Ever since I started working as an HIV specialist at the Cook County Jail in Chicago, I’ve heard questions like “Why do you work there?”, “Aren’t you scared?”, and “What are some of the crazy things you must see there?” These questions have both easy and difficult answers.
I work at the jail because there is a clear and recognized need for the underserved corrections population to receive community standards of healthcare, including for HIV. But to say I specifically chose to work there because I thought a jail was my calling is not totally honest. I was hired right out of my Infectious Diseases fellowship to fill a vacancy there. I imagined it was a stepping-stone to working elsewhere for the citizens of Cook County. But like my boss at the time said, “You don’t find a calling at the jail. The jail finds you.” After only a few months on the job, I knew I had arrived at the right place.
As for being scared? My patients are generally the most gracious, thankful, and interesting people I have served in my career. But scary? No. There are numerous security measures in place on the compound and clinical areas. More importantly, my patients are often at the lowest points in their lives. Threatening or intimidating behavior generally does not result in a meaningful or productive encounter.
And the stories? Endless. Some are tragic. Some are funny. Some leave me scratching my head. But all of them keep me engaged and provide a rich tapestry of the human existence that keeps me humble.
My very first week at the jail, I met “Svetlana” (names changed for privacy). Svetlana was a commercial sex worker struggling with depression and addiction. She was also HIV- and hepatitis C-positive. While taking her medical history, she told me she was arrested for public indecency. When I pressed, she stated her “john” raped her, strangled her to the point of unconsciousness, then threw her limp body into a dumpster. She then pulled back her hair, revealing bruises around her neck that were obvious finger marks. After that encounter, I was simply in shock. Were stories like hers going to be the norm for the rest of my career? I literally cried.
“Larry” was another HIV patient who was a repeat offender. I had seen him at least a half-dozen times over a two-year period. During one encounter, I asked Larry if he could pinpoint the moment in his life when “it went bad” for him. Larry described a childhood of repeated sexual abuse by his father and uncles, followed by living homeless on the streets by age 11. He described getting hooked on heroin by age 13, selling his body to support his habit and for food. But then he said none of that was what turned his life wrong. I was dumbfounded. He then described in vivid detail witnessing the murder of another commercial sex worker right in front of his eyes, her head literally cut off. To this day, I still get goose bumps.
I was consulted to see another patient in the jail infirmary for a fever. After the encounter, the patient stated, “Doc, I want to thank you. You are the only person since I’ve been here who’s been nice to me.” Another head-scratcher. He seemed like an ordinary guy. He was polite, cooperative, and otherwise did not seem to have any ‘red flags’. I asked him why the others were not treating him well, and he replied, “Because I’m a tree-jumper.” I had not heard the term before, so I had to ask. “A tree-jumper is a child molester.” While I appreciated his honesty, I quickly realized why he perceived the others around him to treat him with less regard.
On a positive note, not every encounter made me question why I continue to work at the jail. Many of my patients actually come from supportive families, have a good education or a good job. And once in a blue moon, someone like Patricia comes along, who reminds me of what working at the Cook County Jail is all about.
Patricia is also an HIV patient like Svetlana, who struggled with addiction and depression. She had multiple incarcerations and her health had deteriorated to the point I felt she would probably die sooner rather than later. One day, Patricia wrote me a letter. It was a heartfelt and eloquent thank you letter, telling me how grateful she was that I had not given up on her. While I have received many letters and cards over the years, there was something special about this one, and I decided to tell Patricia a personal story in hopes she would be inspired.
When I was in high school, I would have been best categorized as the “King of the Nerd-Herd.” I longed for social acceptance, to be able to hang with the cool kids. At the end of my senior year, as yearbooks were being passed around for farewell wishes from classmates, I approached someone I had idolized from afar. I figured he didn’t even know who I was. He took my book, wrote something, and handed it back. The inscription stated simply, “You don’t even know your own greatness.” Here I was, thinking that my classmate probably didn’t even know me, and if he did, felt I was beneath him. But here was one of the most inspiring things I had ever read. He actually had observed my achievements as a scholar, student athlete, and student leader, and noticed that I did not even appreciate the gifts I already had.
I repeated this story to Patricia. I saw greatness in her that she either never knew or had long forgotten. Sometime thereafter, she was released. Fast forward to today: Patricia has found her greatness, and soared. We still keep in touch, and she wished to share her perspective with the readers of Positively Aware.
Chad Zawitz, MD, is a Board Certified Infectious Diseases specialist at Cook County Jail in Chicago. He received his Infectious Diseases training at Rush University Medical Center in Chicago and Internal Medicine training at the University of Pittsburgh. He is the Director of the Continuity of Care Clinic for HIV-positive detainees at both the jail and the nearby county-run CORE Center. He is also a Certified Correctional Healthcare Provider (CCHP). Dr. Zawitz has worked exclusively with the incarcerated population in Chicago for more than 10 years. His academic interests include virology (HIV/HCV), correctional healthcare, public health, and LGTBQ health.
A Ray of Hope and Light
by Patricia Douglas
I was a frequent flyer at the Cook County Jail in Chicago (CCJ), in and out on a regular basis. I was a hardcore heroin addict for most of my life. I started injecting different drugs at about 12 years of age, everything from pills to cocaine, and then I found heroin. As a result of the addictive qualities of heroin, I started stealing and prostituting to support my habit. Hence, my frequent visits to CCJ.
On one of these stopovers, I ended up in Cermak Health (the jail’s clinic) where I met a very kind man named Dr. Z. Meeting him saved my life in many ways. I had been so sick from abusing my body with drugs, my CD4s were 50 and my body was overridden with abscesses. I was in a very bad state. Mentally, I believe (if this was possible) that I was in even worse shape. I saw no other life for me but the one I had been living. I truly believed that I was born to be a junkie, and that was the way I was going to die.
On our very first meeting I knew Dr. Z cared, something I had not felt from another human being in a long time. I’m not sure if I can pinpoint one thing or the other that helped me to connect with him. Maybe it was his genuineness and warmth, maybe it was because I did not feel judged.
On one of our meetings, the words he said to me still ring in my ears and bring tears to my eyes. “You don’t even know your own greatness.” I can hear it like it was yesterday. “Oh my goodness,” I thought, “someone actually believes in me.” Simply put, that was all I needed to hear. A seed of hope had been planted and I began my journey to find my “greatness”!
That was four years ago. Today I am a thriving woman who is getting ready to graduate college with an A.A. in Psychology and my CADC (certified drug and alcohol counselor). I have worked my way up from the very depths of hell! There are ways out and I thank goodness that I finally found mine. It’s funny the way things work. Who would have thought that in a place like CCJ, a person like me could find a ray of hope, and a ray of light like Dr. Z.
For those who are still struggling, the moment you feel even an ounce of hope, run with it. It just may save your life. It saved mine.