Volume 56, Number 1 - Winter 2010

 

By Steve Osborn

San Quentin State Prison and Marin County have been intertwined for a long time, going all the way back to their naming. According to legend, the peninsula on which the prison now sits was named for Quintin Camilo Ynita, a member of the Coast Miwok tribe headed by Chief Marin, for whom the county itself is named.

Both Quintin and Chief Marin rose to prominence in the late 1820s, when they led a series of attacks on Mission San Rafael. They were eventually captured by Spanish soldiers and imprisoned at the Presidio. Upon their release, they became sailors, guiding rafts from San Francisco to Sonoma, frequently passing by the peninsula that now bears their names: San Quentin, Marin County. 

History does not record whether Quintin or Chief Marin received any medical care while at the Presidio, but it seems likely. Whatever the nature of their crimes, the fact remains that prisoners are people too, as subject to the slings and arrows of medical misfortune as anyone else. In modern times, at least, wherever there are prisoners, there must also be doctors.

As of this writing, San Quentin is home to 5,247 prisoners and employs 377 medical staff, including many physicians. Together with outside consultants, the staff provides a full range of medical services to a captive community, ranging from routine physicals, to psychiatric treatments, to complex surgeries.

This issue of Marin Medicine examines San Quentin, not only in terms of its medical care, but also with regard to its relationship with Marin County. The two aspects are codependent. Just as the prisoners merit the attention of the surrounding community, so too does the prison itself. You can’t have one without the other.

We begin with a proposal by Assemblymember Jared Huffman for Marin County to forge a new partnership with San Quentin by constructing a mixed-use transit village just outside the prison walls. The proposal could bring thousands of county residents closer to the prison and diminish its relative isolation.

Next is an article by Dr. Jonathan Levin, who together with Dr. Winthrop Hall and Dr. Bart Gershbein has provided outpatient surgical services to San Quentin inmates for several decades. He describes the types of care provided and the circumstances in which it is delivered.

Dr. Eric Monthei, the chief psychologist and chief of mental health at San Quentin, offers a detailed overview of the conditions encountered, the treatment options, and the administrative challenges. His article is followed by Dr. Michael Franzblau’s portrait of Dr. Leo Stanley, an innovative surgeon who was the prison’s chief medical officer from 1913 to 1951.

We close with some sobering comments on lethal injections at San Quentin from the California Medical Association. CMA argues forcefully that physician involvement in capital punishment violates the Hippocratic oath.

Not far from San Quentin is Marin General Hospital, which serves as the county’s trauma center. Dr. James Hinsdale, the trauma director (and president-elect of CMA), describes recent improvements at the center and the ongoing quest to save lives with better treatment.

Another nearby facility, the Marin Community Clinics, has been expanding its care of uninsured and underinsured patients as the local economy continues to falter. Dr. Georgianna Farren, the clinics’ chief medical officer, outlines their new programs and ongoing challenges.

Hospitals and clinics aren’t the only local institutions that continue to grow. Dr. Joan Pont, an internist at Kaiser San Rafael, has spent more than two decades transforming her garden from a jumble of alien plants into a burgeoning showcase of native species that both Quintin and Chief Marin would have easily recognized.

Speaking of growing, Dr. Colleen Foy Sterling, a family physician at Kaiser Santa Rosa, shares an appreciative review of Birth Day, a new book about childbirth by North Bay pediatrician Dr. Mark Sloan.

We close with two essays concerning the importance of CMA (by MMS Secretary/Treasurer Dr. Irina deFischer) and the need for both physicians and patients to take responsibility for their health (by MMS President Dr. Helen Biren). 

We hope you find this issue both provocative and informative. As always, your comments are most welcome.