Letter 9.

Dear DV,

After almost two years of working in the jail, I can sense this particular demeanor of patients who have not been in the jail before. It’s usually one of two things 1) fear or 2) excessive aggression paired with a level of arrogance—you were the latter.  I had already combed through your chart and established this was your first time here, but I asked you to confirm.  Your response, “Yeah it’s so f*cked up and unfair.”  You were visibly disturbed by whatever it was that brought you in.  You had no other medical issues that you needed me to manage, so I thought I’d let you have your opportunity to get it off your chest before you went to general population housing. 

I was surprised that I didn’t have to ask many questions.  So I listened to you explain, how you had court the day before and the judge held you in contempt for your outburst after hearing the jury’s verdict.  You were found guilty of domestic violence against your “crazy Latina girlfriend” (your words not mine).  You described how she was possessive and held a knife to your neck and the only way you knew how to stop her was by using force.  As a tall, white man with an athletic build my imagination went in a number of directions.  You described how she was smaller than you and maybe you left some bruises on her, but you were the victim because as you said, “my life is ruined”.  In your late 30s, you had returned to school and had hopes of completing college so that you could pursue a career as a physician’s assistant.  So when you heard the verdict, your life seemed to fall apart in front of you.   Your emotions overflowed and your outburst of aggression led to the judge sending you to jail before you could even hear your sentence.  You told me how you hoped that the days you spent in the jail would count towards your sentence.  Then you asked me if I thought this would hurt your chances of becoming a physician’s assistant.  I told you I wasn’t sure, there was no changing what already happened, and to get through this experience in here you would have to let go of what you could not control.  There wasn’t much else I could say.  I wasn’t there to judge you and you already had your day in court.  

I explained that you would be transferred to housing after I was done placing my orders.  Then with what I assumed to be the same tone of privilege and aggression you displayed in court you responded with “then I guess I just have to go back into the cage with the animals and wait.”  In that moment, the room where you were going to return to flashed before my eyes.  I looked sternly at you, firmly tried to leave you with an impression, and said “that cage of people you call animals are human beings all of whom are mostly young black and brown men, impacted by society’s structural discrimination, some who had adverse childhood experiences that is the root of their mental illness or disease of addiction, some who had committed crimes in the past and others who took a plea for a crime they didn’t commit because they feared longer sentences, and even some who have never been convicted of a crime like you.”  Though I would love to say that I did not intend  to make you feel the same judgment that you bestowed on those “animals”, I could tell that it did because of the deep inhale you took afterwards.  Unfortunately, I couldn’t help but to end our conversation in a way to one-up your privilege and said, “if you truly want to help others as a physician’s assistant in the future, perhaps this is your lesson in empathy.” 

I am not proud of how I reacted and my job is to provide medical care without judgment, but I am human.  Your spoken privilege upset me.  I wasn’t sure what happened between you and your girlfriend.  I know there is always more than one side of the story for which the jury that was selected decided you were guilty.  Your demeanor with me, made me feel like the judge was justified in sending you to jail.  Your words made it clear that you weren’t learning the lesson that the judge intended you to learn.  You were likely going to leave the jail, with your sentence that may or may not affect your life’s trajectory and you would still live a life where you felt you were better than the next person- whether it is a  friend, colleague, neighbor, or even a person experiencing homelessness that you walked  passed on your way to grabbing your $7 latte.  For me, you personify what is wrong with our society that is divided by differences so that one group can advance instead of finding commonalities that allow for unified progress.  I was wrong to place my frustration with society on you.  Perhaps we both have something to learn.  

Humbly continuing to grow,

Dr. A