Boiled Alive: How Sweltering Hot Prisons Are Becoming Cauldrons of Death

Kenneth Wayne James, age 52, was slated for release from a Texas prison, where he was serving time for parole violation. He didn't make it: guards found him dead in his cell, and prison medical staff measured his body temperature at an astonishing 108F.

To get some idea what such a temperature means, body temperatures above 104F are life-threatening.

I spoke about heat deaths in Texas prisons with Ariel Dulitzky, director of the Human Rights Clinic at the University of Texas Law School in Austin. Dulitzky said that there were 14 documented heat deaths in Texas since 2007, and he suspects the number is even higher.

Also in the Lone Star State, Brian McGiverin of the Texas Civil Rights Project is litigating dangerously high temperatures in Texas prisons.  Like Dulitzky, he believes heat deaths are under-reported by the authorities and thinks there is a coroners' bias against attributing a death to excessive temperature.

Texas is far from the only state where excessive temperatures cause misery, and often, death. Not surprisingly, the sweltering states of the Old Confederacy figure prominently in class action suits to bring down the prison thermometer, but one of the most heartbreaking deaths occurred in the Rikers Island jail which serves New York City. (Rikers Island has been widely criticized for overcrowding and brutality by guards.) Jerome Murdough, age 56, a mentally ill ex-Marine, was awaiting trial for trespassing. In the meantime he was receiving an antipsychotic and an anticonvulsant, both of which would have made him more sensitive to high temperatures. The temperature in his cell was 100F and it killed him; the city settled with the family for $2,500,000 in a wrongful death suit.

Hyperthermia is defined as the inability of the body to cool itself in inclement temperatures. The body's organ for regulating its temperature is the hypothalamus, a nodule of nervous tissue situated at the base of the brain. Hyperthermia should not be confused with fever. The hypothalamus is a biological "thermometer" that regulates the body temperature around a fixed "set point." The set point for most healthy human beings is 98.6F; in illnesses such as infections the white blood cells release toxins that drive up the set point, sothat the hypothalamus is "tricked" into regulating the body temperature at a new, higher degree. This is the underlying physiology of fever. In hyperthermia the set point remains fixed while the body strives to cool itself by perspiration, convection, and to a lesser degree, by heavy breathing. Perspiration is the principal mechanism by which the body rids itself of dangerous levels of heat. Each droplet of water that leaves the overheated skin for the open air takes with it a few units of thermal energy. An Alabama jail cell in July defeats the body's cooling mechanisms not only by high temperature but by high humidity; the presence of water vapor in the air defeats cooling by perspiration.

Illness and death from hyperthermia can come about from several ways. Death can occur from organ failure, especially fatal damage to the brain and the heart.  I also spoke with Michael Baden, formerly chief medical examiner of New York City. Baden said death from hyperthermia is extremely difficult to detect at autopsy, so that the autopsy findings are often written off as "m.i." (myocardial infarction or heart attack). Inmates with physical illnesses are at higher risk of organ failure.

A second major cause of heat death occurs in patients taking certain medications. David Fathi, director of the ACLU National Prison Project, said that the American prison population is getting older, and a higher proportion of inmates are mentally ill. Many of them are receiving drugs. At the head of the list are the second-generation antipsychotics (e.g. Risperdal, Seroquel, Zyprexa) and a class of antidepressants called selective serotonin reuptake inhibitors (e.g. Paxil, Prozac, Zoloft).  It is still not clear how these drugs foster heat death.

In a fruitless attempt to obtain some statistical data on heat deaths, I calledh Allen Beck, a statistician with the Justice Department's Bureau of Justice Statistics. Beck explained that the BJS does not even track heat deaths because the death certificate usually gives some other cause, i.e. myocardial infarction. Baden said that, as far as he knows, New York is the only state that with an agency that seeks to obtain accurate data on every inmate's death.

To find out what it's like to suffer hyperthermia, I reached out to Michael Jewell, who escaped the death penalty on a technicality but served 40 years for murder in a Texas prison. During his confinement, Jewell organized a work stoppage and attempted to escape; for these infractions he was subjected to solitary confinement. The worst experience, he said, was being locked in a cell about 10'x12' with hot water pipes running across the ceiling. It was summer, and there was only a small window in the cubicle. By seven in the morning the cell was "unbearably hot." The window offered no respite: "It was like standing in front of a hair dryer." There was also a sink, but the water came out warm. After a few days in the cubicle Jewell was usually too weak to eat or drink, and when he did manage to get down some food he vomited it back with froth; when he drank some water he because nauseated.

Had Jewel been kept in his oven much longer he would have developed severe symptoms of hyperthermia: fast pulse, rapid breathing, mental symptoms that resemble delirium. A little longer and he would have been a corpse.

Baden said that, when the temperature goes up, it is imperative to make sure inmates have plenty of cold water, or better, electrolyte-enhanced beverages like the kind athletes drink. If a prisoner does succumb to hyperthermia, staff must cool him off as quickly as possible by immersing him in a tub of cold water, preferably with ice in it.

Human rights lawyers have made hyperthermia one of their issues, with variable results. Perhaps the most bizarre commentary on the American system of justice is the Angola prison case in Caddo Parish, Louisiana. At the time of the trial, Angola prison's death row housed 82 men, all of whom were suffering from the sweltering heat. Lawyers won an injunction from a federal judge ordering prison staff to take measures to cool off death row. Thanks to the judge's intervention, Angola's death row inmates can await their fate in a reasonable degree of comfort.

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