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Prisons:3 8/15/07 3:34 PM Page 15 for eight years in the prison chapel, often performing duties as a grief counselor when girls were informed of the death of a loved one. Nikki's cherished objects in prison: her guitar, which she used in prison ministry, and framed photographs of the many friends who surrounded her. Now that they are on the outside, Pat and Nikki continue to help. They actively lobby lawmakers in Sacramento on behalf of elderly and infirm inmates, working with San Francisco-based California Coalition for Women Prisoners to solicit their compassionate release. They also talk to children at risk of incarceration, dispelling myths about prison and making sure vulnerable youth understand the ugly reality of life behind bars. The gentle grace Nikki learned from her mother, a woman who made every house a home despite family dysfunction and violence, served Nikki well in prison, where inmates looked to her to ease their confusion and sorrow. That same grace serves her on the outside. The world is warmer now for Pat and Nikki. The sun bakes the concrete walkway outside of the three-bedroom house they rent with Pat's sister on a quiet treelined street in a California suburb. Wind chimes dangle from the wooden beam above their front porch. Inside, the living room is cool and comfortable, the walls covered with faces of friends and families both inside and out. Their lives improve every day, they say. Said Pat's daughter about her mother: "She's a fighter. I can count on her now. She gets things done." Pat and Nikki continue to "get things done" on behalf of prisoners. Their connection to life in the prison is still strong. "We can't forget the people we left inside," Nikki said. Despite concerns about prison healthcare, Pat, who was convicted of second-degree murder, doesn't dismiss her prison experience as wasted time. She believes her time in prison helped her to change deeply entrenched behaviors born of alcoholism and a troubled past. Pat availed herself of all that prison had to offer. She now boasts a certificate as a legal assistant and she received her GED while in prison. But both Nikki and Pat feel strongly that when prisoners are clearly no longer a threat to society, politicians shouldn't keep them in just to win votes. Both women were declared suitable for parole three times by the parole board, and were three times denied by governors Wilson and Davis. Some might question why the public should be concerned about the health of prisoners, and Pat explained it this way: "They tell us we're supposed to obey the laws of the land and be compassionate. If someone ends up in prison the law says 'no cruel or unusual punishment.' If we're taught to obey all the other laws, why is that one left out? If you can accept people suffering in prison due to medical neglect, what kind of person are you? Why does the law and good behavior apply only when people want it to apply?" Pat and Nikki also return occasionally to prisons to encourage and revive "lifers." "We want to bring the hope of life back to them," Nikki said. Many women in prison have given up because medical conditions are so grim, especially for older prisoners. Pat and Nikki want to show prisoners that there is hope; that they can't stop fighting to survive. Erin FitzGerald is a freelance writer focusing on human rights and healthcare issues. She has just completed a documentary on family caregivers of the traumatically brain injured as part of her studies at the UC Berkeley Graduate School of Journalism. J U LY | A U G U S T 2 0 0 7 HOW THE PLATA CASE JUMPSTARTED CALIFORNIA PRISON REFORM The largest-ever prison class action lawsuit, alleged that the California Department of Corrections was violating the 8th Amendment, which bars cruel and unusual punishment, by crippling and killing prisoners through gross medical neglect. According to the original complaint filed in 2001 by the Prison Law Office, Marciano Plata, the lead defendant, endured medical neglect of injuries he sustained as the result of several falls. Despite severe head, neck, and back pain, Plata, who could not speak English, was repeatedly denied medical care and was forced to work until his knee buckled. Surgery was recommended by a physician but Plata did not receive surgery for 19 months. After Plata's operation, prison personnel forced him to walk back to his cell despite his medical history and the severe pain he endured. Plata continues to suffer from headaches, knee and back pain, but his story would prove to be just the tip of the iceberg. Nine other named plaintiffs in the case suffered similar and, in some cases, more severe abuse and neglect. Expert testimony during the hearing blew the lid off medical conditions inside the California Department of Corrections and Rehabilitation. Ample evidence was presented during the suit to indicate a significant rate of death in California prisons due to medical mismanagement. Widespread medical malpractice was revealed. U.S. Federal District Court Judge Thelton Henderson, who heard the case, delivered a stunning verdict, describing medical treatment in prisons as "horrifying" and "shocking." Henderson further found that the prison healthcare system was "broken beyond repair," causing an "unconscionable degree of suffering and death." The court also found that a California prison inmate dies every six to seven days due to grossly deficient medical care. In 2005, after years of issuing court orders to the state to compel it to provide constitutional standards of care to inmates with little response, Henderson ordered that the California prison healthcare system be placed under the control of a court-appointed receiver who would oversee all aspects of prison healthcare. The appointment was unprecedented in the history of U.S. corrections. Henderson decided that the receiver would become perhaps the most powerful post overseeing the actions of the California Department of Corrections and Rehabilitation. Charged with delivering constitutional care to inmates, the receiver is empowered to take any action to ensure the court order for constitutional care and an overhaul of the prison healthcare system is enacted. In all efforts to deliver care to prisoners, the receiver's orders, coupled with Judge Henderson's rulings, would supersede the orders of the governor himself. W W W. C A L N U R S E S . O R G REGISTERED NURSE 15