Despite Atlanta City Council’s failure to close the Atlanta City Detention Center, as they voted in 2019 to do, the opposition to the lingering jail, along with the systemic ills it encapsulates, continues to grow.

As evidenced by the increasing number of white coats in Atlanta City Council meetings, a group of local medical residents- medical school graduates undergoing post-graduate training in a particular specialty- are galvanizing to elevate the message local activists have been telling politicians for years: close the jail and invest its budget back into the community.

Dr. Mark Spencer, an internal medicine resident at Emory, acting as spokesperson for the physicians, said that he first learned of plans to close the jail sometime in 2020, well after a coalition of local abolitionist groups, including Solutions not Punishment, Black Futurist Group, and Women on the Rise, led by justice-involved women, had “already done 99% of the work-” having successfully won city council’s closure vote, as well as organized a task force, which commissioned plans to replace the jail with a center for Wellness, Equity and Freedom.

Dr. Spencer views the remaining one percent effort needed from him and his colleagues to achieve actual and not propagandized public safety, as any effort or new system “centering the most marginalized patients, who have been exploited and don’t have what they need to live a good life,” patients who he has observed encounter the most barriers to health equity, as a result of “systems-based problems.”

Spencer explains that care provided by medical professionals makes up at most 20% of a person’s health outcome, while the overwhelming determinant of health is ultimately environmental. He refers to the starkness of wealth inequality, particularly in Atlanta, and how based on their zip code alone, patients at hospitals like Emory, located in more affluent areas, tend to live ten to fifteen years longer than patients at hospitals like Grady, located in areas with less concentrated wealth. As witnesses to these inequities firsthand, Spencer and his colleagues believe it is incumbent upon healthcare providers to become politically involved- and to back up community efforts towards necessary public health changes, like affordable housing and closing ACDC.

During the most recent city council public budget hearing, nearly the entire public comment portion involved community members and organizations such as GLAHR and SURJ, urging council members to close ACDC and zero out the $16.1 million budget.

In solidarity with the community, doctors shared harrowing observations of incarcerated patients- including one man who was treated at Grady. He had died from metastatic cancer while awaiting trial, bleeding from the handcuff wounds police had given him while chaining him to his deathbed, despite him being too weak to lift his head. They also refused to let him say goodbye to his seven-year-old daughter.

According to Dr. Vanessa Van Doren, who cared for the patient mentioned above, this maltreatment of prisoners by law enforcement and correctional officers is so commonplace that two of Grady’s emergency medicine physicians published an article about them in the New England Journal of medicine.

Medical professionals are uniquely situated to reimagine public safety as witnesses to their patients who are caught in these intersections of the healthcare and criminal justice systems, with the violence of the latter often interrupting the purpose of the former.

Although the job descriptions of physicians and law enforcement are theoretically both charged with confronting harm, it is in the fallout of their intersections when policing and punishment seem most separated from their prescribed purpose, after which medical treatment can only go so far.

“As healthcare providers, we are not interested in punishment,” Spencer says.

“Punishment is not the same thing as accountability, and we’re interested in bringing people back into community, restoring relationships, ensuring harm doesn’t happen again, and meeting the needs of survivors and victims, which our system does not.”

Aside from care, Spencer and his colleagues are interested in evidence.

“Part of being a physician is understanding data, and looking at data- every single medicine we prescribe, every intervention that we do is supposed to be backed by data, and it’s supposed to do more benefit than harm, and when you look at policing as prevention for crime, the data is just not there.”

Evidence demonstrates that policing and incarceration are major social determinants of health due to their adverse effects.

Spencer points out that parental incarceration is so traumatic, that its effects were explicitly chosen to be studied as one of the original adverse childhood experiences, or ACEs, with research dating as far back as the 90’s.

“Even if you have well-meaning medical providers in jails, the overwhelming, overwhelming, overwhelming feeling of a jail is security. That’s their only priority: security and punishment. There’s no rehabilitation taking place, there are no corrections, despite the name, and there’s rarely any severe actual healthcare going on.

“Some of the best physicians in our country, from top institutions, that have worked in Rikers are very open about the fact that no matter how well trained they are, no matter how well their mission is to help the people that are incarcerated there, they’re unable to do that successfully, given the punishment bureaucracy, and the people in charge.”

Atlanta’s Fulton County jail is “even worse,” according to Spencer, where, due to for-profit healthcare providers, “the interest in saving money is the same as not treating a patient fully.”  Spencer attests to patients incarcerated being denied medications “all the time” for HIV, Hepatitis C, and mental health treatments.

One patient was ejected from Fulton County jail without his seizure medication and almost died. Wickie Yvonne Bryant died in ACDC, after being held in a dark cell for nearly a month on a disorderly conduct charge. Not found until hours after she had died, she was found “lying on her bunk in full rigor, with vomit on her face, on the sheet beneath her and on the floor.”

Educating physicians more broadly, at both the resident and medical school level, about the reality of policing and incarceration their patients face is a top priority for Spencer. He says this is important given most physicians have neither experienced an adverse police encounter nor incarceration due to the majority having wealthy backgrounds.

Spencer recalls how “convicted” he felt when he first began his own “unlearning” process. Despite priding himself on studying, he learned most of the narrative he previously held to be true about the criminal justice system from shows like Law and Order.

Now, approximately five years into his political education, including the influences of Mariame Kaba, Danielle Zered, and The Appeal podcast, Spencer seeks to combine what he has learned with his professional expertise and be a “bridge-builder.” With his activist colleagues, whom he says are increasing in number monthly, Spencer shares data within their informal advocacy group and participates in political advocacy whenever they can. Spencer himself additionally gives lectures to his fellow healthcare workers.

While Spencer is a harsh critic of the current systems, what most excites him are the possibilities of what can be created, a sentiment shared by Bay Area architect DeAnna Van Buren, who designed the plans for Atlanta’s future Wellness, Equity, and Freedom Center, and who is likewise a part of a group of professionals committed to abolition.

“Police have so much positive propaganda about themselves that they put out there,” Spencer says; what we need is to show people. . . that there are limitless other opportunities. This is not the only option you can have for safety.

We can create safety in any way that you can imagine.”