John and Ken
One twin became a guard, the second a prisoner. Their story is a parable of the mistreatment and neglect on New York City’s Rikers Island.
At 2:30 a.m. on January 9, 2006, John Loadholt, a 42-year-old tire repairman from Brooklyn, was in the bathroom at the Anna M. Kross Center of New York City’s Rikers Island jail complex, fumbling with his asthma pump, trying to breathe. A corrections officer, called J.T. in files, knocked on the glass.
“Having a little difficulty,” John told her.
After 10 minutes, J.T., instead of calling a medical team, told John to walk across the courtyard to the clinic. He retrieved his ID and inhaler, and a different officer, P.H., escorted him out of the housing unit into the night. John staggered along the walkway to the other building. The guard asked him to speak, but he was unable.
John began slowly to fall. The guard, P.H., caught him and lowered him to the ground. P.H. felt for a pulse and listened for breath. At 3 a.m., a corrections captain zoomed up on a battery-powered cart, passing the medical unit that was headed to the scene. The captain found John unresponsive.
Half an hour after first complaining of his asthma attack, John Loadholt was pronounced dead.
Since 2008, more than 100 people have died in New York City’s jails. Some were suicides, some homicides, and some were natural, unavoidable deaths. Others were due to substandard or nonexistent medical care. A 32-year-old man and a 61-year-old woman bled internally until they vomited blood. A 44-year-old man died from sepsis, caused by flesh-eating bacteria. As inmates kicked doors or refused food, begging jail workers to help their neighbors, people died of common, preventable illnesses in their cells. Investigative documents reveal at least a dozen such instances in the last five years.
Rikers, the island lockup in the East River, is probably not the world’s worst jail. But it is supremely bad at its de facto job: as the city's unofficial hospital for people who are mentally ill, use drugs, and commit crimes.
Three hours south of the city in Vineland, New Jersey, John’s twin brother, Ken Loadholt, learned of the tragedy and came up to identify his brother’s body at the morgue. He wanted to see John’s face and hands and feet. Ken thought maybe John had been beaten, but when he looked down at his twin on the coroner’s table, John showed no signs of violence.
Ken asked for the coroner’s report, but it was pending. He called the Department of Corrections and the District Attorney. He didn’t know how to get answers. The medical examiner finally issued a death certificate with the cause of death: asthma attack. It also noted that John had been put on methadone, strange because he was a crack cocaine user, not a heroin user.
It didn’t make sense to Ken why his brother would die of an asthma attack during a short stay at a city jail while awaiting trial for a drug possession charge. He was overall a healthy 42-year-old man, working a manual job most days. But Ken ran out of stones to turn, and he made plans to bury his brother near his home in New Jersey.
The Anna M. Kross Center is one of 10 New York City jails concentrated on Rikers Island, which is home to 11,000 prisoners on a given day. Most are serving time for minor crimes such as misdemeanor drug possession or violation of parole. Some are awaiting trial. An estimated 40 percent are mentally ill.
Charges of abuse and neglect on Rikers are nothing new, and reform efforts are underway. This past summer, the federal prosecutor for the Southern District of New York, Preet Bharara, joined efforts to improve the conditions of adolescents in solitary confinement. Mayor Bill de Blasio has now come out with a new plan meant to keep mentally ill people from living at Rikers like long-term patients. Neither of these initiatives would have been much help to John Loadholt, a drug user.
Rikers is not a prison. Those with felony sentences are shipped upstate to rural institutions like Adirondack, Albion, Altona and Sing Sing. There, neighbors from whole blocks of Brownsville and East New York in Brooklyn serve years-long sentences. Rikers, on the other hand, is intended as a transit point for newly arrested prisoners awaiting disposition of their cases; inmates are not supposed to be there for longer than a year, though many are there for much longer.
Because Medicaid, the healthcare program for those who cannot afford insurance, is suspended as soon as a person is arrested, cities and localities foot the bill for medical care in jail. In New York City, the health department for the last decade has contracted out care at Rikers to Corizon Health, a specialist in correctional healthcare. Corizon (called Prison Health Services until a 2011 merger) cares for more than 345,000 people in 27 states, according to its website. The company brought in over $1 billion in revenue last year.
Its critics charge that the company emphasizes profits over care. The Palm Beach Post has investigated Corizon in Florida for deaths there. After a lawsuit in Virginia, Corizon backed out of its contract there, and the company recently lost contracts in Maine, Maryland, Pennsylvania and Tennessee. Washington DC’s City Council voted this spring to keep Corizon out of the district.
In 2011 New York City re-upped its $400-million-plus contract, even giving Corizon immunity from medical malpractice or civil rights lawsuits — meaning that the city foots any bills for mistreatment. At the time, there was little alternative. No local hospitals or community organizations wanted the job. By June 2015, however, sources told me that the city was ready for a change. Corizon’s contract would not be renewed, I was told, and instead the city’s Health and Hospitals Corporation will take over the job of providing care to New York City jail inmates.
Throughout Corizon/Prison Health Services’ tenure, a commission in Albany has been quietly tracking the company’s record. The State Commission of Correction looks into each death in custody in New York, and if it deems it suspicious, writes up a review of the circumstances. The commission wrote up reports on at least eight Rikers cases in the last decade, including four suicides and four deaths related to physical illness.
Commissioners receive a full portfolio of the circumstances of each death, including medical history and the events of the preceding hours. The reports tell the true story of each death, pointing out mistakes on the healthcare company’s part, including misdiagnosis and issuing the wrong medication.
The report on one inmate, David Caban, details his early life, spent in and out of mental hospitals and on the street, and his stumble into Rikers after a run-in at Bronx Psychiatric Hospital, where he had been living for years. Caban was first hospitalized after a hallucination-induced attack on a pedestrian. After he assaulted staff at Bronx Psychiatric, hospital officers took him — wrongfully, the commission found — to a nearby precinct, and from there he was sent to the island. He died within days, ultimately left restrained on the floor to die in January 2009 while attacked by hallucinations to the point of cardiac arrest.
The commission also found serious medical mistakes in the case of Devernon Legrand, 43, who died of asthma in 2006. About a half hour before he died, a Rikers doctor told him there was nothing wrong with him and to leave the medical ward, the commission reported. He was never given the breathing equipment he needed, despite many requests.
In November 2007, inmate Edwin Ruiz, 44, was turned away from the Rikers clinic, which was overcrowded at the time. By the next morning he was going in and out of consciousness, and he died a day later. The commission found that the Rikers clinicians “caused his death” from sepsis caused by necrotizing cellulitis, or flesh-eating bacteria.
The reports lay out an excoriating rebuke of Corizon’s practices, saying the company, in its previous identity as Prison Health Services, is a business corporation holding itself out as a medical provider and calling for a reevaluation of its capacity to give care.
These commission reports were never shared with the families of the deceased. The city corrections and health department received them, as well as the state, but no one thought to pass them on. (I obtained them through a Freedom of Information Law request.)
When I called the Loadholt family eight years after John’s death with news of the report, John’s twin brother Ken was working a double shift at the Cumberland County jail, where he served as a guard.
“Some people say, ‘He’s the good one, he’s the mean one,’ ” said Ken.
“I was always the mean one.”
The twins developed along different paths. John Loadholt was born first, Ken two minutes later, on December 8, 1963, three months after the March on Washington and two weeks after JFK died in Dallas. Their mother, Lula Loadholt, brought her fourth and fifth children home to a low red brick house on Stone Avenue in Brownsville. That snowy Sunday, the dark-eyed, brown-skinned newborns were indistinguishable.
Lula worked as a cook at an Italian restaurant. In addition to fried chicken and collards, the family’s big Friday night dinner gatherings featured lasagna and eggplant parmesan. The cousins played tag and kick-the-can in the street, while the adults listened to the Spinners and the Commodores and talked about growing up on the farm back home in South Carolina.
The seven siblings went to P.S. 155 on weekdays and the Kingdom Hall on Sundays for bible study. At age 10, John and Ken got after-school jobs at Pablo’s tire shop around the corner, where Pablo paid them $5 or $6 to patch rubber and fix hubcaps.
Ken was better at school. Everyone liked John, asking Ken where to find him.
“Some people say, ‘He’s the good one, he’s the mean one,’ ” said Ken. “I was always the mean one.”
They started together at Thomas Jefferson High School in the late ’70s. They had different friends, would DJ in different Brooklyn basements. Music: Ken liked heavy metal. John liked disco.
John was tracked into special ed classes. He dropped out of school in 11th grade, against Ken’s advice. But John wanted to work and make money. He got a full-time gig at the tire shop.
Ken stayed in. A year after graduating, at 18, Ken, unhappy working a series of odd jobs, walked by the local army recruiting station and thought he would take the test and see what happened. He changed his mind and didn’t show up for basic training. But the recruiter did not take no for an answer, and came to his house to get him. Ken watched from a window as the recruiter walked up the steps. And Ken changed his mind again.
He was stationed in West Germany, and he traveled to Belgium, the Netherlands, all around Europe, sending pictures back to Lula and John. But he was homesick among strangers.
He might have switched with his brother if he could have. He wished John could take his place on a ski trip to Austria because the cold didn’t bother his twin.
John and Lula got Ken’s postcards back in Brooklyn. The twins’ older brothers also fled the coop, two to join the Army and Marines. Only John stayed back with their mother. As she aged, he got her groceries and fixed things around the house.
And she took care of him, trying to help him overcome his burgeoning crack habit. Lula’s sisters had a room for her in South Carolina, but she was worried about John.
In the TV room at a missile range in New Mexico, Ken met a medic from New Jersey named Mary. They married in El Paso, calling Lula from a pay phone with the news.
John worked at Pablo’s tire shop six or seven days a week, 10 hours a day. He had an on-again, off-again romance with a girl from the neighborhood, a friend since childhood.
Ken and Mary moved to South Korea, Washington and finally New Jersey, where in 1994 Ken became a corrections officer at the Cumberland County jail.
A Jehovah’s Witness, Lula had banned Christmas and birthday celebrations, but Thanksgiving was the one holiday allowed, and the family reconvened for the feast at the new place on East New York Avenue. It was like old times: lasagna, Lula, all the brothers.
Everyone knew about John and crack, Ken included. Ken warned him that he would report his brother if he saw drugs. John did not smoke in his presence.
Lula died in 2003, and John spent the Thanksgiving of 2005 at the Anna M. Kross Center at Rikers Island, picked up on a drug possession charge. He was in court on November 29, noted in records because he missed an appointment at the health clinic. He missed several other appointments too, because corrections officers never removed him from his cell, despite a chronic asthma diagnosis that needed tending. The clinic was so overbooked that on a typical day the clinicians saw only 20 of the 89 patients scheduled.
In the last conversation Ken had with his brother, John was telling him how he wanted to clean some of the stuff out of his room. Ken offered to help, but John refused the offer. Christmas and New Years came and went. Ken did not know John was in jail.
When I visited Ken’s house in Vineland, an Army flag waved in the driveway. Mary ironed in the den, a scarf tied around her head. John, in a T-shirt and shorts, sitting on a bed, smiled down from a photo hung in the living room. Ken slowly turned the pages of the State Commission of Correction report, learning the details of John’s last minutes.
He read aloud from the report. “Loadholt’s asthma was inadequately managed by Prison Health Services, Inc. (PHS, Inc.), a business corporation holding itself out as a medical care provider.”
He sat quietly, tucked in his chair in a dark corner near the door, reading random pages and sentences out of order. He was remorseful, remembering that his mother, from her deathbed, told him to care for John.
“I knew what she meant,” he said.
He thought his job as a corrections officer might have thrown him off the scent of the answers he sought eight years ago. Even though he had seen the worst of what happens in jail, he said, he wondered if some part of him defended it, too.
But he tried. When I asked to see the death certificate, he went into his office and emerged moments later with two copies in a crisp blue folder. He also held a black-and-white photo of the two boys, in Sunday best, 5 or 6 years old, 1968 or ’69. Maybe it was around when Bobby Kennedy died, or Martin Luther King.
Ken never knew what John thought of him. “I mean, I never really asked him,” Ken said, “but he, say if, you know like probably more times than I can recall, he would say, ‘You did good for yourself. You got out.’ ”
“I don’t know why they refer to it as getting out,” Ken said.
And with that, he had to go to bed. He had worked two doubles in a row at the Cumberland County Jail, and would work another tomorrow.