His liver destroyed by Hepatitis C, Robert Hagenson didn’t receive a transplant, but a type of early parole—in a body bag. His sudden deterioration and death hit many of his fellow inmates at the California Correctional Center hard, particularly me. Watching a man die by inches is unsettling, especially when he’s a fellow prisoner . . . and a friend.

Everyone called Hagenson “Freddy”. I forget why. He was 45 years old when he began serving a sentence of 25 years to life for an armed robbery he committed in San Fernando Valley back in 1997. Freddy was barely over five feet tall, his body covered in tattoos, and a head shaved clean. He looked every bit the criminal and convict. He walked ramrod straight, strutting like a soldier on parade with half a cigar clamped between his teeth and a determined look in his eye—even if only on his way to the water fountain. A blunt spoken grouch, Freddy said what he thought and did so vociferously. He was notorious for his rants against God, government, and the GOP, rarely letting the facts get in the way of his opinion. While his tirades were generally belligerent and his sarcasm almost legendary, no one, including Freddy, really took it seriously. He was a genuine character.

As cellmates, Freddy and I became friends in 2004. Anyone willing to put up with me bouncing off the walls at all hours, coupled with incessant racket from my typewriter, earns my undying friendship and respect. We remained friends even after I moved to another cell.

Freddy’s criminal career spanned four decades and numerous prison terms. He told me many times he expected to die in prison, but he never expressed a desire to die from the Hepatitis C Virus (HCV).

Freddy’s first real attempt to seek medical attention began in mid 2004. Though he hid it well, I knew he didn’t feel right. Those who knew him for a long time saw he was losing weight. Once muscular, he was now thin as a rail, and getting thinner. Sleep came with great difficulty, if at all, and his memory showed signs of failure. I know nothing of medicine, and naively thought him too ornery to fall prey to illness.

Over a period of a year, Freddy saw half a dozen different prison doctors. Rather than a specialist, or even just one doctor who possessed an intimate knowledge about a patient’s condition, inmates will often go months without seeing the same doctor twice. “Every doctor has a different opinion, and they all tell you something different,” Freddy complained to me one day. Since he always complained I saw no real reason for worry.
August 2004 blood tests showed Freddy’s liver enzymes were at double and triple the high range. The levels were alarming. Even to me it was obvious he needed some form of treatment. Yet he received none.

In October 2004, after a slew of “unreadable”, “partial”, and “lost” test results, coupled with empty stares from doctors who responded to Freddy’s pointed questions by ordering more blood tests, an angry Freddy filed an administrative appeal, trying to get someone to do something. The Chief Medical Officer, Dr. Baron, cancelled Freddy’s appeal a month later. Baron stated Hagenson waived his appeal rights by refusing to cooperate because he had grown angry at the medical staff. The appeal was dismissed and still no treatment for Freddy.

Prison is a breeding ground for all manner of blood borne illness, especially pathogens like HCV. Tainted needles follow the path of contraband drugs like the Angel of Death. Since Freddy had shared needles his whole life, he assumed he had HCV. A liver biopsy in January 2005 confirmed it, and also revealed his chronic HCV had caused severe cirrhosis of the liver. Time was of the essence. A doctor told him he’d soon be starting a regimen of interferon-ribaviron, known as combination drug therapy. While HCV is considered an incurable disease, these drugs have literally worked wonders, clearing the virus from those with certain strains and greatly extending the lives of untold others.

Months passed, more blood tests were taken but no treatment. Then in July, prison doctors determined Freddy’s ammonia levels were now “too high” to qualify for treatment. Instead, they told him they were sending his paperwork to the California Department of Corrections and Rehabilitation (CDCR) headquarters in Sacramento. Another round of delays, and the only therapy he received was another layer of bureaucracy. An entire year elapsed while his condition was treated like a procurement order.
By October, massive gastrointestinal bleeding brought Freddy to death’s door. He vomited blood one morning and a lot of it. I’ll never forget the look on his face, a look I’d never thought to see on the ever-stoic Freddy. He was afraid.
They took him in for surgery, and soon after he seemed to bounce back. Some of his old humor and sarcasm returned, but he barely resembled his former self. The improvement didn’t last long. In early December his liver gave out again. They took him to a Reno hospital in what would be a last attempt to stave off death. The only thing that could save Freddy was a liver transplant. “If they got at me 18 months ago, they probably could have saved me,” he told me. “By the time they did something, it was too late. They killed me.” There was no anger in his voice, only a resignation more alarming than any of his rants.

Finally he went on to say the doctors at the Reno hospital couldn’t believe the prison medical department simply left him untreated after his surgery. To doctors concerned with professional ethics and standards, not to mention malpractice suits, complete inaction when a patient is screaming for treatment is unthinkable. The Reno doctors assumed, at the very least, that Freddy would be placed on a diet low in protein and sodium, which alone can add months to a dying patient’s life. I keep replaying that conversation with him in my mind. Sometimes I even hear it in my sleep. When the ambulance came onto the yard, it immediately came back to me. I knew in my gut they had come for my dying friend. It was December 29, 2005. He died that night, alone.
Most of us, especially those with HCV, are shocked at how quickly the virus took Freddy. Just a few years ago he played handball and worked out with men half his age. Now he’s dead. Freddy might have deserved to be permanently separated from society for a life of crime, but he didn’t deserve a death sentence administered, not through lethal injection, but neglect.
In June 2005, a federal judge placed the entire CDCR’s medical department under receivership, citing the 60 preventable deaths a year as the prompt for this unprecedented takeover. To this day, they are still wrangling and politicking over who is going to be in charge. When medical will be brought up to civilized standards is anyone’s guess. For Freddy, it won’t matter. Blaming institutional indifference or incompetent doctors won’t change the fact the Robert Hagenson died just shy of his 54th birthday. As a prisoner in this system, I should be frightened at the medical care I can look forward to receiving if I fall ill or test positive for HCV. But at the moment, I can’t think about that. Every day I see where he fell out for the last time, and I remember.

Freddy was my friend, and now he’s dead.