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A video showing an incident at a federal prison involving Ashley Smith.
A video showing an incident at a federal prison involving Ashley Smith.

Christie Blatchford

Prison health care leaves something to be desired Add to ...

I must remember, the next time I go for a physical, to have the doctor do it through, oh, maybe the screen door of his office.

He could shout out, "Hey Christie, are you okay?" I might tell him to blow it out his bum. Just my yelling, he would know everything was tickety-boo. Then he could fill out a form and charge the taxpayers for the full monty.

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If ever you worried about the state of Canadian health care, relax. It's excellent. Just don't end up in a hospital or prison as a guest of Her Majesty.

Jurors at the Ontario coroner's inquest into the death of teenager Ashley Smith Thursday saw jailhouse videos which offered a glimpse of health care as it was for this vulnerable, lonely, utterly miserable 19-year-old girl who had by this point spent so much of her adolescence behind bars.

Ms. Smith strangled herself to death at the Grand Valley Institution for Women in Kitchener on Oct. 19, 2007. Guards, apparently paralyzed to inaction by the combination of pressure from the Correctional Service of Canada and their own experience with her - Ms. Smith put ligatures around her neck multiple times a day and she and the guards regularly engaged in a macabre dance - watched from outside her cell on camera, rushing to her aid only when it was too late.

There is no question, from what the jurors have seen from the videos played this week, that some of these guards liked Ms. Smith and tried desperately, within the confines of the ridiculous system in which they worked, to keep her alive.

And Ms. Smith appeared to like them back.

The same cannot be said of the relationship between Ms. Smith and the nurses who would frequently be summoned to her cell, usually to conduct what was called "a post-use-of-force assessment."

The CSC post-use-of-force protocol - and many times Ms. Smith put a ligature around her neck, guards would have to enter her cell to cut it off and use one degree of force or another - called for the whole schmear to be videoed if possible.

One guard would operate a handheld camera, and another would do what amounted to a little TV-reporter-like "standup," identifying themselves by name and offering a brief summary of what had happened.

For instance, in the wee hours of Monday, Oct. 15, 2007, just four days before her death, Ms. Smith, who had told team leader Janice Sandeson she was feeling hopeless, was madly garroting herself.

During the 45-minute-long stretch on the video, she tied two ligatures around her neck on one occasion, and a single one on another.

She was a different girl from the smiling, engaging character she had appeared on video taken during her first stint at Grand Valley four months before.

Now, her face was swollen; one eye was half-shut, probably from the pressure when she choked herself; she was morose; she made none of the one-liners that usually amused her hugely and her guards almost as much. She seemed to be having trouble speaking, and the commentary of the guards ("Her face is getting purple") showed alarm and concern.

As the protocol demanded, a nurse was called for, to make sure Ms. Smith hadn't been injured.

She appeared to be speaking through the cell door, which was opened a couple of inches. "Ashley, can you open your eyes for me? Ashley, you feeling okay?" Ms. Smith barked something, unintelligible on the video, at her.

The nurse continued: "There are no marks on her wrists, legs, feet. No marks on her neck. She's refusing to look at me so I can't see her eyes, but she looks well.

"This completes the medical assessment," she said smartly.

In another video, taken the day before on Oct. 14, Ms. Smith had snaked out an arm through her meal slot and grabbed Ms. Sandeson, who promptly grabbed Ms. Smith's arm and bent it back.

Released from that grip, Ms. Smith attached one end of a long strip of white cloth to the bars of her window, wrapped the other around her neck. She lay down on the floor beside her bed, pulled pillows down upon her, ensuring she was all but obscured from view.

For what felt like the longest time, she remained utterly still, then abruptly stood up. Guards were looking in at her from one window, and told her the nurse was coming, gave her a name. "I don't like her!" Ms. Smith said. "Tell her to go away!" She buried her head in her hands, shook it back and forth, the very picture of misery.

But when the nurse arrived, Ms. Smith was on her feet by her bed.

From outside the cell, the nurse did her standup for the camera: "I'll do an assessment, probably through the meal tray," she said.

"Ashley's arms and legs are fine," she said. "She's standing.

"I was in to see Ashley Smith … she was fine. There's a mark on her right arm.… I was able to complete the assessment."

The assessment? Are you kidding me? A 60- or 90-second glimpse through bars or meal slot or smeary glass is an assessment?

They may as well have said, take a ligature and call me in the morning.

cblatchford@globeandmail.com/

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