The Letter To Jeffrey Sterling

Dear Jeffrey,

I have followed your case closely, and I have also read recent updates from John Kiriakou, whose case I also covered extensively. I published his prison letters from FCI Loretto. Thank you for taking the time to answer some questions I have about your current struggle to obtain proper medical treatment for your heart condition.

As of September 26, what is your current condition? What symptoms do you continue to endure? How critical do you believe it is that FCI Englewood take your symptoms seriously and grant you access to proper medical treatment? In other words, what do you need FCI Englewood to do for you now?

How has your condition changed over the past months, and how responsive are officers within FCI Loretto to your insistence or requests for medical treatment? When you complain about pain, how long does it take until you finally see a doctor or medical professional?

I understand you are expected to exhaust the administrative process before going outside this system to force the prison to give you proper medical treatment. What do you think of this process?

I also recognize you, and your wife, Holly, have attempted other actions to convince the prison to take care of your urgent medical needs. What have you tried and what effect do you believe these actions have had?

John Kiriakou reported on August 28 that Warden Deborah Denham had reversed her decision and would put a request into the “Bureau of Prisons Regional Office in Denver” that you “be taken to an outside cardiologist for testing.” Did you get to see a cardiologist? Is that how you found out you had high levels of Troponin?

The system appears to be setup in such a way that the prison reviews the budget to see if it can afford potentially life-saving medical care before approving treatment. It seems like it is extraordinarily difficult for anyone in prison to get preventive health care.

Kiriakou shared the following assessment of the medical unit at FCI Loretto as he completed his sentence:

“People under the care of the medical unit at Loretto die with terrifying frequency. I intend to report on and to write about the unit’s malfeasance soon. You already know about my own experience with Glyburide. Since passing out last August, I have never been called down to see a medical professional. My friend Frank complained for three months about chest pains and shortness of breath. He was told to wait: Medical would ask permission from the BOP’s regional office for him to see a cardiologist.

Frank heard nothing for those three months and then one day, while waiting for an insulin shot, he had a massive heart attack. Paramedics rushed him to a local hospital, where had had successful surgery. He was in the hospital for two weeks, barely having lived through the experience. Two weeks ago, I happened to be in the medical unit when I saw a prisoner wheel in another prisoner who was clutching his chest and crying. The 70-year-old told the technician on duty that he was having a heart attack. Her response? ‘Well, you’re just going to have to wait because nobody else has gotten to work yet.’ There are some very bad animals here, but none have been sentenced to death.”

From what you have experienced, how does Kiriakou’s firsthand account compare? Would you call it standard operating procedure to let a person suffer heart attacks and delay treatment until the prison is ready to admit such person is near death?

Finally, what retaliation (if any) has occurred in response to the collective effort by you, your wife, and supporters to obtain proper medical treatment for you? Or do you think the prison has held off on retaliation for the time being?

Best,

Kevin Gosztola

Jeffrey Sterling’s Response

Mr. Gosztola, Thank you for your note and interest. I will try to answer your questions as best I can.

As of September 26, 2016, I am a few days into taking the beta blocker (metoprolol) that was prescribed. The symptoms I have complained of since June 21, 2016 continue though not as frequent and not as intense. It is so difficult describing the feeling I have during the times my heart does flutter/palpitate, but imagine feeling a sudden very hard heartbeat with a sort of pause that emulates your entire body, breathing, moving, etc. being suddenly halted. There is also an at times sharp pain within my chest at the heart. Add in lightheadedness and shortness of breath in with those events and that’s what it feels like. Some days, the events are continual and it feels like at any moment my heart is just going to stop. In addition, I’m not sure whether it is from the medication or to do with my overall health (not to mention the stress of attempting to obtain help from FCI Englewood), but my energy level is quite low.

Of course, I certainly believe that FCI Englewood should take this situation seriously, this is a very scary situation for me. As I have stated time and again to the medical staff here, the episode of atrial fibrillation I experienced some years ago was serious enough for me to be hospitalized for 4 days and what I felt then is what I’m feeling now. Unfortunately, FCI Englewood has done everything but take what I have presented to them with regard to my health seriously. Certainly indicative of their dismissiveness has been the reaction at each and every instance I have gone to them for help. I cannot imagine any other setting where an individual presents medical professionals with heart related symptoms on repeated occasions and is continually dismissed.

There has been more effort to refute me than there has been to actually provide any care. For example, there’s the assertions about what took place on June 21, 2016. In no uncertain terms, medical at FCI Englewood responded to Holly’s concerns by stating in an email that I was being untruthful when I was told that day by the nurse who administered the EKG that there was a “blockage”. Instead of addressing my health concerns, FCI Englewood medical chose to tell my wife that I was making up the episode and what I was told. Over and over, medical here has claimed that there is no information in my records of a history of atrial fibrillation and that I at no time was scheduled for an EKG shortly after my arrival here. These claims are false.

What has been really troublesome is what happened on September 17, 2016. That day, I was experiencing chest pains and went to medical. I was in such distress, I was in tears waiting for the corrections officer to call up to medical to see if it was okay for me to be seen. Even then, I had to wait until I could be seen, because the medical staffer on duty was with someone else. The response to my complaining of chest pains was another EKG, a cursory exam and a review of my medical records. I was summarily dismissed to return to my housing unit after a mere discussion of my medical situation. It was at this encounter that I first heard of the elevated Troponin level. The blood for the test was drawn on July 27, 2016 (only after I had inquired about whether they said blood test were going to be performed on June 21, 2016). Prior to September 17, 2016, no one had said anything to me about an elevated Troponin level. And then, I learn from Holly, from a conversation she had with someone from the BOP Regional Office that not only was there no information about the Troponin level in the records, but also that there was no record of the September 17, 2016, visit to medical. It is as if the September 17, 2016, visit did not happen and that no one told me anything about an elevated Troponin level. Seems anything that has indicated a health problem that needed addressing has not been included in my records. The position of FCI Englewood with regard to medical situations clearly is, if it isn’t written down, it didn’t happen.

I was finally seen by a specialist on September 19, 2016. For the consult, I was handcuffed, with a waist chain and my ankles were shackled together. I was so restrained during the entire visit with the doctor. Salient or no, it was quite humiliating being paraded on the streets and through the medical facility. Not to mention the fact that even though I was completely restrained, I had to sign a statement promising not to go shopping while away from the prison. Be that as it may, if that is what I have to endure to receive help, then so be it. But, whether I have actually received help is debatable.

The September 19, 2016 doctor visit also calls into question the veracity of FCI Englewood’s concern for my health. The conversation Holly had with the BOP official was on September 21, 2016, so it is apparent that the medical records, if any provided to the doctor by FCI Englewood, were incomplete. Also, even though the doctor prescribed the beta blocker on September 19, 2016, I did not receive the medication until September 21, 2016. As I also understand from the conversation, the BOP is taking the position that I am fabricating everything, which is in line with the stance FCI Englewood has expressed to my wife Holly and via their non-action.

I think there has also been a bit of administrative positioning happening as well. At no point since the issues with my heart started have I actually seen the doctor at FCI Englewood; I have only been seen by PAs and maybe a nurse. And, not until September 20, 2016, was there any information, in the internal system inmates use for medical notices, that there was any notice from the doctor that he approved me to see an outside specialist. I had already visited the doctor on September 19, 2016.

You ask about the internal administrative procedures; there may be utility for such a process, but the delay and self-protective nature inherent in such a process is counter-intuitive and potentially deadly when it comes to issues of health. I have filed three complaints and the responses have been either denial or nonexistent. It has not been because of the administrative process that I have received any help from FCI Englewood. Only because of the efforts of my wonderful wife Holly and our supporters has anything happened in response to my repeated pleas for help. If anything, the administrative process has been used as a tool by FCI Englewood to do nothing.

The account by John Kiriakou is the norm. I have heard such stories while here at FCI Englewood as well. For instance, there was the word going around about an inmate who died in late August 2016. The prison rumor mill (or “inmate dot com” as it is referred) had it that the individual, “William”, succumbed to a heart attack. It was also posited that he had requested help during the attack, but was told he needed to wait until sick call, which was hours later, to be seen by anyone. He returned to his bunk an died. That someone indeed died was evident from the memorial service which was held in early September 2016. Naturally, I was somewhat skeptical about the death until I had a conversation with an inmate who was friends with William. William had been complaining to medical for weeks about chest discomfiture, but medical ignored his condition and told him to drink water. That struck me because that statement is exactly what medical has told me during my encounters with them. As such, it is difficult for me to dismiss the story of his death as mere rumor.

Truly, to FCI Englewood and the BOP, the life of an inmate is a cheap commodity. I am experiencing that attitude firsthand. All I can do is seek help from those who, if anything, have a responsibility and obligation to provide help. I have repeatedly sought out, if not begged for help. I have been left in the position of hoping that something more serious does not happen to me or that I have not developed any lasting damage.