August 7, 2025 • 20 mins
Explores the profound health risks and systemic failures within the U.S. jail system, particularly at Rikers Island. The author, a former Chief Medical Officer of NYC Jails, details how incarceration harms health, often through deliberate indifference to medical needs, physical and sexual abuse, and the detrimental effects of solitary confinement. The text highlights racial disparities in treatment and the criminalization of mental illness and substance use, arguing that jail often exacerbates these conditions rather than offering appropriate care. Case studies of individuals like Kalief Browder, who died by suicide after prolonged detention and abuse, underscore the devastating human cost. Ultimately, the author advocates for greater transparency, accountability, and a shift from punitive measures to health-focused interventions, suggesting that closing facilities like Rikers is crucial for meaningful reform.
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You can listen and download our episodes for free on more than 10 different platforms:
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Get the Book now from Amazon:
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to the deep dive today. We're looking at something
tough but really important. Yeah, the idea that the places
we incarceraate people, well, they can actually make them much
more likely to die or get seriously hurt.
Speaker 2 (00:13):
It really challenges that, you know, common idea that people
behind bars are just getting what they deserve Exactly.
Speaker 1 (00:20):
This deep dive goes into a much darker picture.
Speaker 2 (00:22):
We're getting into doctor Homer Venter's book Life and Death
in Rikers Island, and his perspective is pretty unique because.
Speaker 1 (00:28):
He was the chief medical officer for NYC Jails. Huh,
so he saw it all firsthand.
Speaker 2 (00:33):
That's right, he was right there, and his book it
uses his experiences the data to show how the whole system, well,
it often twists the mission of healthcare because of security concerns.
Speaker 1 (00:44):
And that leads to real harm, sometimes fatal harm.
Speaker 2 (00:48):
Yeah, pervasive harm.
Speaker 1 (00:49):
So our goal today for you listening is to really
show you the human stories the systemic breakdowns inside Rikers.
Speaker 2 (00:55):
One of the most notorious jail complexes anywhere.
Speaker 1 (00:59):
Well, look at how incars there often completely fails in
its purpose through the eyes of people who actually lived it,
So who didn't make it.
Speaker 2 (01:05):
Out Okay, So let's start with this idea of a
fundamental right to health care in jail and how it
gets betrayed. Right, Think back to nineteen seventy three JW. Gamble.
He was incarcerated down in Texas. A huge like six
hundred pound hay bail fell on him, serious injuries, and
the medical care he got was patchy, inadequate, didn't really
(01:26):
help the pain.
Speaker 1 (01:27):
So what do you do?
Speaker 2 (01:28):
Well, eventually he refused to work because he was in
so much pain, still untreated, and for that he got
disciplinary write ups, solitary.
Speaker 1 (01:35):
Confinement, punished for being injured pretty much.
Speaker 2 (01:38):
But then from his cell he actually wrote out a
lawsuit by hand.
Speaker 1 (01:42):
Wow, just wrote it himself.
Speaker 2 (01:44):
Yeah, and incredibly, this handwritten plea. It went all the
way to the US Supreme Court. No way, Yes, in
nineteen seventy six, the case a stealthy gamble. The court
sided with him, and this set a huge precedent that
denying me care to someone incarcerated amounts to deliberate indifference,
(02:05):
and that violates the Eighth Amendment, the one against cruel
and unusual punishment.
Speaker 1 (02:10):
Okay, so deliberate indifference is the key term it is.
Speaker 2 (02:13):
And think about this. It effectively makes incarcerated people the
only group in the whole country with a constitutional guaranteed.
Speaker 1 (02:20):
Healthcare the only group that's striking. It really is so okay,
The Supreme Court says, this decades ago. How then do
we get to stories like Carlos Mercados. It seems like
a total disconnect.
Speaker 2 (02:32):
It's a tragic disconnect. So Carlos Mercado gets arrested in
Brooklyn drug charge. He ends up at the Anna M.
Cross Center am cac on Rikers.
Speaker 1 (02:41):
Which you said is one of the most chaotic spot.
Speaker 2 (02:43):
Absolutely chaotic. Intake is just these crowded pens, people standing sitting,
lying around for hours.
Speaker 1 (02:50):
Waiting awful conditions.
Speaker 2 (02:52):
And mister Mercado, he was diabetic. He starts feeling really sick,
vomiting into a garbage bag. He tells multiple officers, I'm diabetic,
I need help.
Speaker 1 (02:59):
And what happens.
Speaker 2 (03:00):
They dismiss him. They tell him, no, you're just withdrawing,
oh bernover, Oh no. A witness even heard an officer
say something like, well, if you don't get up when
I call him, he ain't gonna get his methodone just
callous disregard.
Speaker 1 (03:10):
They just assumed didn't check his actual medical needs exactly.
Speaker 2 (03:15):
He was eventually sort of walked to another pen, saw
one health staff member very briefly, and then he died
shortly after arriving.
Speaker 1 (03:23):
And doctor Venters calls this jail attributable, meaning the system
itself played a role.
Speaker 2 (03:29):
Yes, precisely, systemic failures, individual errors, they all contributed significantly.
His family ended up getting a one point five million
dollar settlement.
Speaker 1 (03:39):
But it's not just about one mistake, is it's about
the system? Right?
Speaker 2 (03:42):
Mercado's death, like so many others Venters documented, shows that
these aren't just you know, isolated accidents. They are almost
predictable feature of how the jail operates.
Speaker 1 (03:51):
And the withdrawal they thought he had mm hmm, that
could be dangerous too.
Speaker 2 (03:54):
Right, Absolutely, alcohol withdrawal, especially for someone maybe with other
health issues like liver prop can be fatal. It's a
serious medical emergency that needs proper attention.
Speaker 1 (04:04):
So beyond the medical neglect, which is horrifying, Doctor Venters
also documents just outright brutality.
Speaker 2 (04:12):
Yes, the story Robert Hinton is stark tell us about him.
He was twenty six, considered a security risk by the
jail officers, hog tied him took him to a cell specifically.
Speaker 1 (04:23):
Off camera, deliberately, out of you.
Speaker 2 (04:25):
Deliberately, and they beat him so badly his face and
neck bones were broken.
Speaker 1 (04:30):
My god, how did that even come to light?
Speaker 2 (04:32):
Well, the injuries were so bad it became public during
a disciplinary trial. The judge Tanier Richard was apparently furious,
recommended the officers be fired. Were they The city eventually
settled with mister Hinton for four hundred and fifty thousand dollars,
But the story doesn't end well. What happened tragically in
twenty fifteen, right before he was supposed to get that
settlement money, Robert Hinton was killed back in his community
(04:55):
in Brooklyn.
Speaker 1 (04:56):
Oh terrible.
Speaker 2 (04:56):
He'd spent a decade in and out of jail and
enduring this violence in his life, and his death really
show how the system's impact stretches far beyond the jail walls.
Speaker 1 (05:05):
It's a cycle, and his case shows the physical violence.
But you mentioned power dynamics really enabling this stuff.
Speaker 2 (05:11):
Yeah. Jamal Lightfoot's case is a prime example.
Speaker 1 (05:14):
What happened with him.
Speaker 2 (05:15):
He apparently just eyeballed, you know, looked at a group
of senior Department of Correction leaders walking by just looked
at them, that's the story. And the top security official
there allegedly told officers, I want you to knock his fin.
Speaker 1 (05:28):
Teeth in just for looking.
Speaker 2 (05:30):
That's unbelievable, and they did. He was beaten badly, multiple
facial fractures. It became a really infamous face. Why infamous
because it highlighted the incredible power of the Correction Officers
Union COOBA and its head at the time, Norman Seabrook.
Speaker 1 (05:46):
How powerful was he.
Speaker 2 (05:47):
He often seemed honestly more powerful than the actual Commissioner
of Corrections. Doctor Venters talks about this intense meeting where
Seabrook just tore into the health staff really yeah, and
threatened to go back to nineteen ninety.
Speaker 1 (06:00):
What does that mean?
Speaker 2 (06:00):
It was a reference to a big riot in nineteen
ninety where COBA basically showed its muscle, shut things down,
overwhelmed the jail. It was a threat.
Speaker 1 (06:08):
So a real culture of intimidation.
Speaker 2 (06:09):
Topped down, a deep seated culture of brutality, as vendors
calls it. Lightfoot's case eventually led to a three point
nine million dollar settlement. The security chief and six other
staff were actually convicted.
Speaker 1 (06:22):
That's something at least, but it sounds like these incidents
weren't always reported accurately.
Speaker 2 (06:28):
Not even close. Venors analysis found this pattern of just
rampant under reporting, systematic hou So some injuries just vanished,
never recorded. Others were deliberately minimized. You know, a broken
jaw becomes fell on a toilet seriously. Yeah, and patients
were scared, they were threatened more violence solitary if they
told medical staff the truth.
Speaker 1 (06:49):
So a wall of silence built on.
Speaker 2 (06:51):
Fear exactly, a whole system designed to hide just how
much harm was really happening, not just individuals, but the
system protecting itself.
Speaker 1 (07:00):
This leads us to perhaps the most chilling practice, solitary confinement.
Speaker 2 (07:04):
Yeah, down the hall, in the solitary unit, that's where
Jason Eshuveria died. He was only twenty five.
Speaker 1 (07:10):
What happened to him?
Speaker 2 (07:10):
He was in solitary desperate, He swallowed a packet of
industrial they call it a soapball, trying to get out,
get medical attention. Desperate act extremely medical staff even confirmed, yes,
he swallowed soap. He's vomiting, he needs urgent.
Speaker 1 (07:23):
Care, so they took him to the clinic.
Speaker 2 (07:24):
No, he was kept in his cell overnight, ignored, sometimes taunted, taunted. Yeah,
staff labeled him a bing beater, this awful term for inmates,
they think or faking illness to get out of the ban,
out of solitary, dehumanizing him, left him, left him. He
spent his last hours vomiting blood, bile, lie, screaming for help.
(07:47):
His esophagus eroded, then he died. Sure, and get this,
there was an unexplained power outage that stopped the cameras
right before he died.
Speaker 1 (07:55):
How convenient.
Speaker 2 (07:56):
Right. His death led to a three point eight million
dollars settlement, and the doc supervisor actually got five years
in federal prison for his role.
Speaker 1 (08:04):
It's just hard to comprehend. And solitary itself has this
grim history, doesn't it.
Speaker 2 (08:09):
It does. Started way back Philadelphia eighteen twenty nine. The
Quakers thought isolation would lead to quiet, reflection penitents.
Speaker 1 (08:16):
Oh, it didn't work out that way.
Speaker 2 (08:17):
Often led to suicide insanity. Charles Dickens visited and called
it immeasurably worse than any torture of the body.
Speaker 1 (08:24):
And it came back strong later.
Speaker 2 (08:26):
Yeah, after prison killings at Maryan Federal prison in nineteen
eighty two that led to the rise of supermax prisons
using extreme isolation as punishment, which brings us to Candy
Haley's story, right, Candy Haley held on half a million
dollars bail for attempted murder charges she was later found
innocent of, by.
Speaker 1 (08:44):
The way, innocent, but she was held for how long?
Speaker 2 (08:46):
Three years? And she spent over two of those years
in solitary confinement.
Speaker 1 (08:51):
Two years in solitary yes.
Speaker 2 (08:53):
And she acted out understandably, maybe cursing officers, blocking her
cell window, smearing feces. She even said, if you're going
to treat me like a dog, I'm going to act likewise.
Speaker 1 (09:03):
A sign of desperation.
Speaker 2 (09:04):
And she hurt herself repeatedly swallowing things, cutting herself, hitting
her head against the wall.
Speaker 1 (09:09):
How did staff react to that?
Speaker 2 (09:11):
Often again judged as manipulative? Health staff were caught in
this terrible bind what Ventres calls dual loyalty, trying to
figure out is this real mental illness or is she
just trying to escape the torture of solitary.
Speaker 1 (09:24):
An impossible position for everyone. Her case is.
Speaker 2 (09:26):
Still pending, still pending, but the data her situation highlights
is crucial.
Speaker 1 (09:31):
What did the data show? This is from doctor Ventre's team.
Speaker 2 (09:33):
Again, yeahs, team crunched the numbers. Only about seven percent
of all inmates went into solitary. Tiny fraction. Okay, but
listen to this. Over half of all self harm incidents
in the entire jail system happened in that seven percent group.
Speaker 1 (09:46):
Over half from just seven percent of the population.
Speaker 2 (09:49):
Exactly, people in solitary were six point nine times more
likely to hurt themselves almost seven times.
Speaker 1 (09:56):
That's undeniable. Proof of the.
Speaker 2 (09:57):
Harm undeniable, And that data was powerful. It directly led
to NYC getting rid of a specific punitive solitary unit,
the MHAUII, and reforming solitary for adolescents and the seriously
mentally ill.
Speaker 1 (10:11):
So the data made a real difference.
Speaker 2 (10:13):
A huge difference. Justice Kennedy even cited this NYC data
in a twenty fifteen Supreme Court opinion suggesting the whole
country needed to look again at solitary.
Speaker 1 (10:21):
It shows how tracking this stuff, documenting it is so vital.
Speaker 2 (10:25):
Absolutely, which connects to another systemic failure dealing with serious
mental illness.
Speaker 1 (10:30):
Bradley Ballard's story.
Speaker 2 (10:32):
Yes, Bradley Ballard, thirty nine years old, arrested in Houston,
sent back to Wikers, he had serious known mental illness.
After being transferred from Bellevue Hospital, he had some behavioral issues.
Security staff responded by locking him in a cell for
a week.
Speaker 1 (10:50):
A week just locked in? Is that allowed?
Speaker 2 (10:52):
Completely against policy? They turned his water off. He had
no access to mental health care, no medical visits, nothing.
They just abandoned him effectively. Yes, and unknown to them,
he had tied something a ligature around his genitals. It
caused massive tissue death infection.
Speaker 1 (11:07):
Oh my god, didn't anyone notice anything.
Speaker 2 (11:10):
Officers apparently sprayed air freshener into his cell because of
the smell, but nobody went in, Nobody intervened properly.
Speaker 1 (11:17):
They smell him dying and sprayed air freshener.
Speaker 2 (11:20):
That's the report. He died from the infection, from dehydration,
covered in feces, cardiac arrest.
Speaker 1 (11:26):
It's beyond negligence. His family settled.
Speaker 2 (11:29):
Yes, five point seventy five million dollars. But his death
wasn't just one breakdown. It was again systemic. Oh so
chronic understaffing, security not bringing patients to the clinic, health
staff not even knowing where patients were sometimes because they
used ancient paper tracking.
Speaker 1 (11:45):
Systems vapor tracking in this day and age.
Speaker 2 (11:47):
Yep, And this all happens against a bigger backdrop.
Speaker 1 (11:50):
Right.
Speaker 2 (11:51):
Since the nineteen sixties, the US has massively closed down
public mental health hospital the institutionalization exactly. We went from
like five hundred and fifty dy thousand beds down to
maybe forty three thousand by twenty eleven. So where do
people with serious mental illness end up?
Speaker 1 (12:07):
Jails and prisons.
Speaker 2 (12:08):
Jails and prisons have become the default mental health system,
especially for the poor, for minorities. At Rikers, the number
of inmates needing mental health services shot up from a
third to about half the population. Seriously mentally ill people
like Ballard went from five percent to eleven percent of
the daily count.
Speaker 1 (12:25):
The jails became dumping grounds essentially.
Speaker 2 (12:27):
And worse, venors found disturbing racial disparities in how mental
illness was handled within the jail.
Speaker 1 (12:33):
What kind of disparities.
Speaker 2 (12:34):
Well, White patients seemed more likely to actually get mental
health treatment non white patients. They were more likely to
be punished with solitary confinement instead of treated.
Speaker 1 (12:43):
Punished for mental illness.
Speaker 2 (12:44):
The numbers were stark. Black patients were two point five
times more likely to end up in solitary than white patients.
Latino patients almost one point nine times more likely.
Speaker 1 (12:54):
That's shocking.
Speaker 2 (12:54):
And look at when they got care. White patients often
got into mental health services quickly, within days, proactive.
Speaker 1 (13:01):
Maybe, and non white patients.
Speaker 2 (13:03):
They often entered mental health services later, and it was
strongly linked to when they entered solitary.
Speaker 1 (13:08):
So solitary came first, then maybe some mental health attention.
Speaker 2 (13:12):
It suggests solitary itself might have been causing or worsening
their distress, not that they were getting treatment for a
pre existing condition before being punished.
Speaker 1 (13:22):
It sounds like they were punished for reacting to the conditions.
Speaker 2 (13:24):
It really does. It echoes awful historical things like in
the eighteen fifties doctors diagnosing runaway slaves with drape domania,
pathologizing a natural reaction to.
Speaker 1 (13:34):
Oppression, medicalizing resistance exactly. There's another shadow hanging over all
of this, sexual.
Speaker 2 (13:40):
Abuse, a deeply disturbing, often hidden part of incarceration. Doctor
Venter's shares stories like Maria's what happened to her? Maria
was intellectually disabled, making her vulnerable. A specific correction officer
targeted her, targeted her sexually assaulted her regularly, up to
four times a week. Whenever she happened to be in jail,
(14:01):
he'd choke her, threatened her to keep her quiet.
Speaker 1 (14:04):
How could he get away with that?
Speaker 2 (14:05):
Repeatedly he used his keys to get into unused areas,
lack of supervision. It was predatory. He even controlled her
outside jail, involving her family total control.
Speaker 1 (14:15):
That's horrifying. Is her case resolved.
Speaker 2 (14:17):
It's part of a pending class action lawsuit.
Speaker 1 (14:20):
And hers isn't an isolated story.
Speaker 2 (14:22):
Brianna's experience also harrowing. Brianna was actually working as a
suicide prevention aid and inmate role. An officer groomed her,
groomed her, how offered her money for oral sex, then
forced her to do it in a janitor's closet off camera.
Speaker 1 (14:36):
Threatened her and it didn't stop there No.
Speaker 2 (14:39):
He then orchestrated this campaign of abuse against her from
other inmates, other officers, denying her showers, time outside food,
pushed her towards suicide.
Speaker 1 (14:47):
So retaliation for being assaulted.
Speaker 2 (14:50):
Yes, When she finally reported it, they moved her, but
the harassment continued, called snitch bitch. They even tried to
force her to sign a confession, saying she made it up.
Speaker 1 (14:58):
Did she sign it?
Speaker 2 (14:59):
She bravely signed someone else's name, a small act of defiance.
She later found out she'd contract it. An STI from
the assault, just.
Speaker 1 (15:07):
Layer upon layer of trauma. Her cases pending too.
Speaker 2 (15:09):
Also pending, and doctor Venters uses this term nosocomial rape.
Speaker 1 (15:13):
No socmeal like hospital required infection.
Speaker 2 (15:16):
Exactly abuse that is essentially caused by the institution itself.
The setting enables it.
Speaker 1 (15:21):
There's a law about this, right prea.
Speaker 2 (15:23):
Yes, the Prison Rape Elimination Act federal law supposed to
set standards for preventing, detecting, responding to sexual abuse, and detention.
Speaker 1 (15:32):
But it doesn't always work.
Speaker 2 (15:33):
It's met resistance in places like New York City, and
the consequences of failure are horrific. Venters mentions Rodney Huhln,
a seventeen year old in Texas.
Speaker 1 (15:42):
What happened to him?
Speaker 2 (15:43):
Repeatedly raped, beaten by other inmates. He begged for protective
custody denied. He eventually hanged himself died by suicide.
Speaker 1 (15:51):
Just devastating. Why does this keep happening?
Speaker 2 (15:53):
Managerial incompetence, Ventors argues lacks security. He mentions an ex
inmate who literally impersonated staff and abuse detainees, and a
culture that dismisses victims based on who they are mentally
ill LGBTQ.
Speaker 1 (16:06):
So reporting is low.
Speaker 2 (16:07):
Official reporting is low. Anonymous surveys show much higher rates
like nine percent of women five percent of men reporting
sexual abuse in DOJ surveys, but very few reports maybe
two point five percent, actually get substantiated by the facilities.
So if you look at all these stories, Mercado's neglect,
the beatings of Hinton and Lightfoot, the torture and solitary
(16:28):
for Etchivaria and Hayley, Ballard's death from system failure, the
abuse of Maria and Brianna, Yeah, the common thread is
this profound lack of transparency. Howso the outdated paper records
we mentioned, officers moving inmates around without proper tracking, it
all creates blind spots where abuse and neglect can flourish.
Speaker 1 (16:47):
An unseen system, like you said.
Speaker 2 (16:48):
But importantly, Venor shows how his health team tried to
fight this. They use their Electronic Medical Records EMRs almost
like a human rights.
Speaker 1 (16:55):
Tool, documenting everything.
Speaker 2 (16:57):
Meticulously documenting injuries, neglect, abuse patterns, using the data to
try and hold the security side accountable, shining a light
where they could.
Speaker 1 (17:06):
And speaking of shining a light, the role of the
press seems crucial here too.
Speaker 2 (17:10):
Absolutely vital journalists like Jake Pearson, Michael Winup, Michael Schwartz
at The New York Times. Their investigative work was relentless.
Speaker 1 (17:18):
What impact did it have?
Speaker 2 (17:19):
It dragged the brutality, the systemic failures of rikers out
into the open, forced the public, forced policymakers to confront it.
It really drove reforms.
Speaker 1 (17:28):
Which leads to the big debate now, Closing rikers altogether right.
Speaker 2 (17:33):
An idea doctor Venters strongly supports, and the arguments are
pretty clear.
Speaker 1 (17:37):
How what are the main ones?
Speaker 2 (17:38):
Just the sheer scale of the place makes it unmanageable.
The buildings are literally crumbling. Each jail kind of operates
like its own little kingdom, and that culture of violence
is just so deeply embedded.
Speaker 1 (17:49):
What wasn't always a popular idea politically though, no.
Speaker 2 (17:52):
Lots of complexities. Mayor de Blasio initially called closing it unrealistic.
Governor Cuomo supported it, then Deblasio eventually came around and
signed on.
Speaker 1 (18:01):
But it's not simple building new jails elsewhere.
Speaker 2 (18:05):
Huge logistical challenges building smaller, more modern, hopefully more humane
facilities off the island. It's a massive undertaking, but probably
necessary for real change.
Speaker 1 (18:15):
And like you said earlier, this isn't just about Rikers.
We have to look outside the walls exactly.
Speaker 2 (18:20):
Think about bail. How cash bail keeps poor people, mostly
people of color, locked up even when they're presumed innocent.
Speaker 1 (18:27):
Just because they can't afford bail.
Speaker 2 (18:28):
Right, So the need for bail reform, maybe even abolishing
cash bail like Washington d CEDD, is critical, and we
have to remember the long term.
Speaker 1 (18:37):
Damage like Kayleif Browder.
Speaker 2 (18:39):
Kayleief Browder arrested at sixteen accused of stealing a backpack,
spent three years on Rakers, much of it in solitary
because his family couldn't make bail. Charges were eventually.
Speaker 1 (18:49):
Dropped, but the damage was done.
Speaker 2 (18:51):
The trauma was profound. He died by suicide years after
his release. His story is a heartbreaking reminder of the
lasting scars incarceration.
Speaker 1 (19:00):
So wrapping this up, the core message from doctor Venter's
work seems incredibly clear.
Speaker 2 (19:05):
It is incarceration, especially in a place like Rikers, is
inherently dangerous to people's health. It leads to preventable injuries,
deep psychological pain, sexual assault, and death.
Speaker 1 (19:16):
And it's not just about a few bad apples.
Speaker 2 (19:18):
No, these are systemic issues baked into the system, power imbalances,
lack of transparency, a culture that values punishment far above care.
Speaker 1 (19:29):
And why should everyone listening care about this even if
they never set foot near.
Speaker 2 (19:33):
A jail, Because the costs are huge, not just the
human cost, which is immeasurable, but the financial cost taxpayers
footing the bill for millions in settlements for things that
should never have happened.
Speaker 1 (19:45):
And the societal costs. These issues don't stay contained within
the jail walls.
Speaker 2 (19:50):
They ripple out, affect families, communities, trust in the justice system, everything.
Speaker 1 (19:54):
So maybe the final thought for everyone to take away
is this, Yeah, if we as a society fun and
tolerate a correctional system that consistently fails basic standards of safety, health,
human rights, what does that really say about our value right?
Speaker 2 (20:10):
And what's our responsibility? What do we owe to ensure
every single person, no matter their circumstances, is treated with
basic dignity and gets the care they need. That's the
question we have to ask ourselves
Welcome to the deep dive today. We're looking at something
tough but really important. Yeah, the idea that the places
we incarceraate people, well, they can actually make them much
more likely to die or get seriously hurt.
Speaker 2 (00:13):
It really challenges that, you know, common idea that people
behind bars are just getting what they deserve Exactly.
Speaker 1 (00:20):
This deep dive goes into a much darker picture.
Speaker 2 (00:22):
We're getting into doctor Homer Venter's book Life and Death
in Rikers Island, and his perspective is pretty unique because.
Speaker 1 (00:28):
He was the chief medical officer for NYC Jails. Huh,
so he saw it all firsthand.
Speaker 2 (00:33):
That's right, he was right there, and his book it
uses his experiences the data to show how the whole system, well,
it often twists the mission of healthcare because of security concerns.
Speaker 1 (00:44):
And that leads to real harm, sometimes fatal harm.
Speaker 2 (00:48):
Yeah, pervasive harm.
Speaker 1 (00:49):
So our goal today for you listening is to really
show you the human stories the systemic breakdowns inside Rikers.
Speaker 2 (00:55):
One of the most notorious jail complexes anywhere.
Speaker 1 (00:59):
Well, look at how incars there often completely fails in
its purpose through the eyes of people who actually lived it,
So who didn't make it.
Speaker 2 (01:05):
Out Okay, So let's start with this idea of a
fundamental right to health care in jail and how it
gets betrayed. Right, Think back to nineteen seventy three JW. Gamble.
He was incarcerated down in Texas. A huge like six
hundred pound hay bail fell on him, serious injuries, and
the medical care he got was patchy, inadequate, didn't really
(01:26):
help the pain.
Speaker 1 (01:27):
So what do you do?
Speaker 2 (01:28):
Well, eventually he refused to work because he was in
so much pain, still untreated, and for that he got
disciplinary write ups, solitary.
Speaker 1 (01:35):
Confinement, punished for being injured pretty much.
Speaker 2 (01:38):
But then from his cell he actually wrote out a
lawsuit by hand.
Speaker 1 (01:42):
Wow, just wrote it himself.
Speaker 2 (01:44):
Yeah, and incredibly, this handwritten plea. It went all the
way to the US Supreme Court. No way, Yes, in
nineteen seventy six, the case a stealthy gamble. The court
sided with him, and this set a huge precedent that
denying me care to someone incarcerated amounts to deliberate indifference,
(02:05):
and that violates the Eighth Amendment, the one against cruel
and unusual punishment.
Speaker 1 (02:10):
Okay, so deliberate indifference is the key term it is.
Speaker 2 (02:13):
And think about this. It effectively makes incarcerated people the
only group in the whole country with a constitutional guaranteed.
Speaker 1 (02:20):
Healthcare the only group that's striking. It really is so okay,
The Supreme Court says, this decades ago. How then do
we get to stories like Carlos Mercados. It seems like
a total disconnect.
Speaker 2 (02:32):
It's a tragic disconnect. So Carlos Mercado gets arrested in
Brooklyn drug charge. He ends up at the Anna M.
Cross Center am cac on Rikers.
Speaker 1 (02:41):
Which you said is one of the most chaotic spot.
Speaker 2 (02:43):
Absolutely chaotic. Intake is just these crowded pens, people standing sitting,
lying around for hours.
Speaker 1 (02:50):
Waiting awful conditions.
Speaker 2 (02:52):
And mister Mercado, he was diabetic. He starts feeling really sick,
vomiting into a garbage bag. He tells multiple officers, I'm diabetic,
I need help.
Speaker 1 (02:59):
And what happens.
Speaker 2 (03:00):
They dismiss him. They tell him, no, you're just withdrawing,
oh bernover, Oh no. A witness even heard an officer
say something like, well, if you don't get up when
I call him, he ain't gonna get his methodone just
callous disregard.
Speaker 1 (03:10):
They just assumed didn't check his actual medical needs exactly.
Speaker 2 (03:15):
He was eventually sort of walked to another pen, saw
one health staff member very briefly, and then he died
shortly after arriving.
Speaker 1 (03:23):
And doctor Venters calls this jail attributable, meaning the system
itself played a role.
Speaker 2 (03:29):
Yes, precisely, systemic failures, individual errors, they all contributed significantly.
His family ended up getting a one point five million
dollar settlement.
Speaker 1 (03:39):
But it's not just about one mistake, is it's about
the system? Right?
Speaker 2 (03:42):
Mercado's death, like so many others Venters documented, shows that
these aren't just you know, isolated accidents. They are almost
predictable feature of how the jail operates.
Speaker 1 (03:51):
And the withdrawal they thought he had mm hmm, that
could be dangerous too.
Speaker 2 (03:54):
Right, Absolutely, alcohol withdrawal, especially for someone maybe with other
health issues like liver prop can be fatal. It's a
serious medical emergency that needs proper attention.
Speaker 1 (04:04):
So beyond the medical neglect, which is horrifying, Doctor Venters
also documents just outright brutality.
Speaker 2 (04:12):
Yes, the story Robert Hinton is stark tell us about him.
He was twenty six, considered a security risk by the
jail officers, hog tied him took him to a cell specifically.
Speaker 1 (04:23):
Off camera, deliberately, out of you.
Speaker 2 (04:25):
Deliberately, and they beat him so badly his face and
neck bones were broken.
Speaker 1 (04:30):
My god, how did that even come to light?
Speaker 2 (04:32):
Well, the injuries were so bad it became public during
a disciplinary trial. The judge Tanier Richard was apparently furious,
recommended the officers be fired. Were they The city eventually
settled with mister Hinton for four hundred and fifty thousand dollars,
But the story doesn't end well. What happened tragically in
twenty fifteen, right before he was supposed to get that
settlement money, Robert Hinton was killed back in his community
(04:55):
in Brooklyn.
Speaker 1 (04:56):
Oh terrible.
Speaker 2 (04:56):
He'd spent a decade in and out of jail and
enduring this violence in his life, and his death really
show how the system's impact stretches far beyond the jail walls.
Speaker 1 (05:05):
It's a cycle, and his case shows the physical violence.
But you mentioned power dynamics really enabling this stuff.
Speaker 2 (05:11):
Yeah. Jamal Lightfoot's case is a prime example.
Speaker 1 (05:14):
What happened with him.
Speaker 2 (05:15):
He apparently just eyeballed, you know, looked at a group
of senior Department of Correction leaders walking by just looked
at them, that's the story. And the top security official
there allegedly told officers, I want you to knock his fin.
Speaker 1 (05:28):
Teeth in just for looking.
Speaker 2 (05:30):
That's unbelievable, and they did. He was beaten badly, multiple
facial fractures. It became a really infamous face. Why infamous
because it highlighted the incredible power of the Correction Officers
Union COOBA and its head at the time, Norman Seabrook.
Speaker 1 (05:46):
How powerful was he.
Speaker 2 (05:47):
He often seemed honestly more powerful than the actual Commissioner
of Corrections. Doctor Venters talks about this intense meeting where
Seabrook just tore into the health staff really yeah, and
threatened to go back to nineteen ninety.
Speaker 1 (06:00):
What does that mean?
Speaker 2 (06:00):
It was a reference to a big riot in nineteen
ninety where COBA basically showed its muscle, shut things down,
overwhelmed the jail. It was a threat.
Speaker 1 (06:08):
So a real culture of intimidation.
Speaker 2 (06:09):
Topped down, a deep seated culture of brutality, as vendors
calls it. Lightfoot's case eventually led to a three point
nine million dollar settlement. The security chief and six other
staff were actually convicted.
Speaker 1 (06:22):
That's something at least, but it sounds like these incidents
weren't always reported accurately.
Speaker 2 (06:28):
Not even close. Venors analysis found this pattern of just
rampant under reporting, systematic hou So some injuries just vanished,
never recorded. Others were deliberately minimized. You know, a broken
jaw becomes fell on a toilet seriously. Yeah, and patients
were scared, they were threatened more violence solitary if they
told medical staff the truth.
Speaker 1 (06:49):
So a wall of silence built on.
Speaker 2 (06:51):
Fear exactly, a whole system designed to hide just how
much harm was really happening, not just individuals, but the
system protecting itself.
Speaker 1 (07:00):
This leads us to perhaps the most chilling practice, solitary confinement.
Speaker 2 (07:04):
Yeah, down the hall, in the solitary unit, that's where
Jason Eshuveria died. He was only twenty five.
Speaker 1 (07:10):
What happened to him?
Speaker 2 (07:10):
He was in solitary desperate, He swallowed a packet of
industrial they call it a soapball, trying to get out,
get medical attention. Desperate act extremely medical staff even confirmed, yes,
he swallowed soap. He's vomiting, he needs urgent.
Speaker 1 (07:23):
Care, so they took him to the clinic.
Speaker 2 (07:24):
No, he was kept in his cell overnight, ignored, sometimes taunted, taunted. Yeah,
staff labeled him a bing beater, this awful term for inmates,
they think or faking illness to get out of the ban,
out of solitary, dehumanizing him, left him, left him. He
spent his last hours vomiting blood, bile, lie, screaming for help.
(07:47):
His esophagus eroded, then he died. Sure, and get this,
there was an unexplained power outage that stopped the cameras
right before he died.
Speaker 1 (07:55):
How convenient.
Speaker 2 (07:56):
Right. His death led to a three point eight million
dollars settlement, and the doc supervisor actually got five years
in federal prison for his role.
Speaker 1 (08:04):
It's just hard to comprehend. And solitary itself has this
grim history, doesn't it.
Speaker 2 (08:09):
It does. Started way back Philadelphia eighteen twenty nine. The
Quakers thought isolation would lead to quiet, reflection penitents.
Speaker 1 (08:16):
Oh, it didn't work out that way.
Speaker 2 (08:17):
Often led to suicide insanity. Charles Dickens visited and called
it immeasurably worse than any torture of the body.
Speaker 1 (08:24):
And it came back strong later.
Speaker 2 (08:26):
Yeah, after prison killings at Maryan Federal prison in nineteen
eighty two that led to the rise of supermax prisons
using extreme isolation as punishment, which brings us to Candy
Haley's story, right, Candy Haley held on half a million
dollars bail for attempted murder charges she was later found
innocent of, by.
Speaker 1 (08:44):
The way, innocent, but she was held for how long?
Speaker 2 (08:46):
Three years? And she spent over two of those years
in solitary confinement.
Speaker 1 (08:51):
Two years in solitary yes.
Speaker 2 (08:53):
And she acted out understandably, maybe cursing officers, blocking her
cell window, smearing feces. She even said, if you're going
to treat me like a dog, I'm going to act likewise.
Speaker 1 (09:03):
A sign of desperation.
Speaker 2 (09:04):
And she hurt herself repeatedly swallowing things, cutting herself, hitting
her head against the wall.
Speaker 1 (09:09):
How did staff react to that?
Speaker 2 (09:11):
Often again judged as manipulative? Health staff were caught in
this terrible bind what Ventres calls dual loyalty, trying to
figure out is this real mental illness or is she
just trying to escape the torture of solitary.
Speaker 1 (09:24):
An impossible position for everyone. Her case is.
Speaker 2 (09:26):
Still pending, still pending, but the data her situation highlights
is crucial.
Speaker 1 (09:31):
What did the data show? This is from doctor Ventre's team.
Speaker 2 (09:33):
Again, yeahs, team crunched the numbers. Only about seven percent
of all inmates went into solitary. Tiny fraction. Okay, but
listen to this. Over half of all self harm incidents
in the entire jail system happened in that seven percent group.
Speaker 1 (09:46):
Over half from just seven percent of the population.
Speaker 2 (09:49):
Exactly, people in solitary were six point nine times more
likely to hurt themselves almost seven times.
Speaker 1 (09:56):
That's undeniable. Proof of the.
Speaker 2 (09:57):
Harm undeniable, And that data was powerful. It directly led
to NYC getting rid of a specific punitive solitary unit,
the MHAUII, and reforming solitary for adolescents and the seriously
mentally ill.
Speaker 1 (10:11):
So the data made a real difference.
Speaker 2 (10:13):
A huge difference. Justice Kennedy even cited this NYC data
in a twenty fifteen Supreme Court opinion suggesting the whole
country needed to look again at solitary.
Speaker 1 (10:21):
It shows how tracking this stuff, documenting it is so vital.
Speaker 2 (10:25):
Absolutely, which connects to another systemic failure dealing with serious
mental illness.
Speaker 1 (10:30):
Bradley Ballard's story.
Speaker 2 (10:32):
Yes, Bradley Ballard, thirty nine years old, arrested in Houston,
sent back to Wikers, he had serious known mental illness.
After being transferred from Bellevue Hospital, he had some behavioral issues.
Security staff responded by locking him in a cell for
a week.
Speaker 1 (10:50):
A week just locked in? Is that allowed?
Speaker 2 (10:52):
Completely against policy? They turned his water off. He had
no access to mental health care, no medical visits, nothing.
They just abandoned him effectively. Yes, and unknown to them,
he had tied something a ligature around his genitals. It
caused massive tissue death infection.
Speaker 1 (11:07):
Oh my god, didn't anyone notice anything.
Speaker 2 (11:10):
Officers apparently sprayed air freshener into his cell because of
the smell, but nobody went in, Nobody intervened properly.
Speaker 1 (11:17):
They smell him dying and sprayed air freshener.
Speaker 2 (11:20):
That's the report. He died from the infection, from dehydration,
covered in feces, cardiac arrest.
Speaker 1 (11:26):
It's beyond negligence. His family settled.
Speaker 2 (11:29):
Yes, five point seventy five million dollars. But his death
wasn't just one breakdown. It was again systemic. Oh so
chronic understaffing, security not bringing patients to the clinic, health
staff not even knowing where patients were sometimes because they
used ancient paper tracking.
Speaker 1 (11:45):
Systems vapor tracking in this day and age.
Speaker 2 (11:47):
Yep, And this all happens against a bigger backdrop.
Speaker 1 (11:50):
Right.
Speaker 2 (11:51):
Since the nineteen sixties, the US has massively closed down
public mental health hospital the institutionalization exactly. We went from
like five hundred and fifty dy thousand beds down to
maybe forty three thousand by twenty eleven. So where do
people with serious mental illness end up?
Speaker 1 (12:07):
Jails and prisons.
Speaker 2 (12:08):
Jails and prisons have become the default mental health system,
especially for the poor, for minorities. At Rikers, the number
of inmates needing mental health services shot up from a
third to about half the population. Seriously mentally ill people
like Ballard went from five percent to eleven percent of
the daily count.
Speaker 1 (12:25):
The jails became dumping grounds essentially.
Speaker 2 (12:27):
And worse, venors found disturbing racial disparities in how mental
illness was handled within the jail.
Speaker 1 (12:33):
What kind of disparities.
Speaker 2 (12:34):
Well, White patients seemed more likely to actually get mental
health treatment non white patients. They were more likely to
be punished with solitary confinement instead of treated.
Speaker 1 (12:43):
Punished for mental illness.
Speaker 2 (12:44):
The numbers were stark. Black patients were two point five
times more likely to end up in solitary than white patients.
Latino patients almost one point nine times more likely.
Speaker 1 (12:54):
That's shocking.
Speaker 2 (12:54):
And look at when they got care. White patients often
got into mental health services quickly, within days, proactive.
Speaker 1 (13:01):
Maybe, and non white patients.
Speaker 2 (13:03):
They often entered mental health services later, and it was
strongly linked to when they entered solitary.
Speaker 1 (13:08):
So solitary came first, then maybe some mental health attention.
Speaker 2 (13:12):
It suggests solitary itself might have been causing or worsening
their distress, not that they were getting treatment for a
pre existing condition before being punished.
Speaker 1 (13:22):
It sounds like they were punished for reacting to the conditions.
Speaker 2 (13:24):
It really does. It echoes awful historical things like in
the eighteen fifties doctors diagnosing runaway slaves with drape domania,
pathologizing a natural reaction to.
Speaker 1 (13:34):
Oppression, medicalizing resistance exactly. There's another shadow hanging over all
of this, sexual.
Speaker 2 (13:40):
Abuse, a deeply disturbing, often hidden part of incarceration. Doctor
Venter's shares stories like Maria's what happened to her? Maria
was intellectually disabled, making her vulnerable. A specific correction officer
targeted her, targeted her sexually assaulted her regularly, up to
four times a week. Whenever she happened to be in jail,
(14:01):
he'd choke her, threatened her to keep her quiet.
Speaker 1 (14:04):
How could he get away with that?
Speaker 2 (14:05):
Repeatedly he used his keys to get into unused areas,
lack of supervision. It was predatory. He even controlled her
outside jail, involving her family total control.
Speaker 1 (14:15):
That's horrifying. Is her case resolved.
Speaker 2 (14:17):
It's part of a pending class action lawsuit.
Speaker 1 (14:20):
And hers isn't an isolated story.
Speaker 2 (14:22):
Brianna's experience also harrowing. Brianna was actually working as a
suicide prevention aid and inmate role. An officer groomed her,
groomed her, how offered her money for oral sex, then
forced her to do it in a janitor's closet off camera.
Speaker 1 (14:36):
Threatened her and it didn't stop there No.
Speaker 2 (14:39):
He then orchestrated this campaign of abuse against her from
other inmates, other officers, denying her showers, time outside food,
pushed her towards suicide.
Speaker 1 (14:47):
So retaliation for being assaulted.
Speaker 2 (14:50):
Yes, When she finally reported it, they moved her, but
the harassment continued, called snitch bitch. They even tried to
force her to sign a confession, saying she made it up.
Speaker 1 (14:58):
Did she sign it?
Speaker 2 (14:59):
She bravely signed someone else's name, a small act of defiance.
She later found out she'd contract it. An STI from
the assault, just.
Speaker 1 (15:07):
Layer upon layer of trauma. Her cases pending too.
Speaker 2 (15:09):
Also pending, and doctor Venters uses this term nosocomial rape.
Speaker 1 (15:13):
No socmeal like hospital required infection.
Speaker 2 (15:16):
Exactly abuse that is essentially caused by the institution itself.
The setting enables it.
Speaker 1 (15:21):
There's a law about this, right prea.
Speaker 2 (15:23):
Yes, the Prison Rape Elimination Act federal law supposed to
set standards for preventing, detecting, responding to sexual abuse, and detention.
Speaker 1 (15:32):
But it doesn't always work.
Speaker 2 (15:33):
It's met resistance in places like New York City, and
the consequences of failure are horrific. Venters mentions Rodney Huhln,
a seventeen year old in Texas.
Speaker 1 (15:42):
What happened to him?
Speaker 2 (15:43):
Repeatedly raped, beaten by other inmates. He begged for protective
custody denied. He eventually hanged himself died by suicide.
Speaker 1 (15:51):
Just devastating. Why does this keep happening?
Speaker 2 (15:53):
Managerial incompetence, Ventors argues lacks security. He mentions an ex
inmate who literally impersonated staff and abuse detainees, and a
culture that dismisses victims based on who they are mentally
ill LGBTQ.
Speaker 1 (16:06):
So reporting is low.
Speaker 2 (16:07):
Official reporting is low. Anonymous surveys show much higher rates
like nine percent of women five percent of men reporting
sexual abuse in DOJ surveys, but very few reports maybe
two point five percent, actually get substantiated by the facilities.
So if you look at all these stories, Mercado's neglect,
the beatings of Hinton and Lightfoot, the torture and solitary
(16:28):
for Etchivaria and Hayley, Ballard's death from system failure, the
abuse of Maria and Brianna, Yeah, the common thread is
this profound lack of transparency. Howso the outdated paper records
we mentioned, officers moving inmates around without proper tracking, it
all creates blind spots where abuse and neglect can flourish.
Speaker 1 (16:47):
An unseen system, like you said.
Speaker 2 (16:48):
But importantly, Venor shows how his health team tried to
fight this. They use their Electronic Medical Records EMRs almost
like a human rights.
Speaker 1 (16:55):
Tool, documenting everything.
Speaker 2 (16:57):
Meticulously documenting injuries, neglect, abuse patterns, using the data to
try and hold the security side accountable, shining a light
where they could.
Speaker 1 (17:06):
And speaking of shining a light, the role of the
press seems crucial here too.
Speaker 2 (17:10):
Absolutely vital journalists like Jake Pearson, Michael Winup, Michael Schwartz
at The New York Times. Their investigative work was relentless.
Speaker 1 (17:18):
What impact did it have?
Speaker 2 (17:19):
It dragged the brutality, the systemic failures of rikers out
into the open, forced the public, forced policymakers to confront it.
It really drove reforms.
Speaker 1 (17:28):
Which leads to the big debate now, Closing rikers altogether right.
Speaker 2 (17:33):
An idea doctor Venters strongly supports, and the arguments are
pretty clear.
Speaker 1 (17:37):
How what are the main ones?
Speaker 2 (17:38):
Just the sheer scale of the place makes it unmanageable.
The buildings are literally crumbling. Each jail kind of operates
like its own little kingdom, and that culture of violence
is just so deeply embedded.
Speaker 1 (17:49):
What wasn't always a popular idea politically though, no.
Speaker 2 (17:52):
Lots of complexities. Mayor de Blasio initially called closing it unrealistic.
Governor Cuomo supported it, then Deblasio eventually came around and
signed on.
Speaker 1 (18:01):
But it's not simple building new jails elsewhere.
Speaker 2 (18:05):
Huge logistical challenges building smaller, more modern, hopefully more humane
facilities off the island. It's a massive undertaking, but probably
necessary for real change.
Speaker 1 (18:15):
And like you said earlier, this isn't just about Rikers.
We have to look outside the walls exactly.
Speaker 2 (18:20):
Think about bail. How cash bail keeps poor people, mostly
people of color, locked up even when they're presumed innocent.
Speaker 1 (18:27):
Just because they can't afford bail.
Speaker 2 (18:28):
Right, So the need for bail reform, maybe even abolishing
cash bail like Washington d CEDD, is critical, and we
have to remember the long term.
Speaker 1 (18:37):
Damage like Kayleif Browder.
Speaker 2 (18:39):
Kayleief Browder arrested at sixteen accused of stealing a backpack,
spent three years on Rakers, much of it in solitary
because his family couldn't make bail. Charges were eventually.
Speaker 1 (18:49):
Dropped, but the damage was done.
Speaker 2 (18:51):
The trauma was profound. He died by suicide years after
his release. His story is a heartbreaking reminder of the
lasting scars incarceration.
Speaker 1 (19:00):
So wrapping this up, the core message from doctor Venter's
work seems incredibly clear.
Speaker 2 (19:05):
It is incarceration, especially in a place like Rikers, is
inherently dangerous to people's health. It leads to preventable injuries,
deep psychological pain, sexual assault, and death.
Speaker 1 (19:16):
And it's not just about a few bad apples.
Speaker 2 (19:18):
No, these are systemic issues baked into the system, power imbalances,
lack of transparency, a culture that values punishment far above care.
Speaker 1 (19:29):
And why should everyone listening care about this even if
they never set foot near.
Speaker 2 (19:33):
A jail, Because the costs are huge, not just the
human cost, which is immeasurable, but the financial cost taxpayers
footing the bill for millions in settlements for things that
should never have happened.
Speaker 1 (19:45):
And the societal costs. These issues don't stay contained within
the jail walls.
Speaker 2 (19:50):
They ripple out, affect families, communities, trust in the justice system, everything.
Speaker 1 (19:54):
So maybe the final thought for everyone to take away
is this, Yeah, if we as a society fun and
tolerate a correctional system that consistently fails basic standards of safety, health,
human rights, what does that really say about our value right?
Speaker 2 (20:10):
And what's our responsibility? What do we owe to ensure
every single person, no matter their circumstances, is treated with
basic dignity and gets the care they need. That's the
question we have to ask ourselves
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