Fatty Cyst
January 2016
I've been incarcerated in the United States Federal Prison system for approximately 10 years. In that time I've come to understand that I could have made much better career choices. Through the years I have taught myself enough about the law to help several other convicts get back some time that was owed to them. I have learned how the widely used digital radios work, at least well enough to fix them when they get broke. And I have performed a couple minor medical procedures. The term "minor medical procedure" can probably use a better explanation, so let me tell you how this skill came to pass.
It all started, as they say, one day when a fellow convict, let's call him 'Joey", was complaining that he had smashed his toe at work with a cinderblock or some other heavy type object. Usually this injury would require him to go to medical to have it evaluated, documented and treated, but he was afraid that he would be written an incident report, known here as a "shot". This being due to him not wearing the proper footwear at work. The proper footwear being the unaltered version of the boot issued by the prison which is hard, heavy and has a composite piece of plastic sewed into the toe to protect the foot. The boot isn't something most want to wear for 6 to 8 hours everyday, so many of the convicts will cut out the plastic to make them much more comfortable. This leaves you open to getting your foot crushed if you drop something like a cinderblock on it, but some call that an acceptable trade-off.
Since Joey didn't want to get the shot and potentially lose privileges, he didn't report it, choosing to deal with the smashed toe instead. This is where I come in.
I was told his toe was swollen and the toenail was turning blue. I'm no rocket scientist, but I could tell the blood had no place to go, thus causing the pain and swelling. After talking with him I suggested that he relieve the pressure with a razor blade. Most people have a very hard time inflicting pain on themselves, and this was likely to hurt, so he asked me if I would do it. I'm not squeamish and I'll try anything once so I said "sure". So we started preparations, including breaking the blades out of a new disposal razor, finding someone with a tube of antibiotic ointment and I even score an alcohol pad (these are hard to come by).
I washed the razor blade to remove any coating it might have had, used the alcohol pad to clean the toe area I planned to slice open and I got a band aid ready to put on afterwards. I wasn't really sure what to expect so I also had a clean towel ready in case there was an excessive amount of blood.
He propped his foot on a chair in his cell. I used an ink pen to draw a line across the toe where the nail meets the skin to show him where I would be cutting (I've seen "Botched" a couple of times I admit) and to see if he could feel it. He couldn't, it was numb from the trauma. So I took the blade and made an incision across his toe where I could see the blood collecting and I had drawn my line. Instantly blood poured from the cut. Not much fresh blood, mostly dark, old blood, since the accident had taken place many hours before. There was really more than I thought possible, but not so much that I feared I had cut some unknown toe artery I felt relatively certain I had cut deep enough to let off the pressure and reduce the swelling, but not so deep he needed stitches to close the cut, which I was prepared to attempt as well. In for a dime, in for a dollar.
From this point one I became the "go to" guy for all things medical. That's how it works in prison. Someone shows some sort of acumen for a particular subject and he becomes an expert or professional in the minds of the others around him. And thus I end up performing a second toe procedure on a guy with a flag-football injury, some smashed fingers / thumbs and then the piece de resistance.Joey's cellmate, "Homer", comes over to my cell to talk to me and get some advice. He has a fatty cyst on his forehead and wants to know if I will help him get rid of it. Now I'm in the Big Leagues. No more hands and feet, I've got a guy asking me to cut on his face. His visible, soft flesh head. I say to him that I really think this is a job better handled by medical, but he says medical wont do anything because in their eyes it's a "cosmetic" issue. So I say "sure, let's do this", at which point he stops me telling me he has a visit coming that weekend and that he'll come back on the day opposite his visit. My first thought is "chickshit", but when Saturday came around, there he was at my door.
Try not to read too much into this. A fatty cyst on the forehead isn't extremely deep. It looks like a big pimple that has come to a head, but that you can never pop and wont go away None the less, he wanted it gone. So I did all the same preparations I've done in the past with the thumbs and toes, making sure to clean everything as best as I can, but with this being uninjured skin I was concerned that he would feel it more. The last thing I wanted was to have him jerk or flinch while I'm only inches from some body part that I could permanently disfigure. I went to find a tube of Oralgel anesthetic to put on the are with the hopes that it might numb it. I applied it, waited about 5 minutes and guess what P When I asked him if he could feel me poke it with a needle he said "no". Did the Oralgel numb it P Probably not. Is the power of suggestion and my selling skills enough to make him thinks it's numbP Yeah, I was.
After testing for site-numbness (thanks again "Botched"), I tilted his head back, took the blade between my thumb and finger, used them as a depth gauge sliding the blade across the cyst making a cut only deep enough to slice it open, but not touching the rest of his forehead. Nothing happened though. There was no blood. No puss. No fatty goo. Nothing. I though I had missed. That maybe the blade had moved in my hand and that I didn't cut him at all. I asked him if he felt what I had done and he said "a little", so I grabbed the towel in case it started to bleed, put my thumbs on either side of it and did a little squeezing. BAM! A thin line of blood appeared like a paper cut followed by a thick off-white substance. I used a pair of tweezers to pull the fatty stuff out, wiped away the small trace of blood, applied some triple antibiotic ointment and covered it with a band aid. I told him to leave it alone and to not get it wet. I don't know why, it just sounded right.
The next day he goes to visit. No band aid and no real visible marks. When he comes back from visit he comes directly to my cell. He tells me his family noticed right away that the cyst was gone, wanting to know how it was taken care of since he had already told them about the "cosmetic" excuse from medical. His answer, "I know a guy", like it was a mafia surgeon removing a bullet in the backroom of a Brooklyn deli.
He then proceeds to thank me and asks me what he owes me for my services. What P I tell him he doesn't owe me anything. I mean would you charge a guy for giving you the opportunity to be a surgeon for an hour P I thought I should have paid him really He insisted that he had to give me something, so I tell him whatever is fine. He leaves and then comes right back handing me a package of mackerel. I accepted his payment, then he puts his closed fist over his chest and says "from my heart man, from my heart", leaves without saying another word and maybe a tear in his eye. In his mind this might be the nicest thing anyone has ever done for him in prison.
I obtained a certain status with him from that point forward. Until he left early last year I would hear him telling the story from time to time when new guys would come in.Just a touch of awe in his voice saying "that dude Casper, man he's a beast"!
Prison Stories by Brian Casper
Here the Storie Fatty Cyst as pdf
