Category: Act 6

I am really really sick need to lay back down I hurt so cold. 

These were Nikki Rust’s last known words, recorded in her journal on Wednesday, January 8th, 2014.

At 2:00 am on January 11th, Deanna Rust, Nikki’s mother, received a phone call from the McPherson’s Unit prison chaplain informing her that her daughter had died. In a half-waken stupor of dread, she remembers the chaplain telling her that her daughter had been hospitalized earlier that day, and—with the patronizing certainty of men in positions of authority—he reassured her that Nikki’s death was a result of natural causes.

***

Natural causes. 

In relationship to death, the phrase conjures imagery of a peaceful passing on. A gray-haired human being, in the comfort of one’s own bed, crossing over at the end of a long and full life. At the very least “natural causes” implies a welcome inevitability that is supposed to provide comfort for the living. To say someone died of natural causes is to tell the living that it was, “just this person’s time.” However, in the codified language of government agencies, the phrase has a more specific and legally protective nature. 

The Bureau of Justice Statistics collects data on deaths in custody nation-wide, and divides cause-of-deaths up into the following categories: natural, accident, homicide, suicide, and undetermined. Natural deaths are described as “Deaths attributed to natural agents such as illness or internal malfunctions of the body.”  This clinical definition disguises any death not attributable to an act of violence, deliberate or not, to a failing of the human body. This medical practice is not unique to Department of justice, as the health care system of the United states is rooted in a sense that health and illness are the domain of Providence and individual responsibility. What this institutional definition fails to account for, and what Nikki’s family is attempting to bring to public attention, is the question: At what point could death by illness be considered a wrongful death as result of negligence, rather than simply a malfunctioning of the body?

Nikki died at 12:32 am January 11, 2014 at the White River Medical Center in Batesville, Arkansas. The cause of death—listed by the attending physician and medical examiner—was sepsis and staphylococcus pneumonia.

She had arrived at White River Medical Center several hours prior to her death, after being transferred from the Intensive Care Unit at Harris Hospital in Newport Arkansas. Her medical team at Harris Hospital determined that they were unequipped to adequately treat Nikki’s illness because the Harris Hospital lacked a pulmonologist. Despite this inability to receive the necessary treatment, Nikki had to spend hours waiting at Harris Hospital while her medical team attempted to get her moved to a facility capable of treating her illness. First, they tried to secure an emergency medical flight to transport Nikki to St. Vincent’s Hospital in Little Rock. Unable to secure a helicopter for transport to the larger and more well-equipped hospital, the medical team eventually decided to transport her by ambulance to a closer medical facility in Batesville, but it was too late for Nikki. 

On January 10th at approximately noon, Nikki arrived at Harris Hospital after being medically discharged from the infirmary at McPherson. The medical staff at McPherson documented that Nikki was experiencing “difficulty breathing,” that she was extremely dehydrated, and that they were unable to administer necessary fluids via an IV. It was noted in Nikki’s medical records from the infirmary that she had reported that she had been experiencing vomiting and diarrhea for the previous two days before finally securing a visit to the Infirmary at approximately 11:40 am. 

Nikki had spent less than a half hour with infirmary staff at McPherson’s Unit before they had determined that her health had deteriorated beyond their ability to administer treatment on site. Nikki had spent four days submitting sick call request forms, while watching her symptoms grow worse, before she was granted a follow-up appointment from her initial infirmary visit on January 6th, where she was recorded to have a slight fever and “flu-like” symptoms.

***

What about this scenario screams negligence? Certainly, Nikki’s death was tragic, and it is possible to sincerely feel for her mother, her sister and her surviving family, but  four days isn’t that long to go before being able to secure a second medical appointment is it?  Even with the passage of the Affordable Care Act, tens of millions of Americans (myself included) are uninsured and have limited-to-no access to a doctor. What makes the life of one criminal more valuable than my life? Why should I have paid for Nikki to have instant access to qualified medical care when am I unable to seek out medical treatment for myself, even under the most alarming of circumstances. She did get admitted to a hospital eventually, right? And she even got transferred to one with the correct facilities to treat her condition. How can you be so sure that she would have received more adequate care if she had been outside of prison on her own? Not-to-mention, it’s a contentious claim to say that a woman convicted of first-degree battery for causing a major vehicular collision while driving under the influence deserves the same quality of care as the people her actions injured in the first place.  What about this case warrants any more public attention than any number of more pressing public health, safety or security issues?

***

The official record of Nikki’s death leaves a clinically vague picture of an illness-related death that makes it easy to dismiss the concerns of her family with the same sentiment that we generally attribute to the phrase “natural causes.” Individually, we direct our sympathies to the family for their loss. Socially, we issue a kind obituary and then return to business as usual. 

However, illness, like criminal action, does not occur in the isolation of individual bodies—it occurs within a social and public health context, that must be understood before its causes, effects and consequences can be fully addressed.

In a free-market democracy, where we treat health generally as an individual issue instead of a public one, it can be confusing to understand the public’s responsibility for the health of inmates held within the Department of Corrections. After all, correctional facilities exist to limit and control the freedoms of the individuals under their influence. With nearly half of Americans living paycheck-to-paycheck and lacking the reserved funds to pay the deductible for an emergency room visit of their own¹, the cost of medical care in prisons is an understandably contentious issue. 

In the 2014 fiscal year, the State of Arkansas had to pay $323.44 dollars a month for every incarcerated individual it held in custody.² On average, over this same period, Arkansans were spending $284.74 a month on their own health care, if they could afford it.³ Why is it necessary to pay for the health care of those responsible for violating the laws of our state?

Philosophically, these are the reasons why: 

• Incarcerated individuals are, by codified law, wards of the state. Inmates are locked up in close proximity to other individuals, and none of them get to control their exposure to contagious diseases. 
• The Constitution, under the 8^th Amendment, guarantees U.S. citizens freedom from cruel and unusual punishment, and the Supreme Court has upheld that deliberate indifference by prison personnel to a prisoner’s serious illness or injury constitutes cruel and unusual punishment.⁴

Historically, the debate over the necessity of providing health care to violators of the law extends back to the origins of the prison reform movement of the late 18^th century. The desire to keep the conditions of incarceration harsh enough to deter recidivism has been countered by the risk to public health that can develop from letting illness spread through incarcerated populations.⁵ Without a certain level of care, entire communities surrounding prisons are placed at risk for contagious break out.

It is worth considering why the Center of Disease Control approaches issues of health as threats to public health, while our healthcare and insurance systems continue to treat health and wellness as an individual concern, but that discussion is beyond the scope of the Department of Corrections. As far as Nikki and Nikki’s family must be concerned, access to medical care is a constitutionally protected right for all those incarcerated. But what does “adequate medical health” care look like?

On January 1^st, 2014, Nikki’s bunkmate Jan Maier, along with several other inmates in Nikki’s barracks became ill with flu-like symptoms. By the time of Nikki’s first visit to the infirmary with symptoms of her own on January 6^th, she described her bunkmate’s condition as “deathly ill.” Nikki and Jan’s other barracks-mates began begging guards for Jan to receive medical attention, and even submitting sick-call request forms on her behalf. However, she did not receive additional medical attention until the early hours of January 7^th, when her health deteriorated to the point that she stopped breathing in her bunk. Correctional officers and infirmary employees attempted to resuscitate Jan, but they were instructed to stop by the warden and by 3:15 Jan Maier was dead. 

Jan’s death is listed as a result of natural causes. According to Nikki’s Journal entry from Tuesday the 7th, 

Today has been hard Lord. My Bunkie/friend Jan died. She has joined you. Last night we tried to get them to take her back to medical, for she was so pale, feverish, weak, not breathing good. Well finally at approximately 2 a.m. they took her. At 3 a.m., they were packing her things. Lord, I am so sick and am sad. 

By January 9^th, Nikki’s own illness had progressed to the point that she was too sick to attend her computer accounting class, hosted in McPherson’s Unit, through Riverside Vocational Technical School. Unlike students outside of carceral facilities, students within prisons tend to avoid missing learning opportunities out of fear that they will lose them. Nikki’s absence on this date, therefore, is a strong indicator that she was too ill to get out of bed, and not a student playing hooky.

Because of the death of her bunkmate and the severity of her illness, Nikki—and several of her barracks-mates—spent the day requesting and eventually begging the guards to process Nikki’s sick-call request immediately. Even so, it was another 24 hours before she was brought into the infirmary, and then immediately sent on to the local hospital. It is difficult to say, for certain, that Nikki would be alive today if she had received immediate medical attention, or at what point on the 9^th of January her condition went from treatable to terminal. However, it is even more difficult to suggest that those lengthy delays did not significantly decrease her chances of ever seeing her family again. 

But Nikki’s family didn’t even know she was sick.

This is the injustice upon which her sister Bonnie is resting her legal case against the Department of Corrections upon. Despite her mother being listed as Nikki’s institutional emergency contact on her inmate information form, and despite the fact she had spent nearly half a week suffering from an illness that had contributed to the death of her bunk-mate, the first anyone in the family heard of her illness was at 2 am on the 11^th, after Nikki had already passed away. 

The warden claims that Nikki’s medical situation was never classified as an emergency, and thus no call was made while she was still housed in McPherson’s Unit. However, Nikki spent over 12 hours receiving critical care at two separate hospitals, and yet still her family never received notice that their daughter/sister/mother was fighting a life-threatening illness.

Regardless of whether, it was nature or negligence that resulted in Nikki’s death, it is difficult not to see callousness in the institutional response that her family, her mother, her sister, her two children, have suffered.

In a world where information is so often just a click of a button away, it is easy to see why, for so many incarcerated people, that world of human and familial contact feels like one far, far away.

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1. “The [Federal Reserve Board] asked respondents how they would pay for a $400 emergency. The answer: 47 percent of respondents said that either they would cover the expense by borrowing or selling something, or they would not be able to come up with the $400 at all.” Gabler, Neal. “The Secret Shame of Middle-Class Americans,” The Atlantic, May 2016.
2. Hobbs, Ray, “Department of Corrections Annual Report”, Arkansas Department of Corrections, 2015.
3. Arkansas Heath Connection. “2014 Arkansas Health Plans,” http://insurance.arkansas.gov/QHP-Rate-Overview2014.pdf. Accessed 11 Mar. 2017.
4. Estelle v. Gamble, 429 U.S. 97, 103 (1976).
5. McGowen, Randall, “The Well-Ordered Prison.” Eds. Morris Norval and David J. Rothman, The Oxford History of the Prison. Oxford University Press, 1998. pp. 97.

On May 2nd, 2000 Christina Marie Riggs was put to death by the lethal injection of the toxin potassium chloride. She was the first women put to death in Arkansas since the death penalty was reinstated nationally by the Supreme Court in the case Gregg v. Georgia in 1976.¹ This statistic is misleading in scope, however, because Christina Marie Riggs is only the second known woman put to death by the State of Arkansas since it was incorporated in 1836. ² Newspapers across the nation, and across the Atlantic took notice as only the 5th women in the United States was put to death in the post-Furman era. 

While women are less frequently convicted of murder charges in the US, and in Arkansas specifically, than men,³ there are still 95 women in prison for first-degree murder, ⁴ and yet in none of these cases have prosecutors successfully pursued the death penalty in those convictions. What made Christina’s case unique?

***

Christina Marie Thomas ⁵ was born on September 2^nd, 1971 in the city of Lawton in South Western Oklahoma. By her own account—in a journal that she began in prison—her stepbrother began sexually abusing her at the age of seven. That sexual abuse continued until she was thirteen, when she also experienced sexual assault at the hands of near-by neighbor. To cope, and self-medicate the treatment of these traumas, she began drinking and smoking tobacco and marijuana. By the time she was fourteen, she describes in her journal that: “I felt that no boy liked me because of my weight, so I became sexually active. It was the only way I could have a boyfriend.” She got pregnant at the age of 16 and had to put the baby boy up for adoption. The year was 1988.

Christina finished high school in Lawton, Oklahoma and afterwards became a licensed nurse. According to those who knew her, she had turned her life around and had a full-time job working in a veteran’s administration hospital in Oklahoma City. Eventually she began dating an Air Force man, Timothy Thompson, stationed at Tinker Air Force Base. In 1991, she found out again that she was pregnant. When she told the father, the day before he was to be discharged from the Air Force, he denied that he was the father, and returned to his native state of Minnesota.

Christina then rekindled an old relationship with a sailor by the name of Jon Riggs while he was home in Oklahoma on leave. In her journal, she recorded, “It was great. He felt the baby’s first kick. As far as he was concerned, it was his baby.” Justin was born on June 7^th, 1992.  Jon moved in, and they formally became Mr. And Mrs. Riggs in July of 1993, with another baby already in the womb.

However, Christina, felt her relationship with Jon was troubled from the start, and when she miscarried on the wedding night, the relationship got even rockier. Jon and Christina’s marriage teetered on divorce while she became depressed and suicidal—a condition that Christina attributed to her prescription birth control—which she then stopped taking.  Half a year later, in the spring of 1994, Christina Riggs became pregnant again, and in December of that year she gave birth to a daughter, Shelby Alexis. The family adopted nicknames for the children: “Bubbie” for Justin and “Sissie” for Shelby. It seemed like everything was going to be alright. In her journal, Christina described the scene in the Riggs household, “We were so happy. She was so beautiful. I didn’t think things could get any better. Jon cried. I cried. He was full of so much love for her. The way he looked at her.”

Then on April 19^th, 1995, at 9:00 am a man parked a Ryder rental truck turned into a mobile fertilizer bomb in front of the Alfred P. Murrah Federal building. At 9:02 the truck exploded, killing at least 168 people and injuring many hundreds more. Riggs reports that she was assigned by her hospital to work at a triage station a short distance from the blast site. The stress and suffering of working under such intense conditions weighed heavily upon her, and she told her lawyers later that this experience led to the development of post-traumatic stress disorder. With increasing difficulties in her professional life and tension in the marriage, Jon and Christina decided to move to Sherwood, Arkansas to be closer to Christina’s mother, Carol Thomas, and hopefully receive more support from her family. Christina got a new job at a hospital in Little Rock where her mother was also employed, and the Riggs tried to leave the past behind them. 

But the troubles of their marriage followed them across state borders—in the form of Jon’s abusive behavior and Christina’s worsening depression. The situation finally exploded when Jon punched Justin in the stomach so violently that the boy required medical attention. Christina left Jon and filed for divorce. 

However, the financial troubles that caused the Riggs family to move to Arkansas in the first place got worse for Christina as she had to shoulder the cost of raising two children, and child-support from Jon became less and less frequent. Christina Riggs started bouncing checks, and she let the insurance and registration on her car expire. Despite working twelve-hour shifts at the hospital, she realized that she was not capable of keeping herself financially afloat. The stress of the finical situation, compiled with a history of abuse, depression and trauma, eventually led Christina to believe that suicide was her only option.

Court papers and trial testimony ⁶ tell us that on November 4^th, 1997, Christina acquired the anti-depressant Elavil, the pain killer morphine, and the toxin potassium chloride from the Arkansas Heart Hospital where she worked. She returned to her home and at approximately 10 pm, she gave her two children doses of the Elavil mixed in water to make them drowsy. After the children had fallen asleep, Christina injected her son Justin with the toxin potassium chloride. Unfamiliar with the use of potassium chloride as a poison, she did not know that, used in executions, it is diluted with water to speed the toxin’s travel through the blood stream and prevent it from coagulating painfully in the veins before it reaches the heart. 

Justin awoke screaming in pain. Christina immediately injected him with a dose of morphine to ease his screaming. When that did not work to quiet him down, she suffocated him with a pillow. According to Riggs, he fought back, but he was already in so much pain that she could not imagine leaving him alive. 

After seeing how painful the potassium chloride was for her son, she skipped its usage again and decided to smother her daughter. Christina told the police later that Shelby only struggled “for a little bit.”

After murdering her two children, she moved their bodies to her bedroom where she placed the bodies together in her bed. She then proceeded to write suicide notes to her mother, her sister, and her former husband. Next, she took an excessive dosage of Elavil and injected herself with what she believed was enough potassium chloride to kill a human five times over. The quick onset of the drugs caused her to pass out on her bedroom floor. According to the best estimates of the forensic investigators, all of this had transpired by 10:30 p.m.

When Christina failed to show up for work the next day, Carol Thomas went to see why her daughter was not answering her phone. She let herself inside the house and found the children dead in the bed and Christina lying on the floor, unresponsive. Christina had  a silver-dollar-sized chemical burn in her arm, where the undiluted potassium chloride had burned its way out of her vein, and Carol assumed that all three of them were dead. She called 911. All she could manage to tell the operator was, “My daughter and her babies are dead!” as she cried into the receiver. 

When the paramedics arrived, they found Christina Riggs was still alive and transported her to a hospital where she was put in intensive care and placed under police supervision due to the syringes and suicide notes found on the scene.  The following morning, she regained consciousness, although she was still heavily sedated under the influence of the overdose of Elavil she had taken the previous night. Her family requested to see her, but they were told that she was in no condition for visitors. At 9:20 am, with her mother and sister still denied access to Christina, two detectives were given permission to interview her on record, where they obtained a full, if muddled confession. Two minutes after the interview was concluded, Christina’s doctor found her unconscious in her bed, still suffering the effects of her overdose. 

Despite the suspect manner in obtaining a confession (because she was under the influence, and because her family had already retained a lawyer and informed the police of that status, but were not permitted to speak with Christina before she was interviewed), this confession was the primary article of evidence used in the case to prove Christina’s guilt. Her lawyers tried to submit a plea of not guilty by reason of insanity, but the jury convicted her anyway. During the sentencing phase of the trial, Christina Riggs did not allow her attorneys to put forward any defense and begged the jury to issue her a death sentence so that she could be with her babies. The jury obliged and sentenced her to death.

Christina Riggs died by lethal injection of potassium chloride 29 months after attempting to commit suicide by use of that exact same toxin.

Defenders of her sentence have argued that Christina orchestrated an elaborate ruse by staging her own death and attempting to appeal to the emotions of the jury, by showing remorse and appearing to beg for her life not to be spared. They cite the fact that she often left her children at home, alone, while she would go out to attend country Karaoke for hours at a time, as evidence that she was a woman fed up with the responsibilities of motherhood and looking for an opportunity to escape. They have used her position as a nurse against her, claiming that her knowledge of pharmaceuticals should have been sufficient to inform her that undiluted potassium chloride would not be capable of killing her, ⁷ to insinuate that Christina Riggs was an example of the lowest form of woman society could imagine: one looking to shirk her duties as a mother by any means possible, including the murder. 

Despite strong appeals made on her behalf by her mother, by the ACLU, and other international organizations opposed to the death penalty, Christina Riggs refused to appeal her own case or plead for clemency on her own behalf. Governor Huckabee told reporters, “With all candor, I find myself very much aware that this would be a first in Arkansas. I am not particularly comfortable or necessarily happy with that. On the other hand, I recognize the crime and the process that we have to go through, and I’ll weigh all of those things, but I’m going to try my best to be as objective as I can be in all of this.”

In the end, at least for Christina Riggs, “objective” meant Governor Huckabee holding fast to his personal belief that a governor does not have the power to grant clemency to a prisoner that had not asked for it. It also meant ignoring the strong appeal of Rita Sklar, Executive Director of the ACLU of Arkansas, when she stated in a letter to the governor, “It would be a terrible shame if the State of Arkansas executed a person with mental illness because 1) a statement was taken from her in a drug-induced hallucinatory state, 2) the jury failed to judge her mental state properly, and 3) she was too depressed or deluded to ask for help herself.” The fact that Christina refused to ask for clemency all the way through her execution is strong evidence against those who tried to claim that she had carefully engineered an elaborate ploy to escape the burden of motherhood, and it might be more applicable to consider whether this was ever really a case of criminal justice and not just an instance of state executed assisted suicide.

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1. The court had suspended the practice 1972 in the case Furman v. Georgia, under the premise that it constituted cruel and unusual punishment. In response, states began researching ways they could conform their laws and practices of implementing the death penalty in accordance with factors that had caused the Court to impose its original moratorium on the practice. The five death-row inmates bringing their case before the Supreme Court in Gregg v. Georgia were hoping to force the Court to clearly make the case that the death penalty was in violation of the Eighth Amendment of the Constitution. Instead the court ruled “The punishment of death for the crime of murder does not, under all circumstances, violate the Eighth and Fourteenth Amendments.” Justices Stewart, Powell and Stevens clarified that position by stating, “Retribution and the possibility of deterrence of capital crimes by prospective offenders are not impermissible considerations for a legislature to weigh in determining whether the death penalty should be imposed, and it cannot be said that Georgia’s legislative judgment that such a penalty is necessary in some cases is clearly wrong.” And “The concerns expressed in Furman that the death penalty not be imposed arbitrarily or capriciously can be met by a carefully drafted statute that ensures that the sentencing authority is given adequate information and guidance, concerns best met by a system that provides for a bifurcated proceeding at which the sentencing authority is apprised of the information relevant to the imposition of sentence and provided with standards to guide its use of that information.” Gregg v. Georgia, 1976.
2. The first and, until May 2nd of 2000, only woman put to death in the state of Arkansas was one Lavinia Burnett on November 8th, 1845. Lavinia and her husband Crawford were sentenced to hang after their daughter confessed to authorities that her parents and one of her four brothers had colluded to murder and rob a wealthy town resident known for keeping large sums of money on his property.
3. Women account for about 1 in 10 murder arrests; 1 in 50 death sentences imposed at the trial level, 1 in 67 persons presently on death-row, and only 1 in 100 persons actually executed in the modern era, according to the Death Penalty Information Center’s 2016 factsheet.
4. Arkansas Department of Correction FY15 statistics.
5. Most of the details about Christina’s life and the events leading up to the murder of her two children, were extracted from a number of newspaper articles and obituaries, but most of the details about her life and the things she describes in her journal were found in The Arkansas Times article titled, “They Murder Women, Don’t They” by Michael Haddigan, April 9th, 1999, a year before she was executed.
6. RIGGS v. STATE, Arkansas Supreme Court, 1999.
7. Despite the fact that the exact formulas used in executions by lethal injection were at that time carefully guarded and varied from state to state.