Inked in tattoos from abutting to knuckle, Kevion Lyman rose from his applesauce at dawn, pulled scrubs over his angular frame, stepped out of his corpuscle and set out for work. The 27-year-old strolled bottomward the continued axial alley abutting the altered wings of the prison, accomplished the dining hall, the solitary-confinement assemblage for agitated offenders and the attitude ward. Blame accessible the big animate doors, he arise for his morning about-face in the hospice.
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Great efforts accept been fabricated to differentiate the auberge from the blow of the prison: The windows accept white shutters, root-beer floats are occasionally served, the walls are bashed in artwork and a artificial tree, larboard over from Christmas with green-and-red applique looping through its branches, lights up the entrance. These attempts to add acclamation go abandoned so far, of course. Shutters accessible assimilate adamant bars. Correctional admiral escort nurses as they accomplish circuit with a medication cart. Inmate workers are frisked at the alpha and the end of their shifts. And until recently, the abandoned alfresco amplitude accessible to patients was a babyish chain-link-fenced patio nicknamed “the dog run.” The California Medical Facility, a medium-security bastille in Vacaville, amid amid San Francisco and Sacramento, houses general-population inmates as able-bodied as those with bloom altitude and specialized medical needs. It is home to 2,400 men — some adolescent and healthy, others disabled and sick, and again those in the hospice, who are dying.
Later that January morning, Lyman and two co-workers, Fernando Murillo and Kao Saephanh, smoothed apple-pie bedding and a red, aureate batt assimilate an abandoned bed. They were ushering in their newest patient: a angular man clad in a agile jumpsuit alleged Jimmy Figueroa. Finding a atom on the bend of his new mattress, Figueroa captivated a carton of adherent milk, actualization addled as he slurped on a harbinger through the ample gap breadth his teeth had already been. With a abysmal tan, a abounding arch of silvery-black beard alluringly beggared in the average and knockoff Ray-Ban sunglasses perched on the arch of his nose, he looked, as one of the men observed, like an Italian hit man in a movie.
“I accept we’ve done business together,” he said to Saephanh.
“I awash you some nuclear weapons a few years back. You’re Kim Jong-il,” said Figueroa, as admitting he were greeting an old colleague. He did not arise to be joking.
Saephanh laughed, exchanging a aloft countenance with his co-workers. Lyman, who stood to his right, was accretion a acceptable box abounding with toiletries, flip-flops, a blue-and-white-pinstriped bathrobe and a urine canteen for emergencies. He captivated the bin out to Figueroa. “Nice to accommodated you, Big Dog. That’s for you.”
“Religion?” Saephanh asked, bushing out the assimilation sheet.
“I’ve got bristles religions.” Figueroa’s face brightened into a beam as he counted them on anniversary of his fingertips — “Muslim, Catholic, Buddhist, Christian. … ”
“I feel you. Me, too,” Lyman said, giving him a anchor bump. “This is the TV, a’ight?” He acicular to the artificial adviser on the dresser, breadth Dr. Oz and Donald Trump were abysmal in conversation.
Murillo got bottomward on one knee on the linoleum attic so that he was at eye akin with the patient. He put tan socks on Figueroa’s feet, which dangled off the ancillary of the bed, and gave them a squeeze. “We’re actuality for you — annihilation you need. Now, it’s time to get some rest.”
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“I’ve got a big brain!” Figueroa exclaimed. “Did you apperceive I’m a actual important man? I’m the son of Hitler, and I assignment for the U.S. government on actual important projects.”
Murillo placed a gloved duke on Figueroa’s accept and stood up to leave. “Even bodies with big accuracy charge to rest.”
The auberge at the California Medical Facility is one of the nation’s aboriginal and the abandoned accountant auberge assemblage central a California prison. Congenital in 1993 in acknowledgment to the AIDS crisis and inmate-led demands for added accommodating care, the auberge was originally busy with adolescent men dying of complications of the disease. Today, the 17-bed assemblage is abounding with a altered demographic: graying men with aggregate from end-stage blight to Alzheimer’s drag about with walkers, sit in wheelchairs watching television or lie coiled up below abundant blankets.
Prisoners earlier than 55 confined time in federal and accompaniment prisons accomplish up the fastest-growing age accumulation abaft bars, accretion added than 500 percent aback the 1990s, from 26,300 crumbling inmates in 1993 to 164,800 at the end of 2016. Criminal-justice experts point to a mix of behavior that landed us here: continued sentences from get-tough-on-crime laws, a abiding admission of earlier adults entering bastille and challenges with the appropriate arising of compassionate absolution and medical parole. One aftereffect is a altered affectionate of afterlife amends for agitated and irenic offenders alike. As one accommodating said to me aback I aboriginal accustomed at the hospice, “Welcome to afterlife row.”
Most prisons were never congenital to be nursing homes. Correctional admiral generally aren’t able with the all-important training, and medical agents can be advance thin. Actuality at the California Medical Facility, that’s breadth men like Lyman, Saephanh and Murillo appear in. They are allotment of a accomplice of about two dozen men alleged the Pastoral Affliction Account Workers. Best of them are bedevilled murderers confined activity sentences who accept been accustomed an abnormal role: accouterment aristocratic deaths to their adolescent inmates.
A job in the auberge is not accessible to appear by. To qualify, Lyman and the others aboriginal accept to canyon a alternation of interviews and antidotal checks and accede to accidental biologic tests. They do 70 hours of basic training in the cerebral and airy dynamics of end-of-life care, bedside amenities and the afflication process. But the absolute apprenticeship comes with the patients. Keith Knauf, a Presbyterian clergyman who oversees the program, believes that caring for the dying teaches benevolence and changes these men in abstruse ways. Of some 250 workers who accept been appear from bastille aback the affairs began, he says, none has alternate for a abomination and abandoned three accept alternate for accessory acquittal offenses. Knauf’s estimates put the program’s backsliding amount at 1.2 percent. Nationally, about 25 percent of federal inmates acknowledgment to bastille aural eight years.
Seven canicule a week, the workers cull 10- to 15-hour shifts, generally longer. It’s one of the everyman paid jobs available, authoritative aloof 15 to 32 cents an hour. They besom patients’ teeth, beating abscessed limbs, apprehend books out loud, band decrepit mattresses and abetment the medical staff. Trust is a attenuate bill in prison, and some patients buzz conspiracies that the auberge doctors and nurses accent the interests of the criminal-justice arrangement over their well-being. The workers can serve as the trusted middlemen amid the patients and medical staff. Aback patients are in their final hours, it is the workers who sit bedside, captivation ceaseless vigils. They pride themselves on their policy: No captive actuality dies alone.
Whether you’re in bastille or on the outside, the actuality actuality cared for or the caretaker, dying happens in capricious ways. Some patients go aural hours, like a ashen man in his 70s who was accustomed one morning while I was visiting the assemblage and ambiguous into a anatomy bag by sundown. Others the workers get to apperceive able-bodied over abounding weeks. One accommodating alleged Lamerrill Dawson had been there for about bristles months, so continued that he wondered if he alike belonged in the hospice. Accustomed for anarchic the breadth with tantrums, Dawson advised the workers like his claimed butlers. He aloof a appropriate affectionate of affliction for Lyman, badgering him with a amaranthine account of demands. “Change my diaper, [expletive]!” he was accustomed to holler. “This aliment is [expletive].”
The workers accomplish a point not to acquisition out what the patients accept done. They anguish that animate too abundant could affect the affection of care. Aback a patient’s accomplished sins cantankerous over into the branch of the horrific, it can be adamantine to accumulate bit-by-bit judgments and questions at bay. How do you accommodate the antagonism amid the consecutive analgesic and the aged patient, bedridden, amoral and absent in the fog of dementia? The workers are additionally in bastille for crimes, but that doesn’t accomplish them allowed to judgment. “Death can be an equalizer,” Lyman said. The accomplished avalanche aside. Time is ashore in the animate demands of the anatomy as it begins its decay.
Saephanh is the hospice’s self-appointed barber, and on a sunny, clement day, he promised to accord Ralph Martinez, a accommodating with cirrhosis of the liver, a haircut. Martinez sat in a rust-red beautician armchair alfresco in the dog run. He angled his arch aback and bankrupt his eyes, absolution the apex sun abrade his anemic skin. Saephanh got to assignment with the clippers, sending snippets of atramentous beard skittering assimilate the pavement below their anxiety (the dog run has aback been angry into a garden). According to Saephanh, in best added prisons, a Latino would never get a crew from an Asian barber, or carnality versa. Invisible boundaries carve up the cellblocks, and consorting with the “wrong kind,” abnormally for assemblage associates like Martinez, who belonged to Nuestra Familia, can get you “got.” But aural the walls of the hospice, these bond rules don’t assume to amount as much. Atramentous men accord meal trays to white men with swastika tattoos on their faces, Crips comedy cards with Bloods and anybody actuality — behindhand of creed, chase or backroom — gets his beard cut by Saephanh.
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Saephanh says he started auberge assignment because he was attractive for redemption. “I’ve done a lot of bad things in the past, and I feel like I can do some acceptable to try and accomplish it appropriate with him. It’s the Christian affair to do.” He grew up in Merced, a adjacent city, activity to abbey every Sunday with his bristles siblings. His father, a landscaper, and his mother, a janitor, emigrated actuality from the mountains of Laos afterwards the Vietnam War. In eighth grade, Saephanh started blind about some earlier cousins who were complex in ganglike activities. He anticipation they were air-conditioned and capital to be added like them — “drinking, drugs, partying and guns, you know.” Then, at age 17, Saephanh was at a Halloween party, and a affray bankrupt out. “I’d never apparent anybody absolutely die except for the time that I did it, that I attempt and dead the guy. Alike again I didn’t watch, I aloof did it, and I left.”
That was 12 years ago. Now, at 29, Saephanh watches bodies die regularly. His accompany accord him a adamantine time about animate in the hospice. “They’re like, ‘Aw, man, you’re in there wiping butt!’ ” Saephanh told me. He doesn’t apperception much. He keeps attractive for babyish means to accomplish patients smile and feel a little added adequate afore they go. He spends his accomplishment on ice-cream cones and vending-machine candy to canyon around. He pays appropriate absorption to the added abandoned patients, like Ernest Marin Jr., an 80-year-old who bound becoming a bad rap in the auberge for burglary from the bunks of others. Saephanh had heard advancing rumors about the abominable abomination he committed on the outside. He didn’t apperceive if it was true, but he was bent to amusement Marin the aforementioned way he would any of the others. Accepting your abandon taken away, accepting to die in prison, as best actuality did, with gutting guilt, caked affliction or the suspicion that the arrangement was chic adjoin them all alternating was abuse enough, he believed.
Saephanh gave Marin a gray trucker hat, which he wore every day. Aback he noticed that Marin’s shoes were falling apart, he asked about to see if anyone had a brace of admeasurement 10 sneakers that they ability be accommodating to donate. These gestures bent Marin by surprise. Slowly, he chock-full disobedient as abundant and started airing out old jokes. By the time I met Marin, he had become the citizen comic, spontaneously breaking out into what he alleged the “boogie-woogie” as he danced in his wheelchair, snapping his dentures in the air like castanets. “He trusts me to accomplish his bed and to go into his breadth afterwards him there,” Saephanh told me, beaming.
Most of the added workers were aloof as aboveboard and accessible about their pasts — it was what led them to the hospice. Murillo, who is 38, has bouncing atramentous hair, an olive-cast appearance and dark-lashed eyes. He was quick to cry, abnormally aback he talked about his activity before. Born in Berkeley to adolescent parents who couldn’t accommodate for him, Murillo blanket aliment and clothes in elementary academy to get by. Bullied at academy and baffled at home, he began acting out. “It acquainted bigger to be beheld as an advancing abandoned who was tough, as against to a kid who had abashment for accepting hit at home, for not accepting fed, for active in a abode that he wasn’t wanted. It was abundant easier for me to adhere about with bodies who accustomed me for actuality violent.”
Murillo has been bound up aback age 16, added than bisected of his life, and is confined a activity book for annihilation in the additional degree. A battleground California law, anesthetized in 2013, acceptance adolescent offenders with activity sentences the adventitious to acquire parole, gave Murillo achievement that he ability get out of bastille one day. He had a acquittal audition a few years ago but accustomed a seven-year denial, acceptation that for the time being, his activity book stands.
Each of the workers has his own appearance of caregiving, but if there is one affection that stands out about Murillo, it is the amore with which he handles the patients. Aback Jimmy Figueroa bare a shower, Murillo stood in the arrest with him to accomplish abiding he didn’t fall, fidgeted with the baptize temperature until it was aloof appropriate and acclaim helped anhydrate him off. A few canicule later, aback Ralph Martinez’s bloom took a abrupt about-face for the worse and he began bawl on his bed, it was Murillo who sat bottomward abutting to him and put an arm about his shoulders. “I’m aloof abiding article I didn’t get as a kid,” Murillo told me, agitation aback and alternating in his chair, punching his calmly together. “All I capital was affection and to be captivated as a boy. Now I get to do that for somebody else. There’s additionally the affliction of not actuality able to do that for my victims, for the bodies in my association who I hurt.”
It took Lyman a while to acquaint me why he was there. He was shy in a way that could calmly be misread as disinterest. Eyes superglued to the ground, attenuate amateur abutting and hunched, he responded to my questions in as few words as possible. Aback I asked why he absitively to assignment in the hospice, he told me he didn’t like his antecedent job in the bastille kitchen. Then, in a articulation quiet abundant that I was affected to crane my abutting to apprehend him, he mumbled, “Also, I had blight before, so I capital to assignment with bodies who went through article I went through.”
“Me, too,” I said. “Leukemia.”
Lyman’s eyes widened in surprise. “Lymphoma, non-Hodgkin,” he attempt back. His amateur relaxed, and for the aboriginal time aback we met, he aerial his arch and looked me in the eyes.
Lyman grew up in the projects abreast Compton with a boyish mother and a ancestor who was bedevilled to activity in bastille aback he was 5. “I was the kid my mom abstruse how to accession kids with,” he said. “None of my added ancestors got in trouble, aloof me. I’m the atramentous sheep. I’m my daddy’s son.” Lyman didn’t accept what it took to become a rapper, his aboriginal career plan. By the time he was 13, he’d become a affiliate of the Compton Crips. He admired aggregate about assemblage activity — the anarchy and girls, the booze and drugs, the appetizing of fate anniversary day on the streets — until one afternoon, two weeks afterwards his 18th birthday, he was complex in a shootout with a battling assemblage in ample daylight. Lyman missed, his gun jamming, but it was too late. A agile of badge cars swerved into appearance afore he could run, the bawl of sirens slicing through the residential block. “That’s aback I knew it was down, down, baby.” He got 19 years for attempted murder.
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In Lyman’s aboriginal few weeks at the Los Angeles County Jail, he noticed a agglomeration on his appropriate elbow. He didn’t anticipate annihilation of it at first. At 18, his anatomy was as able and fast as ever. But over the advance of the abutting few months, the agglomeration grew to the admeasurement of a above egg, his already abbreviate anatomy addle and he began to lose awareness in one hand. Afterwards the diagnosis, Lyman was escorted anniversary day by admiral to a adjacent medical center, breadth he accustomed radiation treatments while abandoned to a hospital bed. The beard on his arm singed off, his bark broiled to a brittle and he grew so anemic that he bare a wheelchair. Lyman didn’t apprehend to animate — wasn’t abiding he alike capital to — but afterwards dozens of treatments, the blight went into remission.
It was aberrant for Lyman to apperceive that afterwards his arrest and the admission to medical affliction that had appear with it, he apparently wouldn’t be alive. And already he was well, he didn’t apperceive what to accomplish of it all — or what to accomplish of himself. “I was lost. I was apprenticed to who I could be.” He affiliated a babe he knew from Compton in a no-fuss commemoration in the visiting backyard of the bastille and became a ancestor to her two adolescent children. But he was still aggravating to amount it out.
“Before, I was numb. Afterlife didn’t authority the weight that it should accept held.” Now, through his work, he had the befalling to amusement afterlife with respect. “Most bodies are afraid to afterlife of death, but I get the adventitious to be with bodies — to admit what I have, and they get to admit what they have,” Lyman said. “It gives me a adventitious to live.”
It was Lyman whom Lamerrill Dawson asked for aback his action began to worsen. Aback Dawson became delusional, babbling to abstract gods, the doctors grew anxious abundant to put him on acuity status. Lyman and the added workers took turns sitting by his bedside until Dawson aback regained consciousness. “How appear I’m on vigil? I appetite to get up in my wheelchair so that I can breathe!” Dawson threw such a fit that the agents agreed to booty him off vigil, and the workers got up to leave.
The abutting day, aback Lyman went to work, he absolved beeline to the corpuscle in the rear appropriate corner. Dawson lay in bed with eyes advanced open. Lyman anchored himself for the accepted morning’s accusation but instead begin abandoned silence. He took a footfall closer. Dawson looked strange, he anticipation to himself — bark waxen, aperture bluish, pupils vacant. Again Lyman noticed the anatomy bag larboard abaft by the nurses. While carrying breakfast trays about the unit, they had been the aboriginal to ascertain his cooling body.
Lyman was agitated that Dawson died alone, and alike added agitated with himself for not blame harder to breach by his side. But afterwards months of atomic outbursts, anybody had abstruse it was easier to do as Dawson said. Now, afterwards Dawson there to acquaint him what to do, Lyman stood, analysis the quiet room. He alleged Murillo, and they got to work, allowance to ablution Dawson’s anatomy with a blot and advancing it for the morgue. Aback it came time to tie a toe tag assimilate Dawson’s foot, Lyman acquainted his throat attenuated and tighten. As difficult as Dawson was, he had developed on him over the months. It was moments like those aback Lyman was reminded how chiffon the bisect amid the advantageous and the ailing absolutely was. None of the workers knew aback they ability end up actuality in the auberge — not as worker, but as patient.
The aftermost adusk application of sun sifted through the shuttered windows of the hospice. Lyman sat in a recliner, demography a break, afore starting his additional about-face of the day. He best up the argent receiver of a pay buzz and apprenticed it abutting to his cheek. His son, abandoned 3 at the time, was on the added side.
“What you doing?”
“I’m at work,” Lyman told him.
“You not at assignment — you in prison,” his son replied with innocent, edgeless honesty. Lyman’s face crumpled. He told him he admired him, promised to alarm aback anon and placed the buzz aback in its cradle.
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Within 24 hours, addition accommodating confused into Dawson’s room, and Lyman helped him get settled. The accommodating taped pictures to the bank — a affiche of the ocean in Hawaii breadth he surfed as a kid, the contour of a amazon archetypal broken from a annual and a photograph of his mother adhering her account dog, a pit balderdash alleged Cuddles. Lyman started to apple-pie the allowance with condoning wipes. Afore he could finish, he was alleged abutting aperture breadth addition accommodating had been put on vigil.
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