Every day at 1545 hours (3:45 PM), the prison does a yard recall for standing count. This means that all inmates must report back to their cells, i.e. (as announced on the facility-wide intercom), “Recall and lock up.” Once they’re all inside, the master switch is thrown and every single inmate is locked in the cell for count. The tier officers walk up and down the corridors, checking inside each cell to make sure that the occupant is inside, alive, and breathing. It’s called standing count because the inmate has to be standing up to show that he hasn’t been maimed or murdered by another inmate. I know that sounds morbid, but it’s true. And it’s happened before, which is why standing count is completed regularly.
Anyway, so the yard was recalled and it was late in the afternoon and I happened to be checking my team’s triage mailbox to see if there were any inmate requests or staff referrals that needed to be handled. My team’s mailbox was empty. Team 2’s mailbox, on the other hand, contained several forms. I knew that every single member on Team 2 was out on vacation for the rest of the week. I had a choice: I could leave those papers in their mailbox and let them deal with it on Monday when they returned, or I could triage the forms for them. I decided to be a good colleague, because I’d want them to do the same for me.
I pulled out the inmate requests and staff referrals and started sorting through them. They all seemed like routine appointments until I got to one that was marked Urgent. It was a referral from a nurse at the clinic. It seems that the night before, she had screened a new arrival and he had answered “yes” to question 19 on her intake form: Have you had any thoughts to end your life in the past year?
This nurse wanted someone to follow-up with this new arrival within the next 24 hours, just to make sure that he wasn’t suicidal. According to the form, she had completed and faxed it at 8 AM this morning. And apparently, somebody put the referral in Team 2’s mailbox without paying attention to the fact that it was marked Urgent.
Anyway. So there it was, about 4 PM, the yard was recalled, and I had a dilemma. I could either put those forms back in Team 2’s mailbox and pretend that I never saw them, or I could do the right thing and follow through on the referral myself. Which meant that I would not be going home at 5 PM as I’d hoped, and I was about to open up a whole can of worms (and work) for myself.
You know how you have a conversation with a good friend, where you have to make a decision between a right thing and a wrong thing, and you really know which is the right thing to do, but you’d really rather not do it? And you’re hoping that your friend will back you up on choosing the wrong thing, but your friend (because he’s a damn good friend) won’t let you?
I went to my buddy the lieutenant, who was first in command on the yard since the captain had already gone home for the day. And yeah, our conversation went like that.
“L.T.,” I said (which is what I call him, because he’s Lt. H___, even though he says I should call him by his first name). “I got this urgent referral, and I have 24 hours from the time it was sent to see this guy and make sure he’s not going to kill himself.”
(That may sound blunt to you, but when you work in a prison, there is no room for dancing around with niceties.)
“What time was it sent?” Lt. H asked.
“Eight o’clock this morning,” I said. “I was hoping to go home at 5:00. I have until 8 AM tomorrow morning to see him.”
Lt. H gave me a look. “Are you going to be able to sleep tonight if you go home and don’t see him today?”
“Damn it,” I said. “I was hoping you wouldn’t say that. But you’re right. I have to see him today.”
“You have to wait until count is cleared,” he reminded me. “He won’t be able to come out of the cell until then.”
“Well, can I go down the tier and just do a cellside?” I asked. I’d done them before. But I also knew the answer that was coming.
“We-ee-eelll… probably not. You’re going to have to ask him some personal questions, and he’s not going to want to talk to you with all his little homies listening.”
“Damn it,” I said again. “You’re right. I guess I need to wait until count is cleared.”
The sergeant came into the office then. I explained to him the situation.
“Let me see what I can do,” he said. “I might be able to make an exception and get one of our officers to escort him from the building over to your office. But it will have to be in restraints.”
“You mean, like in handcuffs?” I asked. “Do you have to cuff him up, really?”
“Yes,” he said. “If I’m going to make an exception for an inmate to be out on the yard during count time, we have to take all necessary precautions and follow the procedures.”
“That’s okay,” I said. I’ve had guys brought into my office in handcuffs before, and it’s kind of a disconcerting sight when you’re trying to conduct a clinical interview. “I can wait until count is cleared. Thanks, though. I’ll be in my office.”
I went back to my office and started typing up the paperwork. About ten minutes later, an announcement was made over the facility-wide intercom: “Code One, PAD alarm in Building 3, A.S.U. annex. Code One, PAD alarm.”
Then there were the sounds of jingling keys and thundering feet of the responding officers running out of our building to join the other officers at Building 3, the Administrative Segregation Unit, otherwise known as the Hole, otherwise known as the jail inside the prison. A PAD alarm usually meant that there was some sort of disturbance, possibly an unruly inmate or inmates who needed to be calmed down. They were all locked in, so at least it couldn’t be a riot.
Shit, I thought. There goes at least another half hour until count is cleared.
Forty-five minutes later, order was restored and count was cleared. The new arrival inmate was allowed to leave his building and walk over to my office without restraints. I explained to him why he was there. “I just want to make sure that you’re okay, and you’re not having any thoughts to harm yourself.”
“Oh, I’m fine,” he said. “I’m not going to hurt myself. I thought I made that clear to that lady. Matter of fact, I’m happy to be here. I been down for thirty-five years. I been at Level 4s* and I been trying to get my points down so I can come here**.”
“Well, I’m glad to hear that,” I said. “Welcome.”

*Level 4: maximum security prison. Where you’ll find extremely disturbing violence, hardcore gang politics, and death row.
** We are a Level 3 medium security prison.