Health Care at Alcatraz: Hospital, Sick Call and Mortality

Health and medicine are a lesser-known side of Alcatraz life. This page looks at the island hospital, how illness and mental disturbance were handled, and what records say about deaths among inmates.

Suicide

Few inmates made serious attempts, and prison records show five who took their own lives. Close supervision and frequent counts left little time alone, and nothing dangerous lay about: no guns, knives, ropes or narcotics. An on-site hospital meant quick medical help.

The source also argues that suicide was not a major issue because these were hardened offenders serving long terms who had accepted the consequences, and who in an environment that was not that bad felt they were among a “higher class” of criminal compared with other prisons.

Mental health

Probably yes, some men were pushed over the edge. Warden Johnston remarked that it should be no surprise to find eccentric, erratic or mentally troubled people in prison. Discipline at Alcatraz punished behaviour and did not assess personality, so an inmate who was close to psychosis but followed the rules was generally tolerated.

Someone who behaved very oddly was seen by the psychiatrist on one of his periodic visits. If it continued, he might go to D Block, and if the psychiatrist judged him seriously disturbed, to the “bug cages”, special observation cells in the hospital. The profoundly disturbed were moved to a Bureau of Prisons medical facility. Since a lightly guarded medical centre was what many inmates wanted, they needed to behave in truly extreme ways to qualify. One man who did, Rufe Persful, took a fire axe at work and chopped off the fingers of one hand, and was transferred to the Springfield Medical Center.

Ordinary medical care

The United States Public Health Service provided health services. A medical technician assistant held sick call daily after lunch, handing out aspirin and simple remedies and booking more serious complaints for a doctor.

Injuries and illnesses were treated in the hospital upstairs, above the mess hall, which was well equipped, with an x-ray room, a pharmacy and a two-chair dental facility. Some minor surgery took place there, because that was judged safer than taking inmates to the Public Health Service facility in San Francisco.

Were inmates often ill?

Not especially. These were men in the prime of life, and the island was healthier than life on the run. They lived in a safe setting with nutritious food, clean conditions, regular exercise and plenty of quiet time, and typically gained over ten pounds. Illness occurred but epidemics did not. Some reported for sick call regularly, mostly for medication for minor complaints, and the medical staff believed many were there because they were tired of doing time.

Deaths

Records show fifteen inmates died of natural causes, a low total given the hard lives many had led. The sea air may have helped, but it is more likely that those with poor prognoses were transferred to Springfield and died there. The same records show only a handful of suicides, seven or eight killed by other inmates, seven shot dead during riots or escape attempts, and one drowning during an escape.

Executions

None took place at Alcatraz, and there was no electric chair on the island. Before 1937, any federal execution would have been by hanging. After that year, when a federal prisoner receives a death sentence, the nearest state execution facility is used. In California that meant the gas chamber at San Quentin State Prison, where two inmates involved in the 1946 Battle of Alcatraz were put to death.

See also riots and strikes and solitary confinement.

Overall picture

Taken together, the records suggest a prison population that was surprisingly stable in health terms. Close supervision, regular meals, exercise and a hospital on site reduced many of the problems found elsewhere, while the isolation and uniformity of the routine placed a different kind of strain on the mind. That balance is part of why medical staff, wardens and later historians describe the island in such mixed terms. You can compare it with the daily routine on the facts and figures page.