Communication is Inportant

Clyde was brought into the Communicable Disease Unit when his x-ray indicated an area of concern on his left lung. The Communicable Disease Unit (CDU) houses residents in individual units when they are suspected of having tuberculosis or other infectious diseases. The residents are placed in these isolation units until it is determined medically that there in no danger to them or to the general population. The unit was very helpful in cutting down the number of people infected with TB because many of our residents do not seek medical attention when they are not in jail. In addition, since some residents are infected with HIV, they are more susceptible to infections and need additional protection.

The units have a very elaborate air-filter system with two locking door to allow for the air exchange. All personal wear masks when these patients are out of their units for medical treatment. The units are equipped with a shower, toilet, phone, a shelf with an attached seat bolted to the floor, and a television. Meals are placed a shelf between the inner and outer door. Both door are locked unless there is a reason and both door are only open when the patient comes out to see the doctor or nurse. On occasion, a nurse, doctor or mental health professional may go into the cell to speak with a patient. Whenever I go in, I always ask permission. I always ask permission to sit at the table. After all, this is his cell and I am entering only with his consent. Good manners are as important here as they are anywhere else.

The fourteen units are in a semi-circle. The fourteen units are separated by two sets of security door operated by an electrical system house in a building called the Sprung. It is a modern equivalent of a Quonset hut. Each door is opened by an officer with a key. There is a system whereby all the doors can be opened at once in case of an emergency. As with many newly built facilities all doors do not operate exactly as planned. One of the biggest complaints is about the phone system. The intercom that connects the resident with the outer world and the Correction Officer is frequently out of order. The Correction Officer can not see into each unit unless he/she takes a tour and the units are not visible from the nurses station.

The phone is the single most important privilege for a resident. He is usually given two phone calls each day. He is given a pin number as his identification number. He has six minutes of phone time. Residents may use their commissary money to charge additional phone calls. Only one resident can use the phone at any time. He must call the officers to have his phone turned on. The patient can cannot ask the officer to use the phone if the intercom doesn't work.

Clyde was a very well-groomed young man with a British accent. His manner were charming. He said that he was born in Jamaica but raised in London. He said that he went to Eton and was graduated from Oxford with a first in literature.

He was settled in a second unit, which was to the left of the officer's station and out of sight of the nursing station as well. Clyde was a model patient and resident. He was always polite, always pleasant and made no demands on anyone. He seemed to spend time on the phone but no officer remembered opening his line. Since no one remembered anything but complaints, no one took notice of Clyde beyond the usual nursing administrations and the meal deliveries.

Mental Health has the responsibility to see that every patient in isolation is at least well enough to respond by acknowledging a greeting. Clyde was always obliging. One day however, it was nearly time for Clyde to be discharged to general population. The scar on his lung was determined to be benign. He invited me into his cell and asked me to convey his thanks and appreciation to all the staff for their many kindnesses toward him. I told him that he had been a model patient and I wondered how he was able to pass his time so peacefully, without stress. "I'm always on the phone, you see. I talk to my friends and family all over the world." he said. My first reaction was fright. Had I missed some florid psychotic process? "Don't be alarmed " he said. "I'm a computer expert. I am able to tap into the computer here to make my calls. If you don't believe me, give me any phone number any place in the world and I'll connect you." I gave him the number of my sister's office in Cincinnati and he connected me. "All the calls are undetectable. They won't show up on any bill because I re-route them. I'm never bored, you see. For my next trick, would you like to see me open my cell door...all the cell doors in the unit?" I thanked him kindly but declined. The security breeches were too profound and I could not even contemplate the consequences.

A few weeks later, I went into a cell to speak with a patient. The officer opened the door to let me in. Unbeknownst to me, he was a meal relief officer. My conversation with the patient went on for some time and when I was ready to leave, I press the intercom and typically it was not working. Unfortunately when the regular officer came back from lunch, his relief did not tell him I was in the cell. It was not until the shift changed, three hours later, that the new tour began that the incoming officer checked all the cells and found me. The patient and I had watched the afternoon soaps operas together. Since I am not generally available between noon and three to watch television, the patient was kind enough to tell me the plots. It was a very pleasant way to spend an afternoon.