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FEATURES | summer 2008

Carswell Prison Blues
It's a crime how inmates have been treated at a federal hospital for incarcerated women.

My name is Janice Pugh. I was released from FMC Carswell [the only federal prison facility in the U.S. that includes a hospital for inmates] on January 10, 2000. … The reason for me being at Carswell was for medical treatment. I have a history of lung cancer. …The last six months I was coughing up blood, and a lot of it. …There was sputum tests done and a test where they put a scope down your nose. Well, I received NO results from these tests. …[Pugh went home to Alabama after her release; she had served 18 months for drug possession.] On January 20 at the Southern University of Alabama Medical Center there was a test done. …On January 24 I was admitted. …A bacteria was found growing in my lungs …and a mass was found on my top right lobe. They done a biopsy today, January 31, 2000. This is just a few things I have to say and proof that it’s true.

quoteOn March 27, 2000, two months after I received this letter, Janice Pugh died of metastasized cancer in a Mobile, Ala., hospice. She was 52 years old. She had served her sentence at FMC (Federal Medical Center) Carswell, near Fort Worth, Texas, because of her medical needs, yet her symptoms went undiagnosed and untreated there.

 “We were told by the oncologist who treated Mama [in Alabama] that she was ‘very neglected’ at Carswell,” said her daughter, Tracy Ingram.

I wish I could write that Janice Pugh’s case is an aberration. It is not. For almost a decade, I have been writing about the Janice Pughs of FMC Carswell—women as old as 80 and as young as 18, from all races and all classes, who have needlessly suffered or died from what a former Carswell doctor described as “medical mistakes, substandard care and unconscionable delays” in treatment.

Behind the nation’s razor-wire fences, egregious medical neglect has been the norm for decades. But for the most part, this dark side of prison life is ignored by the mainstream media and lawmakers, and too often accepted by the general population as just another price paid by those committing crimes. The Carswell women’s debt to society, however, shouldn’t have included their lives.

The hospital at Carswell is located on a former World War II Air Force base. The facility opened in June 1994 after the Bureau of Prisons (BOP) closed its women’s hospital in Lexington, Ky., following a scathing General Accounting Office report that cited the bureau for failing to provide adequate medical care in its federal prisons and singled out the Lexington hospital’s care as particularly egregious. Little has changed since then, critics say.

According to Bureau of Prison figures, more than 32,500 women were incarcerated in the nation’s federal prisons as of this June. That’s far fewer than men, but women’s rates at all prisons (federal, state, local) are increasing at nearly double the men’s.

Medical neglect is not the only hazard faced by women at Carswell. This May, Vincent Inametti, the prison’s Catholic chaplain for the past seven years, was sentenced to four years in jail for what the judge called “surprisingly heinous” sexual crimes against two imprisoned women. He is now the eighth sexual predator since 1997 to be convicted after working at Carswell. Most were professionals in high positions, including another chaplain, a gynecologist, a counselor, a supervisor of food services and three guards.

Most women currently behind bars in local jails, state prisons, federal penitentiaries and private for-profit penal institutions will eventually return to their communities. Their health care while incarcerated can thus have a huge social impact, financially and otherwise. If not treated effectively in prison hospitals, released inmates return to their homes with a host of mental and medical problems, including untreated AIDS and hepatitis.

Calls for an investigation of Carswell have been made to no avail by inmates’ families for years. Their voices have now been joined by Ross Sears, a retired Texas appellate judge and former Harris County district attorney. He was drawn into the Carswell quagmire when a friend asked him in 2005 to help a breast-cancer victim who suffered from what he terms “grossly negligent follow-up care” at Carswell. He then contacted U.S. Sen. John Cornyn (R-Texas), a longtime political friend, asking him to open a congressional investigation. Cornyn’s staff contacted the Bureau of Prisons and got a response, but it was of the no-problems-here variety, so the senator took no further action.

What will get Congress’ attention quicker than anything is media exposure and citizen outrage. In the meantime, little has changed for the Janice Pughs of Carswell, who remain largely forgotten as they continue to die and suffer needlessly from medical neglect in a prison system that is much more of a threat to them than they ever were to anyone else.

The full text of this article appears in the Summer issue of Ms. magazine, available on newsstands or by joining the Ms. community at www.msmagazine.com.

BETTY BRINK is a staff writer for Fort Worth Weekly, where her series of investigative reports on Carswell has won numerous journalism awards.