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D. O’Neill, …but everywhere lives in chains?, QJM: An International Journal of Medicine, Volume 103, Issue 10, October 2010, Pages 809–811, https://doi.org/10.1093/qjmed/hcq088
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The prisoner looked lethargic and listless. Manacled to one of a trio of prison officers, he hardly raised his head when I poked mine through the curtains of the cubicle in the Emergency Department. The patient but fatigued cluster of trainees was in the periphery of my vision, silently willing me to hurry up with post-take ward-round, and not dwell overly on the young man with new onset jaundice. A polite request to the prison officers to step outside was met with hostile body language and an abrupt refusal. A brief inquiry established that the patient was a first-time remand prisoner with no history of violence or attempting to abscond. Although assessment of the patient would entail sensitive life-style questions, the monosyllabic replies quickly established that the prisoner officers had little time for such niceties. Still, a little early to telephone the prison Governor to negotiate further, I continued with the ward round, aiming to revisit the situation after giving some time for all parties to reflect on the situation.