Once a day except Saturdays and Sundays a small window in the door opens and a stooping figure wearing a gown that used to be white either asks or just states the fact:

- Feeling unwell?!.

The so-called doctor is holding a well-used desk drawer in his hands which is practically empty. Even if there is some medicine in it, it is usually well past the expire date and of suspiciously undefinable origin. Don’t expect to be given the right medication in case you are ill. Such expectations are silly and futile. Prison doesn’t have funds to purchase even the cheapest drugs. Whatever happens to arrive now and then ends up in the pockets of prison staff. That’s why prisoners hardly ever ask for some particular medicine, they just say laconically:

- Give me a pill.

And that’s it. They’ll see afterwards if they need it. Somebody may use it for some purpose. Many prisoners are fond of swallowing any pill. They feel as if whatever they suffer from is being treated in some way. A drug is a drug. Who knows, maybe it will help.

Prison can only make life shorter, there is no doubt about that. Another common belief is that it’s better to be rich and healthy than poor and ill. Behind bars your attitude to health and medicine in general undergoes considerable changes.

Prisoner’s health is his own problem. So don’t expect any sympathy from anyone. Why should you be provided with medical assistance? Why should you be saved? Society treats you as a criminal lost among the scum. What if a prisoner has a heart attack or a fit of appendicitis in the cell? God forbid. Knocking on the door, getting someone to open it, waiting for medical attendant - all this takes hours. Besides, the first thing the ‘doctor’ will say is “Stop simulating!” or something very similar to this. You’ll only be asked about your complaints after your pulse is no more felt. One of my cell-mates happened to have an attack of epilepsy which relieved the monotony of prison life. None of the uniformed pigs paid any attention! We kept knocking on the door but there was no response. When finally a warden deigned to appear the poor prisoner was lying on the floor with a spoon between his teeth.

- Why on earth kick up a din? No big deal! - the warden didn’t even open the door but watched us through a small opening in it.

- Calmed down, hasn’t he? Why make such a noise? Let him lie on the floor for a while and then put him on the lower bunk. There is nothing serious with him. He’ll be OK.

Epilepsy, though quite unpleasant, is not the worst of the diseases that are widespread in prison. There is a number of veneral and skin diseases of which scab is the most ‘innocent’. Though it is contagious prisoners don’t take it seriously. Syphilis and AIDS that can also be contracted are much more troublesome. Scab is a bit scratchy, of course, but that’s no problem, gives you something to do to while away the time.

I was shocked by the number of prisoners with AIDS. Prison administration, however, prefers to ignore this fact. Prisoners are more concerned about TB which keeps spreading in every prison. They are not used to AIDS yet. Many have heard that it’s quite bad but few know how ‘bad’ it can be. The administration first made an attempt to keep prisoners with AIDS in separate cells but when their number increased they were mixed with other prisoners. Let others get used to it.

The policy of the government is very similar. Financing of AIDS tests has been stopped not only in camps and prisons but in clinics as well. The only exception is blood transfusion centers. There is a certain logic in such policy. Suppose tests prove positive, what’s next? Why spoil people’s mood? God knows what might be found in their blood when it is properly tested!

Any kind of medical treatment in prison is supervised by officers from the operation department. They insist on every medical examination being held in their presence. Prisoners realize the futility of seeing a doctor. They know their health is not going to improve after such a visit. For them seeing a doctor is just another chance to leave the stuffy cell and take a walk in the long prison corridors, maybe see other prisoners and exchange news. For every prisoner leaving the cell is a big event in the monotonous prison life. So no one will refuse to see a ‘doctor’ when the opportunity presents itself.

Medical care in prison is remarkable for its drive and energy in getting things done. One of my first days in prison I asked for medical assistance. It was September, the trees were still green. I was taken to see a doctor in December when, as my investigator put it, my injuries ‘healed themselves’. It was snowing outside and the temperature dropped to -20 Celsius.

However, when you don’t ask for a doctor he might appear very promptly. This happens when cops need the doctor to certify that you are in good health and can be put to trial.

One day, early in the morning, without being given any explanations, I was ordered out of the cell and pushed into a small room with no windows or any kind of ventilation. The room was full of prisoners who behaved in a civil way and were involved in a discussion about holes in the ozone layer and cancer cases in Australia. A bearded man in spectacles squatting in the corner expressed concern about Hong Kong’s future after its joining China. The whole scene reminded me a smoking room in the university. Compared to my slow-witted cell-mates those people seemed a bit queer to me. And I proved right. All of us had capital offenses and were put together to be taken to the mental hospital for medical expertise.

After three hours of waiting, when there was practically no oxygen left for us to breathe, the door opened and one by one we were pushed into a van. Two charming girls joined us. The redhead had killed her husband while the short one with bright red mouth had murdered her stepfather. On the way to the hospital the redhead was telling jokes and offering chocolate to everybody.

It was the first time I had been out of prison since my arrest. Through the barred window I watched the snowy streets, people hurrying in different directions or waiting at the bus stops, cars skidding in the snow. I don’t remember feeling so excited watching simple things of everyday life. My eyes, used to look only at short distances limited by small cells and prison corridors, greedily absorbed every detail beyond the barred window. I was watching the world that had been taken away from me. It was so close that I felt I could easily touch it. A wave of tension went through my body and vanished. I felt serene and aloof.

At the mental hospital we were greeted by snow white walls, sturdy attendants and smiling doctors. Their smiles, however, were very specific. I’ve never seen people smiling like that before. They made me feel like saying ‘Cuckoo!’ by way of greeting.

The prisoners grew serious and silent. The girls were taken away and the rest were called one by one into a big room where a dozen doctors were seated around the table. The moment I entered the room they all smiled those specific smiles I had noticed before.

- Hi, honey! Any complaints?

The head of the commission, a middle-aged fair-haired woman with yellow teeth, stare at me. “Like a cobra before a bite,” - I thought.

- No complaints whatsoever.

The doctors’ smiles grew wider, they started nodding understandingly.

- Why are you here then?

- They won’t let me out, - I shrugged uncertainly.

- Really?..

The woman doctor was leafing through my file.

- Do you understand why you were arrested? - she inquired.

Turning over the pages she now and then stopped to read some passages. Other doctors looked bored. I was scrutinizing a picture of Kiev on the wall. The woman finished reading and looked at me.

- Do you feel well?

- In a way yes.

- What do you mean ‘in a way’? When did you have brain concussion?

I was bombarded with questions. I had the impression that they were more interested in my reaction to the Russian language than in what I said or if I answered at all. Their curiosity amused me at first but soon I lost interest.

- OK, that’s enough, I have to go.

- Where to? - the woman sounded surprised.

- Back to prison. Where else?

- But we haven’t finished yet.

I got up and opened the door.

- Hang on. According to your papers you have a degree in philosophy. At the same time you were a professional wrestler and a coach at the institute of Physical Culture. How do these things combine? And why would a philosopher be involved in sport?

- Does it have anything to do with my criminal case or your commission?

- No, nothing. I’m just curious.

- To develop my inner harmony, - I replied in the true Soviet style.

The woman doctor gave a sigh and exchanged glances with her collegues.

- Well, young man, you might be an interesting case to study.

I returned to the hall.

On the way back to prison I asked my neighbor who seemed to be pleased with the results of his chat with the doctors:

- Why do so many people try to imitate Napoleon? I’ve never heard of anyone imitating Byron or, say for instance, Garibaldi.

My neighbor broke into a smile:

-If you mean myself, I’m also short just like him. Napoleon is a famous figure in history. Besides, what can be easier than imitating him? Put your right hand on your heart underneath the jacket, wear your hat on one side - and you are a spitting image! Most people, even if they’ve heard of Garibaldi, won’t know anything about his looks. Not every historic personality had characteristic features easy to remember and imitate.

The bearded man, concerned about the future of Hong Kong, joined the conversation:

- It’s for the seventh time that I’m brought to this hospital,- he sighed. - And those white-gowned jerks still can’t diagnose my illness. God, I feel I’ll be sent to Dnepropetrovsk, that’s for sure.

- Have you been there before?- Napoleon asked biting his nails.

The bearded man spat on the floor.

- I’m a psychiatrist myself. Had my professional training in Dnepropetrovsk.

- Why worry then? There is little difference between doctors and patients. You’ll be like a fish in the aquarium. Why are you in prison?

- For no reason at all. Got rid of an old wardrobe, threw it down from the balcony. Didn’t want to drag it all the way down from the ninth floor. Was going to pick up the remains in the morning, on the way to work. Hardly had I changed and taken a shower cops were at the door. “Was it you who had thrown the wardrobe?” “So what? It’s my wardrobe, I can do with it whatever I want.” The handcuffs had clicked on my wrists before I finished the sentence. How on earth could I have known that in the bushes under my balcony a young couple was having fun? As if there is no better place for that!

Napoleon shook his head in disbelief, others nodded in agreement and support. Six weeks later I learned incidentally that my bearded travel companion had done the trick with the old furniture many times and it always ended in the same way.

The cell seemed twice as small and stuffy after a breath of fresh air. My cell-mates looked at me as if I was Christopher Columbus just back from his travels. They treated me as if I had traveled the world in a police van!

I wondered why I had been taken to mental hospital for medical expertise. What were the cops trying to achieve? To make sure I was mentally fit? But for them anyone with a university degree must seem a deflection from the norm. As for the doctors, they are helpless and have to obey orders. If a doctor decides that a prisoner needs medical treatment or can’t be put to trial because of poor health - he is in big trouble himself. Prison doesn’t need healthy prisoners. They are dangerous and more difficult to manipulate and control. It’s no secret to anyone that a sick person won’t be able to fight the police, public prosecutors or courts. Those who put him behind bars can sleep soundly.

Though a lot of effort is made to let us rot in prisons we have to survive and get free. God is with us. All the hardship we are going through can only harden us, make us stronger. The most difficult and the most interesting is always ahead. We simply don’t have the right to lose presence of mind no matter what the circumstances are. The strong-willed finally get the reward. The weak… they are like dandelions in the field - a gust of wind and they are no more.

Fighting the system is not easy but someone has to do it. We must have clear mind and good health. We’ll discuss physical and intellectual exercises in prison a bit later. Now I would like to talk about some common illnesses prisoners might encounter behind bars.

Mental disorders.

Unfortunately most prisoners are least concerned about these illnesses. One can well understand that: the first symptoms are imperceptible not only for the others but for the prisoner himself. And when the illness manifests itself in the reactions and behavior of a person it is usually too late to do anything about it.

It is practically impossible for anyone to remain mentally sound in prison. A very strong stress multiplied by absolutely appalling living conditions in prison inevitably result in mental disorders. Some of them can be treated, and quite successfully at that, but none pass without leaving a trace. After being released most prisoners are unable to restore their normal state of mind mainly because of the old ‘mental wounds’ that gradually develop into serious psychiatric trouble which is difficult to cure.

In the civilized countries special rehabilitation programs have been worked out for prisoners to help them remain healthy, full fledged members of society who pose no threat to other citizens. Ukraine, unfortunately, can’t be put in the same row with those countries. Here nobody is concerned about prisoners’ health. If you intend to survive in prison you should from the very first days of your detention take care of your ‘gray matter’. Try to notice your reactions to everything happening around you, compare them to the others. Make sure your brain always works clearly and efficiently. Remember: one day you will return to normal life again.

Heart trouble.

Heart trouble is probably the most common among health problems in prison. It is caused by the same reasons: stress and appalling living conditions. Strong will is the best remedy. However, frequent heart attacks prove that not all prisoners are able to avoid concentrating on cruel treatment and barbaric conditions.

Remember: your main enemy is nervous strain. Getting rid of it is not easy. Try meditation or some intellectual activity, like learning a foreign language, for example. Physical exercises are even more effective. Do them every day until you are so exhausted physically that all other feelings and emotions are suppressed. Yoga exercises, especially the so-called ‘upside down’ ones, help to avoid depressions.

In case you do have a heart attack, don’t panic. Lie down, relax your hands and eyes - it helps to achieve the state of peace and quiet. Peace is your only ally in such situation. Some medicine like tincture of valerian or validol can be very handy.

One more piece of advice: never take any medicine offered by cell-mates if it is not properly packed or of unknown origin. Who knows what it might lead to. To be on the safe side proves more effective.

Colds.

A simple cold we are so used to pay little attention to in everyday life can easily develop into a lingering pneumonia in prison. No need to explain why: prisoners are extremely emaciated and kept in the conditions as if deliberately created for viruses to multiply and spread to the enjoyment of the uniformed beasts.

I made it a point to sponge myself down with ice-cold water every morning. I used to hate it before but behind bars it is practically the only preventive measure available.

Tuberculosis.

TB is traditionally the most talked about disease in prison. And not that uncommon. The infected person starts coughing and sneezing spreading bacillus Kochii around him. Unfortunately, any discharge of the TB infected can become a source of infection. You don’t have to be in direct contact to catch the infection. When dry phlegm of the infected person turns into dust it still contains bacillus Kochii. The most common way of infection is through lungs; you can get those micro bacteria just by breathing.

The main preventive measure is very simple: try to keep the cell clean and dry, avoid dampness, keep up personal hygiene standards. The more often you air the cell (especially when doing laundry and drying clothes) or stay away from it (don’t miss a single walk!) the fewer are your chances of getting infected. These are practically the only things you can do being locked in a concrete coffin.

Mange

Discovering in the cell a tiny but extremely malicious bug commonly known as itch-mite won’t add enthusiasm to your drab days in prison. You can catch itch-mite either through direct contact with the infected person or by using his things. The bug is very friendly and likes meeting new people. His movement under your skin can be easily seen as it leaves twisting grayish traces on the body. Itch-mite feels at home under your skin, it reproduces itself successfully and enjoys life in general which is not the case with the unfortunate home-provider. The victim can’t sleep at night because of the unbearable itch, he keeps begging everyone for sulphuric ointment. Once he gets some, he rubs it into his skin several times a day. Washing is not recommended while using the ointment. No need to describe the smell that fills the cell when your cell-mates are fighting the itch-mate.

Syphilis

Syphilis, as you might know, is no longer an incurable disease. However, many prisoners still have various chronic forms of this unpleasant disease. Some haven’t taken the proper treatment in due time, the arrest of others interrupted their course of treatment.

My impression is that most people are quite careless about illnesses, assuming that if nothing bothers them at the moment, there is nothing wrong with them in general. I have encountered two prisoners at different times and in different cells who have had some treatment but haven’t fully recovered. They were surprisingly unanimous in their opinion that syphilis could no longer pose a threat. “Nobody dies of syphilis nowadays”- they would say being absolutely sure that they can get over it without any medical assistance. Frankly speaking, I envied them their optimism. Both had serious offenses and were likely to get long sentences. Who knows, maybe with such attitude to their own health medical treatment won’t do them any good.

Prisoners with veneral diseases are supposed to be kept separately from other inmates. But in reality no difference is made. Some of them don’t even know they have contracted a veneral disease. This is often true about teenage drug-addicts who neglecting all precautions shared the same needle somewhere in the basement of a big apartment building and then screwed the same girl not too concerned about the possible consequences. When they arrive behind bars they are often unaware of the fact that they’ve contracted a VD because of its long latency period. And it is only in prison, when symptoms become too obvious, they realize one has to pay for everything.

AIDS

Acquired immunodeficiency syndrom, another deadly disease, was officially registerd in 1981. The origin of the small virus that ruins human immunity system is still unclear. Virus that causes AIDS can be found in all biological fluids of the infected person - saliva, urine, tears, sweat and semen. Infection, however, is mainly transmitted through blood. Once you have contracted the virus your life inevitably and often quite rapidly comes to its finish.

Inside prison the most common avenues for spreading the deadly virus are:

sharing shaving blades, scissors for haircut and needles for making tattoos. More than once I have watched my cell-mates shaving the backs of each other’s necks with the same razor blade. Another common scene: about ten prisoners sitting in a circle pass a big mug of ‘chefir’ (very strong tea) around each taking a sip. Though contracting AIDS this way is highly unlikely, there is a number of other diseases that can be easily ‘passed’ alongside with the mug.

If the worst happened and your AIDS test proved positive, don’t panic. Cutting your veins or hitting a concrete wall with your head are not the best ways out. You are absolutely right: as of now, the disease has no cure. But let’s take a sober view of things. First of all, depression can only aggravate an illness and AIDS is no exception. Secondly, we are all mortal. People are not so much afraid of death but of its approach. You’ll have to teach yourself to overcome fear. Medical diagnosis gives you the privilege of knowing your span of earthly life. Maybe it’s an advantage when looked at philosophically? Thirdly, being infected with the virus doesn’t automatically mean dying. Poliomyelitis and syphilis also used to be considered incurable. Extensive research is being carried out worldwide. So there are grounds for optimism. Look at some other inmates. Many of them are likely to get a death sentence and their excellent health is not going to help at all.

I hope I managed to persuade you that medical diagnosis is not a death sentence. Everything is in the hands of God. He is the One who arranges stars high above our heads. Remember what Poseidon told Odyssey during his travels?

- A man is nothing without Gods.

Think about it while putting warm socks on. The weather forecast for today is -24 Celsius. Not too hot. Can you hear the noise in the corridor? Guys next door are being taken out for a walk. Our turn is next. So stop dawdling, put a cap on and get ready to go out. You can do with stretching your legs a bit.