Have You Seen Your Wound?

I’m working in the housing unit where inmates who are acutely sick, or have severe chronic conditions, are housed. Anyone in a wheelchair is housed here because a wheelchair, or crutches, and many other assistive devices can be used as weapons. There are people here who are deaf and developmentally delayed. I wonder how bad a crime a blind-wheelchair-bound person could really commit, and learn physical disabilities do not prevent people from being evil mother fuckers. Then, I consider it could actually be a pretty solid reason to be angry at the world and wonder how so many others have managed to cope so well.

I’m doing wound care on a gentleman with pressure sores to his butt cheeks. He is the third person I am performing dressing changes on this day for pressure sores on their butts.  These guys are sitting in their cells on their asses, and their asses are starting to rot away.

Two of them are minor and will heal.  This one though - this guy, has had these wounds over a year. He is wheelchair-bound, but young and otherwise healthy. He is paralyzed from the waist down secondary to an unsuccessful suicide attempt by jumping. I don’t usually work this unit so I’m not terribly familiar with him, but the other nurses are. They tell me he’s non-compliant, doesn’t communicate what they ask him to, like when the dressing becomes saturated. They want to keep the dressings clean and dry so the wound can heal, but he just leaves them there, soaking with wound ooze or feces. They say he is unmotivated and doesn’t care.

I find this reasoning hard to believe. If he had a suicide attempt he has a lot of psychological pain. He is now wheelchair-bound and in jail - the guy doesn’t have great coping skills and now has limited options. He’s still eating and drinking though, so he hasn’t given up.

I feel like there’s a gap between his thinking and his wounds. It’s like he doesn’t understand the severity. They’re nasty, they’re deep, it’s not normal for someone his age with no comorbidities to have a wound like this that stays this bad.  I don’t think he knows that. All it would take is for him to keep pressure off of that spot and the dressing dry for it to heal. As it is, it’s out of hand, it’s heartbreaking, it’s time-consuming for us, and there is no end in sight. I don’t like this. This feels like we’re not doing our job. 

I keep thinking about him and am solutionless. It could be attention-seeking behavior, but he'll be housed here anyway, and even if it's part of it, I still feel unsettled. The next time I’m working the unit, I go in to change his wound and he lies on his belly on his bed.  I talk him through what I’m doing because that is what I was taught to do and because I think it’s respectful and important.  

“I’m gonna pull your pants down, OK?”

“I’m going to spray saline on it to clean it and it’s going to be cold, K?”

“I’m pulling off the old bandage now.”

“I can’t feel anything,” he says, “So you don’t have to warn me.”

“I just want you to know what I’m doing,” I pause and ask, “…Have you seen your wound?”

He shakes his head no.

“Not at all?” I ask.

“No,” he says.

“I was thinking about the fact that there are no mirrors in here,” I say, “and that if you can’t feel this wound, and you can’t see it... it’s easy to be really disconnected from your body and what it’s doing, and what it needs.”

His eyes start to water.

“I know we take pictures sometimes,” I say, “to keep track of how it’s healing, right?”

He nods.

“You can ask to look at the pictures.” I say, “It’s OK to ask.”

He’s still face down on his bed. I’m dressing his wound. I’d wanted to say more, but I didn't anticipate his eyes would water and this is suddenly feeling like an extremely vulnerable position for him to be in.

I don’t say anything else till I’m leaving his cell, “If there’s anything we could do you think might help… let us know, OK?”

He nods.

Taking someone’s freedom to be out in public and do more or less as they wish is one thing. But the psychological punishment of jail is gnarly. We change people’s relationships. With society, with their community, with law enforcement, their family, their work, themselves. We do this at a point when someone is decidedly making poor choices. How do we expect this change in relationships to be for the better without massive, massive support? Is the idea that we want people to become functional, contributing members of society or do we want them to begin the process of rotting away?

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Review

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This story is haunting, deeply empathetic, and painfully honest. It stands out for its unflinching examination of human suffering within a broken system, shining a light on the layers of punishment—physical, psychological, and systemic—that extend far beyond incarceration. It grapples with some of the most uncomfortable truths about how neglect, institutionalization, and isolation can lead to a slow, invisible decay—not just of the body, but of a person’s very sense of self. The raw empathy brought to this story challenges the reader to confront how systems of punishment can erode not just freedom, but humanity itself.

The story tells a tale of a man's absence of physical sensation, mirrors, and human connection exacerbating his suffering. It's not just that he's paralyzed—he's disconnected from his body and his pain, which creates a horrifyingly passive relationship with his own deterioration. It questions the role of our prison system, as punishment, rehab, or a slow, sanctioned erasure of humans whose identities have been reduced to their worst moments. This vulnerable subject matter is navigated with an incredible balance of empathy and clear-eyed realism.

The narrator highlights how the healthcare system in prisons often mirrors the punitive mindset of the justice system and the reality that neglect can be just as destructive—and perhaps more insidious—than overt cruelty.