Abstract
In Jailcare, Carolyn Sufrin took us inside the medical clinic where she treated women incarcerated at the San Francisco County Jail. There, as a physician and anthropologist, Sufrin provided care to society’s most marginalized women. Her ethnography is deeply personal, because the relationships of care that Sufrin built with women throughout several years form a significant bulk of her data. Her ethnography is made up of her own experience and observation of the other relationships of care in the clinic and the block. Sufrin urged readers to understand that care in jail was built through the everyday interactions between medical staff, correctional workers, and the incarcerated women they treated and guarded. She argued, “Care must be understood as an ongoing process people work through in everyday lives” (p. 21). She also argued that care is central to life in jail.
Sufrin acknowledged that understanding the jail as a place where care and nurturing relationships were built is anxiety-inducing for those who understand the injustices and damages of mass incarceration. She worried that this work could be taken as a defense of the criminal justice system. Yet, this analytical ambivalence is in keeping with the work that Sufrin did in the medical clinic. The care that she and her colleagues provided in the jail was life-saving and important, but it was also a byproduct of mass incarceration and systemic inequality. The women she cared for suffered a great deal due to their repeated incarcerations, but they also said that jail saved their lives, provided them with somewhat consistent medical and prenatal care, and was the site of some of the more significant relationships in their lives.
From the moment a woman entered the jail, medical staff managed her care in the midst of contradictory and competing influences. The medical triage area was the first stop after arrest. There, nurses gauged women’s healthcare needs from two perspectives: the deficiencies of the street and her capacity to withstand the conditions of incarceration. Nurses managed pressure from police, who were less than eager to transport women to the hospital, and the conflict between their professional mandate to promote healing in an environment that put punishment above all else. Addressing health concerns of patients who might pay little attention to their own health without the inducement of incarceration was both rewarding and frustrating.
Recidivism is a hallmark of incarceration in the United States, and Sufrin’s greatest contribution may be her illustration of how recidivism shaped the pattern of women’s lives and the relationships they developed with the workers in the jail, both medical and custodial. Recidivism provided a continuity of care that would have been unlikely on the streets. Medical workers grew to know women and imagine their lives on the outside, as they learned what street life did to their bodies in the periods between incarcerations. Doctors and nurses were informed by encounters with women during prior incarcerations when they gave subsequent care. These relationships, while routinely disrupted, often spanned many years.
Women’s reproductive and mothering trajectories were also bounded by recidivism and involvement with state institutions that sought to control and manage their reproduction. No story illustrated this better than that of Kima, a key subject of the book. In her years of cycling in and out of jail, Kima had lost custody of her children, but became pregnant again during the years Sufrin cared for her. According to Sufrin, Kima’s desire to mother her daughter was strongest in jail, anchored by forced sobriety and hope for the future. The birth of Kima’s daughter, Koia, was both joyous and devastating. Sufrin’s skill as a storyteller was at its best as she juxtaposed the moments of joy with those when the punitive aspects of giving birth in jail were most profound. I don’t want to give away Kima’s story, but it became even more complex after she gave birth and left jail. I appreciated Sufrin’s candidness as she worked to understand the ways that Kima’s orientation to her own reproduction and motherhood was entangled with and influenced by punitive institutions.
Sufrin chronicled the lives of Kima and another woman, Evelyn, intensely in the book. Although Sufrin painted a vivid picture of the clinic, the incarcerated women’s voices in this book were limited when compared to the perspectives of medical workers. This makes sense given Sufrin’s experience, but more incarcerated women’s voices would have rounded out the picture of care in jail. In sum, Jailcare is a compelling account that sheds light on jail life, but it will feel familiar to anyone who has spent time in penal facilities negotiating the contradictions therein.