Early one morning in February, a guard banged on the door of David Mustiga’s cell on Rikers Island. Immediately, the 43-year-old man was shackled and put on a bus to Bellevue.
Rikers detainees often have difficulty accessing even basic medical care. But Mustiga and 10 other inmates are undergoing elective bariatric surgery at Bellevue, often spending weeks in the hospital.
Even under the best of circumstances, recovery from bariatric surgery is difficult. Recovering in prison is especially difficult because detainees have little control over what they eat and how fast they eat it.
Miller said the patients at Rikers were “tested and evaluated like any other patient” and held at Bellevue until they were ready to eat the type of food available at the prison.
Mustiga, who was later convicted of drug trafficking, weighed more than 300 pounds and suffered from high blood pressure. When Rikers clinic staff first told him about the benefits of his bariatric surgery a few months ago, he was excited. He said no one warned him about the difficulties of his recovery during his incarceration.
When Mustiga boarded the bus to Bellevue, she thought it was a short visit to get blood tests in preparation for surgery. Instead, he was admitted to the hospital’s locked prison ward and given a liquid diet.
There he met another patient, Luis Perez, who was awaiting bariatric surgery. The men bond over their diet trials and work together to steal leftover food from trays at a local hospital.
Perez was awaiting sentencing for drug possession, but first underwent surgery. He later told Mustiga that the pain was worse than when he was hit by a car and lost his arm above the elbow.
Mustiga panicked. He said he tried to decline the surgery, but his doctor told him this was his only chance to undergo surgery and that if he didn’t comply, he would be sent right back to prison.
Mustiga said he often used similar pressure tactics against drug clients. “When you tell someone this is their last chance, they immediately find their wallet,” Mustiga said.
He decided to undergo surgery.
After surgery, patients are supposed to eat a small meal rich in protein.
Back at Rikers, Mustiga traded cigarettes for protein powder. He reviewed Bellevue’s brochure, which outlined what to do and what not to do after surgery. It suggested eating non-fat Greek yogurt or drinking eight glasses of Crystal Light. Exercise tips included trying Zumba his dance class.
Mustiga was not getting proper nutrition. He said he lost more than 100 pounds in less than six months. This is a dangerously fast rate of weight loss. His hair was falling out in clumps, and his medical records show he was receiving iron supplements for anemia.
This summer, Mr. Perez was transferred to Franklin Correctional Facility, a prison near the Canadian border, where he was sentenced to four years in prison.
When he visited with two Times reporters in August, Perez’s skin had turned pale. He said he didn’t have enough protein and he couldn’t eat without vomiting. He was worried that he had been targeted in prison because of his surgery. His size is important for protection in prison.
Two months later, Mr. Perez was severely beaten. He said the attackers stole protein powder that he had been saving.