DG: Hey, It’s Dan.

We’ve got a special episode for you this week produced by Side Effects Public Media, a collaboration of several public radio stations in the Midwest focused on health care.

We’re featuring an episode of Sick, a podcast that investigates what goes wrong in the places meant to keep us healthy. 

Today hosts Lauren Bavis and Jake Harper take us inside Indiana’s Women’s Prison and show how the system of care broke down for one woman.

From the studio at the Leonard Davis Institute at the University of Pennsylvania, I’m Dan Gorenstein, and this is Tradeoffs.

*****

Jake Harper: After the start of the COVID-19 pandemic, communication got weird for a while. We all spent way more time on the phone and on video calls, frustrated by slow internet and choppy audio. But those hard-to-hear calls that were so annoying for us, that’s the norm for Natalie Medley. All our phone calls start like this: 

Hello, this is a prepaid call from 

Natalie Medley: Natalie.

An inmate at the Indiana Women’s Prison. To accept this call press 0. This call is subject to monitoring and recording. 

Natalie: Hi.

Harper: Hey.

Natalie: Has everything been good on your end?

Harper: Yeah, I’m …

Harper: Natalie has a reputation as a bit of a rabble-rouser. She speaks her mind, even when she knows it will get her in trouble. And it often does. 

Natalie: So I’m a definite fighter. And when I say “fighter,” I just mean, like, against the system. I don’t have good relationships with staff. 

Harper: Those staff members can take away Natalie’s privileges, although you and I might not consider them privileges. Things like being able to watch TV or buy snacks. Worse than that – much worse – they can put Natalie in the segregated housing unit. Solitary confinement.  

Lauren Bavis: At the Indiana Women’s Prison, the segregated housing unit is a hallway with 25 cells. Natalie was sent to that unit in the summer of 2015. She remembers being there a couple weeks before she got some news.  

Natalie: I was told to pack out. A new person had arrived in lock. I was told that she was 19. She was sent to lock from the chow hall that afternoon.

Bavis: People in prison talk in this sort-of shorthand. The segregated housing unit, that’s lock, or seg. A correctional officer, that’s a CO. The chow hall, obviously, is the cafeteria.  

The woman coming to lock – her name was Princola Shields. She was Black and young. Really young. Just 19. She’d only been at the Women’s Prison a few months. Staff took Princola to a bathroom, where she was locked in a shower stall behind a metal grate. It’s a place for staff to strip search the women. A normal stop on the way to lock. Someone new coming in was exciting for the women on the unit. 

Natalie: You know, you’re in this dull environment with no, you know, with nothing. So it’s like oh, OK, something’s happening, right? A new admittee. So everybody’s always excited about a new admittee, especially one that is bumping somebody out of lock, right? So the people who want to get out, are about to get out, are excited. So there was a lot of energy going on.

Harper: Natalie might get out. That was good. What wasn’t good was that Princola, the 19-year-old coming into lock, she wouldn’t stop screaming. And screaming. It was annoying for the officers, which Natalie liked. But as it dragged on, it was more and more troubling. Princola was threatening suicide. 

Natalie: Screaming that she was going to kill herself. And she was begging staff to help her. It was heartbreaking that she kept crying and saying that she didn’t do anything. Because I could relate, I could empathize with how it is. And the people who sent her to lock are very oppressive, period. And especially to young women and especially to young Black women.

Harper: Then Natalie got to go outside for a couple hours of recreation time. 

Natalie: We had rec that day at 1 p.m. Princola was still screaming in the shower. When they brought us in at 3, it was quiet. It was completely quiet. The person across the hall from me, she asked me, “Where’s Princola?” 

Bavis: Natalie remembers coming in from rec at 3 p.m. It was quiet, so she assumed Princola was put in a cell. That she’d left that shower stall. But 15 minutes later, something was going on around the bathroom. Natalie didn’t know what. She couldn’t see the bathroom from her cell. But women in prison use sign language to communicate while in lock or other places they might get in trouble for talking. Another woman with a clear view of the bathroom signed to Natalie what she was seeing. COs going in and out. Then medical staff. And finally, a stretcher. The next thing Natalie knew, the prison was locked down.

Natalie: We were locked in the cells. We didn’t have dinner on time. We weren’t allowed to shower. And the COs were mad if we would ask questions.

Bavis: Natalie had a question: What happened to Princola? Within days, she found out. Princola was dead. 

This is Sick, a podcast about what goes wrong in the places meant to keep us healthy. I’m Lauren Bavis.  

Harper: And I’m Jake Harper.  

In the United States, health care isn’t a right, except for one group of people: the incarcerated. The Eighth Amendment – the one against cruel and unusual punishment – that amendment has been interpreted by the courts to mean people in jail or prison are guaranteed a minimum standard of health care. It doesn’t have to be the best care in the world, but while you’re in custody, you get treatment.   

Bavis: And that’s important, because a lot of people in prison are sick. So this season, we’re investigating prisons. Mostly one prison: the Indiana Women’s Prison, a maximum security facility in Indianapolis.  

Unlike last season, this isn’t one story about one doctor. This is about a system, and the ways that system can break down. What happens when a place that has to keep people healthy is also built to punish them.  

Harper: And we’re starting with the story of Princola Shields. What went wrong with Princola’s care? Pretty much everything.

911 operator: Fire and ambulance, what’s the address of your emergency?

IWP staff: 2596 Girls School Road, the Indianapolis Women’s Prison. There is a woman who has attempted to hang herself. She’s received CPR for the last 15 minutes. 

Operator: OK. 

IWP staff: Nonresponsive. We shocked her with the AED. We need someone ASAP.

Bavis: As we started to report Princola’s story, we saw her mugshot. A picture of a young Black woman with a serious expression in an ugly mustard yellow jail uniform. We also had a mental image based on what Natalie Medley described. Someone locked in a shower stall, screaming for hours. But that’s not the same Princola you see on her Facebook page. That’s where you get a glimpse of the 19-year-old she really was. She’s vibrant and bubbly. Always smiling and laughing. This is Princola Shields.  

Princola, on video: Shoutout to God, my No. 1. Shoutout to all the lovers out there! 

Harper: She posted several short videos to Facebook from the months just before she went to prison. In her videos, Princola isn’t serious or hysterical. She vaped and listened to music.  

Princola, on video: What’s up, y’all. 

Harper: She cooked herself a burger and fries at home. She found a stray cat and reunited it with its owner.  

Princola, on video: Look at its tail, it’s so fluffy. So fluffy. Say hi. Say hi! 

Bavis: Just normal, everyday moments for a teenager. Which made us wonder: How does a 19 year old go from this –

Princola on video: So everybody tell me one thing you’re thankful for. I’ll start. I’m thankful for my sister and my brother. 

Bavis: To hanging in a prison shower stall?

Harper: The brother Princola mentions in her video, he’s seven years older. His name is David Johnson.  

David Johnson: My sister was a loving person. Never met a person that she didn’t like. I mean, if she walked in here right now, she’d compliment the green on your shirt. You know, she’d compliment your hair. You know what I mean? She just was a genuinely good-hearted person.

Harper: David remembers Princola had a job at a burger joint in the fall 2014.  

Bavis: David was excited when she started working there. She’d recently been in trouble. Princola was caught shoplifting at a mall in a neighboring county that summer. But with a new job, it seemed like she was on a good path forward. 

David: So I’m happy for her, you know. I’m also more technical. Like, OK, good, now you should start saving up your checks. I remember I called her and she’s bought a rabbit. A white rabbit. I was just like, OK, why do we need this rabbit at this point in time? You know, we’re trying to get jobs, we’re trying to get life together and you bought a rabbit. But she just was a free spirit like that.  

Me and her were in a disagreement, so to speak, the night she got arrested. 

Bavis: David remembers in January of 2015, they had a fight. He loved that his sister was a free spirit. He also knew that being kind and loving didn’t mean the world would treat you fairly, especially if you’re a young Black woman. And he wanted his sister to be prepared for that. 

David: That’s kind of harsh, you know, to tell someone who’s got a good heart and really just wants to be loved at the end of the day. And you’re telling her that’s not the way life is. That’s not the way the world is. So unfortunately, yeah, we had a big disagreement, kind of spilled out, and she ended up leaving.   

The next day, myself and my girlfriend at the time, both received phone calls. 

Harper: Princola had been picked up by the police for majiuana possession. Remember, she had been caught shoplifting in nearby Johnson County the summer of 2014. She was supposed to go to court, but she never showed. So a judge issued a warrant for her arrest. Princola ended up in the Johnson County Jail, south of the city. 

David: I blame myself. I blame myself 100% because when she left that night, I didn’t do anything to prevent it. I didn’t handle it the right way. That argument, that situation, was like, the last time I got to physically see her living. 

Bavis: At the Johnson County Jail, Princola got into a few fights. During one of them, jail staff came in to restrain her. According to a report, she struggled, and gave a deputy a thin scratch on his eyelid. That added some new charges to Princola’s record. Disorderly conduct. Resisting a law enforcement officer. And a big one: battery. It’s usually a misdemeanor, but when you hit a cop or a corrections officer, it’s more serious. It’s a felony.  

Princola stole two watches, a purse and an electronic device from a Sears in Greenwood, Indiana. She ended up in prison. 

DG: More from Sick in a minute. You’re listening to Tradeoffs.

MIDROLL

DG: Welcome back. 

Today’s episode comes courtesy of the team at Side Effects Public Media. 

Hosts Lauren Bavis and Jake Harper pick up the story.

Harper: Princola got to the Indiana Women’s Prison in May of 2015, and she was placed in the same unit as Noelle Green. Noelle remembers everyone called her “Princy.”

Noelle: I remember her coming up to me and being like, “I love your glasses. You’re so pretty. Blah, blah, blah. I like you.” And I’m like, “Thank you.” And you could tell she was young. And then we started talking about the glasses thing. And she said she can’t see shit. So I helped her get a pair of glasses so she could see. And from that point on, she was my buddy.

Harper: Noelle is a mom. She felt protective of Princola. She says she would get Princola stuff when she needed it. The glasses, a pair of her old shoes. And she got to know her as they palled around the unit. She remembers Princola was funny. And she had a great singing voice. 

Noelle: She sang in church services or whatever. Little church songs. That was always a nice treat.

Harper: Other friends told us some of the same things Noelle and David did. Princola could be fun, sweet and goofy. But she struggled over the five months she was in prison. She got in trouble.   

Noelle: We would have a church service a couple nights a week. And everyone goes, because we all want to get out of the room. And I think she was talking to whoever was next to her. And I kept telling her, “Be quiet.” And the guard kept warning her. She wouldn’t stop. It was like she didn’t take that warning seriously enough. And I kind of realized at that point, she doesn’t really understand the gravity of what was happening in her life. So she went to lock for that.

Bavis: On Sept. 21, 2015, Princola was a few weeks away from getting out. She was excited. Noelle would see her occasionally at lunch, and they sent each other notes after Noelle moved to a different unit.

Noelle: She talked about it all day long. She was like, “I’m gonna go eat this. I’m gonna go see my grandma. I’m gonna live with my grandma, get me a job. Blah, blah, blah,” type of thing. 

So what happened is – oh, God it was crazy. I was in the chow hall.

Harper: How far away?

Noelle: Probably like a table away. There was one table in between us, one of the ones that are like bolted to the floor. She was standing up in line. 

Bavis: This is what Noelle remembers happening. A captain approached Princola. She was wearing a shirt like all the other women. But according to Noelle, there was a faint stamp on it, which meant it was supposed to be a pajama shirt. Noelle doubts Princola even knew there was a rule about which shirts to wear. Other guards never brought it up. 

Noelle: He saw the thing on her shirt and told her she can’t wear that shirt. And she was like, “What?” She didn’t know. So he pointed it out and then, you know, was a dick about it, basically. And she was like, “Oh, OK. So what? Who cares? No problem, next time, I won’t wear it.” That type of attitude.

She was looking at me like, “Can you believe this motherfucker?” You know, that type of look on her face. And I just kept shaking my head telling her to shut up. But she didn’t and he called some guards over and said, “Take Miss Shields to lock.” Because it happens out of nowhere. They took her, and at that point, she was hysterical. Because it’s like, “What the fuck? I didn’t do anything wrong.”

Harper: Noelle felt like the confrontation in the cafeteria was unavoidable. That as soon as Princola copped an attitude, the captain was sending her to lock. Princola was young and impulsive, and COs don’t respond well to that. But the prison knew something Noelle didn’t: Princola’s entire medical history. Specifically, her mental health history.  

Bavis: Many women in prison have mental illnesses, or traumatic pasts. Or both. It’s why some of them go to prison in the first place. Childhood trauma in particular can result in women having hair triggers. It’s a defense mechanism they learn early in life. So they may be prone to conflict with their peers or authority figures. But mental health is health. Prisons are supposed to be equipped to deal with it. 

Prison staff knew Princola had a traumatic past. She had bounced around from house to house as a child, sometimes living with her mom, sometimes her grandma. She spent time in a juvenile facility. She got pregnant, and her child was placed for adoption. All before she was 18. 

When Princola got to jail, she was placed on suicide watch. After she got charged with battery against that guard, she first went to a prison called the Rockville Correctional Facility. And that medical history from the jail, that went with her. And at Rockville, it got longer. About a week into her time there, she used a razor to carve the word “pain” into her arm. She was placed on suicide watch again.  

The staff at Rockville diagnosed Princola with PTSD and depression. She needed special care. That’s why she was sent to the Indiana Women’s Prison. It’s the prison for women with the most serious mental and physical health needs. 

Harper: There’s no question that the staff at IWP knew about the potential difficulties in caring for Princola. Her medical records traveled with her. And the psychologist at IWP even warned the higher ups about Princola’s conditions. He sent an email to the warden and the same captain Noelle remembers from the cafeteria. And several others.  

And even if they didn’t read that email, there were warning signs once Princola arrived at IWP. She tried to kill herself there, twice. Once in June of 2015 and again in August. She wrapped a bedsheet around her neck and prison staff had to cut her down. She was placed on suicide watch each time. 

By Sept. 21, 2015, the prison had a full file on Princola. Putting someone with a history of suicidal behavior into a high-pressure situation like lock could have deadly consequences.   

We wanted to talk to someone from the Indiana Department of Correction about what happened to Princola. But a spokesperson denied our request for an interview. Not just about Princola, but for everything we reported on this season. They also declined to answer many of the questions we emailed them.  

Bavis: A correctional sergeant brought Princola to lock just after noon. The sergeant placed her in a shower. That was normal. What wasn’t normal was how long she stayed there.  

Officially, staff should have checked on her every 15 minutes. And at first they did, more or less. Someone checked on her three times during the first hour. Sometimes they stayed for a few minutes, talking with Princola.  

But after that, the checks were spottier. Twenty-five minutes pass between checks. Then 42 minutes. Three quick ones, then another 24 minute gap. Then finally, a 44 minute gap. It’s likely during this period that she stopped screaming.  

Harper: Princola was locked behind a door. Kind of a metal grate, with small diamond-shaped holes. And just on the other side of that grate was a shower curtain. A bedsheet, really, used as a curtain. Forty-four minutes is a long time. Long enough to figure out that if no one comes by and checks on you, you might be able to get that sheet through one of those tiny holes. And that’s what Princola did. Bit by bit, she pulled the sheet through. Until she had enough fabric to tie it around her neck. 

Investigators later found that it would have taken Princola at least 15 minutes to pull the sheet through the grate. Which means if the guards were checking on her when they were supposed to, they would have been able to stop her. But they didn’t check on her every 15 minutes. At 3:14 p.m., a correctional officer discovered Princola hanging in the stall. It took about three more minutes to get her down. The custody staff started doing CPR. Despite the clear emergency unfolding at the prison that day, it took half an hour before someone called 911. Half an hour.

911 operator: OK, what door do you need them to use?

IWP staff: The very back door.

911 operator: You’re still performing CPR now?

IWP staff: Yes, yes we are. The doctor’s on site. Thank you.

911 operator: We’ll get them on the way.

Harper: An ambulance got there another 10 minutes after that, and Princola was taken to the hospital. She was alive, barely.

Bavis: Princola’s brother David started getting calls and texts while he was at work, from people he didn’t even know had his phone number. His cousin told him he needed to go to the hospital right away. Princola was alive, but there was nothing the doctors could do. When she got to the hospital, she was unresponsive. Soon she would be brain dead.  

David: It broke my heart. Broke my heart. Failed her, you know. It’s my little sister. I mean, it hurts. She had, it was like black, kind of like a tar, coming out, running out of the side of her mouth. She had tubes in her mouth hooked up to everything. Eyes were swollen. Just not how I would’ve wanted to see my sister, ever. 

I kissed her and just apologized. You know, I was there when they took her off the life support. And I literally watched her, I watched the decrease in her breaths. The sheet that’s covering her going … and just slowly, just not even making any movement at all. I watched all of that.  

Bavis: Princola died at the hospital early in the morning on Sept. 22, 2015. She was 19 years old, and would have left the prison in a few weeks. 

Harper: Noelle remembers the prison was locked down. Not long after, she heard what happened from another woman. That Princola had died. Princola was Noelle’s friend. A young woman she wanted to protect. And now, so close to being released from prison, she was gone.  

Noelle was stuck in prison, and her contact with the outside world was limited. But she made a decision right then. The outside world needed to know what happened to Princola, and Noelle needed to figure out how to tell that story. 

Noelle: People have to know what happened here. Wrong is wrong. And if these motherfuckers want to come back at me and punish me for exposing what they did that day, then so be it. I understand what I’m risking. 

Bavis: So how do you get justice from behind prison walls? That’s next time on Sick.

DG: Make sure you subscribe to Sick wherever you get your podcasts to hear the rest of Princola’s story and the rest of their season.

Both are definitely worth a listen in your podcast app or at sickpodcast.org.

Special thanks to Christine Herman and our friends at Side Effects Public Media for this week’s episode, hosted and reported by Lauren Bavis and Jake Harper.

I’m Dan Gorenstein, and this is Tradeoffs.