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On the last day of July, months after quitting his job as a cook on an offshore oil rig, Monte Killian was tooling around the Fourth Ward in his pickup when, police say, they pulled him over and found a rock of crack in his mouth. Forty-five years old, Killian went to jail then, with all of the health problems that people have who wind up in jail — cavities in his teeth, blood clots in his leg, Hepatitis C and a full-blown case of AIDS.
The U.S. Department of Justice had recently found that "certain conditions at the [Harris County Jail] violate the constitutional rights of detainees." Justice officials were especially concerned with the jail's health care system and "found specific deficiencies in the Jail's provision of chronic care and follow-up treatment." "Indeed," they wrote, "the number of inmates' deaths related to inadequate medical care...is alarming."
Nonsense, was the reply from our county attorney, Vince Ryan. The problem was with the Justice Department's investigation, not the jail, he said. "Our criminal justice facilities are doing a great job."
So Killian received the usual jail welcome. Of all his medical needs, perhaps the most important was for HIV meds. "Missing two to three days doesn't cause horrible consequences in everyone," said Richard Beech, the head doctor at Legacy Community Health Center in Montrose, which specializes in HIV care and treats Killian. "It just can." The immune system can be wrecked, and in a less-than-sterile environment, anyone with a compromised immune system can easily contract an opportunistic infection, which, "of course," said Beech, "can kill you."
And yet Killian was not given HIV meds when he arrived on July 31, nor was he allowed to have them brought to him. He was simply locked up with everyone else, moving from one holding cell to another, each so crowded, he wrote later, that "they had to make people who were sitting on the floor stand up so they could push us in." After three days, he arrived at last in the clinic, where, he says, he explained his medical condition "for the third or fourth or maybe 15th time to no avail." Finally, on August 5, Killian borrowed from a relative and managed to bond out "so I could get my medicine." Then, sadly, on September 11, he reported late to a pre-trial drug-testing and was tossed back in.
Again, there was "the unbelievable packing of human beings into standing-room-only cells." Again, he found himself "begging for medical attention and not getting heard." When Killian had been a week without his medication, his partner, Stephen Calmelet, called the Houston Press. I told Calmelet I'd make an inquiry with the Sheriff's Department, which runs the jail, and I was soon on the phone with Christina Garza, the sheriff's hard-boiled media manager.
Garza said she would "look into this allegation," and at the same time, she began cautioning me not to infer too much about the jail from "isolated and anecdotal accounts." That would be to make the same mistake the Justice Department had, when it was much better to rely on the jail's own statistics, she and Ryan maintained. Looking at the statistics, Ryan was able to say that the jail's death rate was not at all alarming, for what were a few deaths when the clinic manages the health care of some 134,000 inmates a year? In the same way, Garza pointed out that the jail has dispensed this year an average of about 12,000 medicines a day, or about 3.6 million through October — and how many "medication-related grievances" have there been? Just 135, she said, the great majority of which the jail's own investigators determined to be "unfounded."
With such numbers, Garza was quite comfortable saying that the jail is "safe, sanitary and in compliance with the strictest of standards" — no matter that the Texas Commission on Jail Standards had just, in September, found the jail in noncompliance for failure to dispense prescription meds. That was just an isolated incident, quickly corrected, Garza said, and it became clear that she viewed Monte Killian's case in the same way.
Calmelet soon happily reported that a "very apologetic" doctor had appeared before Killian and presented him with his meds. But why was there a delay in the first place? This information was far more difficult to acquire from Garza than statistics.
She asserted by e-mail that "Mr. Killian has not been ignored, nor have his medical requests been denied." More than that, Garza said, she couldn't say about him, because of federal privacy laws. Can Killian waive his privacy rights and grant me his health records? Garza allowed ten days to pass before sending a brief e-mail: "Mr. Killian has stated that, in his best interest, he would like to withhold the release of his medical records and is satisfied with the care that he has received thus far here at the Harris County jail."
Calmelet, who visited Killian every night, said, "That's not what he told me." So I told Garza that I'd like to interview Killian, to which Garza replied that I'd first need permission from both Killian's attorney and the judge in his case. But Killian's court-appointed attorney, Stephanie Martin, wouldn't return my calls. Garza reiterated that this procedure was "certainly not meant to obstruct access to the inmates," but was "simply to protect the rights of inmates." She said to "keep in mind that the Harris County Sheriff's Office...is responsible for their welfare."