Customer Reviews

Behind Barbed Wire

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Dr. Charles Marks offers his personal insights into the workings of the medical care system in the Florida Department of Corrections. His thesis is that the structure of the system discourages innovation and promotes the status quo, even when to do so leads to more expensive and poorer quality of care. He provides many examples in support of this position. And it is these fascinating stories which make this book so compelling. Anyone who has ever questioned how medical care in a correctional system is delivered, why things are the way they are, and why it is so hard to make changes will find this book fascinating. Dr. Marks story leaves the reader pessimistic about ever affecting any true reform of "the system."

At the end of a successful career as a surgeon in many parts of the world, Charles Marks took up an appointment as Medical Director of a large Florida Correctional Insitution. There his personal humanitarian drive came into conflict with the essential security requirements of a prison, a place that scars all those who live within its walls. Dr Marks' ideas for a more compassionate and cost effective medical system could save the State about one sixth of its current massive expenditure; since this would be at the expense of entrenched interests he soon provoked many intraprofessional and political antagonisms.

His clinical anecdotes and other stories are cogently told. He gives us a clear exposition of his views, developed after deep reflection on his experience, about the causes of criminal conduct, and its relation to mental derangement. He discussses the death penalty and related appeals processes. This readably written book should be of wide interest, especially to those who would reform the system, or might contemplate a career with the Department of Corrections.

Dr. Marks has clearly defined the good ole boy system that still active in CHaCI. I have worked at Charlotte Correctional for many yrs. After the Edwards affare you would have thought things would change, but only minor inprovements have happened.