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Dying Inside

The HIV/AIDS Ward at Limestone Prison

Benjamin Fleury-Steiner

Publication Year: 2008

The HIV+ men incarcerated in Limestone Prison's Dorm 16 were put there to be forgotten. Not only do Benjamin Fleury-Steiner and Carla Crowder bring these men to life, Fleury-Steiner and Crowder also insist on placing these men in the middle of critical conversations about health policy, mass incarceration, and race. Dense with firsthand accounts, Dying Inside is a nimble, far-ranging and unblinking look at the cruelty inherent in our current penal policies. ---Lisa Kung, Director, Southern Center for Human Rights "The looming prison health crisis, documented here at its extreme, is a shocking stain on American values and a clear opportunity to rethink our carceral approach to security." ---Jonathan Simon, University of California, Berkeley "Dying Inside is a riveting account of a health crisis in a hidden prison facility." ---Michael Musheno, San Francisco State University, and coauthor of Deployed "This fresh and original study should prick all of our consciences about the horrific consequences of the massive carceral state the United States has built over the last three decades." ---Marie Gottschalk, University of Pennsylvania, and author of The Prison and the Gallows "An important, bold, and humanitarian book." ---Alison Liebling, University of Cambridge "Fleury-Steiner makes a compelling case that inmate health care in America's prisons and jails has reached the point of catastrophe." ---Sharon Dolovich, University of California, Los Angeles "Fleury-Steiner's persuasive argument not only exposes the sins of commission and omission on prison cellblocks, but also does an excellent job of showing how these problems are the natural result of our nation's shortsighted and punitive criminal justice policy." ---Allen Hornblum, Temple University, and author of Sentenced to Science Dying Inside brings the reader face-to-face with the nightmarish conditions inside Limestone Prison's Dorm 16---the segregated HIV ward. Here, patients chained to beds share their space with insects and vermin in the filthy, drafty rooms, and contagious diseases spread like wildfire through a population with untreated---or poorly managed at best---HIV. While Dorm 16 is a particularly horrific human rights tragedy, it is also a symptom of a disease afflicting the entire U.S. prison system. In recent decades, prison populations have exploded as Americans made mass incarceration the solution to crime, drugs, and other social problems even as privatization of prison services, especially health care, resulted in an overcrowded, underfunded system in which the most marginalized members of our society slowly wither from what the author calls "lethal abandonment." This eye-opening account of one prison's failed health-care standards is a wake-up call, asking us to examine how we treat our forgotten citizens and compelling us to rethink the American prison system in this increasingly punitive age.

Published by: University of Michigan Press

Series: Law, Meaning, and Violence


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pp. ix-x

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pp. 1-7

For nearly a decade, Dr. Stephen Tabet provided care to incarcerated HIV patients throughout the state of Washington. These prisoners nearly always suffered from multiple maladies, often a consequence of a long-neglected viral infection. In addition to HIV, several were infected with hepatitis C, a disease of the liver that is potentially lethal...

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Chapter 1. Penal Health Care in Contemporary American Society

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pp. 8-28

Sociologists of punishment have long recognized that inequalities in the broader society are mirrored in and through the prison population, beginning with such classic works as George Rusche and Otto Kirchheimer’s treatise Punishment and Social Structure and Donald Clemmer’s The Prison Community, a Depression-era case study of Illi-...

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Chapter 2. The Conflicting Imperatives of Mass Incarceration and Prisoner Health

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pp. 29-42

It may be tempting to write off the Limestone case as a problem typical only to infamous penal institutions in the southern United States. Given the historical record of brutal, inhumane conditions in prisons and jails in this region of the country—perhaps most notably the deplorable treatment of prisoners incarcerated at Louisiana’s notorious...

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Chapter 3. The Conditions That Produce Catastrophic Penal Institutions

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pp. 43-70

The most influential work that provided policymakers of the late twentieth century with a clear conception and rationale for a newly invigorated strategy of law and order was conservative political scientist James Q. Wilson’s Thinking about Crime. According to Wilson, the only realistic policy response was for government to address crime in...

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Chapter 4. Courts, Legal Change, and Institutional Struggle

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pp. 71-94

It is clear that the birth of the prisoner rights movement in the United States cannot be separated from the emergence of the civil rights movements of the late 1960s. For the first time, the myriad injustices behind bars were made transparent to the general public. In addition to the racist, violent, and unsanitary conditions of the na-...

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Chapter 5. The Challenges of Leatherwood

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pp. 95-112

It was the summer of 2002. Josh Lipman had just finished law school and was to begin his first job as an attorney with the Southern Center for Human Rights (SCHR). What he did not know was that he would be in charge of his first case, Limestone, before he even arrived at SCHR’s downtown Atlanta offices. ...

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Chapter 6. Normalizing Catastrophic Loss of Life

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pp. 113-142

As discussion in the preceding chapters has shown, the privatization of prison health has largely been inadequate in addressing the varied, often complex needs of chronically ill prisoners. At the time leading up to the Leatherwood litigation, ...

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pp. 143-167

On February 23, 2004, approximately four months before Judge Ott would hand down his opinion in the Leatherwood fairness hearing, Dr.Stephen Tabet returned for a follow-up evaluation of Limestone’s HIV prisoners. By this time, the entire population had been moved from Dorm 16 to new living quarters. ...

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pp. 168-171

As Birmingham News reporter Carla Crowder sat down with former Limestone prisoner Wilson Rogers1 in a park across the street from Birmingham’s famous rib joint Dreamland, an Alabama culinary treasure located among the bustling bars and coffee shops in the trendy Five Points South, she couldn’t help but be surprised at how upbeat and healthy Rogers looked: “He was very poised and spoke with ease about the deaths.” ...

Appendix A. - A Fuller Account of Methods

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pp. 173-176

Appendix B. - The Institutional Lives of Catastrophic Jails and Prisons in the United States,1990–2007

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pp. 177-180

Appendix C. - Prisoner Activism and Advocacy Organizations in North America

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pp. 181-183


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pp. 185-210


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pp. 211-225

Author Index

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pp. 227-231

Subject Index

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pp. 233-238

E-ISBN-13: 9780472021949
E-ISBN-10: 047202194X
Print-ISBN-13: 9780472114290
Print-ISBN-10: 0472114298

Page Count: 248
Illustrations: 2 figs
Publication Year: 2008

Series Title: Law, Meaning, and Violence
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OCLC Number: 606616159
MUSE Marc Record: Download for Dying Inside

Research Areas


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Subject Headings

  • Prisoners -- Medical care -- Alabama -- Limestone.
  • Prisons -- Alabama -- Limestone.
  • Prisoners -- Health and hygiene -- Alabama -- Limestone.
  • AIDS (Disease) -- United States.
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