My Leg

Nursing staff do a medical and mental health assessment during intake at the jail. Because I did intake assessments in a psychiatric hospital before this job I was expecting to see a lot of room for improvement in the psych area but to be honest, I was impressed.  The mental health section of the assessment is just as long as the medical.

I’m assessing this guy and we’re toward the end and I know he was in special ed in school and has a case manager he works with, but he has good communication skills and seems to take pretty good care of himself.  As part of the suicide risk assessment we ask, “Are concerned about losing your job, your house, custody of kids, basically anything significant to you, because of your arrest today?”

And he says, “My leg.”

I say, “You’re concerned you might lose your leg because you were arrested today?”

He says, “Yeah.”

He’s wearing jeans.  My first thought is that he must have an infected wound on his leg, but I’d asked about open wounds on his body and he had said he had none.  No limp or difficulty walking was noted when he came into the room. 

We do take prosthetics away because they can be used as weapons, until they get placed in longer-term housing cells. 

I ask if it’s his right or left, he says, “Left. Last time I was arrested I was living with my Aunt and they took it.”

I say, “OK, let me take a look.”

I put on gloves, and am careful about where I place myself so I don’t get kicked. I squat as far away as I can in case I find scabies or something. I begin to roll up his pant leg. I start slow in case my moving his jeans turns out to be painful for him.

I get the jeans rolled up and there is a very healthy leg and foot with excellent circulation, motor function, and senses intact, no scars, no signs of surgery. No infections, cuts, bruises. Just a healthy, strong leg. I say, “This is the new leg?”

He says, “Yeah, that’s the new one.”

The officer is looking at me with eyebrows raised and says, “They gave you a really good one.”

He says, “Yeah, they did, thank you.”

I assess the other leg for good measure and find another healthy limb.

He denies any other concerns of loss. 

A psych assessment is ordered for the following day, and he is medically cleared for jail.

The feeling I am left with after these interactions is like radio static, both blank and confused, and has become a regular occurrence throughout my day.

What am I missing?

What was that?

What am I doing?

What. . . the what?

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Review

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This piece captures the exact kind of surreal, inexplicable moments that make jail medicine feel like stepping into an alternate reality. It subtly explores the disorienting nature of working with patients whose perception of reality doesn’t align with what’s physically verifiable.

As a healthcare provider, the narrator is trained to assess, diagnose, and respond to tangible symptoms—but in the jail setting, those rules don’t always apply. The collision between standard medical procedure and unpredictable reality is what makes this story resonate. The tone isn’t dramatic; instead, it’s clinical, observational, and subtly bewildered. This makes the final reflection land even harder. There’s no shock or frustration, just a deep, quiet questioning of reality as it unfolds. The officer’s response—“They gave you a really good one”—adds a moment of absurdity that perfectly encapsulates the strange humor of the job.

The repetitive confusion (What am I missing? What was that?) mirrors the slow erosion of certainty and logic when working in chaotic, high-stress environments. The lack of resolution in the story reflects how many cases don’t have clear answers—just bizarre, unexplained moments that linger.