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As a young doctor, I helped perform a Santeria ritual for a patient in jail, rather than sending him to psychiatrists. I think I did the right thing.
The entrance to Ward D, in the bowels of Jackson Memorial Hospital, was through a thick steel door with a chest-high peephole. A cop sat on the other side. The room was a bare concrete rectangle with steel manacles embedded in the walls and a piss trough at the far end. I figured the D stood for dungeon. In front of each set of wall irons there was a gurney, usually with an inmate from Miami’s Dade County Jail sitting or lying on it.
Many years ago, I was doing my residency at Jackson Memorial, the major teaching hospital for the University of Miami School of Medicine, and part of our emergency room training was caring for sick prisoners. Inmates from the jail, one of the largest and most overcrowded in the country, were transported to Ward D for their medical care.
I remember a young man who’d been stabbed in the eye, a toothbrush quivering in his socket while his hands were shackled over his head to the wall behind him. There was a famous musician, high on a multi-drug cocktail, who had scraped his nimble guitar fingers raw trying to claw his way up his cell wall. And usually, there were a number of heroin addicts having seizures from going cold turkey. The word was that nine or 10 inmates had died in the Dade County Jail the year before, from overdoses, suicides, or murder.
Several of my fellow residents and I tried to improve conditions for the prisoners. We began staffing regular clinics in the jail, and at the minimum security Dade County Stockade, and we were able to substantially cut down on transfers to Ward D.
One late afternoon, as I was leaving the jail clinic, one of the guards asked me if I would mind checking on an inmate he was concerned about. He said he looked like he was in a trance, that he hadn’t moved or batted an eye since they brought him in the night before.
We walked up to the fifth floor, accompanied by a surround sound cursing cacophony. “Hey Doc, look at this!” “Fuck you!” Screams. Urine thrown.
The young man was alone in his cell, sitting in a lotus position, staring straight ahead. He was slender and wore an overlarge white jumpsuit. He was handsome and Hispanic, with dark brown curly hair. His name, the guard said, was Jose, and he’d been brought in the night before on a burglary charge. The guard had no more information.
Jose was motionless, catatonic. I suspected he was schizophrenic—although seeing him sitting like a baby-faced Buddha on the cell floor, it was difficult to imagine him stealing anything the night before. He did not respond to any of my questions. I picked up his hand and felt his pulse, holding his wrist, and he kept it there, chest high, when I let go. He had very long fingernails on his thumb and pinkie. Probably not a guitar picker, but handy cocaine spoons, I thought.
The guard called downstairs for more help and a gurney. We picked Jose up and rolled him to the small jail clinic.
Ron, a physician assistant, was there starting duty for the night shift. He was tall, fit, and smiling, with short blonde hair in a flat top and a clean-cut, confident presence. This was the first time we’d met. Ron watched as I examined Jose. He had evident needle track marks on his hands and forearms, and he kept his arms in the same positions I put them in while examining, like a doll, unmoving. His heart and lungs were fine and his pupils responded normally, contracting to my penlight, but I didn’t even try to have him lie down—he was stuck in his rigid, cross-legged posture.
Ron nodded his head at me, and we walked into our small office. Ron told me he thought that someone had put a mojo on Jose—that he was hexed, and that his fingernails were a clue. “Santeria,” he said.
I’d just learned about Santeria the week before—an Afro-Caribbean belief system that spread from the Yoruba culture of West Africa to Cuba and the Americas. Joan Halifax, a PhD. student in anthropology, had given a fascinating talk to our residents about hexing, spells, mojos, and witchcraft among the mix of Cubans, Haitians, Puerto Ricans, and Bahamians living in South Florida.
I suggested to Ron that we might be seeing hysteria, a conversion reaction in which overwhelming mental stress can cause paralysis. But in any event, we ought to have him evaluated by the hospital psychiatrists, in Ward D.
I called Joan Halifax, introduced myself, and told her about Jose. She said she’d come right over, and I arranged with the warden to allow her to come up to the clinic.
An hour or so later, Ron explained to Joan and me that he had been a medic before physician assistant school, and that after Vietnam, he’d spent considerable time in the “islands” at an unnamed military installation. There he’d become interested in Santeria and had befriended an Obispo, a bishop in this complex religion that blended elements of Catholicism with Yoruba gods and goddesses. The Obispo had taught Ron how to do exorcisms, and Ron said Jose needed one.
I could have said no. I could have just sent him to Ward D. But then Joan and I wouldn’t have this story to tell.
Ron placed a large brown grocery bag on the floor, from which he produced a beautiful king conch shell. We all walked into the exam room, and standing in front of Jose’s staring face, Ron lifted the conch shell above his head and smashed it into a hundred pieces on the floor. Then he picked up a sharp piece of shell, gripped Jose’s left wrist, and cut an X into his forearm, blood oozing out from the pattern. Then, with another piece of shell, he cut a matching X into his own left forearm. Jose did not flinch. Facing Jose, Ron bound their cut arms together, palm-to-palm, with a red bandana. They spent the night in the clinic like that, tied together.
I called the clinic in the morning and Ron told me that Jose was talking, He said that he’d performed some other Santeria rituals that night, and that Jose finally blinked a couple of times and asked where he was. He wasn’t hearing voices, and didn’t seem paranoid, but was pretty scared, reasonably normal behavior under the circumstances. As a physician, I’m still not sure why Jose woke up, but it could have something to do with grooming—that special behavior that we humans share with many animals—the ability to soothe each other, by touch, or talk, or tradition.
We all met late that afternoon at the jail, and Ron related Jose’s history. Jose was in his early 20s. His family had come to Florida from Cuba shortly after the 1959 revolution, while they still could. They moved to New York City to be closer to relatives, but as a teenager, Jose started using heroin, and his mother moved the family back to Miami to try to escape the drugs. It didn’t work. His mother finally kicked him out of the house, and she told him that she’d consulted the Obispo about him, and that he could return if he got clean. Jose told Ron that he’d only come back to his family’s house because he was looking for a place to hide after he’d robbed a convenience store. But when he arrived, he found a king conch shell by the front door and cops waiting in the bushes. Ron said, the king conch shell represented Elegua, the Santeria god and guardian of the crossroads of life, the spirit that controls entrances, exits and decisions, and that Elegua had put a spell on Jose, or at least Jose thought he had.