Jesse Jacobs always thought he’d be a storm chaser. When a funnel cloud swirled over his hometown of Lubbock and windstorms ripped through the trees, Jacobs pulled out a chair on the back porch. He thought about meteorology school in Oklahoma.
But ultimately he chose business school at the University of Houston. A little more fitting for Jacobs’s meticulous, organized nature. He filed away every paper in his office, sometimes color-coding them. He kept his Clear Lake apartment free of clutter and very neat, something jail records would later indicate about his cell.
The 32-year-old field marketer, though, also suffered from something very much outside of his control: panic attacks.
That’s why his psychiatrist, Dr. Don M. LaGrone, was one of the first people Jacobs called before he turned himself in to the Galveston County Jail, where Jacobs would spend his last days. LaGrone would receive a phone call that Jacobs had died just six days after he was booked. He would also find out that the jail failed to give Jacobs the medications he'd prescribed.
Jacobs was slated to serve only 12 to 15 days of his 30-day DWI sentence, on good behavior. It was his second offense in ten years, and his attorney, U.A. Lewis, said he wanted to serve the time and put it behind him. But Jacobs's main concern when he came to see LaGrone that last time was about his medication.
Jacobs had been seeing LaGrone since he was 19, when his ADD diagnosis surfaced. In his early twenties came the others: major depression, severe panic and anxiety disorder, PTSD caused by severe stress. Over the course of a decade, LaGrone, a psychiatrist with 45 years of experience, was able to help Jacobs back to stability with a daily prescription of Xanax, among a host of other medications.
“He built a dependence and he knew that,” Dr. LaGrone said. “That was part of his concern about going to the jail.”
Jacobs had called the jail to verify that he could bring in a 30-day Xanax prescription, the one Jacobs depended on most. He even had LaGrone write a letter to the jail, in which the psychiatrist stated the importance that Jacobs take his prescribed medications every day. Jacobs scoured the Internet about what else inmates could bring, what would be available to him, what he should wear. He chose a teal long-sleeve button-up on the day he was booked, March 6, and did not smile for his mug shot.
The intake stage is often the most crucial part of the booking process, especially for mentally ill inmates. Jails are required to conduct both a mental and a physical health screening to make sure inmates are fit to withstand their time behind bars. At Galveston County Jail, these checks are conducted not by jailers, which is the most common procedure, but by a third-party medical contractor called Soluta Health. If inmates present significant mental or medical health risks during the screening, a magistrate is notified within three days so that trained medical professionals can further evaluate the inmate and decide on a course of treatment.
Jacobs’s intake screening triggered that risk, and the magistrate was contacted three days later, on March 9. His screening form indicates in scribbled handwriting that Jacobs had attempted suicide three months earlier, that he had been treated for alcohol abuse and that, yes, he had been very depressed in the past. An EMT who screened Jacobs listed all eight of his medications — including Xanax, Cymbalta and Lipitor — and for all eight indicated that he was “unable to verify” the prescriptions.
So the EMT ordered that Jacobs be placed on detox protocol on March 6, a decision that was made less than an hour into Jacobs’s stay at the jail. That decision was reviewed by a doctor three days later, so it’s unclear exactly when the detox protocol went into effect. Still, by 9:30 on his first night in lockup, Jacobs was already in pain. Jacbos still had a free phone call, so he called his mom, Diane.
“I asked him if he had gotten any of his medications, and he said no,” Diane remembers. "I said, ‘Jesse, have you seen a doctor?’ And he said, ‘No, mom, I’m not even assigned a bed yet.’”
Jacobs seemed even worse when his mother came to visit him three days after he entered the jail. Over the phone, the on-call psychiatrist had recently prescribed Jacobs one new medication for his high blood pressure and one for depression and generalized anxiety disorder (the same doctor in 1996 was cited by the Texas Medical Board for taking a patient off of a benzodiazepine suddenly and not following protocol thereafter). Jacobs did not appear to be adjusting smoothly.
Visitations at Galveston County Jail are not in person but take place through a closed-circuit video on a clunky monitor. Through the TV screen, Diane asked her son how he was doing. “He said he was not doing well, that his heart was racing and he could not sleep,” she says. Diane asked Jacobs if he was finally getting his medications. “He told me that they had changed some of them, and he was not receiving his Xanax.”
When a person stops taking a benzodiazepine like Xanax cold turkey, the withdrawal symptoms can be dangerous. They may include increased anxiety, depression, suicidal thoughts, insomnia and nausea. And when the medication stops suddenly, “many people will have seizures,” LaGrone told the Houston Press. “It’s an acute drug withdrawal.” LaGrone added that the only place he would see fit for a detox of any kind is in a hospital, certainly not a jail.
Later that Monday night, the nurses would do a “detox check” on Jacobs. He was sweating profusely, or “diaphoretic,” in medical speak. The next afternoon he would have his first seizure. Instead of sending him to the hospital, nurses gave him ammonia capsules, two Gatorades and two waters.
Family and LaGrone say Jacobs had never had a seizure in his life. It's something Jacobs explained to the EMT upon intake and something he told the jail nurse the following morning when he was found lying on the floor of his cell with blood on his face. Jacobs' teeth had chomped down on his tongue during the convulsions. “Patient denies seizure disorder before incarceration in free world,” the nurse writes. “Patient not oriented to location or date.”
Records indicate that Jacobs still had not seen a doctor — not until he had another seizure at 4 that afternoon.
In the medical record, someone identified as a Dr. Becker visited Jacobs in his cell and gave "new orders.” Nevertheless, the following morning Jacobs started convulsing again, and finally the EMTs put him on a stretcher and took him to the medical clinic. The doctors there did "neurochecks," gave him Librium — a drug to treat anxiety — and stressed more fluids. Then they sent Jacobs back to his jail cell.
Diane and Jacobs’s father, also named Jesse, loaded up the following morning to go visit their son through the TV monitor. He was halfway done serving his sentence and would get to return to the free world in just six days.
As soon as they walked through the doors, Diane’s cell phone rang. The jail was calling: Their visit had been relocated to the hospital ICU. Two hours earlier, Jesse Jacobs had suffered his last seizure.
The autopsy report would note that Jacobs died of a seizure disorder. Jail officials would say he died of natural causes. Neither of these explanations made any sense to Jacobs's parents. Nearly five months later, with little explanation from officials, they still don't understand how Jacobs could die from a seizure disorder, which he'd never had until he was taken off his Xanax, and natural causes.
Diane is a bubbly woman with long blond hair, wearing a bright pink T-shirt with rhinestones striped across the front. “I always thought his personality was more like me,” she says of her son, “and I’m very outgoing, very extroverted. But as he got older, he seemed like he was more of a…I don’t want to say an introvert, but more kept to himself.”
Diane and her husband wonder if that’s why their son didn’t protest the detox and speak up more about the full extent of his pain. But beyond what the nurses have written in their reports, Jacobs' parents aren't sure what their son's last days were really like.
They’ve asked to see the videos from inside the jail — Diane’s visit, the footage of their son in his cell — and have been met with silence on the other end, or cold statements from authorities: “The investigation is ongoing.”
Still, Jacobs' parents say they have never been contacted by anyone conducting an investigation who might have questions about their son’s medical history or his 10-year reliance on the drug that let him go to work in the morning without anxiety taking him back home. Among their many questions: Why undo 10 years of stability with a knee-jerk detox protocol?
“It took our son’s life,” Diane insists. “He walked in there, and they carried him out.”
“He was supposed to serve 30 days, and he got a death sentence,” Jesse Sr. said.
In a lawsuit Jacobs's family plans to file this week, they allege Jacobs's incarceration at the Galveston County jail violated the Eighth Amendment's ban on cruel and unusual punishment. They've also accused the jail of failing to provide adequate medical care to an inmate. Galveston County Sheriff Henry Trochesset denies any wrongdoing. The Texas Commission on Jail Standards cleared the jail as well, given that it followed the required minimum standards of completing the screening and notifying the magistrate about Jacobs’s risk.
As Jesse Sr. puts it: “My question is, if you haven’t done anything wrong, what are you concerned about? That’s been one of my frustrations, is there’s been no transparency."
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Trochesset politely answered questions about Jacobs’s death, though some of his answers appear to be contradicted by the medical and jail records the Jacobses' attorney provided to the Press. (Trochesset said he did not have the file in front of him at the time.) When asked why Jacobs would have been taken off Xanax, Trochesset said, “Xanax is a narcotic." (*Xanax is, in fact, a controlled substance, but not a "narcotic.") He then deferred all questions to medical staff who evaluated Jacobs. Soluta Health did not return requests for comment.
Dr. LaGrone is confident that the seizure that killed Jesse Jacobs was a result of Xanax withdrawal. He remembers Diane calling him when she found out Jacobs wasn’t given the medications he’d prescribed — she had told him the jail said its medical professionals did not take prescriptions from outside doctors, LaGrone remembers. “I don’t really understand it,” he said of the detox. “In my opinion, it shouldn’t have happened.”
LaGrone remembers when he first started seeing Jacobs as a patient. Jacobs could barely leave his house because of panic attacks. "It really incapacitated him," LaGrone said. So they searched for solutions, and over the course of the next 13 years, the psychiatrist would see Jacobs go from barely being able to go outside to graduating college and becoming a professional — all thanks to a treatment plan the two of them revised over and over until they found the perfect combination of eight medications, LaGrone says.
The Soluta Health workers at the Galveston County jail would be the first in many years besides LaGrone to assess his patient. So when LaGrone sent off his handwritten note to the jail, he signed it, “Thank you for looking after him.”