If symptoms

persist.. .

PRISON IS a foreign country: they do things differently there.

Thus, a sterile area in prison is not, as in hospital, an area free of germs, but an area free of prisoners. I need hardly add that the achievement of asepsis in the Penitentiary sense requires precautions as elaborate, in their own way, as those required for asepsis in the medical sense.

Prisoners, of course, are human, only more so. Last week, the first patient in my clinic was a man whom I had seen on the out while he was on bail for a serious crime. He had come to me in the hope that I might declare him unfit to plead, thus postponing indefinitely the evil day of reckoning in court, but I saw no rea- son to do so in his case. Secretly, I was rather pleased, because he was repulsive and malignant.

`But I never done what they said I done, doctor,' he protested.

`That's not for me to say, I'm afraid,' I replied. 'And whether you did it or not has nothing to do with your fitness to plead. As far as I can tell, you are per- fectly well able to challenge jurors, fol- low the evidence and instruct counsel.'

`But I can't even remember nothing about the day when they said I done it.'

Then you're not in a very strong posi- tion to deny the charges,' I said. 'I'm not a lawyer, but I advise you to change tack.'

`I'm not feeling well,' he said, taking my advice at once and changing tack. `It's done my head in, all this. I don't know where I am now.'

`Out-patients,' I reminded him.

Needless to say, he wasn't delighted to see me on the in.

`You're the one what got me in here,' he said.

`I had nothing to do with it,' I replied firmly. 'I didn't commit the crime, I didn't give evidence in court, I didn't find you guilty and I didn't sentence you.'

`All I wanted was help and you did my head in.'

`There was nothing wrong with you.'

`Well, I'll do my bird — I can 'andle it, bird's never been no problem for me and then I'll get you.'

I was not in the least worried by his threat, not because it was idle or insin- cere at the moment it was uttered, but because, by the end of his bird, he will have transferred his affections elsewhere and forgotten all about me.

`Would you like to repeat that in front of an officer?' I said.

`No, I fucking wouldn't,' he said, and stormed out.

Next came a prisoner who was to be released the following day. Prisoners are weighed before they leave the custody of Her Majesty, to prove that they have put on weight, or at least have not lost it, since they were received into her tender hospitality. After this simulacrum of a boxing weigh-in, the doctor customarily asks them whether they are fit (medically speaking) to face the outside world. I haven't known one yet who considered himself unfit.

Next day, however, I met the former prisoner on my ward in the hospital. He had taken an overdose overnight — not a serious or life-threatening one — and he was therefore ready for discharge from hospital by the time I saw him there. To prove himself unfit, he went to the ward lavatory and cut one of his wrists slightly.

`Discharge him, sister,' I said.

`But I might cut my wrists again,' he said.

`You might,' I said.

`Fucking wanker,' he said, and stormed out.

Theodore Dalrymple