Dear Director Ryan: Writing to Goliath.

The following is an excerpt from an email I sent to Director Charles Ryan at the Arizona Department of Corrections this weekend. I offered to meet him in his office to discuss a few things, so don't expect me to post a written response from him - they aren't often forthcoming, as emails have their way of making it to court.

My side was a long letter, though - this part of which was a complaint about the phone call I witnessed Friday between Julie and Ryan's people. I still can't figure out how to get the video of that call posted and distributed, but will leave those links here once I do. That recording is as real as it gets, and everyone who's advocated on Davon's behalf needs to see it. Keep acting up out there.

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"...By the way, your doctor was really cruel and condescending to Julie Acklin and owes her an apology - at the minimum - as far as I'm concerned. If you all taped that conversation from your end, you'd better play it back. I hope you weren't there condoning his behavior. I also hope you know more about Hep C in prisons than he does - and more about your high profile prisoners, too. He didn't even know if the patient he swore was in no mortal danger had been tested yet for HIV - yet he seemed to think that Davon hadn't asked for an HIV test, either (which was by way of justifying why he wouldn 't have had an HIV test. He knows that kid wouldn't have known to ask before all this.).

That's inexcusable. Furthermore, it's a standard Hep C practice guideline, even in prison, for the physician to automatically test for other forms of hepatitis and HIV whenever a lab comes back HCV+. He should have had some certainty that Davon had been tested if he knew his patient was so healthy that he wouldn't even evaluate him further at this time.

He's full of it. This guy is either strategically trying stall and ridicule Julie, or he really hasn't been keeping up with his profession, so you might want to check him out again. Even I know more about current treatment recommendations than he does. And medical ethics, apparently.

My report of how that conversation went will be in my blogs, whether or not we plan to meet this week - there's no damage control to be done to head off that one. It exemplifies the stone wall your administrators maintain when you're really into denying a problem that everyone else out here can already see - like security in the private prisons...we've been screaming about a lot of this stuff for awhile. Funny how it's ending up an election issue. It still looks a lot like you're waiting Marcia out - as if you're hoping we collapse from the heat or fatigue and shut up already. I guess your doctors are pretty much the same...

...Regarding Davon - whether it takes five months or 15 years to kill that kid, I'll figure out how to prove that he could have become virus-free and avoided such a fate if he'd been treated according to current community standards now, before his liver functioning deteriorates any further. You could be responsible for helping spread Hep C through the community, with the shoddy care he's received.

The one good thing the doctor had to say today is that it may still be early enough in the progression of the disease that there's still hope if he gets prompt treatment - even though he refused to admit that's what he was really saying. That part - the hope - I celebrated tonight. But it is good news that Davon isn't in imminent danger of dying only if that is true, and your physician didn't exhibit a lot of knowledge about either Davon or Hep C..."

Mother and Goliath: The AZ Department of Corrections.

Julie had a phone appointment with Davon's prison doctor Friday; it's just taken me awhile to figure out the software to save and upload it for you. This is unedited, so be prepared for Julie to really articulate herself on the whole thing after she hangs up. We can use legal assistance on this if any help is out there, but I'm afraid it won't come in time to get Davon treatment now. Therefore, we still need everyone's help putting pressure on the Governor and the ADC.

I think Julie did a pretty good job dealing with these guys, frankly. And Davon's doctor has some studying up to do. He isn't current on his practices, and doesn't seem to know anything about Davon except a few notes he jotted down to justify refusing him treatment for Hep C. How can he swear that Davon isn't in any kind of imminent medical danger when he doesn't even know if he was ever tested for HIV? (He was, by the way, and needs to be tested again. The original test was negative, though. We knew that already, ourselves...)

Making sure Davon was tested for HIV and other forms of hepatitis (which they, on their own initiative, vaccinated him against) was one of the first things Julie did when she began to learn about this disease. That's a standard protocol in the community these days, so the doctor's ignorance about whether it was even done is both an indicator that he hasn't read the chart very well, and a sign that it isn't standard practice for the prison to do that with everyone who tests HCV +.

In any case, his word about how well Davon is doing can't be trusted. Otherwise, we would have both been celebrating the news from this call, not swearing at the end. Every test that might substantiate his health status is being delayed until October because "it isn't indicated" right now (by the tests that were done nine months ago). Despite their lack of current, critical information, the "Hepatitis C Committee" reviewed Davon's case last week and also decided that "treatment isn't indicated". Based on whose account of his medical condition, I wondered? This condescending osteopath's who doesn't even know his patients? This man tried to justify the possibility that Davon may not have been tested for HIV by stating that he wouldn't have been tested if he didn't ask.


Should he really have to? He's disabled by virtue of his mental illness, and beaten down by the discouragement of trying to get help and being ignored. His mom has to fight him to get him to put in a health request - he doesn't expect them to do anything for him. They don't.

What is the ADC exposing the public health sector to, by botching Hep C and HIV treatment in prison this? They're following guidelines that were developed a decade ago - the research out now totally contradicts half of what these guys try to convince Julie of. And it's very clear that Davon's best chances of ever ridding himself of this virus is before further organ damage occurs, not afterwards, as the ADC stipulates.


The reason that October is the magic month to do further labs on Davon, by the way, may have to do with the ADC's budget cycle. It really means that nothing will be done until November, when they have new money again. They've probably spent their medical budget for the year on 911 calls to prisons where they don't really have 24-hour clinical staff on site, as they suggest that they do.


Note that what the doctor is telling Julie, by the way, is not only that Davon won't be getting any treatment right now for his Hep C, but that he won't be recommended for medical release to the AZ Board of Executive Clemency, either.

That makes your appeals to them all the more important. Take the time to write a letter. Insist that these young guys with a shot at responding to treatment get to choose whether or not to go through it. Assert that this community's standards of care are outdated, as are the ADC's. Remind them that prisoner health is public health, and that withholding treatment for infectious diseases running rampant through the prisons puts us all at risk. Please remember, as always, to cc both the Governor and Julie (julie.acklin@yahoo.com) on that, too.

(The video is too long to actually post here, so I'm giving you the Youtube links...no, still too long. I'll keep working on this...).