Author Examines Effects Of Solitary Confinement

Humans are social animals; deprived of regular contact, we lose our minds. And that's just what's happening in solitary confinement cells across the country — that according to surgeon and author Atul Gawande, whose article in the current issue of New Yorker magazine looks at the effects of extended solitary confinement. Gawande talks to host Jacki Lyden about the personal toll of solitary confinement.

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JACKI LYDEN, host:

America leads the world in keeping its citizens behind bars. It also leads the world in the numbers of people locked up in long-term solitary confinement, 25,000 inmates.

In 1983, I profiled Randy Gometz, an inmate in solitary confinement at the federal supermax prison at Marion, Illinois. He still writes to me, and he's still in solitary, now at the new supermax in Florence, Colorado.

For Gometz, a lifer who became an Eastern Orthodox monk while behind bars, it's been 29 years in solitary confinement. In his most recent letter, he compared his existence to that of a frog in a jar of formaldehyde, 23 hours a day in cell time.

Surgeon and writer Atul Gawande has an article in the current New Yorker about the effects of solitary confinement. The title is "Hell Hole," and he joins me now. Dr. Gawande, welcome to the program.

Dr. ATUL GAWANDE (Author): Thank you for having me on.

LYDEN: As I understand it, you're saying that solitary confinement is a hell hole, that it's torture. Why do you say that?

Dr. GAWANDE: The reason is simply the accumulation of experience and studies showing what happens when you put people in isolation from other human beings.

It turns out we are fundamentally social creatures, not just in the sense that we get lonely when we're alone, but in the sense that without social interaction, especially when it becomes months or years on end, we lose our capability of being normal.

LYDEN: You began by looking at a classic case that people might remember from psychology textbooks, going back to the 1950s about solitude and mental health. Please tell me about Harry Harlow and his monkey experiments.

Dr. GAWANDE: Yes. These were ultimately considered somewhat horrific experiments, but he took monkeys, lab monkeys, and tried to raise them the way that the hospitals of the era raised human infants, in nurseries with lots of food and blankets and toys, but in isolation from other infants to prevent the spread of infection.

And after several months of observing these infants, he found that they were, yes, disease-free and larger than those from the wild, but they were also profoundly disturbed.

LYDEN: And the only thing that was different was that they weren't having the human contact, the social interaction.

Dr. GAWANDE: Yeah, or the monkey contact in this case.

LYDEN: Now, we can't conduct the same experiments on human beings, but our prison systems seem to provide thousands of inadvertent test cases. What happens to someone who is put in solitary for a long stretch? Obviously, probably not everyone reacts the same.

Dr. GAWANDE: In the beginning, you're just lonely. Then after a couple of months, you begin to simply slow down. You lose your ability to initiate behavior, organize yourself around any kind of purpose.

You can begin to hallucinate. You start pacing back and forth for hours at a time. Then your thinking pattern begins to break down. There is irrational anger, obsessing on single points, and what ultimately can develop as outright psychosis.

LYDEN: Well, do you see this changing any time soon?

Dr. GAWANDE: I don't. So, there's a striking conversation I had with a state commission of prisons, but he would only speak to me anonymously. And what he explained was that he would stop the use of solitary confinement except for short periods in his prisons because it is producing people who are mentally ill and that it's making the violence that he has to cope with worse rather than better. And that's what the data shows, as well.

More to the point, he says that the majority of the state prison commissioners that he knows feel this way, but they spend their lives defending the use of solitary confinement because when they try to even move one prisoner out of those conditions, they have the tabloids all over them, legislators calling for their heads.

It is fruitless, he argues, for him to end that kind of long-term solitary confinement because the public will not let him.

LYDEN: What prompted you to write this article and take a look at solitary confinement?

Dr. GAWANDE: I'm not sure. It's something I've thought about for a long time. I think as a doctor, for me I think about what the experiences is of individual human beings a lot, whether it's the pain I put a person through under surgery or the pain they experience from illness or disease. And I think on the most basic level, the sense that we are capable of this is my worry.

I think this has become the stain on our generation. Legalizing torture is, for us, our stain in the way that legalized racial discrimination was the stain for many previous generations.

LYDEN: Surgeon and writer Dr. Atul Gawande joined us from the studios of WBUR in Boston. Thank you very much.

Dr. GAWANDE: Thank you.

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