Alcatraz Hospital revisited – patients behind bars

Annabelle Slingerland, MD, DSc, MPH, MScHSR
Leiden University Medical Center, Leiden, the Netherlands

 Image of Alcatraz Island
Alcatraz Island

While many hospitals and their locations become historic icons for the accomplishments of their staff, Alcatraz Hospital is famous for its very walls, its infamous patients, and treatment. It was a hospital inside a maximum security U.S. federal penitentiary on Alcatraz Island, which covers twenty-two acres only a little more than one mile from the San Francisco shoreline and the Golden Gate. This meant that inmates could see the breathtaking view of the Golden Gate, often observed city dwellers happily going about their daily business on the shore, and sometimes heard noises. These sights may have caused more punishment and illness than any of the insurmountable hurdles confronting the convicts.

The prison opened in August 1934 with a first batch of incorrigible federal trouble-makers. “If you break the rules, you go to prison. If you break the prison rules, you go to Alcatraz.” Alcatraz Hospital provided medical and dental care to inmates, to prison personnel, and to civilian employees. It had three wards with five hospital beds each, two isolation wards, an operating room, pharmacy, kitchen, and bathroom, as well as offices for the doctor, chief medical assistant, and dentist.

The inmate patient population was generally young and healthy despite their lives of crime. They benefited from the better living conditions on Alcatraz. Food was plentiful, there were individual cells, balmy fresh sea breezes, and hot showers that ensured that prisoners did not acclimate to the frigid water of San Francisco Bay. The facility offered ready access to medical care. A Classification Committee consisting of the Warden, the Chief Medical Officer, and Chaplain was in charge of planning and recording progress towards rehabilitation. Security – also protecting the prisoners themselves – was paramount, and the ratio of guards to inmates was higher than in any other Federal Prison. The penitentiary claimed that in its thirty years of operation only fifteen of the 1,576 inmates had died from natural causes, only seven or eight fell victim to other inmates, and riots claimed only another seven.

 Alcatraz Hospital Rules and Regulations
Alcatraz Hospital Rules and Regulations

Nevertheless, the enforced solitude, drastic regime, and fear of retribution from fellow prisoners still wore the convicts down. They were haunted by “ill luck” and feeling “sick or unable to do time.” Escape attempts resulted in one reported drowning and five missing but presumed drowned. Even the escape of last resort, suicide, was denied them and only successful in a handful of cases. They had no access to weapons, poison, gas, or razor blades (which were collected after each use), and were under constant, vigilant surveillance. Hunger strikes were foiled by strait jackets, tube-feeding, and forced exercise. Some escaped into delusions, “lack of nerve to knock off suicide,” “once able-bodied men, turned into babbling demoniacs,” mutilating themselves like inmate Persful or banging their heads bloody on walls as did Kalinoski. Wounds inflicted during such endeavors were treated with the panacea of “aspirin, drinking lots of water, and walking slowly.” Those who feigned disease received temporary tender care; and severe mental illness was addressed by solitary confinement and hospital baths resulting in hypothermia. Severe cases, once authorized by authorities in Washington D.C., were transferred to the Medical Center in Springfield, Missouri.

While literally no one escaped unnoticed, the heightened scrutiny ironically made the inmate “pariahs” seem extremely important, as did the extreme measures taken to keep them alive. By means of the sneeze-knock-and-cough telegraph grapevine prisoners established a means of secret communication that hailed those who attempted to escape as heroes and likewise acknowledged those who endured serious medical conditions or prolonged solitary confinement.

Even the media furthered the heroic fantasy of escape. In reality, Al Capone, suffering from neurosyphilis, endured solitary hospital confinement. Inmate Stroud, portrayed in the movie “Escape from Alcatraz” as the likable ornithologist Birdman, was in the only other such cell right next door, with no birds at all. “La Isla de los Alcatraces,” named for the pelicans sighted on the island in 1775 by Juan Manuel de Ayala, hosted birds of a feather flocking together, but with clipped wings.

In the short period of its operation (nearly thirty years) the hospital itself and its inhabitants have occupied a prominent place in the history of medicine. No medical staff accomplishments brought about the final escape from the Bay’s sirens, however. Fifty years ago, Attorney General Robert F. Kennedy closed the penitentiary and its hospital because the buildings were eroding and operating expenses high. This was shortly after three prisoners, Morris and the Anglin brothers, had “left” the “inescapable Rock.”

Alcatraz Island, the penitentiary, and Alcatraz Hospital are now part of the federal Golden Gate National Recreation Area. Visitors must make special arrangements to tour the hospital.

References

  1. William G. Baker, Alcatraz-1259, (BISAC, 2012).
  2. Milton Daniel Beacher, Alcatraz island, memoirs of a Rock Doc, (Pelican Island Publishing, Lebanon, New Jersey, 2008).
  3. Joe Oakes and Gary Emich, Open Water Swimming: Lessons from Alcatraz, (Piano Piano Press, 2010).
  4. Robert J. Schoenberg, Mr. Capone, the real and complete story of Al Capone, (Harper Collins Publishers ,New York, NY, 1992).
  5. Gregory L. Wellman, A History of Alcatraz Island 1853-2008, (Arcadia Publishing, San Francisco, CA, 2008).

ANNABELLE S. SLINGERLAND, MD, DSc, MPH, MScHSR, was born in Sassenheim, the Netherlands. She earned her medical degree from the University of Amsterdam. She obtained masters degrees in public health and also health services research. Additionally, she earned a DSc in Genetics from the Erasmus University in Rotterdam. She (co-) authored research articles in several high-impact medical journals. She founded Kids Chain, an organization for Care, Cure, and Science in diabetes. In 2013, she came for a conference to San Francisco and swam from Alcatraz to shore, making her dive into the history of Alcatraz Hospital and its patients.