I am outraged.

The patient I’m seeing right now is Mr. Carpenter. He is in his late twenties, and he was shot in the spine while doing… well, whatever got him sent to a maximum-security prison for life. It was bad, I’m sure. I don’t want to know.

But none of that is my concern. What is my concern is that Mr. Carpenter is a paraplegic and uses a wheelchair. So he’s sitting on his bottom all day, and then he’s lying on a mattress at night that is paper-thin, and now he has a rather impressive sore on his coccyx that has not been addressed in God knows how long.

“What do you think, Brooke?” Mr. Carpenter asks me. He’s lying on the examining table on his side with his pants pulled down, waiting for my assessment. Unfortunately, I don’t have anything good to say.

“It’s a pressure wound,” I say. “We can put a dressing on it, but it’s never going to heal if you don’t keep pressure off of it.”

“Yeah, well, how am I supposed to do that? The cushion on my chair is halfway decent, but the mattress in my bed is terrible. I’m basically lying directly on metal springs.”

“So you need a better mattress.”

Mr. Carpenter snorts. “How long have you worked here? Nobody’s getting me a new mattress.”

“They have to get it for you if I prescribe it.” “Whatever you say…”

Despite Mr. Carpenter’s skepticism, he’s going to get that mattress. It’s medical neglect not to give a paraplegic a decent mattress with pressure relief. It might involve a stack of paperwork, but I’m going to make it happen.

As soon as I’m done with Mr. Carpenter, I confirm nobody is waiting to be seen and head down the hall to Dorothy’s office. Yes, she has an office and I have a desk in my examining room. But I recognize she has seniority, so I’m not going to say anything. Hopefully, I won’t be working here long enough to get a desk.

I knock on the door to Dorothy’s office and wait to hear her say to come in. After what seems like five minutes, she calls for me to come inside. When I enter the office, she’s sitting at her desk, a pair of half-moon glasses balanced on the bridge of her bulbous nose.

“I’m very busy, Brooke,” she says.

“This won’t take long,” I say. “I just need to find out how I can get a pressure relief mattress for Malcolm Carpenter.”

She peers at me over the rim of her glasses. “A pressure relief mattress?”

She says it like I was speaking in an unfamiliar language. She knows very well what I’m talking about. “He’s a paraplegic, and he’s developed a pressure sore on his coccyx. He needs a decent mattress or it won’t heal.”

“Brooke,” she says flatly, “this is not the Ritz Carlton. We can’t get dream mattresses for all the inmates.”

A muscle twitches under my eye. “I’m not asking for a luxury item.

This is medically indicated.” “I’m afraid it isn’t.”

“Of course it is!” I burst out. “He can’t move or feel the lower half of his body. The sore is just going to get worse if we don’t relieve pressure on it. Getting him a decent mattress is the least we can do.”

“I’m afraid a new mattress just isn’t in the budget. You’ll have to come up with a more creative solution.” She shakes her head. “Don’t you have any problem-solving skills?”

I stare at her, too stunned to respond. The problem is that the man has a pressure ulcer. The simple solution is a decent mattress. What is wrong with this woman? Doesn’t she care about these prisoners at all? They’re human beings, after all.

The phone rings on Dorothy’s desk. She picks it up without saying another word to me. I stand there while she listens to the other person speaking. Finally, she says, “Yes, I’ll send her right over.”

Damn. She probably means me.

Sure enough, when Dorothy hangs up the phone, she raises her eyes to look at me over the rims of her glasses. “There was an incident out on the yard. Officer Hunt is bringing one of the inmates over to see you for an injury.”

Great.

My shoulders sag in defeat as I march back to my examining room/office. I haven’t given up though. I’m going to figure out a way to get Mr. Carpenter that mattress if it’s the last thing I do. But first, I have to treat this guy who got injured in the yard.

I wonder how he got hurt. Was it a lock in a sock? Is that a real thing they do in prison?

Just as I reach my office, I catch sight of Officer Hunt coming down the hallway with one of the prisoners. It must be the guy who got injured in the yard. The inmate is wearing the standard prison khaki jumpsuit, and unlike most of the prisoners, both his wrists and his ankles are shackled, so he’s shuffling along slowly next to Hunt.

As he gets closer, I can see the bandage taped to his forehead, which is saturated with bright red blood. Whatever is under there, it’s almost certainly going to need stitches. Then my eyes drop to the prisoner’s face.

Oh. Oh no. No, no, no… It’s Shane.