Nonfiction NYC

Visiting Rikers Island (II).

Clear partitions divided the building into small waiting rooms, each decorated with dark plastic chairs bolted to the ground. The cinder block walls were painted a dull shade of yellow. Posters advertising social services and drug rehabilitation were plastered in each waiting room. Vending machines, selling chips, candy, and sugary drinks, were near the bathrooms. In the middle of the building was a small enclosed cubicle that resembled a movie ticket booth.

“Who you want to see?” the woman behind the plastic partition asked. She was one of the few people working at the jail who was not wearing a police uniform.

“The Person,” he answered.

“Lemme see your IDs,” she said.

Into the DOS computer she entered our names, our addresses, and our birthdates. After stamping two large white cards, she handed them, along with a half sheet of paper, back to us.

“Fill those out completely and go to area B.”

Area B was facing the back of the building. Windows looked out at the parking spaces in the back. Several buses, empty, sat in the lot. These buses resemble school buses in shape and size, except they are white in color and the words “DEPARTMENT OF CORRECTIONS” are plastered in blue across the sides. There was a queue in Area B leading to a police officer standing behind a counter. She looked annoyed. There were close to ten people ahead of us.

“Why she so slow?” someone behind us mumbled. “A bus gonna come and we won’t get it.”

Several single men sat in chairs in the corners. A baby, maybe eight months old, kicked his legs in his stroller and cooed. An older woman pushed her way through the crowd and demanded, “Is this the line?”

“Yeah,” a young woman with large hoop earrings said. “We’re all in line. All of us.” She pointed at the group of people who had tired of standing and had taken seats.

“Okay,” the older woman said. “This is my spot.”

The group in the chairs glanced at each other and stifled giggles.

Twenty minutes passed. My companion and I each took a free copy of the 2010 Rikers Island Visitors Guide, which included information like:

  • “… on an average day, about 13,500 City residents are detained in our facilities…”
  • “… we also host as many as 1,500 visitors daily.”
  • “Sentenced inmates may receive visits two (2) times per week.”
  • “Provocative attire is NOT acceptable.”
  • “There are several ‘amnesty boxes’ in which you may deposit any illegal substances or items you may have in your possession, no questions asked.”

Ah, I thought.

I reviewed the rules for visits:

During visits:

  • You must remain seated with hands above the table.
  • You are permitted to kiss and hold hands with the person you are visiting.
  • You are not permitted to exchange any items with the person you are visiting or anyone else.
  • The person you are visiting may hold children who are visiting throughout the visit.
  • At the completion of the visit, you must remain seated until the person you are visiting has departed the area.

I also skimmed the acceptable jewelry restrictions:

Although we discourage inmates from receiving and possessing jewelry, inmates may receive the following items of jewelry.

  • One (1) watch (date and time functions only — maximum value $50)
  • One (1) wedding band (no stones or protrusions — maximum value $150)
  • One (1) religious medal (no stones, pins, or protrusions) if worn around neck, a thin chain no longer than 26 inches may be worn (maximum value $50)

Another fifteen minutes passed.

“I’m going to use the bathroom,” I told my companion.

In my experience working in a variety of city, county, and state hospitals, the conditions of the bathrooms can serve as a measure of money, pride, and care that the institution has for the people it serves. The jail thus far looked like any other aging institution.

Two of the five toilets in the bathroom were clogged with toilet paper and excrement. Most of the doors lacked working locks. There was toilet paper in the stall I used, though no trash contraption within the stall. Generic, thin, pink soap was present in the dispensers and the sinks drained well. There were no paper towels, but hot air hand dryers were mounted on the walls.

I felt sad that I wasn’t surprised with the conditions of the bathroom.

After another five to ten minutes of waiting, a bus roared up to the lot and stopped in front of Area B.

“YAY!” one of the younger women squealed. “About time!”

“Show your white cards as you exit,” the police officer shouted at us as we fell into an orderly line at the door. By now, I had grown accustomed to police officers shouting. The driver pulled the bus door open and motioned us to go inside.

My companion and I were one of the last people to board the bus and we found seats in the back. No one on the bus was white.

(Read Part I here.)

Nonfiction NYC

Visiting Rikers Island (I).

As my days in New York are ending, the details of terminating with patients, saying good-bye to dear friends, and relocating to the other side of the continent are consuming my time and energy. As a result, I will repost some earlier writings.

Following is the multi-part story of my visit to the jail of New York City. Everything in the account (except for some names and labels) is true.

Across the street was a large sign advertising the entrance to Rikers Island, the jail for the City of New York. On our side of the street were several check cashing and bail bond storefronts. There was also a jewelry store. A hot dog truck was parked near the intersection.

No buses were approaching. A small crowd of people was gathered on the corner, patiently waiting. They, however, were not at the bus stop.

“The bus does stop over there to go to Rikers, right?” he asked the woman standing at the periphery of the crowd.

“Yes, that’s where the Q100 stops. There’s a van that goes there, too. It’s coming.”

“A van?”

“Yeah. Two bucks to get across.”

“Oh, thanks,” he said. “We’ve never been here before.”

The empty van, painted blue with E-Z Travel splashed in yellow on the sides, pulled up to the curb. The driver, short and mustached, turned the car engine off and came around to the passenger side. He wordlessly slid the door back and pulled out a thick stack of bills. He looked up.

We were in the back of the line and people silently handed over money to him to enter the van. His thin fingers smoothly sorted through the stack of bills to provide correct change. He did not look at me as he took the two dollar bills from my hand.

We crawled inside and sat down. Every single person in the van belonged to a racial minority group.

The van rumbled across the two-lane, sidewalk-less bridge. Planes sat in clusters at Laguardia Airport to the right. The waters of the East River below were choppy. A dark, long-necked bird passed overhead.

Not even five minutes later, the van came to a halt outside of an old building painted an institutional shade of dull white. We all crawled out of the van and looked at the chain-linked fences surrounding the cement campus.

“That’s a great way to make money,” I commented. “A mile for two bucks? Nice.”

My companion agreed as we made our way around the building that looked like a terminal for a small airport. Metal barriers guided us to the entrance, which had both a ramp and a set of stairs. A wall of lockers lined one side of the building. A police officer—hair tightly pulled back out of her face, hands on her hips, firearm at her side—shouted: “C33 and C34 are not open today. If you are visiting someone in these wards, you cannot come in today. Everyone else, take a white bin.”

We pulled our bags from our shoulders and walked inside.

I had purposely removed the small Swiss Army Knife that usually resides on my keychain. The blades on the contraption could do no serious harm, though civil servants often thought otherwise.

“No hoodies, no jackets, no cosmetics, no food items, no electronics,” another police officer shouted. “Put your bags in a bin and then step through.”

My bag and my jacket were already in a bin and rolling along the conveyor belt when I heard this. As I stepped through the metal detector, it beeped.

“Put your arms out,” the police officer on the other side of the metal detector said. He guided the metal detector wand across my chest. “Turn around.” He repeated the motions.

Meanwhile, yet another police officer was digging through my bag and listing all the violating items. “No lip balm, no cell phones, no water, no food, no scissors.”

Still another police officer was also pulling offending items from my companion’s bag.

“Okay,” he said. “We’ll be right back.”

“Where can we get keys for the lockers?” I asked. “We’ve never been here before.”

“You pay with quarters,” the police officer said. “Fifty cents.”

As we turned around to leave the building, I noticed the “Amnesty Box”. The box was about waist high and had a thin slot on top. The words “Amnesty Box” were in faded red and blue hues and the letters were shaped to suggest beauty or hope or joy. The box looked like a tithing box.

Later I would learn that boxes weren’t meant to hold money.

Only a few locker doors hung open like baby birds crying for food. Quarters were jammed in their slots. There were smaller lockers on another wall, but they were too small to hold all the prohibited items we had brought with us.

“Next time, we’ll just leave all this stuff at the office,” he said as he scanned the wall for functional lockers. His efforts paid off and we soon put our offending items inside: A tangerine, two cell phones, hand sanitizer, lip balm, scissors, water bottles, gum, and keys.

We re-entered the building and heard one of the police officers loudly commenting for all to hear: “What does he think he’s doing? Everyone else is taking off their jackets and sweaters and he walks in here, doesn’t take off anything, thinks he can just walk in like that….”

The young man in question turned around so another police officer could wand him.

The police officers dug through our bags again, running their hands deep into each pocket. Since the metal detector beeped again, I was wanded again.

“Where can we find out where The Person is?” my companion asked an officer. The Person didn’t know of our visit, as he said that he hadn’t been able to speak to The Person directly.

“Go to the information window,” an officer replied, pointing deeper into the building. We followed the queue inside.


The Great City.

With iron mined from the earth, they built lumbering machines that crushed trees, dredged holes, and flattened hills. They used their ingenuity and strength to excavate limestone and granite from the mountains. After carving these boulders into blocks, they stacked them into buildings that reached for the heavens. Using the soil and silt beneath their feet, they changed the courses of rivers and increased the area of the island. It was a great city.

From miles away, the skyscrapers were visible, forming a jagged contour that jutted up from the arc of the horizon. They marveled at their achievement.

They also leveled hills, uprooted trees, pulled out grass, shaped new hills, replanted trees, and added flowers. They filled in ponds and constructed new lakes. The result was a beautiful park. It beckoned the citizens out of the grid of the great city onto its manufactured grounds for respite. Tall buildings cast long shadows over its expanse.

No matter the direction of their gaze, they saw their wonderful creations: The skyscrapers. The city grid. The subway system. The works of art. The green spaces. The fashion. The cuisine. There was nothing that they could not do. Everything in the great city was man-made, a product of their brilliance, efforts, and ambition.

In their pride they overlooked the creations of Nature. Some mountains reached heights such that they were frosted with snow throughout the year. Tides splashing over the billions of grains of sand along the oceans’ edges succumbed to the pull of the moon. Though trees were naked in winter, by spring they were dressed in lush leaves that captured the energy of the sun.

They forgot that Nature provided the materials to build the great city. They forgot that there was something greater than them.

Nonfiction NYC

East vs. West: So Serious!

When I was a medical student in California, many of my classmates expressed relief that we weren’t in a medical school on the East Coast.

“Everyone is so serious over there,” they said.

The stories we heard about medicine back East!

  • “The medical students have to give all of their patient presentations from memory during rounds!”
  • “You have to wear a coat and jacket all the time! It doesn’t matter if you are on call! You change into scrubs after 9:00pm and then, before rounds in the morning, you clean up and put your suit back on! The attendings never see medical students or residents in scrubs!”
  • “If attendings ask you a question you can’t answer, they throw you out of (rounds, the operating room, the cafeteria)! They scream things like, ‘DON’T COME BACK UNTIL YOU KNOW THE ANSWER!!!’”
  • “They have to keep their white coats buttoned all the time! ALL THE TIME!”

These stories must have trickled down from the interns and residents who attended medical schools on the East Coast. Funny, though: I did not hear these tales directly from them.

During my surgery rotation, one of my residents attended a medical school in New York City. This surgery resident had olive skin, dark brown hair, and manicured fingernails. He smiled only once during the month-long rotation.

“Medical students don’t have any respect for the attendings here,” he once complained to the chief resident. The chief was a young man who was almost bald, had grey-purple bags under his eyes, and always carried a travel mug full of coffee.

“Back where I went to medical school,” the resident continued, “everyone called the attending surgeon ‘sir’. We all stood up when an attending walked into the room. If the attending asked us a question, we always finished our sentences with ‘sir’. You only spoke when you were spoken to. And our white coats were always buttoned.”

My classmates and I shot knowing glances at each other.

We then shoved our presentation notes for rounds into the pockets of our short white coats that were hanging open over our green scrubs.

During my time in New York City, I rotated through three different hospitals as a fellow. I visited many wards as the roving consult psychiatrist: I noticed the internists rounding in the hallway, saw the obstetricians rushing to labor and delivery, observed the surgeons dashing down the stairs, peeked at the radiologists staring at films on computer screens, spotted the pediatricians cooing at toddlers, and glanced at the internists still rounding two hours later.

From my observations at these three hospitals in New York City, I can say the following with confidence:

  • The medical students do not give presentations from memory. They read from their notes. Their voices are infused with anxiety and self-doubt. They are just as nervous as medical students out West.
  • I never saw any medical student, intern, or resident wearing a suit. If they were post-call, they were wandering around in their wrinkled scrubs and sneakers. If they were not on call, many men did not wear neckties! The occasional attending would wear a suit to work, but that was an uncommon sight.
  • Though I saw many floundering medical students, I never witnessed an attending throw a student out of rounds or the cafeteria. (I can’t comment about the operating room.)
  • Many physicians, regardless of their position in the hierarchy, did not button their white coats.

Nonetheless, I do believe medical training and medicine is more formal on the East Coast. More to follow.