Once I met Ralph Marcus in June 2024 at California Medical Facility, he was sitting in his wheelchair within the backyard, below the shade of a gazebo. This medium safety jail in Vacaville is dwelling to a 17-bed hospice unit, the one licensed hospice program for incarcerated individuals within the state.
Marcus appeared skinny, his grey hair coated by a sweat-stained ball cap. He wore blue fingerless wheelchair gloves on every of his arms and a black flip-flop on his proper foot. What remained of his left leg was coated by grey shorts.
On the time, Marcus had been incarcerated for 27 years. In 2022, he was identified with spindle cell sarcoma, a uncommon bone most cancers. After an harm, spindle cell manufacturing is usually a useful a part of the physique’s therapeutic course of. Nonetheless, as soon as the harm is healed, if spindle cells proceed to divide uncontrollably, a mass or tumor develops.
Marcus instructed me he spent months making an attempt to get medical employees to have a look at his swollen and swelling leg, submitting healthcare request kinds and talking on to nurses and medical doctors. He was dismissed and misdiagnosed, he alleged. In response to his complaints, they gave him compression socks.
Our final dialog occurred over the telephone, three months earlier than he died. By means of intense bouts of coughing, he knowledgeable me that his left lung had shut down and that the proper one would do the identical quickly. He instructed me he had organized to have all of his recordsdata despatched to me after his demise, which added as much as tons of of pages of information and notes regarding his case and his time in jail.
Beneath is a transcript of our final dialog, evenly edited for readability and chronology. Marcus died earlier than he may evaluation the ultimate draft.
In the course of the pandemic, after I was at Mule Creek State Jail, I injured my left shin. This was in late September 2021, and we couldn’t simply go to the clinic due to COVID. The nurse got here out and checked out my leg and stated, “It’s simply irritation. Don’t fear about it. It’ll be OK.” My complete left foot and toes have been swollen and purple.
I saved making an attempt to go to the jail clinic, however [the medical staff] wouldn’t do something about it. Just a few occasions, they didn’t even let me elevate my pant leg up. They saved saying that they’d ship me out to off-site medical to get it checked.
One of many issues I discovered [during this process] was you don’t have a doctor-patient relationship once you’re in jail. They rotate the medical doctors continually, making a relationship all however unimaginable.
Whereas I waited to see a health care provider, my complete leg swelled up — from my foot, up my ankle, my calf, my knee, all the way in which as much as my thigh.
In July 2022, I lastly received to see an off-site physician via telemedicine. On the jail clinic, an MRI was carried out on my leg.
On the finish of that August, I used to be transferred to Highland Hospital in Oakland. They examined me and did biopsies to find out if I had most cancers.
Later, medical doctors instructed me they have been very sorry to inform me that I had spindle cell sarcoma — and that it was not curable. They stated if I had gotten to them when it was in my foot, I might have been OK. It’s very aggressive, I keep in mind them saying. A uncommon type of most cancers.
‘The Subsequent Step to My Loss of life’
Once I first went to the hospital, the physician who examined me stated, “I’m going to wish you to come back again for surgical procedure.” However for an extended whereas, I didn’t return. I couldn’t comply with up with anybody.
I’d see a jail physician and inform them. One even requested, “Nicely, why didn’t you return?” And I stated, “I don’t know. I’m not alleged to be the one to rearrange that.” Then they might ship me again to the hospital, and it will begin another time. I’d be scheduled to exit to the hospital, however then I’d by no means really get to go.
One time, I received to the hospital, however the physician wasn’t there. Simply the assistants noticed me. Once I received again to the jail, all they noticed was that I went to the hospital. It appeared like a profitable go to.
Happily, it wasn’t all the time like that. All through this ordeal, I’ve been off-site 178 occasions.
Lucas Thornblade, from the College of California, San Francisco, was an excellent physician. He tried to save lots of my life by amputating my leg. Nevertheless it was the subsequent step to my demise.
Proper after they amputated, the officers escorting me again to the room have been form of teasing me. After they noticed [what was left of] my leg on the desk, they stated it was gross.
I stayed on the hospital for a short while, a few week. Then I used to be despatched to California Well being Care Facility in Stockton.
It’s been downhill ever since. Not lengthy after I received again to the medical facility, the medical doctors referred to as me again, they usually stated one thing to the impact of, “Marcus, we have to do a biopsy. … It appears prefer it’s potential among the cells received via.”
After which they did three biopsies on my stump. They got here again, and a health care provider [from U.C. San Francisco] stated, “Marcus, sadly, among the most cancers cells did get via, and you’re undoubtedly going to cross away very quickly.”
Very up entrance — I appreciated that.
The Finish
I’m calling you from the backyard. I can hardly sit down. I appear like a monster, like one other “Elephant Man.”
After the surgical procedure, they needed to provide me a bunch of codeine. However the codeine makes it the place you may’t use the bathroom, and it dries the within of your mouth so dangerous. The physician right here gave me this pear and instructed me to take a chunk out of it whereas I’m making an attempt to speak.
Dwelling with this…I can’t describe the way it feels proper now. Simply this morning, the spindle cell broke via into my abdomen. It woke me up, and it principally made a little bit little bit of a large number. I needed to clear it up. I knew it was going to occur in the end. It principally deforms you to the purpose of demise.
I keep in mind I used to be sitting out right here within the backyard when the physician got here out to go to. She noticed me and stated, “Marcus, you should discover one thing to do to get your thoughts off of this most cancers.”
So I began making a birdhouse. And I made it in a method that’s going to remain for an extended, very long time.
Carla Canning is Jail Journalism Challenge’s affiliate editor. Previous to PJP, she was a Tow viewers engagement fellow at The Marshall Challenge and labored on the Life Inside part. Carla holds a grasp’s diploma in engagement journalism from the Craig Newmark Graduate College of Journalism, the place she created an internet site information for individuals visiting family members incarcerated in New York State prisons.
A California Division of Corrections and Rehabilitation’s info officer said that, resulting from medical privateness legal guidelines, they may not disclose the small print of Marcus’ on- or off-site medical therapies. Additionally they said that California Correctional Well being Care Providers assigns each affected person a selected major care supplier. Though a affected person may very well be seen by completely different suppliers than the one assigned, all suppliers have entry to the identical notes of their information techniques.
In response to a query about Mule Creek State Jail’s clinic operations through the COVID-19 pandemic, they said that “there have been no statewide directives that prevented sufferers who weren’t quarantined or below isolation from visiting a clinic.”
