Frank’s heart attack is John Kiriakou’s central example of what medical care at FCI Loretto amounted to in practice.
Frank was 65, diabetic and insulin-dependent, with a history of heart trouble and, in Kiriakou’s phrase, “enough medications to stock a mid-sized pharmacy.” Sitting in their room one evening he felt a sudden tightness in his chest, on top of a day spent short of breath. The two men went together to the officer on duty in the unit. The officer’s answer was “nothing I can do”: sick call ran from six to a quarter past six in the morning, Monday to Friday, and Frank would have to wait.[1][2]
Tylenol
Frank queued the next morning, was seen, and was given Tylenol. The physician’s assistant did offer to do something proactive — apply to the regional medical office in Pittsburgh for approval to perform an EKG.[3]
Months passed. The tightness did not. Frank told Kiriakou it felt as though somebody were sitting on his chest — “or maybe that’s what it feels like when the BOP is sitting on your chest.” Urged back to medical services, he was told again that there was nothing the physician’s assistant could do and that it was all up to the regional office. Another two months went by.[4][5]
The insulin line
One morning Frank went early to the insulin line and Kiriakou slept in. On his way to the shower at eight, another prisoner called out that Frank had had a heart attack in the line and dropped unconscious to the ground. Kiriakou describes feeling dizzy with anger: Frank had been reporting the classic signs of a man having, or heading for, a heart attack for months.[5][6]
He survived — eleven days in a local hospital chained to the bed, then surgery for two angioplasties and two stents. Bypass surgery, which Kiriakou describes as the better and more holistic answer, was refused as too expensive. The Bureau of Prisons then transferred Frank to a prison hospital in Massachusetts, a fifteen-hour drive from his family and his support.[7]
Kiriakou’s judgement of the staff is that everyone failed the most basic professional obligation: the officers he expects nothing from, but the physician’s assistants, while not bound by the Hippocratic Oath, take a professional oath of their own.[8]