Prisoners volunteer to care for sick and dying inmates
By JOHN MANGALONZO
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FORT MADISON — Many people fear death, and what they may fear most is dying alone.
For inmates in the Iowa State Penitentiary, there is the compounded misery of dying alone in prison.
About 25 percent of the 1,100 or so inmates housed there are serving life sentences, and most will die there, away from their families, friends and the life they knew before prison.
Deemed dangerous men by the state, lifers face the reality that behind the massive walls will be the only life they will ever know, and death may be a sweet release from the torment of their past.
Looking forward to that dismal prospect inside Fort Madison’s walled city, their time inside stretches into years of vast loneliness.
But there are fellow inmates willing to pull together to watch over each other during the last moments of life.
Out of the ashes of the institutional unwritten rule where prisoners watch out only for themselves grew the prison hospice program. Basic human compassion, tucked between the silhouette of anger and despair, has transformed some of the “biggest and baddest” into meek and humble servants of their fellow men.
After all, they only have each other.
Transformation
From inside one of the hospice rooms at ISP, Mychael Glover of Louisville, Ky., who is serving a life sentence for first-degree murder, sat on a bed with both hands touching a quilt he will use one day. Hospice patients receive a quilt as a comforting touch.
“My reality is that I’m going to die here,” said Glover, a 53-year-old hospice volunteer. “I’m not going to sugarcoat it. I’m not one of the guys that run around here and think that there is a big chance, one day, I’m going to be free. You have to be realistic, and I want to be treated like I treat people.”
Glover is one of the 15 hospice workers who doubles as a volunteer in helping inmates in the assisted daily living ward, located in the same wing as the two hospice rooms. Most of the hospice workers are lifers themselves.
There were no hospice patients the third week of January when the conversation with Glover took place, and with the two rooms empty, Glover spends most of his time with ADL patients.
“A lot of guys haven’t took care of anybody but themselves,” Glover said. He said that’s a common mentality behind the walls — every man for himself.
Participation in the program takes dedication, willpower and a strong effort to resist being called “softy” by the general population, where toughness is considered currency demanding respect and fear.
Caring for dying patients takes a lot in a man, especially under the circumstances Glover and other lifers are in.
“If you ask the average guy here, he’s never seen a person die, and then if you ask a selected few, the only person they probably seen die was their victim,” Glover said.
Three and a half years ago, when the program was just a concept, Glover was one of the first to sign up, not knowing what he would be asked to do.
Through the years, he has seen changes not only in his way of thinking about what the future may hold but also in younger inmates who have since volunteered.
“I’m proud to say I’ve seen the young guys involved in the program right now do a complete circle,” he said.
It’s not just about meeting the medical needs of the patient but providing for his emotional and spiritual needs as well. That can be as simple as holding someone’s hand and whispering assurances that everything is going to be all right, and it’s time to let go.
“We go through the whole process, from the beginning to the end on every hospice patient. And a lot of time, I think it’s a blessing,” Glover said, referring to a dying man allowing volunteers into their lives.
It is sometimes hard to see someone they consider a neighbor, a friend or a confidant at their death bed. But it is one of the realities of life in prison where structure takes precedence over normality.
“We had guys as young as 36 years old die of cancer,” Glover said. “Eighteen months before that he was in excellent shape, lifting 400 to 500 pounds of weights. Then you watch him gradually go down from 260 pounds to 130 pounds.”
And there are still some men in prison, dying men, who refuse to accept assistance and choose to die alone. Terminally ill inmates have the choice of whether to be cared for in hospice.
“Then there are some that pick you (a hospice volunteer) out of the pack to actually die in front of,” he said.
As they look into a dying man’s eyes, volunteers say they can see the emotions that run through anger, confusion, remorse and fear of “what’s on the other side.”
“Then the next stage is they start accepting it,” Glover said.
Forty-eight-year-old Dan Hampton, who is serving a life sentence for kidnapping, is a long way from Augusta, Ga., but he is making a positive mark in Iowa.
Hampton, who inmates refer to as “Hambone,” exchanged looking over his shoulder with watching over patients, both in hospice and assisted living.
“I realize, one day I will be in the same situation,” Hampton said. “And I would like for someone to help me the way I help people.”
Hampton said he talks to patients about anything they want. He doesn’t look at them as someone who committed a crime but as a human being.
And sometimes, he knows just to listen and allow the patient to do the talking.
“What they’re here for does not matter anymore,” Hampton said. “He knows he’s dying and needs a friend. I can be that friend.”
As he was talking, Hampton walked around and checked on ADL patients, one with dementia and another with Lou Gehrig’s disease, bringing them their food and helping them turn over on their beds.
“You cannot let your emotions take over,” he said, displaying a smile. “You cannot get frustrated.”
Volunteers often are questioned by other prisoners about how they function while laboring countless hours and constantly being around sick and dying people.
” ‘How can you do that? How can you watch someone die?’ ” Hampton said. ” ‘How can you wash somebody up, give them a bath? How can you do that?’ ”
But Hampton, like most other hospice workers, just brushes off those questions.
“I don’t let that discourage me because like I tell them, ‘One of these days you’re going to be in the same situation, and I’m going to be the one taking care of you,’ ” Hampton said. ” ‘I had a son. I washed him, I changed his diapers, so it’s nothing to me,’ is what I say to them. Then I just laugh.”
Before there was hospice
Caring for dying inmates before there was an inmate-run hospice program was described as impersonal and routine.
Most sick inmates went to the prison infirmary, which was not staffed by inmates. If they got “really sick” they were sent to University of Iowa Hospitals and Clinics and were “essentially alone,” said ISP nurse Jo Watson.
Other inmates were not allowed to visit or sit with a dying friend.
“They might have been best friends and neighbors (in prison) for 20 or 30 years. Then it comes to this time in their life, and their friends were not allowed,” Watson said. “It is not possible because they are sent to Iowa City.”
Watson said that while meeting the medical needs of a terminally ill patient is important, a person reaching the end of his or her life needs the emotional and spiritual support from the people they leave behind.
Sadness and a sense of loss doesn’t fade with the passing of time, and the inmates, even though they may be perceived by society as heartless and without conscience, feel that pain.
The program also fosters a sense of camaraderie among the inmates.
“This is their family,” Watson said. “And it gives access to their other extended family in the cell house to be able to visit them.”
It is a big responsibility caring for another human being in a place where solitude is king and might is the constitution.
“It’s a very compassionate work,” Watson said. “They feed them, they turn them, they wipe their bottoms, they keep them clean, and they wipe their slobber off, in a very basic human level.”
Convincing
After starting a similar program at Oakdale Medical and Classification Center, retired Iowa Department of Corrections nurse administrator Marilyn Sales thought a hospice program would better serve an institution that housed lifers, so she set her sights on ISP in Fort Madison.
“Because dying in prison is their reality,” Sales said. “It only takes one poor piece of judgment to put you in prison for life.”
Sales asked one of the unit managers at ISP to send her seven lifers who were deemed responsible. Sales gathered the seven inside a room, popped a documentary about the Angola, La., Prison hospice into a DVD player and let the inmates watch it.
“Angola Prison Hospice: Opening the Door,” produced by Edgar Barens for the Open Society Institute, showed how the hospice experience could profoundly touch even forsaken lives. Angola Prison was the first prison to have an inmate-run hospice program in the country.
After the 23-minute film, tears flowed down the faces of the lifers who watched it, and in late 2004, the hospice program at ISP began. Programs at facilities in Mount Pleasant, Mitchellville and Anamosa soon followed.
“I really started it without getting permission,” Sales said, adding there were people in the institution who had reservations and resisted the idea.
Sales deliberately started the program with no assistance or funding from the state. To this day, the program has remained self-sufficient with money generated from donations from the inmates themselves, contributions from the community and from family members who had loved ones in the hospice program.
ISP Warden John Ault said the majority of the program’s revenue comes from sales of sweetened water to the inmate population. The program has more than $5,000 in available funds.
“Inmates do not expect to die in prison,” Ault said. “And when their physical condition gets to the point where death is imminent, the staff and inmates trained in this program do all they can to ensure that the patient is as comfortable as possible and can die with dignity.”
Training is done through a joint effort from ISP staff and Lee County Health Department.
“This is for those inmates who are doing life, because you know if you’re doing life, after some years you’re in there, you develop a family,” Sales said. She said friends and families outside prison often cut off contact with incarcerated loved ones.
But fighting for a program she knew would work for both the system and the inmates did not prepare Sales for a life-changing experience. That came just from watching the volunteers.
“There is nothing more heart rendering than to see those lifers take care of someone who’s dying,” Sales said. “… and be able to sit there, hold their hand, pray with them, write letters for them and talk to them.”
Sales said the job does not end when an inmate dies in hospice. Volunteers make sure they send off their friend with dignity.
“They have been able to wash the body when their friend dies, comb their hair and make them presentable when they leave the institution,” Sales said.
After much preparation, the volunteer tending to his dead colleague sits in the room and waits for the mortician to arrive.
“You see the workers get very close to them,” she said, adding inmates cry, too. “When you see someone die, I hope you will have tears, because if you don’t, I think there’s something wrong.”
The first person who died at the ISP hospice was one of the original volunteers, Herbie Schnee, who other inmates described as “a hell of a painter.”
They were still getting the room ready, painting it and putting new sheets on the bed when Sales found herself picking up a quilt after Schnee became ill with larynx cancer.
“Herbie accepted it,” Glover said. “Herbie was in for 26 years (of a life sentence), and he went very peaceful. It just goes to show you that any given day, it could be one of us.”
When a hospice patient reaches his last stretch, a volunteer will be with him inside the room at all times. Workers take turns on vigil duty.
“I did not want it to be a staff program, and I did not want it to be a state program because it’s not about us, it’s about them,” she said. “It’s about their reality.”
Outlook
Glover said he is not the same man he was 20 or 30 years ago, when he thought he was invincible and would live forever.
“And I’m looking at this now and think, ‘Man, this could be me,’ ” he said. “This is going to be me. I think we all have our way of getting to the end.”
He said he was reckless when dealing with other inmates in the general population yard. But that changed when he learned the principles of working hospice.
“You cannot be coming here taking care of people then go out there and be a fool out in the yard,” he said. “You have to change your attitude and the way you approach things.”
Workers like Glover and Hampton try to look at the positive, in the midst of sorrow and pain.
The work is painstakingly difficult, requiring not only physical agility but mental and emotional capabilities to handle stress that would enable them to continue and move on, as if waiting for their turn.
But still, at times when they are alone, hospice volunteers often think of the patients they left in the ward, wondering if they are going to get called later that evening because someone died or whether they will see their patients again in the morning.
“You’d be less than a human if you didn’t get caught up,” Glover said.
All the books and training materials given to them did not prepare them for the harsh reality of the work. They soon found out what it meant to be a servant rather than a master.
“Until you actually sit down with them, you’ll never know,” Glover said.
Like most lifers, Glover and Hampton have known other inmates longer than they have known most of their relatives.
And that is how they look at it. They are taking care of a family member.
Accepting death
There are some things in life that are easy to accept, but death is not one of them.
One terminally ill inmate was returned to the facility from Iowa City last week, but he refused to be admitted to the hospice program. He would not let hospice volunteers help him in the final moments of his life. He died Wednesday with two doctors.
Working with forsaken lives coming to an end, Glover has experienced the ups and down of acceptance.
“I’ve seen guys who until the very end did not accept dying, for whatever reason,” Glover said. “But for the most part, they would accept it and go peacefully.”
And then there are men, Glover said, who are adamant about not changing their views, even when lying on their death beds.
“I think they have the right to be who they really are, because they are dying, and we all see that,” he said.
Glover and Hampton have accepted the fact they will never see beyond prison walls, but they no longer live the typical prison life. Taking from people is part of their past. Now they make their rounds at the ward, looking over other inmates like a big brother.
Caring for their patients is what sustains them, they said. It’s through these acts of giving that they finally can reach the atonement they have been searching for. They can be more at ease knowing there was a time in their lives, and the lives of those who have died in prison, when they were good men.
“I never repeat what a dying man said because he respected me enough to say certain things,” Glover said. “But generally, they kind of want to relay they were not all bad. At one point in their lives, they did something good.”
As monstrous as their crimes may be, these men have families who once loved them, children who looked up to them, and peers who called them friends.
“They reminisce about certain things in their life, might be a certain song they have not heard for a while,” Glover said. “It’s not about us. It’s about them. And one day, it will be about me.”
At the end of the day, Hampton goes back to his cell and thinks about his patients. He also thinks about death.
“I can’t put a word to it, but when I go back to the cell house, I try very hard to put all these behind me, then tomorrow would come,” Hampton said. “How long I’m going to be doing this, I don’t know. If I be here. If I be alive.”
With those words, Hampton reached for a tray and placed it on the bedside of an assisted living patient. He turned him over and whispered, “It’s going to be all right.”
Finding redemption
Peace in the middle of a chaotic and constant battle for supremacy in the prison environment may be hard to find. So is redemption.
Hospice workers say religion is not discussed, but they cannot deny the spirituality in their work — finding the good in men the state has labeled disgraced.
“It’s about time for me to do something good,” Glover said. “I don’t like this. I don’t like people dying. But this is reality, and I tapped in something that I don’t mind doing, and it’s for something good.”
He says it’s for selfish reasons, because Glover wants someone to take care of him when his time comes. But the care he takes in looking after the assisted living patients in the ward shows he is sincere in his work.
Sales, the retired nurse administrator, saw that when she first met a quiet and inquisitive Glover when the program started.
And she misses working with him and the other inmates in the program.
“They taught me a lot through the years, and I guess this was my way of giving back,” Sales said.
And even inside a place where people considered threats to society are locked up, Sales saw something good.
“It’s hard to say if it’s a change (in volunteers’ characters) or it has always been there, but nothing was ever there to bring it out, until now,” she said. “I always try to think that there is good there, but sometimes they have forgotten it.”
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