Читать книгу The Prison Doctor: Women Inside - Dr Amanda Brown - Страница 11

‘I’ve got no one and nothing, not even my own teeth’

MURDER

The word sprung out at me from the smudged screen of the computer and my heart sank. I was in my small and windowless consulting room in Bronzefield prison. I was halfway through an evening Reception shift, meeting new prisoners to assess and discuss their medical issues and prescribe any medication they might need. I was only two hours into my shift but was already feeling weary. Despite having met many prisoners who had committed murder, the impact of the word always caused the same reaction in me: shock, horror, and a deep sadness.

I scrolled up the screen to read the nurse’s entry.

Rebecca was 27 years old and it was her first time in prison. That in itself was a surprise. I have seen so many prisoners return time and time again, that when I meet someone who has never been inside before, it’s unusual.

Many of the residents’ lives are so chaotic, complex and traumatic, that for some of them prison is a refuge. A shelter for the homeless and often a place to get help with addictions. The women return for a variety of crimes, such as shoplifting, theft, robbery, burglary, fraud, arson, kidnap, GBH or ABH.

Rarely murder.

When I reached the holding cell, I saw the door was open and there were five women in there. Two were lying down on the stark blue plastic bench seating, looking extremely unwell, most probably because they were withdrawing from drugs. One was pale and sweaty, her hair sticking to her forehead and her eyes shut, as she tried to ride it out. The other was clutching her stomach, groaning miserably – not an unfamiliar sound to me. An overweight woman in a wheelchair stared blankly ahead of her. The other two sat quietly, and appeared to be shaken and fearful.

‘Rebecca?’ I asked as I looked around the room.

A girl’s eyes peered out from her curtain of long, deep brown hair like a cornered animal. She looked much younger than her age, with delicate features, a spray of freckles and intense eyes. She was wearing a knee-length skirt with tights and pale pink pumps, which were splattered with something dark, as was her pale grey top. I tried not to show the shock and surprise I felt, as I realised it was blood. She must have come straight to prison from the scene of the crime.

I led her back along the mottled-blue lino floor of the corridor to my room.

‘Hi, Rebecca. I’m Doctor Brown. Come and have a seat.’ I gestured to the hard and battered plastic chair. ‘I just have to go through some routine questions to make sure you are okay and see if you need any medication,’ I told her. ‘Alright?’

She didn’t reply.

I started to go through her notes. She looked shocked to her core. Her hands were trembling, and she fiddled with her cuffs, pulling them over her hands. I noticed that they were also stained dark and dirty with dried blood. I could smell it.

Metallic. Slightly sweet.

Rebecca’s eyes looked glazed and vacant; the look of someone who could not believe where she was or what was happening to her.

‘I can see here that you are charged with murder,’ I said. ‘Can you tell me what happened?’

‘I killed my partner.’ Her voice was clear but started to crack as she said the word ‘partner’.

I could see she was trying hard to stop the tears, which were pricking the corners of her eyes, from falling. She swallowed hard.

‘I stabbed him.’ She looked up at me through her fringe. ‘I just couldn’t take it any more. I couldn’t see a way out. The years of being controlled.’ She grimaced, and her voice became more defiant. ‘I was his punch bag. I just couldn’t do it any more.’

I was already fairly sure what she was going to say, having heard it so many times in Bronzefield before.

She rolled into her story, the floodgates opening. Sitting in front of me was a criminal, charged with the most serious of crimes, but she was just a normal person. She was well spoken, intelligent and articulate. She reminded me a little of the girl who cuts my hair.

Rebecca met her partner when she was 15 and he was 21. For a while, she said, they were just friends. When she was 17, he persuaded her that they would be better as a couple than as friends.

‘It sounds like such a cliché now, but he did everything for me,’ she said, her eyes downcast. ‘He treated me like a queen. He drove me to college, helped with my work, there was nothing he wouldn’t do for me. Everyone thought he was great; me, my parents, my friends. He was literally the golden guy. My mates really thought I’d lucked out.’

I nodded. ‘When did things change?’

‘It went wrong the first time we went away together. We went on holiday to Spain after I finished my A levels,’ she said. ‘He planned and paid for everything, said it was his way of celebrating the end of my exams. While we were there, he saw me talking to a man. I can’t even remember who he was now; a waiter, I think. We were just talking and laughing; it was completely innocent.

‘That was the first time he hit me.

‘He accused me of flirting. I had nowhere to go, so I stayed in the hotel room, cowering in the bathroom.’

I could see a flash of fear in her eyes as she recalled what had happened.

‘The next day, he was so apologetic. He was sobbing. He said he would kill himself if I left him. I’d never seen him cry like that. It was impossible not to forgive him. I covered up the bruises on my face with make-up and wore a sarong all holiday. I didn’t even go swimming in the hotel pool. I just sat on a sunbed, hugging my bruised ribs. God, it hurt so much that time.

‘That was just the start.’

It was a story that I had heard countless times before. The details and cast were different, of course, but the story of domestic abuse and violence is all too familiar. Men trying to control women and, so often, going too far.

Rebecca’s partner dominated her.

‘Then, of course, he persuaded me to not take the place I got at university – it was over two hours away from where we lived. He made me move in with him. He cut me off from my friends and family and monitored my every move.

‘He made me think I was in the wrong. Always. My attitude was wrong, my clothes were wrong, I looked like a slut,’ she explained.

I could hear the hurt and anger in her voice as she spoke. I knew that women like Rebecca often became increasingly intimidated, and frenzied with fear about when the next blow was coming, so they did everything they could to keep the peace.

‘When one of my colleagues at my office job told me I’d had “one bruise too many”, and asked me if I needed to talk, I felt I had no choice but to resign. I never went back to work. I even stopped going to see my GP in case they suspected him. He called home throughout the day to check up on me. I felt suffocated.’

Rebecca’s partner worked as an accountant and they lived in a nice part of Surrey, not that far away from the prison, with their five-year-old son.

‘So, what happened today?’ I asked gently.

‘I was in the kitchen. I was making his lunch. He always has it at 1 p.m. on the dot – he leaves the office to come home to check on me. I could see he was in one of his moods. He gets kind of twitchy, you know?’

I didn’t correct her tense.

‘He mentioned Jack. He’s not long been at school, and he’s had a few scuffles already in the playground. Just typical five-year-old boy stuff – a bit of pushing and shoving, nothing really. He said he wants him to be a man, like him. We started to row – about Jack, about everything. I hate the fact I’m stuck at home all day. All I do is clean the house. He won’t let me go anywhere or do anything. I even have to ask his permission to go to the shop to buy a pint of milk. I feel so lonely. So alone. All the time. Apart from Jack – he means everything to me. He gives me purpose…’ She tailed off, deep in thought, her face slightly brighter as she spoke about her son.

‘I can tell Jack knows what goes on. He always wets the bed when we’ve had a fight. He knows what his dad’s like; it’s all he’s ever known. Heavy fists and muffled sobs.’ Rebecca’s hair fell in front of her eyes and she pushed it away, then rested her head in one hand.

‘I couldn’t let him hurt my son like he hurts me. I just lost it, I… I’d been making sandwiches and the bread knife was on the surface, and the carving knife. I just grabbed the carving knife and stabbed him. I didn’t honestly realise what was happening until it was too late.’

It struck me how desperate Rebecca must have been to do something like that. How powerful that feeling of hopelessness and despair must’ve been for her to physically do that to him.

To strike him hard enough to kill him.

‘The only time he ever stopped hitting me was when I was pregnant. But once Jack arrived, he started again, saying I was putting the baby before him. Always seeing to Jack and never looking after him. There were so many times he almost killed me. Believe me. It was either us or him.

‘I got him in the chest. There was blood everywhere. I couldn’t quite believe I’d done it. I’ve never hurt a fly. He staggered around for a minute or two, shouting at me, and then fell on the floor.’ Rebecca’s voice was dull and unemotional as she relayed what had happened. Her eyes were glassy and her face was expressionless. I imagined the true horror of the event would not sink in for many days, or even weeks or months.

‘I still couldn’t believe what I’d done. It was like I was in a dream that I couldn’t wake up from. The blood was spreading all over the floor, and he lay there completely still. I was panicking, but knew I had to do the right thing. I called the police and then my mum. Before I knew it, two paramedics arrived. The police must have sent them. They said he was still alive. They tried to save him, but he died within minutes of them turning up.

‘I wanted to clean up the kitchen. I got the mop out. I didn’t want to leave it for someone else to do, but the police wouldn’t let me. They brought me straight here.’

Rightly or wrongly, I felt for her. I could see she didn’t realise the enormity of what she had done. She was desperate, and like so many of the women I see, was despairing and couldn’t see a way out.

We continued to go through Rebecca’s notes. She didn’t use drugs and was not a heavy drinker and she had no medical issues. She was a young woman, who was fit and well.

‘What am I going to do about my son? Will I see him?’ Her voice sounded almost hopeful, that things would not change for her and her son.

For most mothers, being apart from their children must cause the most indescribable pain. I simply couldn’t imagine what that must be like for anyone, especially for someone with very young children.

‘You said your mum’s got him?’ I replied, softly.

‘Yes. She said she would pick him up from school. I guess he must’ve had his tea by now. Done his reading – he’s starting to read now. It’s amazing, and the books are so funny. He’ll be in bed by now, I suppose. I hope he has his favourite teddy.’ She paused, her mind ticking over, like most mothers, the things they do every night to keep their kids happy and comfortable. ‘When will I see him again?’

‘I’m sorry. I don’t know,’ I replied. All I did know was that the chances were, if she was found guilty to the charge of murder, she was likely to be in prison for a very long time.

I put my hand gently on hers. ‘I can’t imagine how you must be feeling. I hope you cope with being in prison, and that you will soon be able to see your little boy.’

The prison officer standing outside came in and led her away. That was the first and last time I ever saw Rebecca. I never knew whether she lived to regret what she had done, or if she was able to see her son regularly whilst she was inside. I simply got a snapshot of her existence, and happened to be there on what must have been the most shocking and tragic day of her life.

The Reception shift in Bronzefield involved seeing to the new prisoners who had arrived from one of the ninety-five courts the prison serves, or from police custody, before they were taken to the house blocks by the officers to start their stint behind bars. Many of them would be withdrawing from a medley of drugs and alcohol, and would need medication to get them through the night. My shift started at 5 p.m. and lasted until 9 p.m. but it was often not possible to see all the new arrivals in that time. They would be seen by the on-call doctor, if needs be. Whatever crimes they had committed, they still needed to be cared for. Some had very complex physical and mental health issues, arriving with bags of different medications: a jumble of boxes, bottles and pill packets, some of them empty, often many of them out of date. Sometimes it seemed to me like they had simply swept the top of their bedside table into a bag in anticipation of not going home for a while. These medications needed to be checked and prescribed on the computer, before the nurses could administer them.

I felt pensive after seeing Rebecca, and wondered how she would cope with the days that would follow, away from her son. I took a deep breath of stuffy air and padded out of my room, along the strip-lit hallway to the small waiting area.

A warming smell of jacket potatoes wafted out of the little kitchen area and made my stomach rumble, reminding me of the fact I hadn’t eaten since mid-morning. Food is provided in Reception for the new arrivals who won’t make it back to the house block in time for the evening meal. The kitchen is kitted out with a small fridge, microwave and chest freezer, supplying the basics, including bread for toast. Often dinner for the new arrivals is a simple jacket potato, with a dollop of beans and handful of cheese.

It was obviously a jacket potato day. For many of them, it would be their first proper cooked meal in days.

‘Hi, Doc.’ Melissa and Shamir, two prison officers, greeted me, smiling. We exchanged a few words.

‘It’s really busy tonight,’ Melissa said with a sigh. She sounded exasperated as she tried to sort out one of the girl’s possessions – a jumble of clothing and prescription medicine that she was passing over the large countertop. Behind the wide counter are rows upon rows of small lockers to house the women’s possessions whilst they are inside. When they are released, they are given back the items.

‘Yes, it looks crazy,’ I replied, scanning the scene in front of me.

The process of getting into the prison can be slow. Some cases are more complex than others. After prisoners arrive inside from their ride in the uncomfortable ‘sweat box’ to the prison, they are processed into the system. This involves searches, sorting their clothing, and getting their ‘welcome pack’.

I could see one girl being handed a white string bag, containing a handful of items, including a mug, a plastic knife, fork and spoon, toothpaste, toothbrush, shampoo, soap, conditioner, six pairs of knickers and socks, two tracksuits, a nightie, tea and coffee, and a hairbrush. These packs are compiled by the residents who work in Reception, earning from £2.40 to £3.20 a day, which they can spend how they wish on items like moisturiser, vapes and snacks. The girls can also take some of their own clothes to wear, if they wish, but many of them only have the clothes that they are standing up in. The prisoners then meet with the nurse, to go through their medical notes, and all those that require medication would be added to my list. There could sometimes be more than fifteen new residents needing to be processed, and sometimes I would need to spend thirty to forty minutes going through their medical history and medication. Any newcomer that had not been seen by the end of my shift would be seen by the duty doctor for any essential medication and then added to the GP list to be reviewed the following morning. It was a finely tuned process that was often exhausting and challenging. But at times, it was also very rewarding. It kept me on my toes, and it was definitely never boring.

There were women standing and sitting everywhere, up and down the corridor. The noise was bouncing off the walls.

One woman was screaming to the officer: ‘But I don’t wanna share a fucking cell. Last time I was in ’ere I was put in with a right wrong ’un. I ain’t sharing again. I got to ’ave a single cell.’

There were also happy shrieks and joyful whoops as girls were reunited with familiar faces from previous sentences. Also in the mix were a handful of girls who looked withdrawn, scared and bedraggled.

Some women were heading off to have a shower, clutching thin towels and small bottles of shower gel. There are showers within the Reception area along the main corridor, so once the women have checked their belongings in, many choose to have a wash, especially those who are homeless and may not have showered for days. Others were on the two phones, chatting noisily to their families and recounting the events of the day, whilst some girls queued patiently behind them, obviously desperate to speak with their families before they got locked up for the night. Several were walking to the toilets with small plastic pots, to provide urine samples, screening for infection, drugs, and if indicated, pregnancy.

Also milling up and down the corridor were peer support workers in blue T-shirts.

These are longer-term residents who help new arrivals find their feet and answer the many questions they may have about prison life. During their first few days in prison, residents are said to be at their most vulnerable, and are at high risk of self-harm. I smiled at one of the peer support workers, Amber, as I passed her. Petite, with dark features, she was always positive and upbeat. We often worked together in Reception and I loved her bright and warm company. She gave me a cheerful nod back as she guided a new arrival to one of the small interview rooms. Through the cacophony of noise, I could easily hear her talking with reassuring and soothing tones. This peer support can be invaluable in helping the women through the first few hours.

Some women were waiting in small holding areas to see the nurse or to go through paperwork. As I walked along, I could see another woman locked in a holding room, shouting at the top of her voice to be let out, and banging the door with her shoe, her dreadlocked hair sticking out in all directions and her eyes wild.

The noise ricocheted around me as the throbbing life of prison Reception played out its daily drama.

Scrolling down my list, I spotted a familiar name. Shannon was someone I’d grown to know well. Repeat offenders, sometimes called the ‘frequent flyers’ by prison staff, make up by far the majority of the women I meet. So much so that one of the questions on the medical template I go through when I see them is to ask when they were last released from prison. When Shannon came back into custody I was never surprised because she had been homeless for years. I was always glad to see her as I had grown to like and understand her. It was like meeting an old friend again and made my job so much more enjoyable. But every time she was released, I hoped I wouldn’t see her back again.

I looked into the waiting area and saw her sitting down with her head in her hands. Rather than jump up and greet me with her usual toothless grin and a ‘Hello, Doc!’ I could see she was agitated and crying. She was wearing a grubby blue tracksuit. I glimpsed the top of her head; her auburn hair was matted and greasy.

‘Shannon?’

She looked up and slumped back in her chair for a moment, a look of relief on her haggard and pock-marked face.

‘Come on,’ I said as I led her to my little room.

I shut the door and she gave me a hug as the various smells associated with living rough, like body odour, dirty feet, and foul breath, soon filled the air.

‘What’s happened? You’re never normally like this?’ I asked.

‘Doc… it’s good to see you. The judge… he said…’ She started sobbing. Messy and loud, snot-filled sobs. ‘He called me a worthless wretch.’

A worthless wretch, I thought, what an awful thing to say.

I was momentarily stunned by the language the judge had used. Judges can use their summary judgements to say what they like and whilst this is normally a standard administrative process, this judge had obviously made his personal views known. I couldn’t help but think about the vast gulf between the day-to-day lives of Shannon and the judge who had just sentenced her. Society and the judge might see Shannon as a useless criminal, but she didn’t see herself like that, and neither did I, because I understood the dreadful details of her life that inevitably had led Shannon to commit crime.

‘You are not worthless, and you are not a wretch,’ I told her firmly. ‘I really believe you can make something of your life. And I am sure you will, if you can get the help you need.’

I tore off a large piece of paper towel from the roll and passed it to her. She clutched it and wiped her dirty face. Shannon had substance misuse issues and I could already see the signs of withdrawal. Beads of sweat were visible on her forehead and she had goosebumps on her track-marked arms.

We started to go through the routine medical questions, though I knew Shannon’s medical history well. After all, this was the ninth time I had seen her in around two years.

‘Okay, let’s sort out your medication Shannon, so that you can go over to House Block One as soon as possible to get your methadone,’ I said.

Before my time in prison I had worked as a GP for twenty years in the community near where I live in Buckinghamshire, but had very rarely treated patients who had ever been involved with the criminal justice system. Like many others, the mainstream media soundbites meant that before I started to work in prisons, my opinion was condensed down into a narrative of ‘good people’ and ‘bad people’, with a clichéd list of ‘bad’ characters ranging from violent psychopath to petty criminal. The reality is far more complex.

Female offenders are some of the most vulnerable people within our society. Women make up just five per cent of the prison population in England and Wales, and the vast majority are imprisoned for non-violent offences, and are often sentenced for a matter of just weeks at a time. Many of them are caught in a vicious cycle of domestic violence, drug abuse and homelessness. Written off by society, they disappear into a world that most of us are oblivious to, of lost invisible souls who have no voice. I am now all too aware of the awful lives so many of them have to endure, as are many other people and organisations who work tirelessly to try to help in all sorts of different ways.

These are often brave, funny and kind women, who are trapped, and without hope so often of a better life, and they are at risk of being dismissed and vilified by society. They are human like us, and they face the same battles many of us do, yet their lives are just much harder.

There are many, many issues and obstacles in the way of them rehabilitating and breaking free of the way of life they are caught up in. Their lives are often desperate and can spiral into the most savage circumstances. Far too many of them are sleeping on the streets. If they are lucky, they may ‘sofa-surf’ with friends and family, but all too often they inevitably head back to the streets, having outstayed their invitation. The last time I had seen Shannon, she had been sleeping in a stairwell near Victoria station. She’d told me the day before her release that she was planning to return to her old spot and had given me a scrappy piece of paper with biro scrawl, which read ‘Elizabeth Bridge, Victoria.’

‘Come and try and find me, won’t you? When you’re next in London,’ she’d said, like any old friend inviting me round for a coffee. I wanted Shannon to hope for a better life for herself, however impossible it may seem given the shocking life she was living on the streets. In reality, her life was one of despair and hopelessness. Despair was sadly evident in so many of the people I had come to know through the course of my day-to-day work.

By far the majority of the women I see have experienced or continue to experience some kind of trauma. Many have a history of domestic violence and sexual abuse. They live in terror and this leads to substance abuse, self-harm, suicide attempts and serious mental health issues.

‘What are you in for this time?’ I asked her gently.

‘I nicked a laptop from Currys. Thought I could sell it to my mate, Mike – he’s always got cash.’

‘How long are you here for?’

‘Just twenty-eight days. I was only out two weeks ago.’

Women often serve far shorter sentences for minor crimes like theft and shoplifting and are locked up for a matter of weeks, before leaving to go back onto the streets, only to reoffend and come back in – hence the frequent flyer moniker. The longest sentence Shannon had received was two years when she was in her late teens.

She was now 26 and had been using drugs for over a decade.

‘How much heroin are using at the moment, Shannon?’ I asked. ‘Are you still buying benzos and pregabs as well?’

‘I usually spend about 100 quid on crack and a 100 quid on heroin every day,’ she told me. ‘I’m also taking about 40mg of diazepam and as many pregabs as I can get my hands on. The drugs and booze just get me through. Some days I feel like I’m drowning. It all just helps me to forget the evil shit I’ve been through.’

‘How much are you drinking now?’ I asked.

‘A bottle of vodka a day, if I can get it,’ she replied staring at her feet.

Shannon sat forward, grasping her stomach and wincing in pain because she had really bad abdominal cramps due to withdrawal.

‘I think I’m gonna be sick,’ she said, clutching her hand to her mouth.

I looked around the room for a disposable bowl and fortunately found one in the corner, which I quickly handed to her.

‘Here you go, Shannon,’ I said.

I sat and waited in silence until she felt able to continue talking.

‘I live from one hit to the next. I owe my dealers money and I spend my life in fear. They keep coming after me. Say I owe them more and more. I’ve lost track of it all now, and I don’t know how I’m going to pay them back.’ She sounded terrified. Women were not simply scared of violent partners. Men dominating these women came in all guises. Many women turn to sex work to keep their dealers happy.

She had also been sleeping rough for the majority of her adult life, heading to the streets with a measly bag of possessions and a sleeping bag to find somewhere she could call her own – even if this was a shop door, in a stairwell or under a bridge. Solving housing issues for this section of society is hugely challenging. Many organisations use online systems to process requests and details, but women without their own phone or access to the internet cannot get near them. Shannon always sold the cheap phones she got her hands on for drugs, and aside from the odd night in a hostel, she was on her own. She had no bank account. She had fallen through all the nets.

Over the many hours I had spent before then with Shannon trying to tackle her drug and alcohol dependency, I had heard her story in full.

‘My dad beat up my mum so badly when she was expecting me, it’s a miracle I’m here at all,’ she said. ‘Even after all that, she stayed with him. He was locked up when I was two and I never saw him again.’

Her mum worked three jobs to put food on the table and became involved with another man. Her new stepfather soon moved into the house.

‘He was a bastard. Mum had two more kids with him. He would play us all off against each other. It was like some sort of weird power game of cat and mouse.’

Her face looked pale and impassive.

‘We would all be beaten in turn. I was always the last because I’m the eldest. Listening to my sisters cry and scream before me was unbearable.’ Her voice started to crack.

‘I would hide under my duvet and put my pillow over my head, but nothing would drown out the noise.’

The tears started to fall as she relived the memory. I gently placed my hand on her arm, a little comfort as she talked.

‘My stepdad would beat and rape my mum in front of us, and he would come into our rooms after Mum left at night. She worked as a cleaner at the local leisure centre.’

‘He sounds like a really evil man,’ I said, deeply sickened by her awful tale.

‘First, it was just weird touching, but when I was eight, he started raping me. I could never scream, as he was so heavy. I felt I couldn’t breathe. I would just look at the tree outside my window and pray it would be over,’ she told me. ‘I never told my mum. I didn’t want her to be upset.’ The lengths people would go to protect the people they loved never ceased to amaze me, and often left me speechless. I frequently met people who took the blame for crimes they did not commit; from mothers who claimed the drugs in the house were theirs and not their kid’s, to girlfriends who provided an alibi or who covered up for their partners in other ways.

‘Me and my sisters were always hungry, and I sometimes passed out at school. I was terrified about my mum getting into trouble, so I would lie and say that I’d had some toast or cereal for breakfast.’

Thankfully, Shannon’s mum met someone new and their lives changed for a few years. The abuse stopped and there was more money for food, and birthday and Christmas presents.

When Shannon met her first boyfriend at 14, sadly the cycle of abuse started again. She became dependent on drugs and alcohol and started bunking off school. Her grades had never been good, and she was struggling to keep up. Eventually, her mum threw her out, because she didn’t want her drug use to influence her sisters. She ended up on the streets. She had no qualifications, and having lost contact with her mum and sisters a long time ago, she also had no support network on the outside.

‘I’ve got no one and nothing. Not even my own teeth,’ she said, showing me a gappy mouth with a few rotten, brown teeth, worn down to stumps from the years of drug use and neglect.

Those words seemed to sum up the story of so many women I had come to know during my time working at Bronzefield.

I knew Shannon’s history and needed to help her manage the symptoms of alcohol withdrawal, and to stabilise her on methadone whilst she was in prison. Realistically there was not enough time for her to detox from methadone, and there was also a risk of her overdosing on heroin after release if she was on too low a dose. It was not going to be easy for her; it never was.

I had learnt early on in my time at Bronzefield that the women themselves had to want to stop using drugs and conquer their addictions. No matter what I or anybody else did or said, it was up to them to make that choice and see it through.

‘I haven’t got any drugs in my lady pocket, Doctor Brown. Honest,’ she said. I knew that she had smuggled drugs into prison in her vagina before – it was an obvious way for many prisoners, as internal searches are not permitted.

She looked up and gave me a smile, so I would know. If she told me she had drugs on her I would have to report her, so I swiftly moved on to sorting out her medication. As we chatted away, the upset of the judge’s comments seemed to fade, and I started to see the old smiley Shannon emerge.

‘To be honest, in some ways I’m happy to be back and have a warm place to sleep. It’s getting proper cold out there now. My sleeping bag got soaked in the rain the other night and it just won’t dry. And I’m starving,’ she rattled on. ‘I can’t just sit there all day. Shoplifting gives me something to do. That, and riding round the Circle Line. It’s warm, and much more comfortable than just sitting on the street. I also feel safer when I’m not sitting on the street. I’m so scared the dealers will find me and beat me up again.

‘It’ll be nice to be with some of my mates again. We understand each other. I’ll keep busy in here, maybe try and learn something; get back on the education programme. It’s good to know I’ll feel safe at night again, for a while.’

This was something I heard again and again from the prisoners. Being in prison for many women is far safer than being on the outside. She was back in a place she associated with safety, familiarity, security, and even opportunity. With three meals a day and regimented timetabling, she also wouldn’t need to make many decisions for herself.

As well as addictions to crack cocaine – a crystallised form of cocaine – and heroin, Shannon drank heavily and was addicted to benzodiazepines and pregabalin. Highly addictive, benzodiazepines – referred to as ‘benzos’ by the inmates – are drugs like diazepam and Xanax and were originally prescribed for anxiety when they first came on the market in the 1960s. Many girls I see are addicted to high doses of these drugs because it calms them down. Pregabalin is another prescription-only drug used to treat epilepsy, general anxiety disorder and neuropathic pain. Like heroin, it induces feelings of euphoria and calmness and is hugely addictive, so there is a rampant black market for this drug. Many of the women I see say that it is harder to withdraw from pregabalin than heroin.

‘It’s just so awful,’ they tell me, with haunted expressions.

Shannon was addicted to so much that withdrawal from it all was medically a blurred picture. Her face was glistening with sweat and her hands were shaking. As she looked at me, I could see that her pupils were widely dilated. She would experience a whole range of debilitating symptoms over the coming days and possibly weeks, including diarrhoea, abdominal cramps, nausea and vomiting, shivering, sweating, anxiety, panic attacks and paranoia.

I started typing out a whole list of medications that she would need to enable her to cope.

Methadone is prescribed as a substitute for heroin and helps to ease withdrawal symptoms from opiates and reduce the cravings. Bright green in colour, it is a slow-acting opiate substitute and is prescribed in a liquid form. Most people that take it say that it tastes disgusting. In the past, all prisoners were expected to detox completely from methadone if they were due to remain in custody for more than three months, but this is no longer the case. Often, especially in the case of a short sentence, it has to be ‘titrated up’, to try to protect the user from overdosing on release, or to control their dreadful symptoms of withdrawal.

Prisoners are given their daily dose by the nurses at 9 a.m. but if the dose is not high enough, it won’t hold them through until the next day.

We agreed on a dose to build up to, and along with methadone, I prescribed all the other medications she would need to combat her withdrawal symptoms.

‘I know I say this every time I see you,’ Shannon grinned. ‘But you really are like a mother to me. Thank you.’

I stood up to give her another hug.

‘Good luck, Shannon,’ I told her. ‘Be good.’

‘I’ll try, I really will.’

Deep down, I knew I would almost certainly be seeing her again after her current stay. I always, always hoped girls like Shannon would get their lives back on track, but it felt like she had the odds stacked against her. The statistics state that the more previous custodial sentences a woman has had, the higher her reoffending rate; the reoffending rate for women with eleven or more previous convictions is eighty-three per cent. It’s sad but it makes sense that just as women’s paths into crime are chaotic and complex, so their paths out to a better life are likely to hit just as many bumps along the road.

I glanced at my watch. It was just past 8 p.m. and I was feeling really tired and ready to go home. Despite the fact that I had been working in prisons for many years, I had never become immune to the rawness of it; the shock, fear, relief, sadness, shame, despair. It was a melting pot of extremes, and emotionally draining. So often, I was all too aware that I had very little to offer the people I was meeting, as I could not change the fact of where they were and what they had done. All I could hope to do was to try and offer a bit of kindness and reassurance, and to relieve any physical pain and suffering they may be going through. I try my best, if I possibly can, to take the edge off their undoubted apprehension, as I realise it must be so overwhelming and intimidating for some people to find themselves in prison. It is strange that whatever their crime and however awful, it fades into the background momentarily and I just see them as a scared and shocked human being. I am so used to the environment that I feel totally comfortable within the prison walls. But I find myself trying to imagine seeing it through their eyes, and wonder how it would feel if I was sitting in that chair opposite me.

As I was finishing off my notes on Shannon, Amber popped in to ask if I would like a cup of coffee.

‘I would love one. Thank you, Amber,’ I replied without giving it a second thought. ‘How has your day been? Any gossip?’ I asked her, hoping for a little light relief. Amber always cheered me up, as she is blessed with such a wonderful sunny nature and positive outlook on life.

‘Nothing much, Doctor Brown,’ she replied. ‘Same old, same old. I’m really happy though, because my family are coming to visit tomorrow, and I can’t wait to see them. Also, I’m reading a brilliant book – a thriller – which is really gripping.’

We chatted for a few minutes about the book and then she went off to get me a drink. It felt good to have people like Amber around. During my time working in Reception, I had become very close with the women who worked there and we tried to look out for each other. I thought how lucky I was to have them with me; we were like a little family and there was a lovely sense of belonging between us. Whenever I felt a bit down, they always managed to cheer me up.

A prison officer wheeled the next patient along the corridor, manoeuvring the heavy chair with some difficulty, taking a number of turns to get into my room.

In front of me was a black woman, in clean clothes and bright mauve lipstick. She was very overweight, with rolls of flesh sagging over the side of her chair.

I glanced at her notes. Gloria was 68 and had a multitude of medical complaints, including a condition that affected her joints. I read that she had already undergone two hip replacements. She also suffered from type 2 diabetes and hypertension, and was unable to walk due to the severe pain in her knees. This explained the wheelchair.

‘Hi Gloria, I’m Doctor Brown…’ I started telling her about what I was doing and why she had been sent to see me.

I went through my usual questions, one of which was to ask what she had been charged with.

Gloria explained that she had been charged with fraud, but she denied any involvement.

‘… but I didn’t do it,’ she said. ‘I got caught up in something I didn’t understand. I didn’t realise it was illegal. I’ve been given three years, Doctor Brown. Three years! Surely that’s not right?’ She looked at me imploringly. ‘I’ve never been in trouble before in my life.’

Gloria had come straight from the court where she had been sentenced, so it was clear that whatever she felt, the judge felt differently.

Fraud is not an uncommon crime, and includes benefit fraud and other far more elaborate types of fraud, including complex money laundering. This is one of the convictions that many women really struggle to come terms with. They often feel angry that they have ended up in prison as they didn’t realise the severity of what they were doing.

I asked her about her long and complicated medical history. As we chatted it was clear that Gloria’s main support was from her husband, Reg. They lived north of Manchester on their own and didn’t have children. They only had each other.

‘It’s not going to be easy for him to come and see me, is it?’ she said, looking despondent

‘When you get to the house block, have a chat with the officers,’ I told her. ‘They’ll be able to help you, and tell you what you need to do next to try and arrange a visit.’

I knew the prison did their best to help residents maintain family ties by facilitating visits and contact, but of course, as with most things in life, there are forms to fill and protocols to follow.

‘Who’s going to help me get in and out of bed?’ she asked. ‘Reg does that for me. He gets me up, cooks my breakfast and helps me get dressed. He sits me in front of This Morning on the TV, before he goes to get the paper.

‘I’ll be lost without him,’ she continued. ‘I just don’t know how I’m going to cope.’

She continued to tell me about their daily routine, down to the finest detail, with Reg featuring in every element of her day. I felt for Gloria. Her sentence was years, not months, and it was going to be hard for her to adjust, assuming she ever would.

Thirty minutes later, I had completed her notes on the computer and prescribed everything she would need for the time being. She looked relieved but nervous.

‘They will get my pills to me on time, won’t they?’ she asked, her eyes flicking from me to the computer and back again.

For many women, the fact they are not allowed to keep their medication with them, that it is handed out by the nurses, is another loss of liberty.

‘The nurses will give your medication to you each day,’ I explained. ‘Once you are settled, you will have an in-possession risk assessment – it’s called an IPRA – to see if you can look after your own medication. But up until then, I’m afraid you’ll just have to go to the nurses for it.’

She looked resigned to the fact that there was nothing she could say to alter the situation.

She added: ‘The other thing is I also suffer from claustrophobia. I hate being in lifts, and any small space, in fact. Even being in this room makes me feel nervous.’

Gloria’s new home would be a small cell, with only enough space for a narrow bed, sink, desk and a toilet. With a door that would be locked. And many doors would be locked behind that door.

As I finished my shift that evening and walked across the car park to make my way home around the M25, I wondered how Gloria, Rebecca and Shannon, and the other women I had met that night, would cope with the new phase of their lives. How prepared they would be for the many challenges they might face, and how they would handle them.