Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

What it’s like to practice medicine behind bars

Torie S. Sepah, MD
Physician
November 30, 2017
Share
Tweet
Share

I hear many comments and genuine inquiries about being a physician in a prison.  They’re all well-meaning yet hint at how little is known about this world on the “inside” and those who inhabit it.

I take my time answering questions about the complexities of practicing behind bars, yet also highlight that despite the challenges, it’s difficult to see myself working anywhere else.

The “why” is tough to answer. I’m not a martyr. I get paid handsomely for my work. Sure, there are logistics particular to a physician that corrections has removed from our burden (dealing with health insurers being a significant one), and I guess the patients always show up. (As we know in psychiatry this is a particular source of anxiety: What happens to the patient after they leave your office or you discharge them from the hospital. That riddle is gone.) But there is more to it.

Perhaps the answer to the “why” is encompassed in one of my favorite questions: What is it like to work with inmates — from convicted murders serving triple life sentences to those who are so severely mentally ill that their crimes albeit minor, have become multiple, and this is now their safety net. We are their anchor. (Twenty percent of the U.S.’s incarcerated population are the severely mentally ill. We have not one, but two licensed inpatient psychiatric hospitals on our prison grounds. Fodder for another post.)

What I can say is that inmates are not unidimensional. There are many individual stories leading to one place.  The common thread I see may be surprising. No, not an evil nature. Not a “bad” gene. What I see is resilience. The most impressive examples of it.  Survival again and again. And again. How many times can you pick yourself up and start over?  I bet fewer times than many of the men and women behind bars do.

In fact, how many of us would be able to go fight the deadly and devastating brush fires that rage across California six months out of the year? A surprising and little-known fact: In California, 4,300 state inmates serve alongside CalFire as firefighters.  They include about 200 female inmates from my institution, one of whom perished fighting the Malibu fires in 2016.

And in this day and age of conspicuous consumption from toddlerhood (my kids have more clothes than their parents and certainly more toys than I ever did), I find inmates to be the most resourceful among us.  I once saw a geriatric patient, who has spent more than half of her life in prison, and noticed that her shirt and pants were different than the ones issued and allowed.  Out of concern for her, I pointed this out, that she may receive an infraction. To myself, I noted to conduct a screening dementia exam. “Oh honey, you must be new. This was the uniform in 1972.  I take very good care of my things. I don’t like those new jeans. New isn’t always better.”

In short, I’ve learned more from them than vice versa. If there is a hero, it’s not the physicians, nurses or therapists who work with them.  We don’t face the brush fires, risking our lives to save people’s homes. They do.

Torie Sepah is a board-certified psychiatrist specializing in interventional psychiatry. She is the founder and medical director of Pasadena Neuropsychiatry & TMS Center, a multidisciplinary clinic that provides novel, evidence-based treatments—including TMS, esketamine (Spravato), and medication-assisted treatment (MAT)—for individuals with treatment-resistant depression, OCD, schizophrenia, dementia, and for those in the peripartum and perimenopausal stages.

Connect with Dr. Sepah on Instagram at @toriesepahmd or visit her website at www.toriesepahmd.com.

Image credit: Shutterstock.com

Prev

There shouldn't be a debate about funding CHIP

November 29, 2017 Kevin 4
…
Next

An emergency physician travels to Puerto Rico. Here's what she saw.

November 30, 2017 Kevin 1
…

Tagged as: Psychiatry

Post navigation

< Previous Post
There shouldn't be a debate about funding CHIP
Next Post >
An emergency physician travels to Puerto Rico. Here's what she saw.

ADVERTISEMENT

More by Torie S. Sepah, MD

  • Safety on campus, except for Jews: a parent and psychiatrist’s perspective

    Torie S. Sepah, MD
  • How “self-care” is elusive until there is no choice

    Torie S. Sepah, MD
  • It takes more than marching to make Black lives matter in health care

    Torie S. Sepah, MD

Related Posts

  • How social media can advance humanism in medicine

    Pooja Lakshmin, MD
  • Why academic medicine needs to value physician contributions to online platforms

    Ariela L. Marshall, MD
  • Improving physician satisfaction by eliminating unnecessary practice burdens

    Yul Ejnes, MD
  • The difference between learning medicine and doing medicine

    Steven Zhang, MD
  • KevinMD at the Richmond Academy of Medicine

    Kevin Pho, MD
  • Medicine rewards self-sacrifice often at the cost of physician happiness

    Daniella Klebaner

More in Physician

  • How subjective likability practices undermine Canada’s health workforce recruitment and retention

    Olumuyiwa Bamgbade, MD
  • Why judgment is hurting doctors—and how mindfulness can heal

    Jessie Mahoney, MD
  • Why evidence-based management may be an effective strategy for stronger health care leadership and equity

    Olumuyiwa Bamgbade, MD
  • The gift we keep giving: How medicine demands everything—even our holidays

    Tomi Mitchell, MD
  • From burnout to balance: a neurosurgeon’s bold career redesign

    Jessie Mahoney, MD
  • Why working in Hawai’i health care isn’t all paradise

    Clayton Foster, MD
  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

What it’s like to practice medicine behind bars
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...