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7 Few people head to prison intentionally, but that's just what a couple of KU School of Medicine-Wichita students did. Fourth-year students Christina Bourne and Claire Thomas asked the school to set up a rotation at the El Dorado Correctional Facility so they could familiarize themselves with a small but significant part of health care, Bourne said. "Around three percent of the U.S. population has been incarcerated at some point in their lives," Bourne said. "Having a basic understanding of that culture, and also learning a different system of health care delivery, is important." El Dorado is a maximum-security prison. It houses the state's biggest long-term segregation unit, where inmates considered dangerous are kept in their cells 23 hours a day and has inmates on death row. It also serves as the intake and diagnostic unit for the entire state. "Anybody going to a state prison in Kansas goes through El Dorado — they do an initial intake and health screening. That's where we were able to start off," Bourne said. Bourne and Thomas shadowed Dr. Gordon Harrod, a family medicine specialist and 1994 graduate of KU School of Medicine. Harrod oversees an inpatient hospital known as the infirmary and an outpatient clinic where much of the work is done by nurses. The infirmary also functions as a nursing home for some inmates. In many ways, the health care facilities are like those on the outside — albeit with metal doors, bulletproof glass and guards. Bourne said she and Thomas got plenty of hands-on experience performing such procedures as toenail, cyst, and lipoma removal and suturing lacerations. There are higher incidences of hepatitis and HIV among inmates, and patients with hypertension and diabetes are seen regularly. Inmates from the segregation area were accompanied by a physician, two guards and a nurse when the students saw them. "There is no privacy," Bourne said. "It's quite different compared to the outside, where patient privacy is a priority." Bourne praised prison caregivers, from Dr. Harrod to inmate "porters" who assist in the clinic and infirmary. "He's great," she said of Harrod. "I love watching his interaction with the prisoners. It's very genuine. It's not like there are multiple Dr. Harrods. He goes out of his way to provide the best medicine for the prisoners." Harrod and the other caregivers make the most of their resources, Bourne said. "You might not have every tool available. Maybe you're utilizing a tool in a more creative way." Bourne clearly feels a great deal of empathy for the inmates, while not discounting their crimes. "Everybody in there is a human being. (They've experienced) a lot of poverty, a lot of racial injustice. A lot of guys in there have had hard lives — all of their lives." Bourne and Thomas have collaborated before and share an interest in helping medically underserved populations. They helped establish the JayDoc satellite clinic on north Broadway. "Health care is a right for every individual," Bourne said. For KU faculty, connecting the students with the El Dorado Correctional Facility wasn't as simple as picking up the phone. "It was quite difficult, because there are a lot of layers of red tape you have to go through," said Dr. Kari Clouse, assistant professor in KU's Family and Community Medicine department who helped set up the rotation. "It took a fair amount of work, but now that we have it all in place I think it will be easier for other students." Students are required to do an elective rotation, which can either be one regularly offered by the school or one of their own devising. Several students recently completed special rotations with a direct- pay primary physician, and others took part in a new dermatology rotation. Clouse said at least one other student is interested in following Bourne and Thomas. "I hope they take advantage of the opportunity," Bourne said. "We've been spreading the word. It's the best rotation I've done in medical school." FROM LEFT Rick Kellerman, M.D., Chair, Department of Family and Community Medicine Claire Thomas, Gordon Harrod, M.D., Christina Bourne, and Kari Clouse, M.D.