therapeutic modules

One of the most powerful days at San Quentin yet. I spent the morning with a psychiatrist who provides care to the inmates in East Block. East Block houses Death Row inmates, otherwise known as the condemned. These patients live in small single cells, and are handcuffed at all times when they are not otherwise locked up. During a visit with a psychiatrist, they are placed in a clear cage so that the security guard can leave and offer a semblance of confidentiality. These cages are called "therapeutic modules" by the department of corrections, and are called cages by everyone else who actually uses them. These limitations made East Block distinct for me. I also had my own limitations--this is the only place in San Quentin others felt compelled to have me wear a security vest, which I have never worn before. In the same way that I feel lighter after leaving the prison and turning in my alarm system, I felt relieved to take off this weight after leaving East Block, despite its design for protection.

Many of these inmates have been here for twenty, thirty years. California hasn't executed an inmate in years, and is unlikely to ever do so. So these people are serving life sentences on what is called Death Row, and they have learned to adjust to a unique kind of life that I honestly never gave any thought to until I saw it in front of me.

There doesn't seem to be a set time for each appointment, and the loose wandering time that is locked up in our tiny interview room made me feel, in a small remote way, parallel to the inmate. He spoke incredibly insightfully and thoughtfully about his experience. "There are so many parts of yourself that aren't fulfilled while you're here, and you sit with your thoughts all day long trying to fill yourself." He spoke about experiencing by imagining experiences. "I thought, if I had money I'd go out and buy an expensive kite--the kind that costs a hundred dollars. I'd go out to the park and roll out the string until it flew high, so high you could barely see it...and then I'd pass it off to a kid. See the magical look in his face. Knowing that when I was seven or eight, that would just be magic." And for two minutes, he could feel the joy of this experience. Instead of being angry about not being able to experience it, he could really feel it. Then let it pass.

We talked about mindfulness, stories, and relapses. It's not always so easy to fulfill yourself without light to define shapes and senses. I thought about how I've never a thought quite like that one about the kite, an urge that captured quite that sentiment. I know it is too obvious, but it is too true that imprisonment opens parts of people that maybe everyone has but no one else truly experiences.

Unlike other times I've shadowed providers, these patients spoke to me directly. Asked me questions, explained things to me, looked at me instead of their actual doctor. They seemed to appreciate having another person to share with, to drink in the fact their words were being heard by a new person, newness being a rarity in this environment. One man sat quietly in the cage, and another pressed himself against the glass and stood on tiptoe, getting as close as possible to the small opening of air at the top. I've never spoken to a patient through a glass cage before, and never thought I'd feel such weight and closeness in that environment.

I spent some time in interdisciplinary team treatment meetings, where an inmate in the EOP (enhanced outpatient program for mental health) would sit at the head of the table and discuss his care with a team of psychiatrists, psych techs, and counselors. One felt he no longer needed these services. One wanted more services. Each meeting felt a little tense to me, partly because we were crowded in a room designed to house half the amount of people in it, and partly because each person in the room seemed to be either holding back or removed from the space. It reminded me of working at the Connecticut Mental Health Center in New Haven, where morning rounds which consisted of these strange meetings that I knew were meant to be patient centered but felt kind of like a court trial.

It's hard to write truly about these experiences, partly because I just want to record them before I forget more so than write about them well. But mostly because I don't really understand them enough to write about them, and I don't write well enough to write about things I don't understand. But it's this distance that compels me to stay, move closer, try.