After 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 house to a 17-bed hospice unit, the one licensed hospice program for incarcerated folks within the state.
Marcus regarded skinny, his grey hair lined 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 lined 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 damage, spindle cell manufacturing is often a useful a part of the physique’s therapeutic course of. Nevertheless, as soon as the damage is healed, if spindle cells proceed to divide uncontrollably, a mass or tumor develops.
Marcus advised me he spent months attempting to get medical workers to have a look at his swollen and swelling leg, submitting healthcare request varieties and talking on to nurses and docs. 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 intense bouts of coughing, he knowledgeable me that his left lung had shut down and that the suitable one would do the identical quickly. He advised me he had organized to have all of his information despatched to me after his loss of life, which added as much as a whole bunch of pages of information and notes regarding his case and his time in jail.
Beneath is a transcript of our final dialog, flippantly edited for readability and chronology. Marcus died earlier than he might assessment the ultimate draft.
In the course of the pandemic, once 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 mentioned, “It’s simply irritation. Don’t fear about it. It’ll be OK.” My total left foot and toes have been swollen and pink.
I stored attempting to go to the jail clinic, however [the medical staff] wouldn’t do something about it. A couple of instances, they didn’t even let me raise my pant leg up. They stored saying that they’d ship me out to off-site medical to get it checked.
One of many issues I realized [during this process] was you don’t have a doctor-patient relationship while you’re in jail. They rotate the docs always, making a relationship all however not possible.
Whereas I waited to see a physician, my total 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 bought 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, docs advised me they have been very sorry to inform me that I had spindle cell sarcoma — and that it was not curable. They mentioned if I had gotten to them when it was in my foot, I’d have been OK. It’s very aggressive, I bear in mind them saying. A uncommon type of most cancers.
‘The Subsequent Step to My Loss of life’
After I first went to the hospital, the physician who examined me mentioned, “I’m going to want you to return 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, “Properly, why didn’t you return?” And I mentioned, “I don’t know. I’m not purported to be the one to rearrange that.” Then they’d ship me again to the hospital, and it could begin yet again. I’d be scheduled to exit to the hospital, however then I’d by no means truly get to go.
One time, I bought to the hospital, however the physician wasn’t there. Simply the assistants noticed me. After I bought again to the jail, all they noticed was that I went to the hospital. It regarded like a profitable go to.
Thankfully, it wasn’t at all times like that. All through this ordeal, I’ve been off-site 178 instances.
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 loss of life.
Proper after they amputated, the officers escorting me again to the room have been form of teasing me. Once they noticed [what was left of] my leg on the desk, they mentioned it was gross.
I stayed on the hospital for a short while, a couple of 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 bought again to the medical facility, the docs referred to as me again, they usually mentioned one thing to the impact of, “Marcus, we have to do a biopsy. … It appears prefer it’s potential a few of the cells bought via.”
After which they did three biopsies on my stump. They got here again, and a physician [from U.C. San Francisco] mentioned, “Marcus, sadly, a few of the most cancers cells did get via, and you might be undoubtedly going to go away very quickly.”
Very up entrance — I appreciated that.
The Finish
I’m calling you from the backyard. I can hardly sit down. I seem 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 unhealthy. The physician right here gave me this pear and advised me to take a chew out of it whereas I’m attempting 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 somewhat little bit of a multitude. I needed to clear it up. I knew it was going to occur in the end. It principally deforms you to the purpose of loss of life.
I bear 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 mentioned, “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 approach that’s going to remain for an extended, very long time.
Carla Canning is Jail Journalism Undertaking’s affiliate editor. Previous to PJP, she was a Tow viewers engagement fellow at The Marshall Undertaking 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 a web site information for folks visiting family members incarcerated in New York State prisons.
A California Division of Corrections and Rehabilitation’s info officer said that, as a result of medical privateness legal guidelines, they may not disclose the small print of Marcus’ on- or off-site medical therapies. In addition they said that California Correctional Well being Care Providers assigns each affected person a particular main 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 methods.
In response to a query about Mule Creek State Jail’s clinic operations in the course of 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.”
