In 1987, Karen Gedney walked up to the gatehouse at Northern Nevada Correctional Center to start her first job out of residency. The officer told her he'd never heard of her. Inside, the nurse said she was too busy and handed her off to a man in scrubs — who turned out to be an inmate, not staff. Two weeks later, the medical director who had hired her was dead of metastatic cancer, and Gedney, in her early thirties, was the only physician in the northern half of the Nevada prison system with nobody above her to ask.
She stayed thirty years.
In this conversation with JP Maroney, Dr. Gedney describes what she calls the two worlds inside every prison — the custody world, organized entirely around security, and the medical world, organized around the sickest, most addicted, most traumatized, and most dying people in the building. Her formulation of the difference is the sharpest line in the episode: "They're constantly looking for you to do something wrong. I'm constantly looking for them to do something right."
She talks about the men who couldn't read well enough to spell "hemorrhoids" on the request form required to see a doctor, and the night classes she volunteered to teach after full workdays. She talks about being investigated by the Inspector General's office in her first months on a complaint that she favored Black inmates because her husband was Black — filed, she says, by a director of nursing married to an associate warden, in a system she describes as deeply nepotistic at the time.
And she talks about October 13, 1989, when a patient serving life without parole took her hostage in the infirmary for roughly ten hours. She was assaulted and raped. A tactical team ended it with a concussion grenade and killed him a few feet from her. She went back to work Monday. Not one custody officer spoke to her. The inmates sent cards — every lifer on the yard signed one.
The second half turns to what she watched from the intake center: men released, then returned within weeks, most of them for technical parole violations rather than new crimes. A construction worker sent back because his crew crossed the invisible line at Lake Tahoe onto the California side. Men returned for missing a monthly supervision payment. Eight-dollar medical copays that follow people out the gate as debt. Twenty-eight dollars and a bus ticket at release, in an era when, as one official told her, that was the whole plan.
She closes on what's working now — reentry programs built by formerly incarcerated people who lived the problem, including a Nevada organization that negotiated an agreement to get the DMV inside the walls so men don't walk out without ID, and a dry-cleaner who collects abandoned clothing so nobody starts over in prison-issue blues.
Chapter markers
TimeChapter00:00 | Introduction — Dr. Karen Gedney,
30 Years Behind Bars00:51 | What does "justice" actually mean?
01:20 | Placed in a men's prison by the National Health Service Corps
02:18 | Two worlds inside one prison: security vs. medicine
03:24 | "There may be accountability, but there should still be dignity"
04:22 | Literacy, the kite system, and men who couldn't request care
05:20 | Volunteering nights to teach Health Related Recovery classes
06:47 | "They're looking for you to do something wrong. I'm looking for them to do something right."
08:46 | JP on Kent McGowen: a sentence is a chapter, not a life
10:16 | The officers are confined too
12:03 | Day one: the gatehouse, the nurse, and the man in scrubs
14:00 | Learning the vernacular the hard way
14:58 | Two weeks in, the medical director is dying
16:56 | "I was just thrown in and totally clueless"
17:55 | Nepotism, and a complaint from the director of nursing
18:56 | Investigated for treating Black inmates — and married to a Black man
19:54 | "Go right to the top": meeting the prison director
20:38 | More afraid of coworkers than of inmates?
20:47 | October 13, 1989
21:47 | Suicide by cop, and a fourteen-year lifer
23:05 | The cards from the yard
24:22 | Back at work on Monday
25:03 | The alleyway question
25:56 | German resilience, and a husband who knew what to do
28:03 | Blood in the grout, holes in the wall
28:40 | The phone call from his mother
30:13 | Choosing forgiveness so it doesn't own you
31:29 | The officer who wasn't at his post that morning
32:04 | Watching them come back through intake
33:39 | Technical parole violations
34:09 | Sent back for crossing a line at Lake Tahoe
35:09 | 2019: what the Attorney General told the Governor
36:37 | No money, no job, no housing, and medical debt
38:06 | "Twenty-eight dollars — that's the bus ticket to California"
38:35 | The people fixing this lived it
39:31 | Getting the DMV inside the walls
41:28 | Three dry cleaners and a clothing closet
42:00 | Why Justice Impact exists: everyone is working in a silo
45:24 | Two probation officers who don't agree
46:26 | The 90/90 model: ninety days before, ninety days after
48:14 |
30 Years Behind Bars — the elevator pitch
49:16 | Chapter artwork by a man who served twenty-seven years
49:46 | Toastmasters behind the wall
51:35 | The icebreaker speech that broke the yard's racial lines
52:26 | Where to find Dr. G — discoverdrg.com and
Prison Unlocked53:51 | Close
Karen Gedney, MD is an internal medicine specialist who spent nearly thirty years as a physician in the Nevada Department of Corrections, based at Northern Nevada Correctional Center in Carson City. Placed there in 1987 through the National Health Service Corps to satisfy a four-year scholarship obligation, she became the first woman physician assigned to a men's prison in the state — and stayed three decades.
She was recognized as "one of the best in the business" by the American Correctional Association and received a Heroes for Humanity Award in Nevada for her work on HIV in the correctional setting. Inside, she taught volunteer night classes in health and recovery, founded a Gavel Club (a Toastmasters-format speaking program) for incarcerated men, and arranged for inmate artwork to be exhibited at a Reno gallery.
She is the author of 30 Years Behind Bars: Trials of a Prison Doctor, illustrated by Ismael "Izzy" Santillanes, who served twenty-seven years in the Nevada system. Since retiring she has worked in prison reform, including advocacy for the abolition of the death penalty in Nevada, and serves on the boards of Ridge House and the Nevada Prison Education Project. She hosts the podcast Prison Unlocked.
Guest Links
- Website: discoverdrg.com
- Podcast: prisonunlocked.com (also on Apple Podcasts and Spotify)
- Book: 30 Years Behind Bars: Trials of a Prison Doctor (DRG Consulting)
- LinkedIn: https://www.linkedin.com/in/karen-gedney
Other Links
- Justice Impact: https://justiceimpact.com
- JP Maroney: https://jpmaroney.com | https://linkedin.com/in/jpmaroney