New warden named at Nevada State Prison

January 22, 2009

CARSON CITY, Nev. (AP) – Greg Smith, whose 22 years working in Nevada’s prison system has included stints as an administrator and public information officer, has been named acting warden of Nevada
State Prison.

Smith replaces Bill Donat, a state Corrections Department staffer since 1976, who will retire Jan. 30.

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Donat was praised by Corrections Director Howard Skolnik for helping to meet department goals and leading the prison system to “financial responsibility.” But a representative of prison employees said he’s glad to see Donat leave.

Read more here… , and in the Nevada Appeal (see comments), and and also read these comments here (I copy them here in case they are moved):

Another case of “good riddance to bad rubbish”.

The only one missing him will be that scumbag Skolnik.

—-

This article is incomplete. Donat’s replacement has been appointed. Greg Smith, now Warden Smith, another 400 to 500 pound barnyard hog, to go along with his buddy at Ely State Prison, Warden McDaniels. Could you imagine trying to feed these two calorie burners on $2.17 a day like the inmates have on their plate?

Director of prisons, Howard Skolnut, has in his employ some of the most arrogant, brutalizing & despicable clowns this state could possibly dig up from under a rock–as wardens for the prison system.

What bothers me is that few citizens speak out and permit this type behavior to continue. Most know this brutality exists and duck their heads rather than correct it, or demand from their legislators–this brutalizing stupidity stops.

We all know this is an unpopular subject, but folks, this treatment is brought from those iron gates to your front yard when the inmates are released. Very seldom is a fairly treated inmate leaving prison, come out with hatred in his heart and punishes the first person he sees
standing in front of him.

How can an inmate think you all deserve his hatred? Well, your tax dollars permit this brutalizing warehousing to continue by correctional staff. Folks, you get what you pay for…

Demand your tax dollars go towards schooling, trade-training, plus drug & alcohol treatment programs and other meaningful life skills. An inmate locked away in a hole 24/7 is never going to be the correctional answer for reform.

We all know that, but yet–we still close our eyes as to what prison treatment is doing to our misbehaving citizens, and then, we all wonder why these men & women act so negatively when released.

All the above won’t stimulate most, and in your best interest folks, seek better answers, but this state is foundering in stupidity and money woes. Do you think a half billion of your hard earned tax dollars in the next two years could be better spent on schools, mental health and seniors?

Speak up, or your next tax bill may have you selling your home to pay that tax bill. Release the non-violent & minimum custody inmates & get rid of the brutalizing prison administrators,who have made a career out of tricking the public into believing the job they are doing is the only way to successful rehabilitation and is in your best interest.

Get rid of the present parole system as we know it, and replace it with a better plan, and totally call for an audit of the prison system. Until then, you are just their continuing sucker.

geezelouise, you’ve got it right, again.

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New allegations against Ely Max

This is an article published on May 11th, 2008 in Coyote-TV, by the High Desert Advocate. The full article can be read here.

New allegations about inadequate medical care at the maximum security prison in Ely may take the case to a whole new level, said ACLU attorney Alan Lichtenstein.

“If they are true we are moving beyond simple negligence to malfeasance and perhaps criminality,” the ACLU lawyer said in a telephone interview Wednesday.

Contained in a declaration to the Nevada Public Defender by former ESP Registered Nurse Lorraine Memory Wilkins, Wilkins maintains that even the most basic medical care was purposely denied to some inmates resulting in the deaths of at least two.

The declaration published in this edition of the High Desert Advocate, further asserts that the now suspended Chief Medical officer Dr. Stephen MacArthur would intentionally provoke inmates with racial and/or religious insults and when the inmate became combative would use their reaction as reason to suspend medical care.

Wilkins further contends that the administration at Ely Max turned a blind eye to the Chief Medical Officer’s actions and took no action to remedy the situation.

The declaration to the public defender is part of Wilkins unjust termination lawsuit filed last month in federal district court.

The suit alleges that Wilkins was fired after she complained to prison official about MacArthur’s personal and professional conduct.

Fired in 2006 Wilkins first pressed her claims at the state and then at the Federal offices of the Equal Employment Opportunities Commission.

Earlier this year the Federal EEOC issued Wilkins a letter finding that she had grounds to file a wrongful termination suit.

Wilkins suit gives strong support to a suit filed earlier last month by the American Civil Liberties union on behalf of five ESP inmates that claim they and others were being denied medical care even to the point of death. …….

Excerpts from the Declaration of Ely Nurse Lorraine Memory

Taken over from: Make the Walls Transparent

“My name is Lorraine Memory. … I am a registered nurse, licensed by the state of Nevada. I am also employed by the state of Nevada as a registered nurse at Ely State Prison. I am making this declaration because I believe that the medical care provided by the state of Nevada at the Ely State Prison falls below the standard of care mandated by the state medical licensing requirements and, further, that the health and safety of the individuals incarcerated or working at Ely State Prison has been and is endangered. …

“Dr. (Steven) McArthur and Warden E.K. McDaniel are indifferent to the medical needs of every inmate. I believe that most of Dr. McArthur’s medical decisions were made based upon the costs of treatment. Indeed, Dr. McArthur has bragged on many occasions about the amount of money he saved the prison system. …

“Dr. McArthur did not treat Mr. Lisle’s cardiac condition. I believe I know the reason behind this. There was another death row inmate who suffered a stroke and Dr. McArthur saved his life. Dr. McArthur told me that Warden McDaniel jumped on him and asked him why he did this. Warden McDaniel told Dr. McArthur that we are not to save a death row inmate’s life. Once this occurred, Dr. McArthur essentially stopped anything more than rudimentary care for death row inmates. …

Warden McDaniel told Dr. McArthur that we are not to save a death row inmate’s life.

“I believe another reason for Dr. McArthur’s actions is that he is unable to interpret lab results. … Dr. McArthur never attempted to diagnose a skin condition. … (To save money), inmates did not receive x-rays. … (N)o hepatitis testing is allowed … (B)y overruling the orders of a medical professional, I believe that Warden McDaniel is practicing medicine without a license. … (I)nability to have medical visits has persisted for a period in excess of eight weeks. …

“I believe that Dr. McArthur does not have the training or experience necessary to treat the inmates at Ely State Prison. Moreover, I do not believe that Dr. McArthur wanted to provide adequate medical care to the inmates. Based upon my observations of Dr. McArthur’s actions and statements, I believe Dr. McArthur to be racist and, in some cases, sadistic. I have heard Dr. McArthur call African American inmates ‘nigger,’ ‘nigger pussy,’ ‘Black motherfucker,’ and ‘Black son of a bitch’ to their faces. I have observed Dr. McArthur bait inmates into verbal confrontations to avoid treating them – through the use of similar racial slurs. …

“(H)e often discontinued medication for an inmate whenever the inmate responded to Dr. McArthur’s verbal provocation. In reality, Dr. McArthur discontinued life saving medication such as insulin which may have caused the early demise of some of our patients. …

I have heard Dr. McArthur call African American inmates ‘nigger,’ ‘nigger pussy,’ ‘Black motherfucker,’ and ‘Black son of a bitch’ to their faces. I have observed Dr. McArthur bait inmates into verbal confrontations to avoid treating them.

“I believe that Dr. McArthur wants to punish some of the inmates. He has said so. Moreover, Dr. McArthur specifically stated in my presence that he wanted to ‘kill every one of you mother fuckin’ Muslims in this country and not let any more of you in here.’ On another occasion Dr. McArthur stated to me he was ‘sick and tired of dealing with all these whiney people – I wish I could have been a hit man for the Mafia.”

Ex-ESP nurse sues NDOC for wrongful termination

By JOHN PLESTINA
Ely Times Reporter
Ely Times, April 16, 2008

Allegations of retaliation for workplace whistle blowing against a former Ely State Prison employee has resulted in a federal lawsuit seeking $1 million in damages. Additional allegations contained in a court document that was filed last week include racial discrimination, sexual harassment and intentional medical malpractice.

Lorraine Wilkin is suing for $1 million.

Attorney Treva Hearne, representing former ESP nurse Lorraine Memory Wilkin, filed the lawsuit April 8 in U.S. District Court in Reno. The complaint and demand for a jury trial names the Nevada Department of Corrections, DOC Director Howard Skolnik, ESP Warden E.K. McDaniel, ESP nurses Joe Brackbill and Mary Eaton, Dr. Stephen MacArthur and DOC Medical Director Dr. Robert Bannister as codefendants.

The complaint calls conduct by the defendants “outrageous” and demands financial remedies totaling $1 million for the wrongful termination of Wilkin. The suit alleges that Wilkin has suffered discrimination in employment, emotional distress and interference with her professional license.

Language contained in the complaint includes, “statutatory protected whistle blowing by the plaintiff of drastic malpractice intentionally inflicted upon prisoners held at Ely State Prison.” The suit states that Brackbill and Eaton were both supervisors of Wilkin.

MacArthur, an obstetrician-gynecologist working at the William Bee Ririe Hospital Rural Clinic, was the supervisor of the medical unit at ESP for several years until the DOC placed him on leave in early 2006.

MacArthur eventually was terminated from the state job. The reason cited was he refused to give up his job at the Ely hospital clinic.

Hearn, of Hager & Hearne of Reno said if the case reaches a jury there will be a lengthy wait. “I think it’s (wait for trial) going to run about 20 months,” she said. Hearne cited a large number of immigration cases scheduled in U.S. District Court for the delay.

She was asked it she expects an out-of-court settlement. “There is no way of knowing. All you can look at is statistics. Eighty-five percent of cases are settled out of court,” Hearne said.

“We were hoping they would expedite it more than that because I have a really bad heart,” said Wilkin, 61, who has suffered five heart attacks, three during the more than nine years that she was employed at ESP.

Known as Lorraine Memory during most of the time she was employed at the prison, she married Ely physician Bruce Wilkin in September 2006.

An ESP employee since 1997, Wilkin filed a complaint with the U.S. Department of Health and Human Services Office of Civil Rights in January 2006 claiming racial discrimination against African American inmates and sexual harassment of female professional staff by MacArthur.

Language in the complaint filed on April 8 says that the U.S. District Court complaint states that MacArthur made “sexual innuendos” toward Wilkin and “showed her pornography on his (office computer) screen saver “knowing that she would be shocked and offended.”

“It was pornography,” Wilkin told the Ely Times last week.

The document that was filed in U.S. District Court states that the civil rights complaint accuses MacArthur of “racial discrimination and intentional medical malpractice against black inmates at the prison.” It also states that she reported the denial of medical care to prisoners who were in pain or suffering respiratory distress and patients with diabetes.

In February 2006, Wilkin filed a complaint stating that MacArthur made unwanted sexual advances, retaliated against her for rejecting his advances and displayed pornography at ESP.

In June of that year, Wilkin was reassigned to a night shift. The suit alleges that the action was in retaliation for her previous complaint.

Wilkin filed a subsequent complaint with the Nevada Equal Rights Commission and with the U.S. Equal Employment Opportunity Commission.

Her reassignment to a night shift came after Wilkin had suffered a heart attack and took sick leave. Her physician had advised her to work on light duty during daylight hours. The complaint states that her supervisors knew about her medical condition.

“I had three (heart attacks) while I was working there. Yes they knew,” Wilkin said last week.

The Department of Corrections terminated her on Feb. 18, 2007. The suit claims that her firing was in retaliation for reporting “the abuse of inmates at Ely and the neglect of their medical conditions and for her reporting the sexual harassment by Dr. MacArthur.”

The complaint alleges that her firing was the result of her disclosing information to the federal Public Defender and other agencies investigating medical malpractice and abuse at ESP.

Wilkin’s lawsuit comes on the heals of a class-action suit filed March 6 by the American Civil Liberties Union, also in U.S. District Court in Reno. That action is class-action on behalf of the more than 1,000 prisoners at ESP and does not seek monetary damages. It simply demands improved medical care for ESP inmates that meets minimum constitutional standards established by a previous court decision.

That complaint alleges that adequate health care was not provided to ESP inmates and calls the lack of care “a pervasive pattern of grossly inadequate medical care” and demands that a court-ordered monitor be appointed to oversee medical care at ESP. That suit names the NDOC, Skolnik, Bannister, McDaniel, Gov. Jim Gibbons, Attorney General Catherine Cortez Masto and Secretary of State Ross Miller as codefendants. Gibbons, Cortez Masto and Miller comprise the State Board of Prison Commissioners.

The ACLU lawsuit claims that several inmates were denied medications while suffering excruciating pain. Some inmates receiving medical care at ESP have died including former Coasters manager Patrick Cavanaugh, an insulin-dependent diabetic who died in the ESP infirmary in 2006 at age 60 after developing gangrene. The ACLU maintains that Cavanaugh had been denied medication. He had been convicted in Las Vegas in 1984 of the murder of Coasters group member Nathaniel “Buster” Wilson in 1980.

Adding to the Department of Corrections’ woes, Cavanaugh’s family also filed suit last week against the state’s prison system, claiming it failed to provide medical treatment for him.

In its lawsuit, also filed in U.S. District Court in Reno, the family contends the maximum-security prison refused to dispense insulin for Cavanaugh’s diabetes.

In reporting the Cavanaugh suit, the Associated Press said Dr. Simone Russo claimed in a medical report attached to the family’s lawsuit that MacArthur denied Cavanaugh his insulin.

“It seems obvious that this goes beyond malpractice to the level of criminal behavior,” Russo said in his affidavit. “But I am not qualified to make that judgment.”

Nicole Moon, spokeswoman for the state attorney general’s office, declined to comment on the lawsuit. “At this point, we are still reviewing and evaluating it,” she told the Reno Gazette-Journal.

A large number of complaints over the past few years to the ACLU of Nevada about health care deficiencies at ESP led to a review by Dr. William Noel (a physician contracted by the ACLU) in October 2007 of the medical records of 35 ESP inmates.

The ACLU’s National Prison Project reported that some prisoners were refused pain medications and others were denied heart medicines. The most serious allegation is that Cavanaugh developed gangrene after being denied insulin and subsequently died. As a response to Noel’s report, the ACLU asked the NDOC in late 2007 to comply with the nationally recognized medical standards established by the National Commission on Correctional Health Care.

Attempts to contact MacArthur by telephone were unsuccessful.

(Ely Times Editor Kent Harper contributed to this report.)

ACLU Lawsuit Charges Grossly Inadequate Medical Care At State Prison In Nevada

This is a press release on the ACLU website of 3rd June 2008, about the report made by Dr Noel about the medical neglect at Ely State Prison. Up to today, in January of 2009, nothing has been done by the Nevada Department of Corrections to stop medical abuse (including withholding vital medication for prisoners). This is widely considered cruel, inhumane and totally unnecessary extra punishment.

The original article, including podcasts of victims and the ACLU can be viewed here.

In December of 2007, Dr. William Noel, a medical expert retained by the American Civil Liberties Union to investigate medical conditions inside the Ely State Prison in Ely, Nevada — a small town located at the junction of State Routes 50, 93 and 6 in Eastern Nevada — released a report that exposed galling inadequacies in the level of medical care provided to the 1,000 inmates — including more than 60 Death Row Prisoners — incarcerated there.

Noel was retained after the ACLU’s Washington, D.C.-based National Prison Project and the ACLU affiliate in Nevada received dozens of complaints from prisoners charging that both acute and chronic illnesses were not being cared for, that prescription medications were not being handed out and that many prisoners were forced to endure undue pain and suffering — even to the point of being left on the brink of death — as a result of callous disregard on the part of prison officials.

What Noel discovered and detailed in his report was nothing less than shocking. Margaret Winter, Associate Director of the ACLU’s National Prison Project — which tracks prison systems across the country — said the conditions at Ely “are as horrific as any we have ever seen.”

In his report, Noel wrote that medical care at ESP shows “the most shocking and callous disregard for human life and human suffering that I have ever encountered in the medical profession in my 35 years of practice.” According to the report, which was sent to Nevada Department of Corrections Director Howard Skolnik last December, there is a horrific pattern of neglect, misguided health care policies, and little accountability for frequently under-qualified staff. Noel also noted numerous instances where important medical records were missing from prisoners’ medical files. Finally, Noel and the ACLU have raised serious concerns about prisoners who died and were cremated before autopsies were completed and their families notified.

In the wake of the report, lawyers from the National Prison Project leaped into action, pushing hard for corrections officials and officials from Nevada’s state government to begin implementing desperately needed reforms aimed at ensuring that the prisoners at Ely were no longer denied their constitutional right to basic medical care. The ACLU’s pleadings fell on deaf ears. So on Thursday, March 6, 2008, the National Prison Project and the ACLU filed a lawsuit against Skolnik and other top corrections and governmental officials.

A copy of that lawsuit, along with numerous other resources — including a podcast with an ACLU lawyer from the Capital Punishment Project who draws a direct connection between Ely’s substandard medical conditions and the fact that a higher percentage of Nevada’s Death Row inmates volunteer for execution than anywhere else in the country — can be found on this site. It is all part of the ACLU’s ongoing litigation and advocacy aimed at protecting the rights of all Americans.

Poor medical care cited at Nevada prison

LA Times
December 06, 2007
Ashley Powers and Henry Weinstein, Times Staff Writers

ELY, NEV. — When Nevada death row inmate Charles Randolph asked for a specific medicine to address his heart condition earlier this year, Max Carter, the prison’s physician assistant, sent a curt reply: The medication was the wrong kind and potentially lethal, but he would be happy to prescribe it “so that your chances of expiring sooner are increased.”

When another prisoner, John O. Snow, asked for pills in July to ease the pain from his deteriorating joints, Carter’s denial came with another stinging missive, stating that he was “gonna let you suffer.”

To many prison observers, Carter’s responses exemplify the callous indifference custody officials at the maximum-security Ely State Prison have for sick prisoners. There has been no staff doctor to handle the medical needs of any the 1,000 inmates here for more than 18 months. Carter is the highest-ranking medical worker at the men’s prison; the last staff doctor was a gynecologist.

According to interviews and records obtained by The Times, prisoners at Ely have been denied care for heart problems, diabetes and other serious medical conditions. Earlier this year, a nurse was fired after complaining about substandard care at the facility, which she said led to one inmate needlessly dying of gangrene.

Attorneys for some Ely inmates say they believe the lack of medical care has played a role in a high percentage of death row inmates giving up their appeals and “volunteering” to be executed. All but two of 12 inmates executed in the state in the last 30 years have been volunteers. No other state in the country has had close to that percentage of volunteers, records show.

Recently, the American Civil Liberties Union’s National Prison Project has taken up the cause at Ely. ACLU attorneys Amy Fettig and Margaret Winter have met with corrections officials and pressed for reforms to improve inmate care.

A doctor working with the ACLU was granted access to 35 inmates and their medical records in October, and he came to a stark conclusion.

“The medical care provided at Ely State Prison amounts to the grossest possible medical malpractice, and the most shocking and callous disregard for human life and human suffering that I have ever encountered in my 35 years of practice,” Dr. William K. Noel said in a report sent Wednesday to Howard Skolnik, director of the Nevada Department of Corrections.

“It is highly unlikely that these 35 cases are aberrations,” Noel wrote. “These cases show a system that is so broken and dysfunctional that, in my opinion, every one of the prisoners at Ely . . . who has serious medical needs, or who may develop serious medical needs, is at enormous risk.”

Skolnik said Wednesday he had not seen Noel’s report and could not comment on any specific allegations. However, he added: “I do know that I have recently been informed through some other auditing that the access to medical care and the quality of care provided by the department meets or exceeds community standards.”

An attorney who represents the corrections department said she could not comment, as did an assistant to prison warden E.K. McDaniel.

Max Carter did not respond to messages left for him at the prison’s medical department.

Dr. Steven MacArthur, the obstetrician-gynecologist who was the prison’s last staff doctor, said it was difficult to treat inmates with severe psychological problems and who cursed and spat at staff. Some prisoners refused to visit the infirmary simply because they couldn’t smoke there, he said. Nonetheless, he said, they were well cared for.

“Most inmates age in dog years. They beat the hell out of themselves,” he said. “They have lots of aches and pains.”

In his report, Noel said he found instances of prisoners being denied medical attention despite suffering from seizures, syphilis, deep vein thrombosis and rheumatoid arthritis. He acknowledged that many Ely prisoners “have committed horrible crimes” but said physicians took an oath to make “no judgments as to character or morality” when treating a patient.

Under a 1976 Supreme Court decision, based on the 8th Amendment’s prohibition against cruel and unusual punishment, government officials are obliged “to provide medical care for those whom it is punishing by incarceration.”

In a letter accompanying Noel’s report, ACLU attorneys Fettig and Winter asked the director of corrections to set up a meeting with Gov. Jim Gibbons because the “medical crisis” at the prison goes far beyond the lack of a doctor and it “seems unrealistic to expect” the department “to summon the resources to resolve the problems without the assistance of the governor and the Legislature.”

(Page 3 of 4)
The facility, which opened in 1989, is more than 250 miles from the state’s population and power centers: Reno, Las Vegas and capital Carson City, where executions take place. It handles the day-to-day medical needs of prisoners, but if inmates experience serious ailments, like chest pains, they are sent to a local hospital; life-threatening cases, such as stabbing victims, are airlifted to a larger city.

The prison sits about a dozen miles outside its namesake’s downtown.

The prison’s desolation — a source of frustration to inmate families and defense attorneys — is part of its appeal to the 4,000-person town, said Mayor Jon Hickman The facility is easy to ignore, he said. It also provides hundreds of secure jobs to a city whose economy is tied to the tumultuous mining industry.

In this setting, inmate advocates say, corrections officials have denied prisoners needed antibiotics, pain pills and surgeries with little outcry because no local groups exist to do so. When a nurse who had worked at the prison for nearly a decade spoke out, she was forced to scrub the infirmary floor with a toothbrush, court papers say.

That nurse, Lorraine Memory, said in an interview that the prison’s dozen or so medical staffers lacked equipment, including an IV pump and a blood pressure monitoring machine, that were particularly helpful during a medical trauma. Little training is provided to the staff, some of whom struggle to use a defibrillator, said Memory, who was eventually fired.

Jewel Jacques, a nurse who has worked at Ely since 1993, and two other prison staffers have signed declarations backing up Memory’s account of prison conditions.

Most inmates complaining of pain are given only a handful of Tylenol a week, Jacques said.

Relatives of some inmates say prisoners with minor ailments often avoid the infirmary, convinced that Ely’s medical staff would either ignore or harm them.

Inmate Snow, who is on death row for the 1983 contract killing of a Las Vegas nightclub owner, has no cartilage in his hips, but was given no painkillers to cope with bones that scrape against one another, Noel’s report said. Instead, the prisoner was prescribed Indocin, whose side effects are so severe that the anti-inflammatory medication is mainly used on horses.

At Noel’s suggestion, Dr. Robert Bannister, medical director of the state corrections department, changed Snow’s medication. But the doctor is still balking at allowing Snow to have hip surgery, Noel wrote. Without it, the inmate will eventually be unable to move, Noel said.

Bannister did not return calls seeking comment.

Such cases frustrate medical staff who said their superiors had long shrugged at inmate suffering because they were concerned about the costs of treatment, according to court papers.

In a complaint to the federal Equal Employment Opportunity Commission, Memory alleged that two diabetic prisoners were denied insulin because MacArthur “wanted to hasten the demise of these two inmates in order to save money or cause them more pain and suffering.”

MacArthur denied the allegations.

One of the diabetics, Patrick Cavanaugh, likely suffered from dementia after three years without insulin, according to Noel’s report.

Cavanaugh, a former manager for the rock group the Coasters, was on death row for shooting to death one of the group’s singers, mutilating his body and dumping it in a canyon.

In prison, Cavanaugh developed gangrene, Memory wrote, and his “toes and feet turned black and this gradually progressed up the legs until it had turned into a stinking, rotting, oozing mess of dead flesh which had reached clear up the level of his knees.”

Cavanaugh’s medical records, however, described his condition as cellulitis, which Noel said was akin to calling “9/11 a high-rise fire.”

MacArthur said Cavanaugh refused oxygen and was never denied insulin. If he was not given it, it was because Cavanaugh declined it, the doctor said.

Cavanaugh died in April 2006; his death certificate was signed by a doctor who had not seen the body and lists “natural causes” as the reason, Memory said.

A month later, state officials fired MacArthur — but not because nurses and other prison employees charged that he provided poor or negligent care. Rather, corrections officials said, it was because MacArthur refused to give up his full-time job at the local hospital, though there was no evidence that it caused him to neglect his prison duties.

MacArthur said the dismissal was unmerited. In a letter to his private practice patients he said that he “was responsible for saving the taxpayers of this state $1 million per year.”

In an interview with The Times this week, MacArthur said he was proud of care he provided to prisoners, but acknowledged limits on what the medical staff would treat.

“We didn’t cater to every rash and boo-boo that you’d run to your mommy and get kissed,” he said.


ashley.powers@latimes.com
henry.weinstein@latimes.com

Powers reported from Ely and Weinstein from Los Angeles.