The Prison Doctor: Women Inside

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The Prison Doctor: Women Inside
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DR AMANDA BROWN is a GP at the largest women-only prison in Europe, Bronzefield. She was a regular NHS GP for a number of years, until she gave up her practice to move into the prison service. She worked at a teenage detention centre, before moving on to Wormwood Scrubs and then finally to Bronzefield where she continues to practise to this day.

Also by Dr Amanda Brown

The Prison Doctor

The Prison Doctor: Women Inside

Stories from my time inside Britain’s biggest women’s prison

Dr Amanda Brown with Georgina Rodgers


ONE PLACE. MANY STORIES

Copyright


An imprint of HarperCollins Publishers Ltd

1 London Bridge Street

London SE1 9GF

First published in Great Britain by HQ in 2020

Copyright © Dr Amanda Brown 2020

Dr Amanda Brown asserts the moral right to be identified as the author of this work.

A catalogue record for this book is available from the British Library.

All rights reserved under International and Pan-American Copyright Conventions. By payment of the required fees, you have been granted the non-exclusive, non-transferable right to access and read the text of this e-book on-screen. No part of this text may be reproduced, transmitted, downloaded, decompiled, reverse engineered, or stored in or introduced into any information storage and retrieval system, in any form or by any means, whether electronic or mechanical, now known or hereinafter invented, without the express written permission of HarperCollins.

This is a work of non-fiction, based on real events. Names and identifying characteristics and details have been changed to protect the identity and privacy of individuals.

This book deals with sexual assault, substance abuse and other difficult topics. The author has taken great lengths to ensure the subject matter is dealt with in a compassionate and respectful way, but it may be troubling for some readers. Discretion is advised.

Ebook Edition © June 2020 ISBN: 9780008386924

Version 2020-06-09

Note to Readers

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 Page numbers taken from the following print edition: ISBN 9780008385736

In loving memory always of my beloved

mother and father, and of their unconditional

love and the values they instilled in me.

‘But there is that within me which will tire

torture and time, and breathe when I expire.’

LORD BYRON

‘Out beyond ideas of wrongdoing and

rightdoing, there is a field. I’ll meet you there.’

RUMI

This book is dedicated to all the abused and

homeless women I have met at Bronzefield,

and to so many other fascinating people who

have been kind enough to share their stories

with me, with gratitude, love and respect.

Contents

Cover

About the Author

Booklist

Title Page

Copyright

Note to Readers

Dedication

Chapter One

Chapter Two

Chapter Three

Chapter Four

Chapter Five

Chapter Six

Chapter Seven

Chapter Eight

Chapter Nine

Chapter Ten

Chapter Eleven

Epilogue

Acknowledgements

About the Publisher

Chapter One

‘I’ve got no one and nothing, not even my own teeth’

MURDER

The word sprung out at me from the smudged screen of the computer and my heart sank. I was in my small and windowless consulting room in Bronzefield prison. I was halfway through an evening Reception shift, meeting new prisoners to assess and discuss their medical issues and prescribe any medication they might need. I was only two hours into my shift but was already feeling weary. Despite having met many prisoners who had committed murder, the impact of the word always caused the same reaction in me: shock, horror, and a deep sadness.

I scrolled up the screen to read the nurse’s entry.

Rebecca was 27 years old and it was her first time in prison. That in itself was a surprise. I have seen so many prisoners return time and time again, that when I meet someone who has never been inside before, it’s unusual.

Many of the residents’ lives are so chaotic, complex and traumatic, that for some of them prison is a refuge. A shelter for the homeless and often a place to get help with addictions. The women return for a variety of crimes, such as shoplifting, theft, robbery, burglary, fraud, arson, kidnap, GBH or ABH.

Rarely murder.


When I reached the holding cell, I saw the door was open and there were five women in there. Two were lying down on the stark blue plastic bench seating, looking extremely unwell, most probably because they were withdrawing from drugs. One was pale and sweaty, her hair sticking to her forehead and her eyes shut, as she tried to ride it out. The other was clutching her stomach, groaning miserably – not an unfamiliar sound to me. An overweight woman in a wheelchair stared blankly ahead of her. The other two sat quietly, and appeared to be shaken and fearful.

‘Rebecca?’ I asked as I looked around the room.

A girl’s eyes peered out from her curtain of long, deep brown hair like a cornered animal. She looked much younger than her age, with delicate features, a spray of freckles and intense eyes. She was wearing a knee-length skirt with tights and pale pink pumps, which were splattered with something dark, as was her pale grey top. I tried not to show the shock and surprise I felt, as I realised it was blood. She must have come straight to prison from the scene of the crime.

I led her back along the mottled-blue lino floor of the corridor to my room.

‘Hi, Rebecca. I’m Doctor Brown. Come and have a seat.’ I gestured to the hard and battered plastic chair. ‘I just have to go through some routine questions to make sure you are okay and see if you need any medication,’ I told her. ‘Alright?’

She didn’t reply.

I started to go through her notes. She looked shocked to her core. Her hands were trembling, and she fiddled with her cuffs, pulling them over her hands. I noticed that they were also stained dark and dirty with dried blood. I could smell it.

Metallic. Slightly sweet.

Rebecca’s eyes looked glazed and vacant; the look of someone who could not believe where she was or what was happening to her.

‘I can see here that you are charged with murder,’ I said. ‘Can you tell me what happened?’

‘I killed my partner.’ Her voice was clear but started to crack as she said the word ‘partner’.

I could see she was trying hard to stop the tears, which were pricking the corners of her eyes, from falling. She swallowed hard.

 

‘I stabbed him.’ She looked up at me through her fringe. ‘I just couldn’t take it any more. I couldn’t see a way out. The years of being controlled.’ She grimaced, and her voice became more defiant. ‘I was his punch bag. I just couldn’t do it any more.’

I was already fairly sure what she was going to say, having heard it so many times in Bronzefield before.

She rolled into her story, the floodgates opening. Sitting in front of me was a criminal, charged with the most serious of crimes, but she was just a normal person. She was well spoken, intelligent and articulate. She reminded me a little of the girl who cuts my hair.

Rebecca met her partner when she was 15 and he was 21. For a while, she said, they were just friends. When she was 17, he persuaded her that they would be better as a couple than as friends.

‘It sounds like such a cliché now, but he did everything for me,’ she said, her eyes downcast. ‘He treated me like a queen. He drove me to college, helped with my work, there was nothing he wouldn’t do for me. Everyone thought he was great; me, my parents, my friends. He was literally the golden guy. My mates really thought I’d lucked out.’

I nodded. ‘When did things change?’

‘It went wrong the first time we went away together. We went on holiday to Spain after I finished my A levels,’ she said. ‘He planned and paid for everything, said it was his way of celebrating the end of my exams. While we were there, he saw me talking to a man. I can’t even remember who he was now; a waiter, I think. We were just talking and laughing; it was completely innocent.

‘That was the first time he hit me.

‘He accused me of flirting. I had nowhere to go, so I stayed in the hotel room, cowering in the bathroom.’

I could see a flash of fear in her eyes as she recalled what had happened.

‘The next day, he was so apologetic. He was sobbing. He said he would kill himself if I left him. I’d never seen him cry like that. It was impossible not to forgive him. I covered up the bruises on my face with make-up and wore a sarong all holiday. I didn’t even go swimming in the hotel pool. I just sat on a sunbed, hugging my bruised ribs. God, it hurt so much that time.

‘That was just the start.’

It was a story that I had heard countless times before. The details and cast were different, of course, but the story of domestic abuse and violence is all too familiar. Men trying to control women and, so often, going too far.

Rebecca’s partner dominated her.

‘Then, of course, he persuaded me to not take the place I got at university – it was over two hours away from where we lived. He made me move in with him. He cut me off from my friends and family and monitored my every move.

‘He made me think I was in the wrong. Always. My attitude was wrong, my clothes were wrong, I looked like a slut,’ she explained.

I could hear the hurt and anger in her voice as she spoke. I knew that women like Rebecca often became increasingly intimidated, and frenzied with fear about when the next blow was coming, so they did everything they could to keep the peace.

‘When one of my colleagues at my office job told me I’d had “one bruise too many”, and asked me if I needed to talk, I felt I had no choice but to resign. I never went back to work. I even stopped going to see my GP in case they suspected him. He called home throughout the day to check up on me. I felt suffocated.’

Rebecca’s partner worked as an accountant and they lived in a nice part of Surrey, not that far away from the prison, with their five-year-old son.

‘So, what happened today?’ I asked gently.

‘I was in the kitchen. I was making his lunch. He always has it at 1 p.m. on the dot – he leaves the office to come home to check on me. I could see he was in one of his moods. He gets kind of twitchy, you know?’

I didn’t correct her tense.

‘He mentioned Jack. He’s not long been at school, and he’s had a few scuffles already in the playground. Just typical five-year-old boy stuff – a bit of pushing and shoving, nothing really. He said he wants him to be a man, like him. We started to row – about Jack, about everything. I hate the fact I’m stuck at home all day. All I do is clean the house. He won’t let me go anywhere or do anything. I even have to ask his permission to go to the shop to buy a pint of milk. I feel so lonely. So alone. All the time. Apart from Jack – he means everything to me. He gives me purpose…’ She tailed off, deep in thought, her face slightly brighter as she spoke about her son.

‘I can tell Jack knows what goes on. He always wets the bed when we’ve had a fight. He knows what his dad’s like; it’s all he’s ever known. Heavy fists and muffled sobs.’ Rebecca’s hair fell in front of her eyes and she pushed it away, then rested her head in one hand.

‘I couldn’t let him hurt my son like he hurts me. I just lost it, I… I’d been making sandwiches and the bread knife was on the surface, and the carving knife. I just grabbed the carving knife and stabbed him. I didn’t honestly realise what was happening until it was too late.’

It struck me how desperate Rebecca must have been to do something like that. How powerful that feeling of hopelessness and despair must’ve been for her to physically do that to him.

To strike him hard enough to kill him.

‘The only time he ever stopped hitting me was when I was pregnant. But once Jack arrived, he started again, saying I was putting the baby before him. Always seeing to Jack and never looking after him. There were so many times he almost killed me. Believe me. It was either us or him.

‘I got him in the chest. There was blood everywhere. I couldn’t quite believe I’d done it. I’ve never hurt a fly. He staggered around for a minute or two, shouting at me, and then fell on the floor.’ Rebecca’s voice was dull and unemotional as she relayed what had happened. Her eyes were glassy and her face was expressionless. I imagined the true horror of the event would not sink in for many days, or even weeks or months.

‘I still couldn’t believe what I’d done. It was like I was in a dream that I couldn’t wake up from. The blood was spreading all over the floor, and he lay there completely still. I was panicking, but knew I had to do the right thing. I called the police and then my mum. Before I knew it, two paramedics arrived. The police must have sent them. They said he was still alive. They tried to save him, but he died within minutes of them turning up.

‘I wanted to clean up the kitchen. I got the mop out. I didn’t want to leave it for someone else to do, but the police wouldn’t let me. They brought me straight here.’

Rightly or wrongly, I felt for her. I could see she didn’t realise the enormity of what she had done. She was desperate, and like so many of the women I see, was despairing and couldn’t see a way out.


We continued to go through Rebecca’s notes. She didn’t use drugs and was not a heavy drinker and she had no medical issues. She was a young woman, who was fit and well.

‘What am I going to do about my son? Will I see him?’ Her voice sounded almost hopeful, that things would not change for her and her son.

For most mothers, being apart from their children must cause the most indescribable pain. I simply couldn’t imagine what that must be like for anyone, especially for someone with very young children.

‘You said your mum’s got him?’ I replied, softly.

‘Yes. She said she would pick him up from school. I guess he must’ve had his tea by now. Done his reading – he’s starting to read now. It’s amazing, and the books are so funny. He’ll be in bed by now, I suppose. I hope he has his favourite teddy.’ She paused, her mind ticking over, like most mothers, the things they do every night to keep their kids happy and comfortable. ‘When will I see him again?’

‘I’m sorry. I don’t know,’ I replied. All I did know was that the chances were, if she was found guilty to the charge of murder, she was likely to be in prison for a very long time.

I put my hand gently on hers. ‘I can’t imagine how you must be feeling. I hope you cope with being in prison, and that you will soon be able to see your little boy.’

The prison officer standing outside came in and led her away. That was the first and last time I ever saw Rebecca. I never knew whether she lived to regret what she had done, or if she was able to see her son regularly whilst she was inside. I simply got a snapshot of her existence, and happened to be there on what must have been the most shocking and tragic day of her life.


The Reception shift in Bronzefield involved seeing to the new prisoners who had arrived from one of the ninety-five courts the prison serves, or from police custody, before they were taken to the house blocks by the officers to start their stint behind bars. Many of them would be withdrawing from a medley of drugs and alcohol, and would need medication to get them through the night. My shift started at 5 p.m. and lasted until 9 p.m. but it was often not possible to see all the new arrivals in that time. They would be seen by the on-call doctor, if needs be. Whatever crimes they had committed, they still needed to be cared for. Some had very complex physical and mental health issues, arriving with bags of different medications: a jumble of boxes, bottles and pill packets, some of them empty, often many of them out of date. Sometimes it seemed to me like they had simply swept the top of their bedside table into a bag in anticipation of not going home for a while. These medications needed to be checked and prescribed on the computer, before the nurses could administer them.

I felt pensive after seeing Rebecca, and wondered how she would cope with the days that would follow, away from her son. I took a deep breath of stuffy air and padded out of my room, along the strip-lit hallway to the small waiting area.

A warming smell of jacket potatoes wafted out of the little kitchen area and made my stomach rumble, reminding me of the fact I hadn’t eaten since mid-morning. Food is provided in Reception for the new arrivals who won’t make it back to the house block in time for the evening meal. The kitchen is kitted out with a small fridge, microwave and chest freezer, supplying the basics, including bread for toast. Often dinner for the new arrivals is a simple jacket potato, with a dollop of beans and handful of cheese.

It was obviously a jacket potato day. For many of them, it would be their first proper cooked meal in days.


‘Hi, Doc.’ Melissa and Shamir, two prison officers, greeted me, smiling. We exchanged a few words.

‘It’s really busy tonight,’ Melissa said with a sigh. She sounded exasperated as she tried to sort out one of the girl’s possessions – a jumble of clothing and prescription medicine that she was passing over the large countertop. Behind the wide counter are rows upon rows of small lockers to house the women’s possessions whilst they are inside. When they are released, they are given back the items.

‘Yes, it looks crazy,’ I replied, scanning the scene in front of me.

The process of getting into the prison can be slow. Some cases are more complex than others. After prisoners arrive inside from their ride in the uncomfortable ‘sweat box’ to the prison, they are processed into the system. This involves searches, sorting their clothing, and getting their ‘welcome pack’.

I could see one girl being handed a white string bag, containing a handful of items, including a mug, a plastic knife, fork and spoon, toothpaste, toothbrush, shampoo, soap, conditioner, six pairs of knickers and socks, two tracksuits, a nightie, tea and coffee, and a hairbrush. These packs are compiled by the residents who work in Reception, earning from £2.40 to £3.20 a day, which they can spend how they wish on items like moisturiser, vapes and snacks. The girls can also take some of their own clothes to wear, if they wish, but many of them only have the clothes that they are standing up in. The prisoners then meet with the nurse, to go through their medical notes, and all those that require medication would be added to my list. There could sometimes be more than fifteen new residents needing to be processed, and sometimes I would need to spend thirty to forty minutes going through their medical history and medication. Any newcomer that had not been seen by the end of my shift would be seen by the duty doctor for any essential medication and then added to the GP list to be reviewed the following morning. It was a finely tuned process that was often exhausting and challenging. But at times, it was also very rewarding. It kept me on my toes, and it was definitely never boring.

 

There were women standing and sitting everywhere, up and down the corridor. The noise was bouncing off the walls.

One woman was screaming to the officer: ‘But I don’t wanna share a fucking cell. Last time I was in ’ere I was put in with a right wrong ’un. I ain’t sharing again. I got to ’ave a single cell.’

There were also happy shrieks and joyful whoops as girls were reunited with familiar faces from previous sentences. Also in the mix were a handful of girls who looked withdrawn, scared and bedraggled.

Some women were heading off to have a shower, clutching thin towels and small bottles of shower gel. There are showers within the Reception area along the main corridor, so once the women have checked their belongings in, many choose to have a wash, especially those who are homeless and may not have showered for days. Others were on the two phones, chatting noisily to their families and recounting the events of the day, whilst some girls queued patiently behind them, obviously desperate to speak with their families before they got locked up for the night. Several were walking to the toilets with small plastic pots, to provide urine samples, screening for infection, drugs, and if indicated, pregnancy.

Also milling up and down the corridor were peer support workers in blue T-shirts.

These are longer-term residents who help new arrivals find their feet and answer the many questions they may have about prison life. During their first few days in prison, residents are said to be at their most vulnerable, and are at high risk of self-harm. I smiled at one of the peer support workers, Amber, as I passed her. Petite, with dark features, she was always positive and upbeat. We often worked together in Reception and I loved her bright and warm company. She gave me a cheerful nod back as she guided a new arrival to one of the small interview rooms. Through the cacophony of noise, I could easily hear her talking with reassuring and soothing tones. This peer support can be invaluable in helping the women through the first few hours.

Some women were waiting in small holding areas to see the nurse or to go through paperwork. As I walked along, I could see another woman locked in a holding room, shouting at the top of her voice to be let out, and banging the door with her shoe, her dreadlocked hair sticking out in all directions and her eyes wild.

The noise ricocheted around me as the throbbing life of prison Reception played out its daily drama.


Scrolling down my list, I spotted a familiar name. Shannon was someone I’d grown to know well. Repeat offenders, sometimes called the ‘frequent flyers’ by prison staff, make up by far the majority of the women I meet. So much so that one of the questions on the medical template I go through when I see them is to ask when they were last released from prison. When Shannon came back into custody I was never surprised because she had been homeless for years. I was always glad to see her as I had grown to like and understand her. It was like meeting an old friend again and made my job so much more enjoyable. But every time she was released, I hoped I wouldn’t see her back again.

I looked into the waiting area and saw her sitting down with her head in her hands. Rather than jump up and greet me with her usual toothless grin and a ‘Hello, Doc!’ I could see she was agitated and crying. She was wearing a grubby blue tracksuit. I glimpsed the top of her head; her auburn hair was matted and greasy.

‘Shannon?’

She looked up and slumped back in her chair for a moment, a look of relief on her haggard and pock-marked face.

‘Come on,’ I said as I led her to my little room.

I shut the door and she gave me a hug as the various smells associated with living rough, like body odour, dirty feet, and foul breath, soon filled the air.

‘What’s happened? You’re never normally like this?’ I asked.

‘Doc… it’s good to see you. The judge… he said…’ She started sobbing. Messy and loud, snot-filled sobs. ‘He called me a worthless wretch.’

A worthless wretch, I thought, what an awful thing to say.

I was momentarily stunned by the language the judge had used. Judges can use their summary judgements to say what they like and whilst this is normally a standard administrative process, this judge had obviously made his personal views known. I couldn’t help but think about the vast gulf between the day-to-day lives of Shannon and the judge who had just sentenced her. Society and the judge might see Shannon as a useless criminal, but she didn’t see herself like that, and neither did I, because I understood the dreadful details of her life that inevitably had led Shannon to commit crime.

‘You are not worthless, and you are not a wretch,’ I told her firmly. ‘I really believe you can make something of your life. And I am sure you will, if you can get the help you need.’

I tore off a large piece of paper towel from the roll and passed it to her. She clutched it and wiped her dirty face. Shannon had substance misuse issues and I could already see the signs of withdrawal. Beads of sweat were visible on her forehead and she had goosebumps on her track-marked arms.

We started to go through the routine medical questions, though I knew Shannon’s medical history well. After all, this was the ninth time I had seen her in around two years.

‘Okay, let’s sort out your medication Shannon, so that you can go over to House Block One as soon as possible to get your methadone,’ I said.


Before my time in prison I had worked as a GP for twenty years in the community near where I live in Buckinghamshire, but had very rarely treated patients who had ever been involved with the criminal justice system. Like many others, the mainstream media soundbites meant that before I started to work in prisons, my opinion was condensed down into a narrative of ‘good people’ and ‘bad people’, with a clichéd list of ‘bad’ characters ranging from violent psychopath to petty criminal. The reality is far more complex.

Female offenders are some of the most vulnerable people within our society. Women make up just five per cent of the prison population in England and Wales, and the vast majority are imprisoned for non-violent offences, and are often sentenced for a matter of just weeks at a time. Many of them are caught in a vicious cycle of domestic violence, drug abuse and homelessness. Written off by society, they disappear into a world that most of us are oblivious to, of lost invisible souls who have no voice. I am now all too aware of the awful lives so many of them have to endure, as are many other people and organisations who work tirelessly to try to help in all sorts of different ways.

These are often brave, funny and kind women, who are trapped, and without hope so often of a better life, and they are at risk of being dismissed and vilified by society. They are human like us, and they face the same battles many of us do, yet their lives are just much harder.

There are many, many issues and obstacles in the way of them rehabilitating and breaking free of the way of life they are caught up in. Their lives are often desperate and can spiral into the most savage circumstances. Far too many of them are sleeping on the streets. If they are lucky, they may ‘sofa-surf’ with friends and family, but all too often they inevitably head back to the streets, having outstayed their invitation. The last time I had seen Shannon, she had been sleeping in a stairwell near Victoria station. She’d told me the day before her release that she was planning to return to her old spot and had given me a scrappy piece of paper with biro scrawl, which read ‘Elizabeth Bridge, Victoria.’

‘Come and try and find me, won’t you? When you’re next in London,’ she’d said, like any old friend inviting me round for a coffee. I wanted Shannon to hope for a better life for herself, however impossible it may seem given the shocking life she was living on the streets. In reality, her life was one of despair and hopelessness. Despair was sadly evident in so many of the people I had come to know through the course of my day-to-day work.

By far the majority of the women I see have experienced or continue to experience some kind of trauma. Many have a history of domestic violence and sexual abuse. They live in terror and this leads to substance abuse, self-harm, suicide attempts and serious mental health issues.

‘What are you in for this time?’ I asked her gently.

‘I nicked a laptop from Currys. Thought I could sell it to my mate, Mike – he’s always got cash.’

‘How long are you here for?’

‘Just twenty-eight days. I was only out two weeks ago.’

Women often serve far shorter sentences for minor crimes like theft and shoplifting and are locked up for a matter of weeks, before leaving to go back onto the streets, only to reoffend and come back in – hence the frequent flyer moniker. The longest sentence Shannon had received was two years when she was in her late teens.

She was now 26 and had been using drugs for over a decade.

‘How much heroin are using at the moment, Shannon?’ I asked. ‘Are you still buying benzos and pregabs as well?’

‘I usually spend about 100 quid on crack and a 100 quid on heroin every day,’ she told me. ‘I’m also taking about 40mg of diazepam and as many pregabs as I can get my hands on. The drugs and booze just get me through. Some days I feel like I’m drowning. It all just helps me to forget the evil shit I’ve been through.’

‘How much are you drinking now?’ I asked.

‘A bottle of vodka a day, if I can get it,’ she replied staring at her feet.

Shannon sat forward, grasping her stomach and wincing in pain because she had really bad abdominal cramps due to withdrawal.

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