Like all dutiful physicians, TDCJ Health Services Division Director Dr. Lannette Linthicum practices the Hippocratic Oath in caring for the 153,000 state prisoners who are her patients. But a Bible quotation also guides her. It reads, “Remember them that are in bonds, as bound with them; and them which suffer adversity as being yourselves also in the body.”
“That is the quote that has sustained me,” said Dr. Linthicum, who recently marked 20 years with the agency. “It’s sort of been my mantra. Whenever I was discouraged, I would look at that and get renewed.”
Indeed, when Dr. Linthicum made her first rounds of the Texas prison system in 1986, she found its health care delivery system ailing. Years earlier, a federal judge presiding over the Ruiz prison reform lawsuit had declared nearly the entire medical program inadequate.
“Things were difficult during Ruiz,” she said. “But I’ve never walked away from anything. The offenders are my patients, and they’re counting on me to advocate for their needs. Everything we do in the Health Services Division is related to advocacy for our patients.”
Dr. Linthicum, then a 29-year-old internist, came to TDCJ committed to four years of public service in return for the federal government’s help in seeing her through the University of Maryland’s School of Medicine as an enlisted member of the National Health Services Corps. In the span of a long medical career, it was to be but a house call. But when it came time to return to her hometown of Baltimore, she chose to stay on to see the Ruiz case through to its successful conclusion.
“Technically, I could have left in 1990,” she said. “But I stayed, and the reason that I stayed was we had not negotiated the final judgment yet and I was asked by the health care administration to stay until we could see a consent decree. It was like there was light at the end of the tunnel but we weren’t quite there.”
But even when the medical program was released from the lawsuit in 1992, the prison system’s mental health services program was not. So Linthicum stayed on to see that happen two years later. By then, however, the agency was converting to its current correctional managed health care system in which medical services are provided to the offender population through contracts with the University of Texas Medical Branch and the Texas Tech School of Medicine. So Dr. Linthicum stayed on to smooth the transition from one system to another. With that done, she figured she might finally return home and open the inner city clinic she had originally envisioned doing after spending her four years in Texas. Instead, she stayed.
“I sort of had an epiphany,” Dr. Linthicum said. “What I realized was that the community that I wanted to serve was here in the prison. It was the same people that would be in the inner city. I also had an overwhelming feeling that this population deserved to have well-trained, competent physicians to take good care of them.”
In fact, Dr. Linthicum said a ruling in a Texas case heard by the U.S. Supreme Court exclusively guarantees prisoners the right to health care.
“Because of that case, prisoners are the only class in the United States with a constitutional right to health care,” she said. “Prisoners have a right to access care, they have a right to a professional judgment, and they have a right to receive care that is ordered. And if you do not meet those basic rights, then under the Eighth Amendment to the Constitution, you are considered deliberately indifferent to a serious medical need.”
Dr. Linthicum, who started her 20-year career with TDCJ as a staff physician at the Huntsville “Walls” Unit, was named director of the Health Services Division in 1998 after a series of promotions. She is a certified internist by the American Board of Internal Medicine and, in 2003, was named a fellow of the American College of Physicians, the premier organization for internists in the country.
“That was one of my career goals,” she said. “It took about 10 years to get that honor.”
The oldest of five children raised in the heart Maryland’s largest metropolis, Dr. Linthicum excelled in academics in public school and earned a scholarship to prestigious Phillips Exeter Academy, a private preparatory school in New Hampshire, for her high school years. She spent her senior year in high school abroad living with a family in Rennes, France, and then accepted an academic scholarship to Smith College in Massachusetts, where she majored in both French language and literature and biochemistry. Up until her sophomore year in college, she had planned on teaching school.
“I was always into the arts and literature, and I found that I had some interest in science, as well,” she said. “So as I started to take biology courses and classes like organic chemistry, it really made me come alive.”
She decided then that she would become the first physician in her family.
“I always knew that I wanted to help people, and I felt like I could help more people by being a physician than I could by being a teacher,” she said. “And then I thought that part of being a physician is being a teacher, because you have to teach your patients how to take care of themselves. So I thought it would be the perfect niche for me.”
But once a doctor, Dr. Linthicum didn’t expect the National Health Services Corps to send her to work in a prison system far from home.
“I was extremely apprehensive about working in a correctional environment,” she said. “In fact, I was very apprehensive about being sent to Texas. I didn’t know anything about Texas. I had no family down there. I didn’t know a single person.”
But 20 years later, despite some complications, Dr. Linthicum says she’s happy she journeyed south and stayed a spell in the Lone Star State.
“In the 20 years I have been here, I have given my all -- blood, sweat and tears,” she said. “And I know in my heart that I have done some good… that I have positively contributed to this health care system."