hours, Curtis Bellows was packed up, escorted out, and spared the trauma of certain violence.

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