[Music] Hello, and welcome to another episode of Evolving Prisons with me, Kate and Carrie. If you want to listen to monthly bonus episodes, you can subscribe for only £3 per month by hitting the link in the show notes. Before we jump into today's episode, I'd be really grateful if you'd please rate the podcast on whatever platform you listen, as more ratings mean more people will discover the show. My guest today is Dr Amanda Brown. Dr Brown was a GP in the community for 20 years before government changes made her impulsively resigned. She went on to work as a doctor in prisons in England for 19 years, despite not knowing that doctors even worked in prison. She worked with young offenders, adult males and females, and foreign nationals. And she is also the author of the Prison Doctor book series. Dr Brown tells us what being a doctor in prison entails. She shares some of the heartbreaking stories that have stayed with her. And why working in prison has significantly shifted her values. I hope you find this conversation insightful. [Music] So, Amanda, thank you so much for coming on and chatting with me. You spent many years in the community working as a GP. And because of changes that were being made, you know, having to... the way our GP system changed, where you had to meet targets and things, I know that it no longer felt aligned for you, so you decided to leave. And you found yourself in the prison space. What were your thoughts or views of prison before you got that job? Was it something that you thought much about? I never ever thought about prisons or prisoners or the fact that doctors either worked in prisons. So it's not something that was part of my life, but it certainly became a huge part of my life. But no, before that, not part of my thought process. So tell me, how did that job come about for you and what were your thoughts when you became aware that doctors did, in fact, work in prison? Well, the job came about because I resigned from my practice after just under 20 years of being a GP in a nice little cosy, village practice. And then because of the government changes that I knew I was not going to be able to comply with, I resigned. But I loved my job as a GP, and I felt basically angry that I felt I could no longer continue doing the job I loved. And so I wrote an article that appeared on the front page of a GP magazine called Pulse. And in that article, I expressed my views quite unlike me, because I'm not normally very outspoken or anything, but I was really upset. But anyway, the article was on the front page, and as a result of that article, a doctor who was recruiting doctors to work in prisons, tracked me down, contacted me, phoned me up one day when I was sitting in my little surgery, feeling really very lost. And I got three weeks left before I was going to be out of work when I was. So this chap rang me up and said, would I like to work in a prison? And that thing called changed my life, and I'm ever grateful to the doctor that rang me that day, because it was the beginning of 19 years of the most wonderful time. And when he offered you that, what was your first thought? Was it an instant yes for you, or were you a bit hesitant because prison wasn't a space that you knew much about? It was a definite yes for me. I was excited. I thought, well, you know, that's wonderful. So, no, I didn't hesitate. I wasn't sure if I'd get the job because I had to be into you and everything. But no, I just thought it was a fabulous, quite exciting change. Yeah, it was lovely. And did your family feel the same when you told them that you were going for that job? Yeah, they, they've 100% supported me. I mean, two sons and a very mature husband thought it was great. So yeah, they were fine with it. Brilliant. So you get the job and tell us what was your first day like walking into the prison and starting? Again, very exciting. I was interested for the job, I think in the April, but I didn't actually start there until November because of prison clearance and all the groups you have to go through. But someone finally got to start this new job. I was very excited and it was, I can still remember parking up in the car park and walking up the slope into the gatehouse and giving my ID. And it was just so different. The environment, the great big walls and wire gates and all the rest involved wiry stuff rolling around in circles. So, no, yeah, I'm even more exciting when I got through the ID bit and a big glass panel door slid to one side and I walked through it and waited in the air, locked to go to the other side. Yeah, it was a, it was like, you know, first day at school. I bet. But more exciting, I suppose. And what was that? What was that first prison like? What kind of prisoners were you working with? First prisoners with young offenders of 15 to 18 year old boys, quite a small prison in Oxfordshire, a hunt to come in prison as it was then. Well, still called hunt to come, but it's not all the young offenders. So, yeah, so 15 to 18 year old boys and my sons were the same age at that time. So I was hoping that I'd have a vague understanding of teenage boys, if that's possible. So, yeah. And what was, what was it like working with them? Did you notice any common denominators with them? Kind of made you understand, like, I can see why you've fallen into this life of crime. I think mainly because, of course, most of these lands were quite damaged. Many, many of them have grown up in care and then sadly have been abused and were pretty angry with life or they've never known a proper stable loving family to support them or believe in them. It was that trend and also I found it quite surprising at how many of these boys who, again, you know, 15 to 18 year olds were already fathers and proud to be fathers and always trying to create. The families that they wanted. And did you find that the fact that they were fathers, did that make them motivated to turn their life around in your experience? Yes, they were proud to be fathers and they wanted to do better and they wanted to improve their lives. I didn't get into that depth of conversation with all of them, but that was a thing that I noticed. But it was, I think it was the fact that so many of them have never really known a proper stable loving family, just felt a bit lost and prisoners, said I hadn't. Yeah, yeah. And what did Addie look like for you as a GP in a prison then? Well, but then it was very straightforward for a GP clinic work because it was a small prison, so I wasn't on call for the whole prison as such, so I'd just basically do a GP surgery for very routine. GP type problems, but with young boys, it was sort of asthma and acne and fungal infections of their feet, usually. They're nothing major. If they had any genital urinary concerns, they could be seen in the special clinic for that there, but they refer to as the "dict doctors clinic". So it didn't have to deal with sexual health concerns as such. And they also, if they had any mental health issues, had a very, very good psychiatrist mental health team to help them. So my job was pretty low-key general medicine, very different from being a property, if you like, not a property, but a GP in a practice where you see all age ranges and, you know, multitude of diseases. So these boys were, it was relatively straightforward medicine. It was more of the, trying to relate to them and help them as best I could. And did you find that, I mean, maybe you find this as a GP, even out in the community, but did you find that they would lean on you a bit more than just further their physical health? Would they tell you about their problems and talk to you a lot more than your clients out in the community? It's not necessarily. I mean, there were certain boys that really did want to talk, a lot of them, some boys just grunt and walk off, you know, with your trousers hanging right down, pulling their underpants and all those bits. So they, not all of them wanted to chat and be friendly, but there was some, there was one lad, for example, in particular, and he got no family and he couldn't sleep and he was, so we ended up talking about writing poetry or something. And he made an excuse to come and see me, pretending he got something wrong with his feet or something, and instead he actually just wanted to show me the poems he'd written, because he wanted somebody, I suppose, to believe in him and care about him. So there were, there were a few that related to me like that, which was great. And did you find on the whole, throughout your whole prison career that prisoners would have a good relationship with you, because with prison officers, obviously they see both sides of the prisoner, they see them when they're angry and they see them when they're happy? For you being a bit more removed, were your relations with them mostly positive? Very much so, very positive. I've always realised that I was there to help them not judge them. I was sort of on their side, and so luckily that made the relationships very, very good on the whole. I mean, you know, some people would hate everybody perhaps, but generally I was on their side, so I had a very comfortable relationship with them, which I don't think I could have worked there if I hadn't to be honest. You know, I mean, I'm not just talking to the boys, you know, 19 years in prison, I think if you don't actually enjoy the people you're trying to help work with them, then it would be horrible, so that was lovely. Yeah, and as a doctor, you are there to help them. I mean, you've no doubt worked with all sorts of people who have committed all sorts of crime, but you are just there to help them, you're not there to judge them. And I know that you've said before in other podcasts that that wasn't your place, you didn't care what they've done, you weren't just there to do your job and help them. Definitely, and again, I just don't think you could work in an environment like that, and judge people so fortunately, and I do say fortunately it didn't, it somehow just disappeared when I was seeing that person, the background to their crime or whatever reason they were in prison. Thankfully, it just didn't, it wasn't there. Thank God. I mean, of course occasionally I was aware of what had gone, and there were a couple of occasions where I actually felt physically sick, because I was going to see somebody who knew what this person had done. But then when you actually, when I actually see them, that somehow goes away. Well, that's amazing. And would you see that the person you saw didn't seem like a person that would commit the type of crime that you knew they'd committed. Absolutely, really extraordinary. Yeah, you just see another human being, you think, no, that didn't happen, you couldn't have done it almost. It's very broad, very, very strange. So how long did you work in that prison for? I worked in that prison from 2004 until 2010, because the prison was due to clothes and reopens an adult category C prison, so it's going to be shut for six months. So that's what prompted me to try and find a job working in a women's groups. So for a while I was overlapping, I started my women's groups in November, I think it was 2009. And so I started working on those groups while I was still doing a few sessions at Hunter Cooper before it finally closed down for six months in, I think it was May or June 2010. So then I went on to women's groups from 2009 for seven years I was in women's groups. And then after women's groups having been told by very many officers in this group don't ever work with women, they'll be bitchy and manipulative and they'll eat you alive. I got offered a shift in H&P Bronze Field, which is a largest female prison in Europe, and I decided that was December 2015. I thought, hang on, can it be that bad? So I thought, I'll just give it a go, a couple of shifts, just as a local doctor, which is what you do, thinking, well, if it's really that bad, I'll only sign up for three shifts. But for the minute I started there I basically absolutely loved it and spent the last over seven years of my career before I retired working with women in Bronze Field, and that was really wonderful. Would you say working in Bronze Field was the highlight of your prison career? I think so really, because I really, again, compared with someone like women's groups, which was dramatic, exciting and 13, 1400 prisoners, that had its weirdly had its magic. I mean, it sounds odd to say that, but it was like, anyway, so that was great, working with women, which although it's the largest female prison in Europe, there's only about 500 prisons. You sort of get to know them a lot better, and because so many of those women were desperately deeply damaged, I just really felt for them. So it was a lovely sort of relationship there with the women. So I think in its way, it probably was the highlight. Yeah, so we'll go on and talk about Bronze Field, but first of all, with Scrubs, so you would have had different prisoners coming in and out of Scrubs all the time, because it's a local prison, right? Where people can come in on romance and then there are people are coming in going all the time, is that right? Oh, yeah, absolutely. Busy, busy prison, Ramon Prison, yes, they're there for however long and then move on to all the term prisons, but so yeah, very, very busy turnover. And so reception and working reception in the evening and the first night centre was kept you busy. So how did your work look there then at Scrubs? So what different jobs might a doctor be doing in Wyrmard Scrubs? So there were lots of doctors working there at different days, at different times. Some doctors chose to sign up to do GP clinics on the wing, so every wing had a GP clinic two or three times a week, specifically for prisons on that wing. Or you could sign up to be duty doctor, which is what I tended to do, because it was a bit more exciting and that duty doctor meant seeing patients that arrived the night before, first off in the morning, first night centre, seeing anybody who'd arrived the night before, hadn't been seen by a doctor, then go around the segregation unit to see everybody in the safe, who had to be visited every day. Well, not then, I mean, at any time there might be a code blue cord over the radio to go to an emergency in the prison. So it was very varied, a very, very big prison. I mean, the most difficult bit to start with was finding my way around the prison and then start to see patients coming into prison in the afternoon evening in the reception area. So it was on a working day when I was duty doctor, started at 9am, finished at 10pm, so it was a long, long day. But I used to miss the traffic I set off very early. I used to get there about 7 o'clock in the morning, and then I'd have a little sleep in my sleeping bag before starting work at 9. Then I'd have another little kid with a lunch every morning sleeping bag to try and get every three of the day, because, you know, I'm getting old, you know, I've needed to have my little power nuts. But it was a long, long day, but it was the most challenging thing, I think, was walking past the cells at the end of the day, past bewing. You had to walk past all the cells at night to get to the gatehouse, and sometimes prisons would call out "night dog" and all that, which was really nice. But there was a risk that prisons were known to sometimes throw things at anybody walking past, so they might throw their meal or oranges or anything they could to try and hit somebody. So I, you know, tended to keep my head down and walk quite fast to get out. Were you ever hit with anything, or were you lucky to miss it? No, I was lucky, I never got hit. I did have somebody call out some horrible, I'd probably shouldn't send on the podcast where you can edit it out, but basically after a long, long day, this bloke called out the window and said, "Pit all poem you'll hopefully get run over by a bus on the way home." I'm sure you can edit it out the nasty word, but now I think about it was actually quite funny, but at the time, when you're tired, you had a long day. But that's what happens. Especially when you're just trying to help people. You know, as a doctor, you're just there trying to help. Yeah, but funnily enough, the next day, I knew the seller had come from somebody in a second. He was a murderer, waiting to be transferred to a category A prison. And I sort of said, I think I pretty much knew it was him and I said, "Well, that wasn't very nice to me." I don't think he quite realized who he was calling out to, and he felt pretty ashamed. Okay, interesting. So you mentioned about getting called to code blues. So working as a GP in the community would be very different. I imagine than in prison because when somebody is involved in a traumatic incident in the community and they're really badly hurt, the GP isn't where they go. They'll go to A&E and it'll be any doctors and nurses that deal with them. But in prison, you are seeing all of those traumatic events. How did it impact you going from being a doctor for so long that didn't deal with that to them being the doctor that did have to see things like that? Well, yeah, I wouldn't say scary, but quite shocking. To suddenly be on the front line seeing somebody, I mean particularly, I say the most ghastly, awful thing I've ever ever seen was this beautiful young man who slit his throat. I will never forget, I have never seen so much blood splattered around this obviously very tiny cell, but that was very, very shocking. But it's again, it's funny how you revert back to, even back to the old days when I was working in A&E and hospitals and everything else. You just kick into the right sort of mode and get on with it. But it was pretty, yeah, it was pretty dramatic at times, all going to see somebody that was, "Thank God, I never actually arrived to find somebody actually hanging." There was always that fear of, you know, when a cold blue is cold, what nurse are you going to find? I mean, I think one of the saddest things I'll never forget is this, as a young man who had arrived late, very late at night, straight from hospital, fallen out of balcony and fractured his legs so badly, they were both amputated literally from his hip. So he arrived in prison, 30-year-old man speaking no English with no legs, and I absolutely, absolutely broke my heart. It just makes me appreciate things more than I liked you otherwise. Yeah, and how has working in prison changed your view of the world? Well, not necessarily changed my view of the world. It's probably made me less tolerant of people that value things that I don't think are worthy of value, like the flash car or the posh-ham-bat-angle, though nonsense that people care about. I certainly say nonsense, that's wrong, that's bad. I mean, just as visits change my values to some extent, and I appreciate that you don't, you know, just having a roof over my head and enough food and enough money is fabulous. But I don't yearn for the stuff that maybe when I was younger I would have yearn for. Yeah, I've read in research before where prison officers talk about the fact that they feel like they can't really relate to people that they used to relate to because they're talking about trivial masters while prison officers are thinking, I've seen somebody take their own life today or I've seen horrific things. We just don't live in the same world anymore. And I read that you'd said something similar about how you, you're just no longer related to some people's way of thinking because of everything you'd seen. 100%, absolutely 100%. I've never, deep down I suppose, have never been particularly sociable, you know, but I, there was, you know, people with kind of friendly invite us to parties and that sort of thing, but they reached a time when I just thought I just can't face. I just can't relate to these people anymore because exactly as you've just said, the value is it's also trivial and stupid when I've seen the sort of things I've seen and I've heard stories that have broken my heart and they're talking of very superficial things. And also, I don't mean to be on kind or rude, but I've got, I just thought I just can't be doing with this and try if at all possible to avoid actually going to do is like that, which I managed to do quite successfully. Yeah, and how do you cope yourself with it because in that job working in a prison or in any kind of emergency service area, you do, you take on a lot. You, Amanda, are clearly a very compassionate person. How do you cope with everything that you see and manage to not take on as your own burden? Um, it's a strangely difficult question to answer that one. I am, I think almost at times painfully compassionate. You know, I can cry anything, you know, I think the only way is firstly, thank God, my husband's hardly died, but before, you know, I'd come home to a very loving husband, a huge support from family. I have a faith. I'm quite spiritual. I would go on my long walks, which I still do as a sort of therapy. And when I'm walking, I sort of say my prayers. I clear my head. I think of what I've been dealing with and I try and I literally pray for inner peace and strength, actually, and hope somehow to contribute a little bit to other people's lives. Which makes me feel worthwhile, I suppose, or dead because I'm retired now. Well, you're still adding a lot of value because I've read your books and your books are incredible. I said this to you before to have you on the podcast is such a privilege for me because I remember reading your first book very quickly after it came out and just thinking this woman is incredible. So, if I knew then that I would have the opportunity to talk to you, I wouldn't believe it. So, thank you for being here, but also you are adding so much value to people's lives. It's very, that's so sweet thing and thanks you. Thank you for that. So, what would you say when you were at the scrubs before you moved on? What do you think, is there anything that sticks out for you as being really beautiful experiences that you had with some of the prisoners in your work? Yes, I think one of the most truly beautiful experiences, I think it's in the book, but basically I met a very angry young man late one night, first night center, the sort of person who's a person who's quite intimidating, who's angry, didn't want to engage, staring at his feet, and I tried to get into engage by asking him about his family and he talked about he got a daughter and a partner and something other anyway, turned out that he grew up in care and his mother had been trying to get in touch with him. And I said, "Oh, that's wonderful. Hopefully you're going to meet your mum." And he said, "No, no," he said, "I can't face being rejected again." And I was tired, it was late, and as a mother, the thought of that mother out there somewhere trying to find her son just got to me. And this young angry young man could see that I was upset because, I mean, I was literally tears, my eyes, I was just welling up. And he went from this angry person to, he just stood up and hugged me, which was not allowed in prisons, but it was the most beautiful hug, and off he went, and that was that. And then weeks later, I saw him, well, he saw me walk through his wing and he was on the top landing and he came flying down the metal stairs, calling out Dr. Brown, Dr. Brown, and a completely different demeanor. And he said, "I've been in touch with my mum and we're a family again, and to the day I die, that's probably one of the most beautiful things that, because he saw how a mother might be needing him back." Oh, it's lovely. I mean, again, even all these years later, it can make me cry. Oh, it's beautiful. Yeah. So you also worked with foreign nationals, and as you say, there would be some prisoners who couldn't speak English. That must be a very scary experience being in prison and not being able to speak the language. How would that work for you treating them? How would you communicate with foreign national prisoners who couldn't speak English? Well, with huge difficulty, because we had to use language line, translation line, which in itself was very time consuming, quite frustrating at times. Sometimes it couldn't find a translator. You'd be waiting on the line with this person. We're sort of sitting, looking at each other, unable to communicate. So I did become quite good at miming, and it's sort of trying to act out to almost just try and start communicating. But eventually, as and when, if ever, hopefully we got the translator, it was obviously a three-way, four-way conversation almost. Very time consuming, and actually quite frustrating, because some of the times I wondered if they were translating properly, you know? And actually, I think of all the prisons, the foreign national prison was probably the most... I felt probably the most difficult because of that, and because these prisons mostly were waiting to be deported back to countries that they probably never even could speak the language from. So they were very, very stressed, and I couldn't change that for them. I didn't have the magic wand to really help them, which was hard, really hard. Yeah, and did you in prison suffer with the same issues as GPs on the outside where it did become? You only had a very short amount of time to deal with your patients, and you couldn't give them all the time and patients that you wanted? Was it the same in prison, or did you have a bit more autonomy over how much time you took? I mean, strangely, yes, on the whole, I did have more time with them, actually, which was wonderful. Yeah, thank goodness. I mean, they were, some of them were very, very complicated, could possibly rattle through it every 10 minutes. I actually don't know how GPs do it, to be honest, because I was pretty small when I was a GP, but in prison somehow the time wasn't such a problem, actually, which was great. So when did you start working in the foreign national prison? It was all slightly overlapping, because when I was working in the scrubs, I'd heard that the Hunter King Prison, which is where I worked before, one of the nurses, it was quite complicated reason. But anyway, one of the nurses that was still working at Hunter King suggested maybe they'd get in touch with me to go and do some sessions there. So I started working back at the foreign national prison 2013. I think it was slightly overlapping with still working at one of the scrubs, so as a local, you can do two or three days to one of the scrubs, a couple of days for a national prison. And I'd also started doing some shifts at Bronzefield. So I had a foot in all of the prisons at one time, doing a bit here and a bit there. And then eventually, after seven years in the scrubs, I realised that I had to leave the scrubs, because Spice was just a nightmare. And then I got more and more shifts coming up in Bronzefield, so I ended up full-time in Bronzefield after three years in foreign national prison. So it was all a little bit overlapping each other at the time. I almost forgot myself now. What was your experience of Spice? Because as you said, it was becoming over a run in the scrubs, and it can have really detrimental impacts on people. What were some of the experiences you had with prisoners on Spice? I absolutely hated it. It would range, literally, could make somebody just a bit silly and giggly to becoming completely psychotic. It was really, really scary. Or they could have seizures, you know, anything. I mean, it was complete random. And I think it depended on what was mixed in with the Spice, the strength of the Spice, because it's synthetic. And apparently, rat poison was put in. It is all sorts of stuff. So being a bit giggly and silly was one thing, but becoming completely psychotic, wild and dangerous. And that could last for days sometimes. But the worst thing for me as a doctor was that I couldn't help them. So somebody was having a fit because of Spice. They had the fit that they might go to hospital, but I couldn't do anything about it. An awful thing as a prison doctor. If anybody dies in custody, there's a coroner's court. And that is the most unpleasant, horrible experience imaginable for someone like me. Because it was usually 80 months later, you had to appear in court. And I just can't go through that again to sit in a coroner's court. You know, if somebody dies of Spice while I'm on duty, I will be almost the one to blame. And I just, I can't do that anymore. So that's why I left scrubs in the end, because there was almost like an epidemic. There was so much Spice getting in at that time. And I saw one young man on the ceiling where everyone was. He looked so sick and ill. It had a fitted, you spice. And apparently, some of the guys that were in charge of all this tried to brand out on somebody that was vulnerable, like this young man was. And it made me so upset. I just, I just, I just can't deal with this. So it wasn't, you know, I could deal with murderers and all the rest of it. But the spice is what finally finished me off. The drugs hate what they do to people. Absolutely. They're terrible. And with Spice, it can have secondary impacts on other people as well. But did a prisoner die while you worked at scrubs from Spice? No, thank God. It was just an accident waiting to happen. And I, and it, I was really upset because it was, I've said it before, but working this crows was had its weird magic. But I think it was because of the camaraderie with the prison officers. I knew the prisoners, you know, I'd see them walking around on free flow and they'd shake my hand or hide dog or whatever. And it was just a great place to be part of. So it was very, very sad. I was really sad to leave it, but I knew, I knew sooner or later, I could, I just can't deal with that stress again of going to coroner's court. Did you have to go to coroner's court while you worked at the scrubs? Yes, I think there were two occasions, and luckily at least the scrubs had a fantastic legal team behind them. So, so I felt supported. But yeah, there was the two occasions that I had to go to coroner's court, both of which horribly, horribly, horribly stressful, partly as well. Because I'm very shy, you know, just to, I felt like I really had murdered somebody, it was horrible. I was made to feel that almost, you know, you've really given a grilling. Somebody I might have only seen for about five minutes, you know, it wasn't as if, and it's a big prison. So, yeah, it was horrible. Yeah, I bet. And when you go to work with women, were you apprehensive because of, because of what people had told you about female prisoners? I was apprehensive, yes, because I say for 11 years or something, I was offered, I mean, all the way shut by then. But I'd been off for shifts in Holloway, and people don't go anywhere near women. So yeah, I was apprehensive. And it was weird the first day, it was just so odd seeing women in prison. But I, I mean, literally from the first day, I loved it because I've said many times that the stories behind the reasons the women were in prison never ever stopped shopping. Because 86% I think statistically are victims themselves of abusive relationships, controlling, you know, so these women mostly were very, very damaged. And their stories were utterly shocking, horrible. So yeah, and I loved working with them. Is there any story that sticks out for you that a prisoner that you really remember having a really sad story? Oh, gosh, there were so many, there really were so many. It's hard to always pick one out over another, but a lot of it related to cause horrible childhoods. I mean, one woman told me she was injected by heroin by her own mother at the age of about 12 to set her up for prostitution, for example. So your own mother injects you as heroin to make your daughter a prostitute and then become heroin dependent. And that sort of story was not unusual. Another poor woman had been abused so badly sexually by her father at the age of four, she had her surgery to repair. And of course it affects their upbringing, they don't often attend school, they're illiterate. They have to become maybe sex workers, depend on drugs, become homeless, get into prison, and prison in a way becomes their refuge. And if I could change anything, I think it would be the fact that instead of prison being a refuge for women in such a situation, there should be refuges for women. There should be anywhere. I mean, although prison is a safe place for them, one woman said it was the first time in seven years she felt safe and bed at night because she was away from the man that was abusing her. So prison is not seen necessarily as a punishment, it's a refuge, but surely there could be better ways of rehabilitating and safeguarding women. You said something on another podcast, I didn't know about this and it's really changed my outlook. You said that if you see women sleeping during the day on the street, it's likely that they're homeless and they're too scared to go to sleep at night. And that's heartbreaking, and I had no idea about that, so you really opened my eyes to that when you shared that. Well, yes, and it opened my eyes too when women told me often they'd sleep during the day in a public lavatory, or sleep during the day. I mean, I just remember one using that, it was a public lavatory, sheep sleeping, and yes, so that they could keep awake at night, so they wouldn't get raped at night, absolutely shocking. And another woman told me that she used a supermarket's lavatory so that she could wash her hair in the sink and try and have some sort of self respect and stay clean, so she'd use someone like that to wash. So I think 65% when I was working out of women in prison were released to homelessness, but quite the extent of homelessness amongst women, I don't know. But to imagine being too scared to sleep at night before being raped, and that was very, very real and very genuine. So yes, they'd sleep in the daytime. And I don't often go to London now, but when I saw a woman sleeping in a bag, sleeping bag on the streets, I thought, "Well, I know why you're asleep now. How can you sleep in a noisy road, but woman?" Really hard to see. And I honestly think, I mean, I'm coming at 70 years of age, but I don't think I've ever appreciated more the fact that I have a bed to sleep in and I'm safe at night since working with these four souls. But it's nice, Kagan, that maybe it's made you aware of that. We take these things for granted, don't we, that we have a safe shelter? We forget how lucky we are. Oh, absolutely, yes. So again, back to my values changing, I just appreciate so many things that I took for granted before. And how would your work look then in bronze fields, because it was much smaller than the scrubs? Mainly GP clinics, so prisons were put in an application to see the doctor for whatever reason, so it would be running a clinic. On a Tuesday, I worked all day with a substance misuse prisoners who was on the block where anybody addicted to drug cell call, et cetera, would be admitted to that particular wing. So I'd work with them on a Tuesday, helping them to detox through heroin and stabilise on methadone, detox my alcohol, et cetera. So I worked with the drug users and in the afternoon evening, working reception, seeing new prisoners arriving. So it was quite nice mix and Sunday morning was just a routine GP clinic, for example. And was it easy for our patients to see the GP, because I heard people say that in prison, it can be difficult depending what prison you're in to get a doctor's appointment? How was it for you and your prisoners were prisoners able to see a doctor easily enough? I think as far as I'm aware, I mean, I wasn't. Generally, I think they managed to get appointments if they needed them, because yes, it was a smaller prison and I didn't get the feedback that it was that difficult. And again, being a small prisoner, I worked there a long time. A lot of the prisons I've really got to learn quite well anyway, which helps. Because I think it's really nice when you've seen somebody that you've already got an idea about them, which was definitely a plus for working there. And again, back in reception, I'd see them come in time and time again, like meeting old friends. And that must be hard for you, because as you say, prison isn't supposed to be a safe haven for people. It's not supposed to be a place people want to go to. But in your experience, they want to go there because it's the place they feel safe. It must be very difficult for us to get out of that cycle of offending in their experience, and you're seeing them coming time and time again. And it must be quite disheartening when you think, how do they get out of this cycle of offending when prison is the safest place for them? It's really, really, really sad. And absolutely for sure, some women would tell me that they tried to get arrested so that they could come back to prison. Some told me they wanted a longer sentence because they knew that when they were released they'd be back to homelessness again. So who do you want to be released to homelessness? And of course, homelessness, very often again, they tell me that they'd go into a crack house to get shelter, but to get into the crack house they had had drugs, so they'd be back on drugs again. And this cycle of homelessness and drugs, crime, prison, just goes round and round and round. And it's awful to say it, but it's their way of life. And that's why I think I desperately wish it could change. And I am very naive about politics, but I was delighted to hear that Mr. Timson has been made prisons men's tour. You know, somebody that actually understands prisons and why people end up in prison and that, again, he's referring back to women, but there should be somewhere else that women could be rehabilitated. I actually got evil Christians in prisons. I think I think Bronzefield is a very good job. You know, they're given training and so they're all enough as they need to be. But way, way back, I was told it was 65,000 a year to have a prisoner in Bronzefield. It's probably a lot more than that now. But that money could be spent, I think, in such a better way. Yeah, absolutely. Dame Angelini wrote and she did an inquiry into women in prison and some of her recommendations were that women shouldn't be in prison and we should be housing them in community type housing instead. And Scotland started out where they have community custody units for women. So I went to visit one last year and it was really refreshing and gave me hope because they're houses. They're beautiful looking houses in the middle of a residential street and the women have their own bedroom and their own ensuite bathroom and a shared kitchen and living room where they cook meals. And they have links with the community to try and get them out and about and get them linked to the community. And if it works, it's early days. But if it works, I really hope that it is a change in the right direction for how we incarcerate people. Honestly, it would be wonderful. I mean, utterly wonderful. It cannot be right that's going on at the moment. And I said, "I'm not pointing your finger particularly at anything, but surely things should be better than they are at the moment." And when you treated women, did you find that a lot of them would they come to you for a different problem than the men would or was it quite similar, similar things you were seeing each day? I suppose medicine is always going to have similarities. You know, if somebody's got diabetes or asthma or whatever, but women, I suppose they had more obvious mental health issues and post traumatic stress disorder, et cetera, et cetera. And although I was not a psychiatrist and they had a very good psychiatric team in Bronsfield, I suppose there were more emotional problems. But medically, you know, medicine doesn't change, so you just see whatever walks through the door that day. But it often would lead to talking about something else and strange things really. And would you deal with a lot of, did you have a lot of court blues in Bronsfield, or did you have more of that in the male estate? Much more in the male estate, much more because there was a huge amount of violence in women's groups between the prisoners. You know, sometimes they attacked the prison officers, so it was much more drawn or an anger and violence in the scopes. I mean, some of the women would have a kick off against each other, but no, definitely more in the male prison. And when you'd go home at night, would you be able to speak to your family about what you'd seen each day? If I wanted to, but sometimes it was, you know, I didn't necessarily need to and I don't want to bore people, but yeah, I mean, my poor old husband had his fair share of listening to what I'd seen that day. And sometimes it's as they say, it's good to talk and share it and get it off your chest and all the rest of it, but there were times when I just didn't need to do that. And would you find though that their stories would stay with you? I mean, here you are years later and they've stayed with you, but was that difficult to have all of these people's stories in your head? But your family and friends not know anything about it or understand the things that you're dealing with? It wasn't hard, I just, it was part of my life I suppose, and in a weird sort of way, I actually felt very privileged that people would share their stories with me. But no, it's funny how you just put it all away in the locker and when I, I mean, extraordinary, I did find that trying to write the books, it was amazing how much was in there. You know, I couldn't believe how much was in my head still, but once I started it, the stories came back to me and it was nice, you know, and although I didn't particularly enjoy the book thing, now I've retired and they're written and they're out there. I'm actually quite pleased that I wrote them and the women, particularly the women loved while I was, I was only working in bronze for them, but they were so pleased that somebody was telling their story was, they were so happy about it. And there was one very lovely woman, chapter 10 in the second book, who I will never ever forget. What a life she had and what a sad life, but what a wonderful person she, she is, was, is. She was in her, I think early 30s when I met her, she'd been in prison since the age of 20 years, or an IPP sentence, which I don't know how much people understand about IPP sentences, but I never even heard of them before I met this girl. And so she was on an indefinite sentence and could never really get out of this prison system for basically she was a heroin addict after an incredibly abusive childhood homeless on drugs. She robbed a lady of her handbag for money for the drugs and threatened her with a syringe and saying she got hepatitis or something so there was this, that made the sentence more for anyway so she was an IPP sentence for robbing somebody and threatening them with a syringe. And she said, I would never have used this syringe and there was nothing in it, you know, tell me I would never have used that needle, but it was a fear that it instilled in the victim that made the judge decide that this woman is to serve an IPP sentence. She'd been in prison I think 17 years by the time I met her, and I have never seen such terrible self harm scars she pulled up her jumper to show me the lacerations across her abdomen where she'd and down her legs where she's self harm. She tried to commit suicide at the age of seven I think it was, but she was such an incredibly articulate, intelligent woman who'd had no chance in life ever really because abusive childhood homeless in his drugs. It's prison IPP sentence which in itself, I mean, a member of prison officer saying to me about another IP prisoner is that he said we've created a monster because this person, there's no hope they always feel what's the point. I'll never get out because system is so difficult, and many IPP prisons apparently have committed suicide so it's a horrible, horrible, horrible thing. And she knocked on my door and it was unusual because normally if somebody would knock on my door at the end of the clinic, it'd be a thumping knock, you know, quite, quite a shock. But there was this gentle attack on my door at the end of a rather long day in Bronzefield, and this sweet little person was standing there very politely said could she have a word with me. And I knew I shouldn't really have left her in because it was time to go home, but I did, and her story just broke my heart she just she just shared all this story with me. And I instantly had so much admiration for her, and we just became, I became very sort of close with her. And I remember walking through the waiting room once going into the clinic and she was sitting in the waiting room with other prisoners and I'm getting quite shy walking through with knowing people are looking at me walking through them. And this girl called out to me, you know, morning Dr Brown, and she said to the other prisoners she said I've got so much love for that woman. And that just broke my heart, but I, you know, to the day I die once again her and I love her I've lost touch with her of course but I love her. You were a doctor in prison, but you're much more than there to solely treat health, you know, from your books and from just talking to you here. You build relationships and these people's stories stick with you, you're not just there to help them with their health, you're there for so much more, you're a much bigger figure in their life and they're a much bigger figure in your life than just being there to help them with their elements. But that was honestly incredible privilege and very fulfilling for me so selfish because I got probably more out of it than they did and I still do, you know, and I still, I won't forget them and I'm very, I feel very incredibly grateful for the job that I was allowed to do. This is maybe a difficult question. What was the most rewarding thing about working in prison for you? I suppose if somebody managed to kick a 20 year heroin addiction in prison, that was probably, well, it wasn't probably, it was incredibly rewarding, not all that common, but it happened. And one woman that I met, she'd been, I think she was early 40s, this is going back a long time, but she was early 40s, she'd been on a heroin for at least 20 years, and it was the first time in prison actually, which is unusual because often drugs cause of current prison But so first time in prison and she was in for long enough to just get off heroin and she was determined, I mean determined to do it, it was wonderful and it took a long time, but she got off heroin. She was transformed by the time she left prison from a scraggly bedraggled thing, almost looking like a little old lady, and there she was leaving prison, looking beautiful and healthy and positive and fabulous. And as a doctor then, would you be involved in them trying to come off of drugs or was that a specialist team that would do that? No, that was part of my job and that's how I got to know her so well because I've done a special, you have to do a qualification in substance misuse to be able to work with prisoners or anybody coming off drugs. So fortunately I did that certificate in 2011, and so I was, that was the job I was doing, and so I got to know I saw her on a regular basis and did whatever I could to support her get her through it, get her off. So I, yes, so I saw her a lot, so that was the job I was doing for her, and so that was lovely, really lovely. I think the saddest thing for me is that I can't ever keep in touch with them and know how they are now, but that's part of working in a prison space. Yeah, I can imagine because these people become such a big part of your life. It's interesting, last night I was reading an article about doctors who work with people with alcohol addiction. In the article some of the doctors said it's a very difficult job because you see people relapse, you see them relapse and sometimes you just feel completely hopeless and that you're really not making a difference. Did you find that working with people who had substance addictions? Was it quite difficult for you sometimes because it's not like people are addicted and then all of a sudden they're not, they relapse and they can relapse time and time again. How did you deal with that? Well, they're very, very disappointing and frustrating, but it was what happened. So again, you just have to do what you can at the time, but really, really frustrating, which I think is why when somebody really wants to get off drugs and they do. That's the, in a way, the exception. But of course, again, I forget the percentage, but a lot of women, for example, are only in prison for less than three weeks. They've got no time at all to rehabilitate or get off drugs. If anything, you've got to make sure they're on enough medication so they don't overdose when they get out of prison and kill themselves. So really disappointing and of course, sitting back in reception, I'd see the same women come back time and time again, but so often that related to their homelessness. I mean, how do you, I can't imagine. I just cannot imagine being homeless. God forbid, I'd probably be on drugs. So it didn't surprise me because if their lifestyle, if they were going out to nothing and no one, they will be back on drugs again because they would say to me, it would just brought out the memories. It was like a war blanket being wrapped around them when they were on drugs. They could forget all the trauma. So who am I to criticize? I just, but it certainly opened my eyes to things I had no idea existed before I worked in a place. And what made you write your books then? How did that come about? It happened because a friend of my son, who I'd never met before, rather long story short, is a ghost writer. And when I met this girl for the first time, and she said, "What do you do?" because I've just got that late, a very late shift in Bronzfield and I was tired and I was not particularly in the mood to chat to a complete stranger, but she come to stay for the weekend. Anyway, so I told her what I did and I said at times it's really sad, but there are times when it's wonderful and that particular day I'd been given a letter by a prisoner thanking me for helping her, which was just beautiful. And I showed the letter to this girl, who turned out to be the ghost writer, and I said, "But when you, a day like today and I get a letter like this, it makes it all feel worthwhile." So she heard what I did. She read the letter, and she sort of said, "Wow, you should write a book." And I thought, "Don't be daft, I can't write a page at the end book." But anyway, so she decided that it would be a book that should be written, so it was through her introducing me to her literary agent, who introduced me to some publishers, and in the end HarperCollins decided to give it a go, not thinking for a minute. I honestly thought I counted up about nine people might buy the book, you know, my sister, my best friend, so I was a bonkers surprise when it actually got published, and it did what it did. So it was one of those things in life, and I know at the time when the literary agent or whoever it was said, "Are you going to do this or not?" And I remember thinking, "I just don't think I can do it." But my son, one of my older boys, has always sort of teasing me, saying, "Oh, don't be a coward, Mom, go on and do it, da, da, da." And it was my older boy, Rob, who said, "Oh, go on, Mom, give it a go." And I thought, "But once I had committed to it, there was no turning back." And I did find the process quite challenging, because I am shy, and I felt embarrassed in a way about the book's strange thing to say, but it's a bit like exposing yourself, I suppose. So I was really, really nervous about the whole thing, and then back to the shyness, you know, having to do interviews and stuff. It's not where I'm comfortable with. And I think on a woman's hour into your house, I think I said it was more scary being... I'd rather be in prison than on the radio. I heard that. I listened to that interview. It's funny, because reading your first book, obviously, that's where you build a perception and a picture of somebody from the first moments with them, I guess. And it was in your first book that I got this perception of you where I thought, "Wow, she is a powerhouse woman. She is a role model. She is a strong, confident woman." And then when I spoke to you and you said, "No, I'm terribly shy. I'm not like that at all." It's so interesting, because to me, I think the way you write and the things you've dealt with and working in prison for a start, I think, "Wow, you have to be this confident, very outgoing person to do that." But your testament to the fact that you can do all these things, but actually, inside, still feel shy. Absolutely. And I deep down, I've never, literally never really ever believed in myself. So, yeah, it's just weird, isn't it? How the perception from a book is that I'm this confident, outgoing powerhouse and actually I'm quite, quite shy and I don't have a lot of confidence. But you are still a powerhouse. I mean, everything that you've done and, yeah, incredible. It takes an incredible amount of courage to do something that you don't think you're good enough to do. You know, you, with the book, thinking, "Oh, no, I can't do this." And then you went on and wrote three incredible books. I think that is a testament to your character. So, I have three questions from my listeners. One person has asked, "What medical support is available for prisoners with extra needs, for example, physical disabilities?" From my experience, not a great deal. I mean, for example, the poor man that arrived late at night with both legs amputated, still in bandages, straight from hospital, to actually find him a cell that could accommodate a wheelchair, et cetera, et cetera, was really, really difficult. I mean, we found him somewhere in the end. It was I didn't. But the governor in charge found him a cell. But it wasn't easy. I mean, they had disabled themselves, but there were times when they weren't enough, maybe. And I know in bronzefield, when there was a lady who is really very unwell, somebody came in from outside from a patient therapist. Yeah, sorry. So sometimes we'd have people come in from outside to accommodate somebody's physical needs if necessary. And bronzefield was better than was gross, because obviously it's a modern prisoner. They had bigger cells for people with disabilities, but gross being ancient old prison with Chinese. So it's different prisons probably have different facilities, but my experience wasn't great on that one, particularly with this poor man trying to find him a cell. Oh, it was so horrid. And his prison experience must have been very difficult, because prison isn't designed for people like that, unfortunately. Well, I mean, this is saying for a young man, never been in prison for, didn't speak English, and it just had both his legs amputated. I cannot imagine that will stay with me probably to the day I die in the memory of that, but I can still see it now. And I see literally when he left, when he finally got wheeled away from me, I just put my head in my hands and sought and sought. I was tired, but I just couldn't believe what that man was going through. How do you cope with that? Yeah, I have no idea. Okay, the next one is, do prison health care also treat injured staff, or do you only treat prisoners? Only prisoners were not allowed to treat injured staff, which I found very surprising, because there was only once on a Sunday, a prison officer had been badly assaulted, and he was blood everywhere, and I was asked to see him. In theory, I wasn't meant to. So I'm not meant to treat prison and staff. And nor do we look after the babies in Bronzefield, the children in Bronzefield, we weren't, we only look after the prisoners. Okay, and why is that? Why is that that you don't look after the prison officers or the babies in Bronzefield? I genuinely don't know. I remember seeing this officer, he was, he, you know, blood everywhere, he was in a really bad way. I was so upset for him, and I said, this, you know, this is what should be in the papers, you know, this is things happen. And they said, no, it's not allowed or something like that, but I never ever understood why I wasn't, why we didn't. So would you also not see pregnant mothers in Bronzefield as well then? I'd say them if they had medical illness, but they were looked after by an outside team, so they'd have obstetricians midwives coming into the call for their pregnancy. So again, completely different. So we didn't, we didn't look after the pregnancy side, only if they had any other medical issues. For the staff, that must have been really difficult for you seeing prison officers who were really hurt, and knowing that you'd probably very naturally want to help them, it's your duty and knowing that you couldn't, that must have been difficult. Yes, I mean, didn't happen that often, but it was, I was very surprised that I wasn't, you know, they would go to a local A&E, I presume, whereas of course the prisons couldn't go to A&E, well, they could, but, you know, it was much more difficult to get a prisoner to hospital than it was for an officer, so I suppose maybe that's the reason. Yeah, where prisoners engaged in self harm, would it be you that they'd come to see for a treatment? Yes, I mean, often I'd see them, I mean, it's, I mean, it was one girl who regularly swallowed, and it was all plastic cut in prison, but she would swallow regularly, swallow cutlery, I mean, I can't even imagine how you could swallow a spoon or a fork or a knife, but, you know, and I'd see her name on the list, and I knew exactly why I'd be seeing her. You know, she followed another foreign body, and she'd go to the hospital to have it taken her, and was told, they came at time and that she was told if she carried on doing it, if she was at risk of rupturing her gut, you know, it was a lot bigger. I haven't read the stuff they would do. One girl stuck pins in her eyes. I mean, yeah, it makes me cringe to even think about it now. Stick needles in there, abdominal walls, swallow razor blades, smash light bulbs, swallow it, smash light bulbs, rate them with batteries, that was another common one to swallow. And when they did this and came to see you, I mean, I'm guessing there was not much you could do but send them out to hospital. Sure, certainly the girl that swallowed the cutlery would have to go to hospital and the batteries because they, you know, they can corrode and cause problems. So, yeah, on the whole, unless it was sort of minor lacerations or something, but mostly, yes, they'd have to go to hospital. Wow, it's such a transition from being a GP, especially because you worked in quite a leafy suburban area to them. I mean, I'm sure the things you saw in prison, you could never dream of seeing as a GP out in the community. Absolutely not. No, no, only in the community, I think I only had one patient who was addicted to benzodiazepines, one patient in all those years, 20 or 20 years, and no, I mean, I saw stuff in prison that I wouldn't couldn't imagine. But, yeah, very, very different medicine. Okay, my last final question for you. From your experience, if you could see any changes happening in the prison system, what would you want to see as soon as possible? Well, the fact that drugs are just everywhere in prisons is just shocking to me. I mean, again, I remember a man in one with drugs, he'd never taken a drug in his life before, but had become addicted to heroin while in prison. So, yeah, if you could get rid of drugs that would, I mean, travel from spice, you know, am I supposed to resent for in a way because if it worked for spice, I could have carried on enjoying the job and why was gross, but it's extraordinary, but, yeah, get rid of drugs. And I'm guessing spice wasn't a problem in Bronzefield. It was, but not to the same extent as in one was gross, whether there was a better batch going around or whether I don't know, but it was a problem, but it was nothing like the scrubs. Well, Amanda, thank you so much for coming on and speaking with me. It has been an absolute privilege and an honor to have you on the podcast. You are so sweet, bless your heart. Thank you for inviting me in. Thank you for believing in me. I hope you enjoyed this conversation. If you want to listen to monthly bonus episodes, you can subscribe for only £3 per month by hitting the link in the show notes. And before you go, I'd be so grateful if you'd quickly rate the podcast on whatever platform you listen. It only takes a second and it helps more people to find the podcast. [MUSIC] [BLANK_AUDIO]
