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1 " Thus far we have been able to protect [our children] from the deep and enduring traumas that scar the minds and selves of so many of the patients I see. How — how?—can I make it always so? "
― Christine Montross , Falling Into the Fire: A Psychiatrist's Encounters with the Mind in Crisis
2 " Standing on the edge with my patients — abiding with them — means that I must harbor a true awareness that I, too, could lose my child through the play of circumstance over which I have no control. I could lose my home, my financial security, my safety. I could lose my mind. Any of us could. "
3 " Visions and voices and fear and despair cannot be captured by CT scan or measured in the amplitude of EKG waves. Try as we might, we simply cannot predict which of our patients will kill themselves, which will murder their children, and which will leave the hospital healed, never to return. "
4 " The wisdom of that moment of pure emotion resonates with me still: that the dearest and most enduring moments of our lives are sometimes the quietest ones. "
― Christine Montross
5 " During my first semester of medical school, I cannot know how the emotional difficulty of the actions we perform on our cadavers will help us prepare for the agonizing moments we will observe in the lives of the living. "
6 " But the problem arises when instead of setting aside our natural reactions, they are denied altogether. Then the culture simply becomes superhuman. And thus is the realm of the superhuman there is no room for human frailty, and admission of it by one risks revealing the illusion of the many. So no one speaks up, and as a result each person believes that she is alone in her experience. To that end, we are left in a profession of untouchable greatness and infallibility, but one whose members kill themselves more than others. "
― Christine Montross , Body of Work: Meditations on Mortality from the Human Anatomy Lab
7 " The midpoint in medicine between excessive emotional involvement with patients and a complete lack of empathy is not a simple one to locate. "
8 " And so, just as the humanity of our cadavers asserts itself in nail polish and tattoos, the inverse of humanity emerges in the body's utter lack of response to profound wounds. "
9 " As her body empties, I feel more and more hollow. I think I must offer her some explanation, but when I look to her face, there is clear and perfect water swirling from her open mouth, a question in a language I cannot comprehend. "
10 " The most alarming moments of anatomy are not the bizarre, the unknown. They are the familiar. "
11 " I feel your body, your sick and scared body. And I feel how it must be different from how it was, and how it is different from mine. "
12 " Even the most comic moment contains an element of melancholy; even the deepest tragedy harbors a trace of the ironic. "
13 " was once caught in a downpour on my way into a prison. As I waited to pass through a set of doors, I groused to an inmate on work duty who was mopping the hallway that even my socks were soaked. “They cancel outdoor rec in storms,” the man said to me with a soft smile. “I haven’t been in a rainstorm in eighteen years.”) "
― Christine Montross , Waiting for an Echo: The Madness of American Incarceration
14 " The locked-down structure of the supermax contains within it yet further mechanisms of control. Elaborate strategies are put in place in order to restrict the movements and behaviors of prisoners. Just as often as these tactics are implemented, they fail, requiring new strategies of control or a never-ending modification of existing ones. "
15 " These measures are justified by the argument that the men held in solitary confinement must be so contained because of the wild dangerousness that is in their very natures. Only these drastic measures can contain the risk that these men embody. That logic, of course, does not track. We have now known for more than a century that the human behavior cited as the rationale for solitary confinement is consequence, not cause. "
16 " This move to incapacitate and punish also coincided with the country’s push toward deinstitutionalization. Jail and prison populations swelled from an influx of the undertreated mentally ill. The overcrowding of prisons had a predictable consequence: violence in correctional facilities escalated. Prison systems responded with an unprecedented increase in the number and use of supermax cells, justifying this shift by classifying modern-day criminals as “harder” and “unable to be rehabilitated.” The long-held aim of reforming prisoners was now classified as a fool’s errand and therefore a waste of resources. The grim new management strategy for these “hardened criminals” was to isolate them from one another, often for the duration of their sentences, sometimes for the duration of their lives. This ethos of incapacitate and punish is now dominant in the American corrections system, and its toll is devastating. "
17 " Although solitary confinement was present throughout the twentieth century in American corrections, the use of the practice expanded exponentially in the 1970s amid a confluence of changes in the legal and philosophical landscape of the United States. Sentencing policies—including guidelines for probation and parole—grew even stricter, giving rise to a substantial increase in the country’s incarceration rates that would continue to spike during the “War on Drugs.” Between 1985 and 1995, the government cut back dramatically on prison education and treatment programs where they were not completely eliminated. The goals of incarceration shifted from rehabilitation to a correctional strategy intended purely to “incapacitate and punish. "
18 " Solitary confinement is presented in our country as a means of dealing with violence, of attempting to protect correctional officers and the general prison population from dangerous inmates. But the stated purpose plainly differs from the reality. While major infractions in jails and prisons routinely lead to administrative segregation, the accumulation of multiple minor violations can also result in solitary confinement, or an extension of a person’s time therein. Of the 13,000 times that detainees are sent to disciplinary segregation in the state of New York each year, for example, roughly 85 percent are punishments for nonviolent infractions. "
19 " These consequences are imbalanced and inhumane. They are also ridiculous, as investigative journalist Dave Maass points out. “If a South Carolina inmate caused a riot, took three hostages, murdered them, stole their clothes, and then escaped,” Maass writes, “he could still wind up with fewer Level 1 offenses than an inmate who updated Facebook every day for two weeks. "
20 " Some people may argue here, what right do prisoners have to anything beyond basic nutrition? But this is the wrong question. The relevant question is, what do we accomplish by serving nutraloaf? We shame the men and women who receive it, certainly. We cause them to suffer. Perhaps Sheriff Clarke is correct that the fear of it improves prison discipline in the short term. If these are our only goals—shame, vengeance, and control—then the loaf may well serve these purposes. "
