© Copyright 2020 Will McKeithen 1 Life in Prison: Biopolitics, Ill-Being, and the Neoliberal Penitentiary Will McKeithen A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy University of Washington 2020 Reading Committee: Michael Brown, Chair Kim England Larry Knopp Megan Ybarra Program Authorized to Offer Degree: Department of Geography 2 University of Washington Abstract Life in Prison: Biopolitics, Ill-Being, and the Neoliberal Penitentiary Will McKeithen Chair of the Supervisory Committee: Dr. Michael Brown Department of Geography In the US today, 2.3 million prisoners have a constitutional right to healthcare. At the same time, policies driven by neoliberalism and White supremacy have ballooned US prisons, incarcerating largely the working and workless urban poor. This dissertation investigates this juncture through a case study of prison healthcare in Washington state prisons – both its everyday practice and its administration. To do this, I employ policy analysis alongside interviews with state actors, prisoner advocates, and formerly incarcerated women and trans folks. I make three claims. First, I argue that the prisoner’s ostensible right to healthcare depends upon a particular form of what I term ‘carceral biocitizenship.’ Both prison policy and prison healthcare enable and result from a double ontological violence: first, the incarcerated person’s biological being is divorced from its political context or agency; second, the incarcerated person’s biological needs are devalued according to a penal hierarchy of human value. Second, I argue that nutritionist ideologies have been central in enabling the project of mass incarceration. Over the past two decades, Washington state has combined nutritionist ideology with neoliberal rationalities to slowly marketize its prison food system, producing a malnutritious prison food system harmful to prisoner health, well-being, political life, and dignity. Now, the state is finally reforming it prison food. Yet, bureaucrats have taken nutrition science as the only paradigm for ‘healthy’ food. As a science based in White, middle-class food habits, however, nutrition science privileges (cis)sexist, classist, and racist ideals of health. Reform efforts that seek to improve prison food within state-sponsored frameworks reinforce the carceral state and its biopolitical control. Third, I argue that prison creates a care deficit marked by carceral isolation, expropriation, and organized abandonment. To compensate for this crisis of care behind bars, the prison then coerces and expropriates incarcerated people’s unpaid care labor as stopgap. For their part, incarcerated women and trans folks respond to this care crisis through myriad practices of counter-conduct aimed at survival, autonomy, and the pursuit of a good life in a bad life. In my conclusion, I address the implications of this analysis for prison abolition. 3 Table of Contents Figures 5 Abbreviations 6 Chapter One | Carceral Care: Mapping the Biopolitics of Health in a Neoliberal Prison 7 What’s Wrong with Rights? Administrative Violence and the Biopolitics of Prison 10 Biocitizenship and its Discontents 20 Carceral Care 25 Chapter Two | Research and the Politics of Knowledge in Prison America 28 Great Expectations 39 “Notice to stop all work on DOC interviews.” 45 The Carceral State, Criminal Methodology, and Abolition as Horizon-Oriented Praxis 49 Coda: On Language 52 Chapter Three | Carceral Care and the Administrative Violence of Carceral Biocitizenship 56 Prisoner or Patient? 59 The Birth of the Prison Clinic 63 Mass Treatment 67 Uneven Carceral Biocitizenships under Racial Capitalism 74 Suffering—(Un)Diagnosable and (Un)Deserving 76 Gendered and Sexualized Vulnerability under Carceral Care 81 Medical Authority under Carceral Care 86 Afterlife 90 Chapter Four | Prison Food and the Biopolitics of Health Knowledge: Nutrition as Carceral, Reformist, or Abolitionist Science? 94 Nutrition and Neoliberal Penology 99 Eat to Live (On): Nutrition as Carceral Science 107 Nutrition as Reformist Science 125 Chapter Five | Taking Care: Carceral Expropriation and Incarcerated Women and Trans Folks’ Everyday Acts of Commoning 133 Carceral Expropriation and Coerced Care 136 Everyday Dispossession and the Crisis of Care Behind Bars 147 Taking Care: Survival, Reproductive Autonomy, and the Prison Commons 156 Carceral Capture and the Possibilities and Limits of the Prison Commons 171 Conclusion | Abolition Healing 176 Reform vs Abolition 177 Life Beyond Biology 180 Abolition Healing 185 Appendix 187 Works Cite 188 4 Figures Figure 1: Washington Corrections Center for Women from above. Figure 2: Racial and ethnic disparities in prison and jails in Washington, 2010. Figure 3: Washington incarceration rates by race/ethnicity in 2010. Figure 4: Washington’s twelve state prisons. Figure 5: The “breakfast boat” served at many Washington prisons. Figure 6: The difference between recommended, required, and actual vegetable servings in mainline meals in Washington men’s prisons in 2016. Figure 7: The difference between recommended, required, and actual protein servings in mainline meals in Washington men’s prisons in 2016. Figure 8: The racially uneven effects of incarceration on wealth accumulation. Figure 9: Average commissary spending per category per person in Washington state prisons. 5 Abbreviations ACA American Correctional Association ACFSA Association of Correctional Food Service Affiliates ADLs Activities of Daily Living AHA American Heart Association ARNP Advanced Registered Nurse Practitioner BMI Body-Mass Index CI Correctional Industries CO Correctional Officer or guard CRC Care Review Committee DGA Dietary Guidelines for Americans DOC Washington State Department of Corrections DOH Washington State Department of Health DSM Diagnostic and Statistical Manual of Mental Disorders EO Executive Order FDA Food and Drug Administration FPE Feminist political economy HNGs Health Nutrition Guidelines HS Health Services HSD Human Subjects Division HSR Health Status Report IRB Institutional Review Board LWOP Life without the possibility of parole MCS Multiple chemical sensitivity NCCHC National Commission on Correction Healthcare OB/GYN Obstetrician and gynecologist OCO Office of the Corrections Ombud OHP Offender Health Plan PAR Participatory action research PIC Prison-industrial complex PLRA Prisoner Litigation Reform Act PRA Public Records Act PVW Prison Voice Washington RDC Reception Diagnostic Center RDI Recommended Daily Intake RDN Registered Dietician-Nurse RPP Residential Parenting Program SNAP Supplemental Nutrition Assistance Program TEC Treatment and Evaluation Center USDA United States Department of Agriculture WCCW Washington Corrections Center for Women or Purdy WSIRB Washington State Institutional Review Board Carceral Care: Mapping the Biopolitics of Health in a Neoliberal Prison 6 If you really want to understand a system and make significant change (and not just manage symptoms), you must look away from what appears to be the immediate crisis and toward the crisis that is at work even when the system is functioning well. This crisis constitutes the system itself; the system cannot function without its internal crisis…Crisis is not what happens when we go wrong; crisis is what happens when we go right. - Eric Cazdyn, The Already Dead “I asked for them to X-ray my jaw after I got assaulted. They didn’t do it.” In 2010, Morgan was a prisoner at the Washington Corrections Center for Women (WCCW), nicknamed Purdy (see figure 1), when she was attacked by a fellow prisoner. “I got assaulted … my arm, everything … I was laying on my side.” The woman stomped her boot into Morgan’s face nine times, breaking her jaw. “So, she went straight to the hold” and Morgan “went straight to Health Services1,” where a nurse examined her while a nearby guard stood watch. “My face was like swollen. They gave me ice. They put me on like three days of not working. And they sent me on my way.” Morgan laughs as she tells me all this, her guffaws inflected with rage.2 “They wouldn’t X-ray my face. They never took pictures.” Indeed, it would be years later, after leaving Purdy, before a medical professional confirmed that Morgan had indeed had her jaw broken3. “They didn’t give me anything else. The nurse felt so bad the next day that she actually came up to my unit and brought me medicine. Brought me Ibuprofen. Because I was such a mess.” Morgan lay in her bunk in pain for three days, after which she was forced to resume her prison job and programming. Yet, her pain persisted. “My jaw was stuck … and I was having all this 1 “Health Services” can refer to the Washington State Department of Corrections Health Services, to prison healthcare workers, or, as Morgan does here, to the prison clinic as a place. 2 “Almost all great literature on [bureaucracy] takes the form of horror-comedy" (Graeber, 2014: 53). 3 Morgan also later learned from a guard that prison staff had either lost or destroyed the video recording of her assault. 7 Figure 1. Washington Corrections Center for Women from above. Source: Washington Department of Corrections pain radiating down my neck and stuff.” Desperate and hurting, Morgan called her mother, Teresa, who worked as an Advanced Registered Nurse Practitioner (ARNP). “She'd call me,” Teresa explained. “‘What can I do for this and what can I do for that?’ And I’d say, ‘Ask the nurse or the doctor if you can do this. Tell them to give you muscle relaxers’” (personal interview, 2017). Morgan followed her mother’s advice and, after sending several kites4, she received a prescription for muscle relaxers “and those helped,” Morgan told me. Health Services (HS) still refused, however, to X-ray Morgan’s face. “Even if your foot is hanging off of your leg and you say ‘Can I get X-rayed?’ [they will say] ‘The X-ray person will be here in two weeks from Thursday. We’ll see if we can fit you in.’ They’ve got the X-ray machine right there, but they won’t … They’re gonna X-ray you 4 A “kite” refers to any written or electronic communication between an incarcerated person and a prison employee.