Early one morning in February, a guard knocked on David Mustiga’s cell door on Rikers Island. Soon, the 43-year-old was handcuffed and put on a bus to Bellevue.
Detainees at Rikers often struggle to get even rudimentary medical care. But Mustiga and 10 other prisoners underwent elective bariatric surgery at Bellevue, often spending weeks in the hospital.
Even in the best conditions, recovering from bariatric surgery is difficult. Trying to recover in jail, where detainees have little control over what they eat or how quickly they eat it, is especially difficult.
Miller said Rikers patients were “screened and evaluated like everyone else” and remained at Bellevue until they were ready to eat the types of foods available in the jail.
Mustiga, who was later convicted of drug trafficking, weighed more than 300 pounds and had high blood pressure. Months earlier he had been excited when a staff member at the Rikers medical clinic first told him about the benefits of bariatric surgery. He said no one had warned him about the challenges of recovering while he was incarcerated.
When Mustiga boarded the bus to Bellevue, he thought it was for a brief visit to get blood work done in preparation for surgery. Instead, they admitted him to the hospital’s closed ward and put him on a liquid diet.
There he met another patient waiting for bariatric surgery, Luis Pérez. The men bonded over their dietary ordeals and teamed up to steal leftovers from their neighbors’ hospital trays.
Mr. Perez, who was awaiting sentencing for drug possession, underwent surgery first. Afterwards, he told Mr. Mustiga that the pain was worse than when he was hit by a car and lost his arm above the elbow.
Mr. Mustiga panicked. He said that he had tried not to have the surgery, but a doctor told him that this was his only chance to undergo the procedure and that if he did not comply with the procedure, he would be sent back to jail immediately.
Mustiga said he often used the same pressure tactics on his drug clients. “Tell someone it’s his last chance and you’ll find his wallet pretty quickly,” Mustiga said.
He decided to have surgery.
After surgery, patients are supposed to eat small, protein-rich meals.
Back at Rikers, Mustiga traded cigarettes for protein powder. She reviewed a brochure from Bellevue that outlines the do’s and don’ts after surgery. She suggested he eat low-fat Greek yogurt or drink eight cups of Crystal Light. Exercise tips included trying a Zumba dance class.
Mr. Mustiga was not receiving adequate nutrition. He said he lost more than 100 pounds in less than six months, a rate of weight loss that can be dangerous. His hair fell out in clumps and his medical records show that he was receiving iron supplements for anemia.
This summer, Perez was transferred to Franklin Correctional Facility, a prison near the Canadian border, to serve a four-year sentence.
During a visit in August with two Times reporters, Mr. Perez’s skin was sallow. He said that he was not consuming enough protein and that he could not eat without vomiting. He worried that the surgery had made him a target in prison, where size matters for protection.
Two months later, Mr. Pérez was brutally beaten. He said his attackers stole the protein powder he had been saving.
