Held Hostage Friday. Back at Work Monday. Dr. Karen Gedney's 30 Years Behind Bars

In 1987, Karen Gedney walked up to the gatehouse at Northern Nevada Correctional Center to start her first job out of residency. The officer told her he’d never heard of her. Inside, the nurse said she was too busy and handed her off to a man in scrubs — who turned out to be an inmate, not staff. Two weeks later, the medical director who had hired her was dead of metastatic cancer, and Gedney, in her early thirties, was the only physician in the northern half of the Nevada prison system with nobody above her to ask.

She stayed thirty years.

In this conversation with JP Maroney, Dr. Gedney describes what she calls the two worlds inside every prison — the custody world, organized entirely around security, and the medical world, organized around the sickest, most addicted, most traumatized, and most dying people in the building. Her formulation of the difference is the sharpest line in the episode: “They’re constantly looking for you to do something wrong. I’m constantly looking for them to do something right.”

She talks about the men who couldn’t read well enough to spell “hemorrhoids” on the request form required to see a doctor, and the night classes she volunteered to teach after full workdays. She talks about being investigated by the Inspector General’s office in her first months on a complaint that she favored Black inmates because her husband was Black — filed, she says, by a director of nursing married to an associate warden, in a system she describes as deeply nepotistic at the time.

And she talks about October 13, 1989, when a patient serving life without parole took her hostage in the infirmary for roughly ten hours. She was assaulted and raped. A tactical team ended it with a concussion grenade and killed him a few feet from her. She went back to work Monday. Not one custody officer spoke to her. The inmates sent cards — every lifer on the yard signed one.

The second half turns to what she watched from the intake center: men released, then returned within weeks, most of them for technical parole violations rather than new crimes. A construction worker sent back because his crew crossed the invisible line at Lake Tahoe onto the California side. Men returned for missing a monthly supervision payment. Eight-dollar medical copays that follow people out the gate as debt. Twenty-eight dollars and a bus ticket at release, in an era when, as one official told her, that was the whole plan.

She closes on what’s working now — reentry programs built by formerly incarcerated people who lived the problem, including a Nevada organization that negotiated an agreement to get the DMV inside the walls so men don’t walk out without ID, and a dry-cleaner who collects abandoned clothing so nobody starts over in prison-issue blues.

Chapter markers

TimeChapter00:00 | Introduction — Dr. Karen Gedney, 30 Years Behind Bars 00:51 | What does “justice” actually mean? 01:20 | Placed in a men’s prison by the National Health Service Corps 02:18 | Two worlds inside one prison: security vs. medicine 03:24 | “There may be accountability, but there should still be dignity” 04:22 | Literacy, the kite system, and men who couldn’t request care 05:20 | Volunteering nights to teach Health Related Recovery classes 06:47 | “They’re looking for you to do something wrong. I’m looking for them to do something right.” 08:46 | JP on Kent McGowen: a sentence is a chapter, not a life 10:16 | The officers are confined too 12:03 | Day one: the gatehouse, the nurse, and the man in scrubs 14:00 | Learning the vernacular the hard way 14:58 | Two weeks in, the medical director is dying 16:56 | “I was just thrown in and totally clueless” 17:55 | Nepotism, and a complaint from the director of nursing 18:56 | Investigated for treating Black inmates — and married to a Black man 19:54 | “Go right to the top”: meeting the prison director 20:38 | More afraid of coworkers than of inmates? 20:47 | October 13, 1989 21:47 | Suicide by cop, and a fourteen-year lifer 23:05 | The cards from the yard 24:22 | Back at work on Monday 25:03 | The alleyway question 25:56 | German resilience, and a husband who knew what to do 28:03 | Blood in the grout, holes in the wall 28:40 | The phone call from his mother 30:13 | Choosing forgiveness so it doesn’t own you 31:29 | The officer who wasn’t at his post that morning 32:04 | Watching them come back through intake 33:39 | Technical parole violations 34:09 | Sent back for crossing a line at Lake Tahoe 35:09 | 2019: what the Attorney General told the Governor 36:37 | No money, no job, no housing, and medical debt 38:06 | “Twenty-eight dollars — that’s the bus ticket to California” 38:35 | The people fixing this lived it 39:31 | Getting the DMV inside the walls 41:28 | Three dry cleaners and a clothing closet 42:00 | Why Justice Impact exists: everyone is working in a silo 45:24 | Two probation officers who don’t agree 46:26 | The 90/90 model: ninety days before, ninety days after 48:14 | 30 Years Behind Bars — the elevator pitch 49:16 | Chapter artwork by a man who served twenty-seven years 49:46 | Toastmasters behind the wall 51:35 | The icebreaker speech that broke the yard’s racial lines 52:26 | Where to find Dr. G — discoverdrg.com and Prison Unlocked 53:51 | Close

Karen Gedney, MD is an internal medicine specialist who spent nearly thirty years as a physician in the Nevada Department of Corrections, based at Northern Nevada Correctional Center in Carson City. Placed there in 1987 through the National Health Service Corps to satisfy a four-year scholarship obligation, she became the first woman physician assigned to a men’s prison in the state — and stayed three decades.

She was recognized as “one of the best in the business” by the American Correctional Association and received a Heroes for Humanity Award in Nevada for her work on HIV in the correctional setting. Inside, she taught volunteer night classes in health and recovery, founded a Gavel Club (a Toastmasters-format speaking program) for incarcerated men, and arranged for inmate artwork to be exhibited at a Reno gallery.

She is the author of 30 Years Behind Bars: Trials of a Prison Doctor, illustrated by Ismael “Izzy” Santillanes, who served twenty-seven years in the Nevada system. Since retiring she has worked in prison reform, including advocacy for the abolition of the death penalty in Nevada, and serves on the boards of Ridge House and the Nevada Prison Education Project. She hosts the podcast Prison Unlocked.

Guest Links

• Website: discoverdrg.com
• Podcast: prisonunlocked.com (also on Apple Podcasts and Spotify)
• Book: 30 Years Behind Bars: Trials of a Prison Doctor (DRG Consulting)
• LinkedIn: https://www.linkedin.com/in/karen-gedney

Other Links

• Justice Impact: https://justiceimpact.com
• JP Maroney: https://jpmaroney.com | https://linkedin.com/in/jpmaroney