Insider Scoop: Treating Pain in a Prison, part Five

  For a few years, I worked clinically in a Maximum Security Prison in Africa… I mostly had to deal with Inmates who lives with painful conditions; much of their pain was due to common ailments, like old fractures and others a bit weirder, unexplained phenomena. I can only share a very limited amount of information due to patient-privacy obligations and safety concerns (literally fearing for mine own life and those I love).

Prelude

  This tale begins one year prior to starting work at the prison. I had a female patient who was highly pregnant. She was admitted to the Burns unit due to extensive burn wounds to basically her whole body (70%).

  For those who don’t know, burn wounds are probably one of the most severe conditions one could have. Your whole life changes afterwards and nothing’s ever the same again. Join that thought with having your first child…

  One morning, as I entered the ward, I noticed quite the commotion in her room. A doctor and a few nurses stood around her and she was crying profusely. Unfortunately, due to her ailing physical health, she lost the baby in the third trimester. I could truly only imagine the anguish one would experience. I could offer no input or advice.

  The very next day, we had to continue with her rehabilitation, which initially only involved stretches of the affected limbs (which were all of them). She experienced severe pain for the next week, as you could imagine. Her condition started to improve; she started to talk and could sit in a chair by Friday.

  As is the norm in a hospital, everyone uyahleba (gossips). The story doing the rounds was that the lady’s husband caught her cheating with one of his friends. The man was a prison guard before being arrested. One evening, he drove with the two of them in his car. Next to the highway, he stopped and forced her into the boot with a gun. He then poured petrol over the car and lit…

  The following Monday morning, upon arrival, they were busy resuscitating the lady, but failed.

Fast-forward two years back to prison

  A new Inmate was referred to me for long-standing headaches. I saw him and established that he had tension headaches from trigger points and stiff musculature of the neck. Treatment involved treating him with manual therapy and trigger point release. I found no evidence of spinal or facet joint involvement.

  His trigger points were rather stubborn and his symptoms did not improve. During one treatment session he decided to ‘confess’; to today, I have no idea why. Perhaps he was just a typical Inmate who loved to indulge in his crimes?

  He relayed his story monotonously. Apparently, three years ago, he found his wife with a boyfriend in his car. He apparently told them to get out, but the boyfriend jumped out and lit the car on fire. But, as kindling a fire usually goes, things got out of hand and the car burned down with her inside. He relayed that he did everything in his power to get her out of the burning vehicle, as she also carried his unborn child, who he already loved from the bottom of his heart.

  I did not comment. I just listened to the way he spun the story. Most Inmates are ‘victims’, in their own words. I did not care to mention that I knew his wife and that I also knew that the boyfriend also died in the passenger seat of the car.

  After my interventions did not result in any improvement of his symptoms, he wrote me a letter threatening legal action. As a precaution and to protect myself on a medico-legal level, I sent him for X-rays, which of course were normal (I’m rather thorough with my evaluations and diagnoses, if I must say so myself).

  I must say, this whole case shook me. It was the first time I actually knew the victims of the perpetrator. It was difficult to stay objective through the whole thing.

  I referred the Inmate to the psychologist, as I believed his trigger points were due to psychological influences, and not due to a physical ailment.

  Perhaps his conscience caught up with him, at least to some extent, and he developed stress-induced trigger points.

  Guess I’ll never know for sure.