Taylor Gilmer May Die of Type 1 Diabetes in Prison

Thanks to poor medical care across US prisons, a term in prison can become a life sentence, with states slashing funding and private medical firms competing to cut costs.

With “Orange is the New Black” introducing everyone to a hipsterized and entertaining version of life in women's prisons, it is perhaps time for a reminder that the reality for most incarcerated women is very, very different. Fewer inspirational moments with clueless white ladies, more basic battles for survival.

As has been illustrated sharply this week with the case of Taylor Gilmer, who may die of a perfectly manageable and treatable disease in prison because officials are refusing her the basic care she needs -- and the only reason her story is in the news at all is likely her race. As a young, attractive white woman in prison, her story is viewed as more accessible and heartwrenching than that of the scores of incarcerated women of color in similar situations.

Type one diabetes (formerly called juvenile diabetes) is a chronic medical condition usually identified early in childhood. For many patients, it's very manageable with constant glucose monitoring and insulin medication to keep glucose levels stable. It can require a lot of work, but thanks to constant improvements in medical care, it's no longer the nightmare it was once cast to be. Gilmer had no complications or problems with her diabetes until she entered prison, where she was abruptly cut off from the care she needed.

Now, her feet are turning blue, a sign of poor circulation, which is a known issue for diabetic patients. Left untreated, it could lead to “diabetic foot” and the need for amputation. Furthermore, Gilmer is also losing her eyesight, another potential complication of poorly-managed diabetes. The lack of control over her condition isn't her fault, though: a private medical company, Armor Correctional Health Services, is refusing her needed medications (not the first time Armor has been in the news for doing so) while guards won't allow her to take glucose tests.

If her diabetes is allowed to progress, she runs a very real risk of dying in prison. Taylor Gilmer went from a vibrant young woman with a manageable chronic illness to a very ill 22-year-old dying of diabetes complications, all because of the result of privatization of medical services in a women's prison.

The privatization wave sweeping US jails and prisons is creating sea changes across the correctional system. Many states have turned to privatization because they see it as a cheaper way of managing their needs, but the cost to prisoners have been extremely high. Private prison firms work to maximize their profits, cutting down in every way possible; that means substandard food, limited medical care, unsafe living conditions, abusive and underpaid guards, and other abuses within the prison system.

For women prisoners, who represent a relatively small percentage of the overall prison population, these abuses are sometimes even more dramatic. At the Fluvanna Correctional Center for Women, where Gilmer is currently housed, several women have died in custody under suspicious circumstances, and the prison has been heavily criticized for its segregated so-called “butch wing” for gay inmates. Inmates have also been denied access to religious services, a deprivation of their civil rights.

No wonder it's being targeted by a class-action lawsuit, which Gilmer is participating in, hoping to get medical care before it's too late. According to the suit, doctors reject prescriptions for being too expensive, refuse to examine patients with serious medical problems, and charge excessively for visits (yes, even in prison, you have to pay for health care). Systemic denial of care is a policy with Armor, which wants to save as much money as possible on a potentially costly aspect of prison life.

After all, women in prison tend to be more likely to have active HIV infections, along with substance abuse problems, mental health conditions, and other complex medical needs. Preventative care and active treatment can be costly, and for companies like Armor, the goal is to keep costs low. If they don't, they'll be kicked out and replaced by another company that can underbid them, creating a sort of race to the bottom when it comes to prison health services.

The health and wellbeing of prisoners is not a primary concern for these companies, many of which operate at a tremendous profit. One might think that states would be concerned by this rampant abuse of tax dollars, which places state funds directly into the hands of corporations, but evidently this is not the case, because prison health providers are rarely audited by states. It takes truly horrific conditions for outside intervention, too, as in California where overcrowding and widespread systemic health problems finally spurred the Supreme Court to appoint a receiver to oversee prison health services since the state was clearly no longer fit to do so. Even under the receiver's supposedly watchful eye, abuses like forcible sterilization continued in California prisons.

In an editorial this summer, “The New York Times” described the consequences of privatization at Mississippi prisons:

The 'solitary confinement zones house dozens of seriously mentally ill prisoners who are locked down in filthy cells for days, weeks, or even years at a time,' the suit alleges. 'Rapes, stabbings, beatings, and other acts of violence are rampant,' and inmates have set fires as 'the only way to get medical attention in emergencies.'

Such nightmarish conditions are only the tip of the iceberg. Here's Florida:

One prisoner, Robert Boggon, was sent to jail after suffering a mental episode in a Dollar Tree store. Boggon never received a psychiatric evaluation even though he was rocking on the floor of his cell and urinating on himself. After 11 days in jail, Boggon was found dead, naked, and strapped to an emergency restraint chair with a towel around his head in his cell in the jail infirmary. The death was ruled a homicide, but the medical examiner placed the blame on no one.


'I am locked in a room alone, freezing. I ask for a blanket. No, they snarl. Why is everyone so nasty?' [Stage 3B breast cancer patient Sue Ellen Allen] recounted. 'I haven't eaten in twenty hours, I haven't slept, I'm freezing and facing surgery alone.' After the mastectomy, Allen should have begun chemotherapy, but the jail delayed it to avoid shouldering the costs. Allen did not receive chemotherapy until she was transferred to the Perryville prison three months later.

Minnesota, where a patient died after medical personnel at a prison refused ambulance transport:

Johnson, 27, a St. Paul native who suffered from schizophrenia and a seizure disorder, was found soaked in urine on the floor of his cell. He was coiled in a fetal position and in an altered state of consciousness that suggested he had suffered a seizure, according to notes taken by nurse Linda L. Andrews, who was on duty at that hour. He was somewhat combative when a nurse tried to take his vitals and wipe him with a cool washcloth, but his breathing was normal.

The list goes on. Thanks to poor medical care across US prisons, a term in prison can become a life sentence, with states slashing funding and private medical firms competing to cut costs. The UN has quite clearly declared that prisoners are entitled to the same medical care as people who are not incarcerated, and that denial of care can cross the line into torture. Violations of international law are occurring within the walls of US prisons, and it is troubling indeed to see life in prison made into fun and games for primetime television while actual inmates undergo extreme suffering.

Taylor Gilmer is one among many prisoners, but her fight for survival is symbolic of all the women like her, and those who have gone before her, who are being killed by neglect, cost-cutting, and refusal to treat prisoners with dignity and respect.