Amid ill and dying inmates, a search for redemption

Inmate pastoral care worker Andrew Shelton, left, reads the bible to William Merritt as the terminally ill inmate lay dying in his room the inmate hospice, inside the California Medical Center in Vacaville on February 11 2011. When a hospice inmate is thought to have less the 72 hours to live, they go 'on vigil' and are never left to die alone. (Brian van der Brug / Los Angeles Times)

By Kurt Streeter, Los Angeles Times

November 20, 2011

First of two parts

The two men walked slowly through the steel-framed door, the older one leading the younger. The door slammed shut behind them.

"Don't worry," said the older man, John Paul Madrona. "It's true people die here, but we help them."

Care and Atonement

At the California Medical Facility in Vacaville, thousands of inmates, some dying, are cared for inside the walls of a high-security prison.

Photos: Hospice care in a high-security penitentiary

Part Two:

In prison hospice, at a loss for the right words

"What's it going to be like?" Freddy Garcia asked.

They passed a row of rooms filled with men in their 50s, 60s and 70s. Most had committed horrendous crimes and would spend their final days in this small wing of the California Medical Facility, a high-security prison at the base of rolling hills near Sacramento. The facility housed roughly 3,000 criminals: some in good health, some ill, some dying.

In the hospice, the oldest inside a California prison and one of the nation's first, some of the dying men looked robust, as if defying their illnesses. Some were hunched and gaunt. One stood in a corner, a mound of flesh jutting from his neck. Inscribed on the fingers of his right hand was LOVE, on the other, HATE. He glared as Garcia walked across the worn linoleum.

"This is going to be the best place for you now," said Madrona, a healthy inmate who had worked at the hospice for two years.

"Six months," Garcia replied. That was how much time a doctor had given him. He grimaced. He was now the hospice's youngest patient, only 24 and with colon cancer.

The tattoos on his head glistened with sweat, but he puffed out his chest, trying to act tough. To Madrona, 35, he seemed like a mixed-up kid — the kind Madrona had been years before.

"We will take care of you," Madrona said. "No matter what, I will be here for you."

Maybe by helping Garcia, he thought, he could make amends for the terrible thing he had done as a young man. Maybe he could find redemption.

Pastoral Care Worker John Paul Madrona, serving a prison term for a 1993 murder, keeps an eye on Steven Thomas as he bathes in the hospice wing. (Brian van der Brug / Los Angeles Times)

John Paul Aranas Madrona was born in the Philippines in 1975, the third son of a prison guard who prayed that he would grow up to become a priest.

A sweet-natured child, he was in large part raised by his maternal grandmother, Lourdes. The young boy vowed to always be at her side, to care for her in her final years. But his mother and father dreamed of America, and as his teens approached he was on a plane to Los Angeles with his parents, sister and older brothers.

The family settled into a cramped apartment in Redondo Beach, and John Paul, dark-skinned and shy, became a target for roving gangs. They would corner him and beat him. One day on the playground, he fought back; before long, he had gained a reputation for his fists. He joined the Scout Royal Brotherhood, a Filipino gang based in Carson. He convinced himself that if a bullet flew in a gang fight he would take it, just to earn his stripes.

On a November night in 1993, Madrona and another gang member named Jeremiah DeGuzman went to an apartment in Gardena and banged on the door. Tracy Takahashi was inside. A 30-year-old environmental chemist, Takahashi had many friends who sometimes would stop by unannounced. He walked to the door, slid back a bolt lock and opened it.

Without pause, Madrona and DeGuzman raised handguns and fired rapidly. One bullet plowed into Takahashi's forehead. When Madrona was caught two weeks later, he realized his mistake. He had gone to shoot a rival gang member. But Takahashi wasn't in a gang, not even close. Madrona and DeGuzman had gone to the wrong door.

A year later, after a jury found the two men guilty of murder, Madrona sat in a Torrance courtroom as the judge read a letter from Takahashi's brother, Dean, then a business reporter at The Times:

I've often wondered what I would say if I had a chance to confront [Tracy's] killers as they pleaded for leniency. They have no reason to fear me.... I don't believe in macho folly retaliation. I would ask them to think about what they've done.... When you pull the trigger, it shatters the bonds that cement the lives of dozens of people together.... You have to realize that you took from this earth someone who was loved dearly. Think about that for a long time. And turn your life around, whether you're in jail or not. No excuses.

The judge sentenced both men to 30 years to life. Madrona entered prison, a 19-year-old trying to mask insecurity with arrogance. But as he grew older, he began to sit alone in his cell and reconsider his life. He replayed his crime, over and over. He thought of Dean Takahashi's letter and imagined Tracy Takahashi living a good and fruitful life if not for him.

One day in the mid-1990s, he and his grandmother spoke by phone. "When are you coming home?" she asked. He'd never told her he was in prison. Weeks later, Lourdes died. His vow to care for her would never be fulfilled. He knew then that he had to change. But how?

Around that time, an inmate asked him to join in a gang fight. Instead, he headed to the prison chapel and prayed to become a different man.

Eventually, he immersed himself in group counseling and took college correspondence courses. Long ambivalent about faith, he became a devoted Christian, attending every worship service he could. He began walking without his strut, stopped cursing and grew out the hair he'd worn for years in the close-cropped style favored by gangs. Prison guards considered him a model inmate.

In 2008, he was transferred to the California Medical Facility penitentiary in Vacaville, 30 miles southwest of Sacramento. He heard about the hospice.

Opened in 1991 in response to the AIDS epidemic, it was cramped and spartan: 17 beds in seven patient rooms surrounding a narrow nursing station. Ill inmates from all over the state could petition to be transferred there if prison doctors gave them a prognosis of six months to live.

A Presbyterian minister inspired by Mother Teresa and Gandhi was in charge. Chaplain Keith Knauf believed that working to ease death could teach compassion. He decreed that no sick convict be judged: not the rapists, not the kidnappers, not the serial killers. Dying in prison — dying, as many did, with overwhelming guilt or bitterness — was judgment enough.

"These men are not pleasant to look at," the chaplain explained matter-of-factly. "How could they do what they did?

"But Jesus was asked: 'How many times should I forgive?' 'Seventy times seven' is what he said. And when you realize Jesus died alongside criminals, to me it makes sense to be here."

Roughly a dozen inmates from outside the hospice worked for Knauf. Most were convicted murderers. The chaplain called them his Pastoral Care Workers. After a series of interviews and background checks — to screen for troublemakers, drug users or sexual predators — he chose them, trained them, mentored them and leaned on them to give the hospice heart.

They massaged aching hands, scrubbed urine-soaked floors, walked sickly men to showers, read to them from magazines and letters, Bibles, Torahs and Korans. Trust, uncommon among prisoners, was built: Whites helped blacks, Latinos helped Asians, Bloods gangbangers helped Crips.

When an inmate's last days arrived, at least one care worker sat vigil day and night. No prisoner, they vowed, would die alone.

Madrona hoped to join these men. Becoming a care worker might help him prove to himself that he could treat death with respect, just as he'd promised to do for Lourdes. Maybe it could be his path toward redemption.

When he applied, Knauf told him there would be peaceful, poignant, even spiritual moments. There would also be gruesome sights, nauseating smells and the curdling shrieks of frightened men.

Each month, on average, five inmates died.

The job, Knauf said, would burrow inside him. Could Madrona handle it?

The chaplain looked across his desk and saw a quiet, starkly handsome man. Madrona had thick wrists, dark eyes and long black hair pulled neatly into a ponytail. He looked both physically strong and deeply sad. "No matter what I say, you won't know my heart until you see the work I do," Madrona said, his Filipino accent thick. "Please…I won't fail you."

The chaplain took a chance.

Freddy Garcia, suffering from terminal colon cancer, prepares to change his colostomy bag in the hospice's common shared bathroom. (Brian van der Brug / Los Angeles Times)

By now it was March 2011, and Madrona was good at his job. "There's not a guy among our dying prisoners who does not find John Paul to be a favorite," said Knauf, who'd come to lean on Madrona. "Despite what he's done, the man we see today personifies kindness."

Madrona had experienced a lot, but he'd never seen a patient like this one.

Garcia had been a member of the Varrio Keystones, a Carson gang. The two men had a lot in common. They'd roamed the same unforgiving streets.

As much as they shared, Madrona quickly realized the new patient was full of contradictions.

Garcia had a sharp wit and could be surprisingly sensitive and self-aware. But there were flashes of wariness and temper.

He looked relatively fit and could walk unaided. But his colon cancer was spreading. A procedure called a colostomy had created a hole in his gut and a bag was attached to it. Every few hours he drained the bag into a toilet.

Then there was Garcia's face: soft, open, with glimmers of innocence. His scalp was covered with menacing tattoos: a prowling jaguar and a skull, the horror icon Freddy Krueger, an intimidating Aztec god, a demon, an angry snake.

Madrona knew they were signs of his ties to Mexican gangs. Though hardly imposing at 5 feet 2, Garcia was known on the streets. He'd already been in state prison once, for burglarizing a house when he was 18. His cancer was discovered in 2009, shortly after he began a second term, nine years for stealing an Oakland Raiders flask from a JC Penney while carrying a loaded gun.

Was Garcia a hard-luck thief — or something worse? He spoke of doing all he could to not hurt anyone on the streets. But he also talked about shootings for which he was never caught.

"I don't think I killed anybody, but I can't be sure," Garcia said, eyes fixed downward. "If I did, it was an accident. I didn't mean to, I swear."

At first, Madrona simply listened. He heard Garcia speak of a future, heard him boast about how he was going to marry a girl he'd met in a visiting room at his old prison. They were going to live peacefully in a suburb.

Marina Luevano was round-eyed, smooth-skinned and as pretty as he'd described. She visited the hospice often. One afternoon, in a patio near a guard tower, she asked her dying boyfriend to marry her. "He might not have much time left," she explained later. "But what time he has, even if people think I'm a fool, I want to be his wife. Some people might look at him and think he's terrible. They just don't see the inside."

There had never been a wedding in the hospice, but Garcia was hardly deterred. When the chaplain agreed to work out details and officiate, he took it as a sign.

"My 'happily ever after' story is going to come true," Garcia said. But when Madrona looked at his tattooed scalp and his sandals covered with scrawled gang symbols, he worried. Garcia hadn't let go of his old ways.

Garcia had petitioned the state for a compassionate release and he'd been turned down twice. That was no surprise. Prison officials, judges and politicians are leery of sending sick convicts home early, partly in fear of a public backlash.

In 2009 and 2010, the state reported 810 inmate deaths in California prisons, many from cancer and liver disease. During that time, 34 compassionate releases were granted.

Despite the odds, Garcia thought he could beat back any obstacle, even if he needed miracles.

Sometimes, though, it was hard to hope. "Why am I here, John Paul?" he whispered one day, looking suddenly frightened. Garcia spoke of how his roommates were a pair of convicted killers and a man who'd molested a young girl. Compared to them, his crimes were tame. "I don't deserve this," he said. "Is God taunting me?"

"Don't doubt God," Madrona said, his voice forceful. "It's not for any of us to know why things happen. What is important is to do our best with what we've been given."

One night, Garcia made an offer: "John Paul, for all that you are doing for me, I want to thank you. I can get you a cellphone." Madrona knew this was a gesture to show that Garcia still had power. Cellphones are prized by prisoners and considered contraband by guards. Madrona no longer played those games.

"No," he said.

Then Garcia said he knew a lonely girl who would write to Madrona. "She can be your girlfriend," he said.

That answer came quickly too: "No, Freddy, I'm fine. Don't you see? I don't need anything material." Garcia stood back, shocked, before saying he understood.

Weeks passed. Garcia threw up blood. He complained his arms felt numb. His chest felt tight. Knowing it might be the last good thing in Garcia's life, Madrona worked to get him to focus on the wedding.

Garcia asked him to be his best man.

"I'm sorry, but I can't," Madrona said, explaining he had to work that day. It was a lie. Prison officials were allowing one guest from the hospice to attend, and Peter McDonald wanted to go. McDonald, 60, was dying of cancer after spending nearly half his life behind bars for murder. He'd dubbed Garcia "the kid" and watched over him. Knowing this, Madrona backed out.

Chaplain Keith Knauf, center, officiates at the wedding of inmate Freddy Garcia, right, and his longtime girlfriend, Marina Luevano. The ceremony was simple and quick. (Brian van der brug / Los Angeles Times)

Finally it was May 6, wedding day. Down a low hallway full of convicts, the chaplain pushed "the kid" in a wheelchair to a well-guarded room lined with vending machines. Luevano, dressed in a purple blouse, arrived with her family. Garcia's family, including Breanna, the winsome 3-year-old daughter he barely knew, drove in from Carson.

The ceremony was simple and quick: the young couple standing skittishly in front of the small audience, an inmate playing low chords on a beat-up guitar, the chaplain speaking of transformation and strength and patience, making no mention of sickness or death.

Luevano's shoulders quivered. Garcia looked ashen. He wrung his hands as he struggled to repeat the chaplain's words: "I will trust you, loving you faithfully forever and ever.... I, Alfredo, take you, Marina, to be my wife."

When it ended, the newlyweds returned to the hospice. They held hands and gently kissed and then Luevano left. Garcia had put up a brave front, but bolts of pain were searing his abdomen. Barely able to hold himself up, he fell onto his bed and covered himself with a thin blanket. He wanted to see Madrona, but at that hour, Madrona was in his bunk.

Madrona now had hopes for Garcia that had little to do with marriage or miracles. He hoped Garcia would grow his hair to cover the tattoos on his scalp. He hoped Garcia would erase the scrawled symbols on his flip-flops. He hoped Garcia would believe that anything was possible but also accept the likelihood of death.

Madrona had seen that the most peaceful deaths came to men who accepted their fate.

"You have to be ready and start preparing for what is coming next," Madrona told him. "Think about showing signs that you have stepped away from what you were."

He might have been saying those last words to himself.

To find redemption, Madrona knew that he too had to show a sign that he had repented — that he had turned away from what he had been. The work in the hospice was not enough.

Perhaps a letter might be.

It would be a letter of remorse and apology to Tracy Takahashi's brother and parents. If only he could find the right words.

kurt.streeter@latimes.com

Part two: As "the kid" battles for his life, John Paul Madrona wonders if he can ever make amends.

Photos: Hospice care in a high-security penitentiary