Megan Flynn recognizes the two black stars tattooed on the chest of the man she's trying to save.
The 44-year-old nurse is on the floor outside of cell 5W28 in the Spokane County Jail. She's come to relieve the guards who began resuscitating the man they found hanging by a bedsheet alone in his cell.
Flynn quickly pushes the tattoos' familiarity from her mind and begins pumping oxygen into the man's lungs as she has for others who've tried to end their lives behind these bars.
Eventually an ambulance arrives and medics take over, while Flynn goes to fill out paperwork. Only then does she realize that her two worlds — family and work — have just collided.
The nurse asks for the man's name.
"Flynn," someone tells her.
And the first name?
"That's my brother," Flynn says.
She staggers away from the cell until her legs register the weight of the situation. She collapses by a bank of nearby elevators. Her mind is locked in a single thought: "It can't be him. It can't be him. It can't be him."
Absent from her mind are the childhood memories of Patrick, or "PJ," as a 2-year-old running straight from the bathtub out the front door and of the child who broke his arm jumping off a deck playing Superman. Those would come later.
Soon, a jail sergeant tells her they have a pulse. Flynn asks to see the man's booking photo. She has to know for sure.
Patrick is transported to the hospital, but he never regains consciousness. For two days this May, family and friends flock to the intensive care unit. Some haven't seen him in a year or more. Perhaps ashamed of his addiction and failure in recovery, Patrick stayed away. He was protecting them from himself, they believe.
About a month after his death, jail officials would announce reforms intended to eliminate suicides in the facility. In addition to Patrick Flynn, two others have died by suicide in a 12-month period, while two more deaths are currently being investigated.
But for those close to Patrick Flynn, the reform efforts bring little comfort. They still have questions about his arrest, if he called anyone from jail and why he wasn't under closer watch when jail officials learned he was withdrawing from heroin.
Patrick wasn't alone in the world, but had good, decent people surrounding him: a mother who worked as a corrections officer, a sister who is a nurse, another sister who is a social worker, a brother who runs his own business and friends who've escaped the addictions that gripped him.
So, where did they go wrong? Where did Patrick go wrong? Why him?
It had been months since Patrick's best friend, Mat Coyle, had spoken to him, and years since they'd seen each other. Coyle moved away from Spokane in 2009. He left behind a lifestyle of drugs and drinking and devoted his life to God.
Coyle says he tried to encourage Patrick to do the same. Instead, Patrick distanced himself — aware of his addictions and worried he'd pull Coyle back into the life.
In April of this year, just about a month before Patrick's death, Coyle received a call from Patrick, who asked to come stay at his home in Chewelah. There, Patrick could get away from the people and places that fed his habit, Coyle says. He would stand a chance.
Several other friends describe similar conversations with Patrick in the months leading up to his death. Patrick had reached out in this way before, but this time was different, Coyle says. He was sober. Coyle could hear it in his voice.
Coyle offered to come pick him up that day in April, but Patrick declined, saying he had some work lined up for the next few days. Patrick promised to call again when the work was completed.
"The next phone call I got was that he was in the hospital," Coyle says.
Patrick was arrested May 17 after an altercation with a former girlfriend at a dog park near the Browne's Addition neighborhood. Witnesses who talked to police say they saw Patrick approach a car where the woman was sitting with another man. Patrick and the woman began arguing, though it's unclear from court documents what the dispute was about.
Eventually, Patrick reaches into the running car and removes the keys, according to court records. The woman tries to get them back and, at one point, Patrick throws her to the ground. Patrick leaves, and she follows, records state. Eventually he turns and throws the keys back at her. He's booked into jail on one count of first-degree robbery with domestic violence.
Less than 48 hours later, a corrections officer finds Patrick hanging from his cell's top bunk. A Spokane County Sheriff's detective's report lays out the official narrative:
Early on May 19, Patrick's cellmate asks to be moved to another cell. Patrick was detoxing, the inmate tells officers. Both men are served lunch at 11 am and, shortly after, the cellmate is moved to a different cell, leaving Patrick alone.
At this time, Patrick tells the corrections officer that he's sick from heroin withdrawals.
The officer would later tell a sheriff's detective that "Flynn was fine at the time, did not appear to be in any distress, did not appear to be sick and did not express any suicidal thoughts or other ideations of depression."
Patrick's family now questions why his statements about drug withdrawal, and the cellmate's request to be moved, did not trigger any sort of intervention.
About two hours pass before a corrections officer finds Patrick at 1:48 pm. The guard kicks the cell door and radios for backup when Patrick doesn't react.
There is no response to the initial radio call, according to the detective's report. The officer radios again, and when he hears that help is on the way, he unlocks the door and uses a blade to sever the makeshift noose.
The sheriff's detective's report does not give the amount of time between the first, unsuccessful radio call and the second. The corrections officer tells the detective that jail policy prevents him from entering an inmate's cell alone when an inmate is found unresponsive.
To Patrick's family, it seems a crucial lapse. It takes nearly 30 minutes of resuscitation to get a pulse, his sister Megan Flynn recalls.
Suicide has been the leading cause of death in local jails since at least 2000, when the U.S. Bureau of Justice Statistics began collecting data. Of the more than 14,700 jail inmate deaths in the U.S. from 2000 to 2014, 31 percent were by suicide. But because jails are only required to report deaths that happen while an inmate legally is in their custody — rather than under the care of family making end-of-life decisions — many are not captured in the federal data.
Each of the three men who died by suicide in the Spokane County Jail in the 12 months from June 2017 to May 2018 were found hanging by bed sheets in their cells. Each of them died in the hospital, but only one was still legally in Spokane County's custody and will be reported to the BJS.
Two other inmates died in the Spokane County Jail during that time period. Their deaths are still under investigation by the Spokane County Sheriff's Office.
As Patrick lies unconscious in a hospital bed, Michael Jackson plays over a set of speakers — songs he used to dance to. Family and friends tell stories. They try to remember his smile. And they inspect his tattoos.
Two stand out. On his forearm is a quote taken from Alcoholics Anonymous' primary text, the Big Book. The full quote reads: "As we become subjects of King Alcohol, shivering denizens of his mad realm, the chilling vapor that is loneliness settled down." The tattoo is unfinished, says Shannon Griffiths, Patrick's sister.
The second, those two black stars on his chest, are reminders of his children, he once told his mother. For friends, he has a different explanation:
"So the girls will see stars," he would say in reference to women he'd bed.
And that was Patrick. A jokester and a bit of a maverick. A man so dedicated to the principles behind AA that he has a piece tattooed on his body. Yet like the tattoo, his own recovery is left unfinished.
"He was a chronic relapser, but he knew more about AA and recovery than anybody," says Erin Linhart, who met Patrick in AA. "The problem was, and he would admit this, he would not fully surrender. He was stubborn."
Linhart is now sober, and she says without Patrick's guidance, she might not have made it.
One of his AA sponsors, Robert G., backs this up. He says Patrick has done more work to guide people through recovery while he was using and drinking than most people have done sober.
"He did not want people to be around him when he was in pain, when he was in that way," Robert G. says. "Every time he would get so sober, he would hit a wall of reality, like, 'This is what's happened to me.'"
Robert G. says trauma in Patrick's past contributed to his addictions, but declined to elaborate so as not to violate Patrick's confidence.
As people such as Robert G. come and go from the hospital room, his family learns more about the man who had distanced himself from them in the past two or three years. A more complicated picture comes into focus as one woman in particular fills in some gaps. Alice Schroeder met Patrick about six years ago. She takes recovering addicts into her home and says Patrick would crash there from time to time.
At 63, she needs an oxygen tank to breathe and a motorized scooter to get around. She says Patrick helped her in the way an in-home caregiver would with personal care and other handy work around the house, but was not paid. He did so out of kindness, she says.
"He'd come by maybe twice a week, or sometimes he'd be here for a whole week," Schroeder says. "But if I texted him, bam! He'd be here within a few hours."
The girl Patrick was dating, the same one he got into an altercation with that led to his arrest, was supposed to be caring for Schroeder, she says, but she suspects the woman had taken some things from her house. Schroeder had asked Patrick to retrieve them, she says, and that's what he was doing on the day he was arrested.
"He was in love with her," Schroeder says.
After Patrick was taken to the hospital, detectives found a copy of a protection order barring him from contact with the woman ripped up and thrown in a trash bag in his cell.
Patrick checked many of the boxes for a person at high risk to attempt suicide in a jail.
He's white, male, single, 36 years old, addicted to drugs and was incarcerated for less than three days.
His childhood lends more risk factors. At a young age, Patrick and his siblings witnessed domestic violence in the home, says Griffiths, Patrick's sister. And many family members have a history of alcohol abuse, adds Megan Flynn, his half sister.
Darla Sawyers, Patrick's mother, and his father divorced before he turned 10. Around age 15, he would often be left without supervision when Sawyers worked double shifts as an officer for the Department of Corrections. That's about when he started drinking and smoking marijuana, Griffiths says.
At 18, Patrick got a girl pregnant and they were forced to give the kid up for adoption, Sawyers says. He had three other kids with different women, and his failure as a permanent father figure in their lives was a source of constant pain for him, friends say.
Karen Ersche, a professor at University of Cambridge, studies addiction and specifically how it can manifest differently in siblings.
In her research, brain scans show that siblings share abnormalities that are linked to impulsive personality traits and may predispose them to drug addiction. Yet a variety of factors may determine whether one sibling can overcome while the other cannot, including gender and age at the time usage began. As the youngest of four siblings in a blended family, Patrick's struggles with addiction may be due to the perfect storm of genetics, trauma in his past, self-destruction and stubborn free will.
"We all struggled with some point in our lives, and we still do, with our parents' choices," Griffiths says. "And I feel like Pat got the short stick of that. This didn't start because he made choices as a young adult. It went deeper and darker than that."
In the days and weeks following Patrick's death, Griffiths returns to the last time, about two years ago, that she talked to her younger brother. He had overdosed after injecting bong water into his veins and landed in a hospital in the Spokane Valley.
Before picking him up at the hospital, Griffiths had talked with two of Patrick's AA sponsors, trying to pull strings to get him into detox. No beds were available. In the car on the way back, she asked Patrick, "If a bed opens up, will you go?"
No, he replied, asking to be dropped off at a friend's house on the South Hill instead.
"And that's when he said to me, 'You just don't get it. You don't get who I am, and you think I live this horrible life,'" Griffiths recalls. He was right, she says now. She didn't understand.
HIGH PRICE TO PAY
Sgt. Tom Hill, a spokesman for the county jail, says inmate threats of suicide are a daily occurance. During his nearly 30-year career, he's seen people take extreme measures, including inmates using razors they're given to shave with, inmates throwing themselves off ledges and one inmate who ingested so much toilet paper that medics could not clear an airway in time.
In 2017 alone, corrections officers and mental health staff in the Spokane County Jail identified 2,753 different inmates in crisis.
When jail staff are aware of inmates' potential to harm themselves, they are successful at stopping them, Hill says. Inmates are moved to special "watch cells," where bunks have been removed and where corrections officers check on them every 15 minutes. "We're struggling with the people we didn't identify, and how do we prevent those?" Hill says.
About a month after Patrick's death, the jail announced several efforts to prevent future suicides. Starting in September, the jail will replace bed sheets with a thicker blanket, as other facilities have done in response to inmate suicides.
The jail has also hired a nationally recognized consultant, Lindsay Hayes, to evaluate its suicide prevention protocols, Hill says.
"Our commitment is to figure out a way to identify those people who are at risk of harming themselves," Hill says. "We won't be satisfied until we have no suicides in our facility."
Hill also says the jail's health care provider will soon add the drug buprenorphine to its treatment plan, which helps treat opiate withdrawal. That's in addition to the jail's current partnership with the Spokane Regional Health District's methadone program, which allows patients to continue methadone treatment if they're arrested.
In some ways, Spokane's efforts to get treatment for drug-addicted inmates stands apart from other local facilities in the state. The Whatcom County Jail is currently facing a federal civil rights lawsuit for denying inmates access to opiate withdrawal treatment.
For Flynn's family, these changes come at a high price.
"Three people's lives later, you make a decision?" Griffiths says. "Changes will be great for future inmates, but those changes should have happened 12 months ago when the first suicide took place."
Although his family is still struggling to take meaning from his death, Sawyers has found a purpose. She wants to organize a group of people who have also lost family members to jail deaths.
"I want to know who your son is and what happened to him," she says. "Let's talk about what could have been done differently, and let's hold the jail responsible for making these changes."
PUSH AND PULL
June 25 would have been Patrick's 37th birthday. Griffiths hosted friends and family at her South Hill home to celebrate. A couple of days before, more than 100 people showed up for his memorial service at the Valley Landmark Missionary Baptist Church.
For the celebration at her home, Griffiths got a replica of Patrick's 3-year-old birthday cake.
Although she doesn't have all the answers she wants, for now she's taking some solace in the fact that his death has sparked changes in the jail and will hopefully prevent more suicides.
She also takes comfort in the fact that both his kidneys and his liver were donated, though she jokes, "Who the hell would want his liver?"
Finally, Griffiths says after her brother's death, she now sees his life through a different perspective. For all his sins, he also did good. He helped people in ways that he couldn't help himself.
"He changed lives," she says.
She thinks back to the last time she talked to him after an overdose landed him in the hospital. She wonders if she could have been more open, more patient. Should she have pressed him harder into rehab? Would it have mattered?
"I get that he didn't fit into the box that we needed him to fit into," Griffiths says. "And through that we probably pushed him away as much as he pulled away. So that's what I'm sorry for — that I didn't make that call [for help] sooner."
SUICIDE AND DRUG ADDICTION RESOURCES
Learn the warning signs that can indicate whether a person is considering suicide: talking about wanting to die or harm themselves, feeling hopeless or trapped, acting anxious or agitated, isolating themselves, showing extreme mood swings, including suddenly appearing happier or calmer.
In Spokane, you can call Frontier Behavioral Health's First Call for Help hotline, which is available all day every day for anyone in crisis and for those who just have questions: 838-4428.
Additionally, the National Suicide Prevention Hotline is 1-800-273-8255, or you can text the Crisis Text Line at 741741.
For drug treatment, the Substance Abuse and Mental Health Services Administration hotline is a good place to start and can refer patients to treatment centers: 1-800-622-4357. The organization's website (samhsa.gov) also has a treatment center locator, which will identify all the service centers in a given area. Washington state also has a Recovery Helpline for those looking for addiction treatment services: 866-789-1511.
DEATH BEHIND BARS
In the past 20 years, 13 inmates have died by suicide in the Spokane County Jail, according to news releases and old newspaper reports. Suicide is the leading cause of death in local jails around the country, and a 2010 report by the National Institute of Corrections estimated the rate of jail suicides to be "several times greater than that in the general population."
In addition to the three men who hung themselves with bedsheets between June 2017 and May 2018, Brandon Ryans, Chris Rogers and Patrick Flynn, two other men have died in the facility during that time.
David Good, 52, was found unresponsive in a cell at 2:40 am on March 1. The Spokane County Sheriff's Office is waiting on lab test results to complete its investigation into Good's death. A cause and manner of death has not yet been determined.
Shane Alan Carson, 31, was found unresponsive in his cell June 13 when a corrections officer went to move Carson's cellmate to another cell. The Spokane County Sheriff's Office is investigating the death, which may have been the result of an assault from Carson's cellmate. A cause and manner of death have not yet been determined.
ABOUT THE AUTHOR: Mitch Ryals comes to the Inlander from St. Louis, Missouri. He covers criminal justice and has written about a teenage confidential informant, bounty hunters and a train hopper who lost his leg. Contact Ryals at 509-325-0634 ext. 237.