Fellow Inmates Ease the Pain of Dying in Jail

[The Watchmen]

Written by John Leland for the New York Times, October 17, 2009.

COXSACKIE, N.Y. — Allen Jacobs lived hard for his 50 years, and when his liver finally shut down he faced the kind of death he did not want. On a recent afternoon Mr. Jacobs lay in a hospital bed staring blankly at the ceiling, his eyes sunk in his skull, his skin lusterless. A volunteer hospice worker, Wensley Roberts, ran a wet sponge over Mr. Jacobs’s dry lips, encouraging him to drink.

“Come on, Mr. Jacobs,” he said.

Mr. Roberts is one of a dozen inmates at the Coxsackie Correctional Facility who volunteer to sit with fellow prisoners in the last six months of their lives. More than 3,000 prisoners a year die of natural causes in correctional facilities.

Mr. Roberts recalled a day when Mr. Jacobs, then more coherent, had started crying. Mr. Roberts held his patient and tried to console him. Then their experience took a turn unique to their setting, the medical ward of a maximum security prison. Mr. Roberts said he told Mr. Jacobs to “man up.”

Mr. Jacobs, serving two to four years for passing forged checks, cursed at him, telling him, “‘I don’t want to die in jail. Do you want to die in jail?’ ”

“I said no,” said Mr. Roberts, who is serving eight years for robbery. “He said, ‘Then stop telling me to man up,’ and he started crying. And then he said that I’m his family.”

American prisons are home to a growing geriatric population, with one-third of all inmates expected to be over 50 by next year. As courts have handed down longer sentences and tightened parole, about 75 prisons have started hospice programs, half of them using inmate volunteers, according to the National Hospice and Palliative Care Organization. Susan Atkins, a follower of Charles Manson, died last month in hospice at the Central California Women’s Facility at Chowchilla after being denied compassionate release.

Joan Smith, deputy superintendent of health services at the Coxsackie prison, said the hospice program here initially met with resistance from prison guards. “They were very resentful about people in prison for horrendous crimes getting better medical care than their families,” including round-the-clock companionship in their final days, Ms. Smith said.

The guards have come to accept the program, she said. But still there are challenges unique to the prison setting. Some dying patients, for example, divert their pain medication to their volunteer aides or other patients, who use it or sell it, said Kathleen Allan, the director of nursing. She added that patients can be made victims easily, “and this is a predatory system.”

But she said the inmate volunteers bond with the patients in a way that staff members cannot, taking on “the touchy-feely thing” that may be inappropriate between inmates and prison workers.

At Coxsackie, 130 miles north of New York City, administrators started the hospice program in 1996 in response to the AIDS epidemic using an outside hospice agency, then changed to inmate volunteers in 2001. The change saved money and was well-received by the patients.

Perhaps more significant, said William Lape, the superintendent, was the effect the program had on the volunteers. “I think it’s turned their life around,” Mr. Lape said.

John Henson, 30, was one of the first volunteers. When he was 18, Mr. Henson broke into the home of a former employer and, in the course of a robbery, beat the man to death with a baseball bat. When he entered prison, with a sentence of 25 years to life, he said, “I thought my life was over.”

At Coxsackie he met the Rev. J. Edward Lewis, who persuaded him to volunteer in 2001. “You go in thinking that you’re going to help somebody,” Mr. Lewis said, “and every time they end up helping you.”

Before hospice, Mr. Henson said he had given little thought to the consequences of his crime. Then he found himself locked in a hospital room with another inmate, holding the man’s hand as his breathing slowed toward a stop.

Like many men in prison, the dying man had alienated his family members, who rejected his efforts to renew contact. In the end, he had only Mr. Henson for companionship. When the prison nurse declared the man dead, Mr. Henson broke down in tears.

“They just came out,” he said. “I don’t even know why I was crying. Partly because of him, partly because of things that died within me at the same time.”

Mr. Henson, dressed in prison greens and with his blond hair buzzed short, spoke directly and without hesitation.

“I was just thinking about why I’m in here and the person’s life that I took,” he said. “And sitting with this person for the first time and actually seeing death firsthand, being right there, my hand in his hand, watching him take his last breath, just caused me to say, ‘Wow, who the hell are you? Who were you to do this to somebody else?’ ”

Ms. Allan, the nursing director at Coxsackie, said that with a number of inmate volunteers, “You can identify in each of these guys something inside them driving them to do this. It’s a desire to redeem themselves, so even when it gets hard they’re able to plow through it. “

She added, “I think Mr. Henson made me a better mother.”

Benny Lee, 38, has spent half his life in prison for manslaughter, and for most of that time, he said, “the only thing I regretted was getting caught.” Four months ago he began as a hospice volunteer, feeling he needed a change. “I’m trying to offer some payback,” he said.

On a recent afternoon, Mr. Lee was scheduled to sit with Eddie Jones, 89, who was dying from multiple causes. Mr. Jones, who was convicted of murder at age 70, said, “I can talk with them better than staff members, because staff members have their minds made up about how things should be.”

Mr. Lee said he does not know how Mr. Jones’s death will affect him. “I’m hoping it will have an effect, period,” he said. “Growing up and in prison, I put up walls. But I have to be more emotionally receptive to these guys. This is going against everything I’ve tried to do. But I realize it’s a change I have to make.”

Mr. Lee said hospice was forcing him to learn to trust people.

“It’s helping me mature,” he said. “My views of life and death are changing. I was unsympathetic when it comes to death. I’ve had friends die, and I was callous about it. Now I can’t do that. I’ve come to identify with these guys, not because we’re inmates, but because we’re human beings. What they’re going through, I’ll go through.”