Last year, my friend Raymond Gregg stepped up to the lectern in Union Correctional Institution’s chapel to open our monthly Vietnam Veterans of America meeting with a prayer, as he had done every month for the last half decade. The white-bearded man, who looked much older than his 75 years, had a bandage covering his right ear, which often oozed fluid. 

Gregg is a former Marine with a history of post-traumatic stress disorder, which he blames in part for the murder that landed him in prison in 1998. We’ve been incarcerated together for over a decade, and a lot has changed for Gregg in that time. 

Gregg often feels dizzy and gets blindingly painful migraines. He doesn’t like looking in the mirror anymore. His once handsome face has gone haggard. His hair, once brown with a touch of gray around the temples, is white and thin. His cheeks are drawn and there is no sparkle left in his eyes. Though he has trouble getting around, Gregg refuses to use a cane. Instead, he walks slightly bent, tottering back and forth. He describes it as “a controlled stagger.” At nearly all times, he is escorted by two or three fellow vets in case he loses his balance.

My friend had the misfortune to develop one of the worst kinds of cancer you can get in prison. 

Doctors told Gregg that he suffers from eccrine carcinoma, a rare form of skin cancer that attacks sweat glands. In 2024, after more than a decade of what he described as misdiagnoses, insufficient symptom management and overwhelming discomfort, a doctor told Gregg his cancer had spread to his brain.

Eccrine carcinoma is known as an “extremely rare cutaneous malignancy.” The prognosis is typically favorable when caught in early stages, but becomes dire when the tumors metastasize, according to the National Library of Medicine. Eccrine carcinoma can also masquerade as basal cell carcinoma — as was the case for Gregg — a much more common form of skin cancer.

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This type of cancer is hard enough to manage in the outside world. But Gregg’s experience shows how much more difficult it is in prison, where coordination between correctional health care systems and outside doctors is often strained, and every visit to an outside medical facility requires approvals, triggering safety protocols that can slow the process down. Meanwhile, the patient is frequently kept in the dark. Gregg’s medical records from the prison health care system, which PJP editors reviewed, repeatedly state that patients should not be made aware of scheduling information for any appointment outside their facilities. 

A diagnosis saga

Gregg said he first noticed something wrong in 2012. A painful pimple had formed on the outside of his ear. At the time, he thought it was a symptom of an ear infection. Shortly after, he sought care with prison medical staff, who put him on antibiotics. For years, Gregg experienced this revolving door of symptoms and antibiotics.The pain would stop for a while, but it always came back. 

He said medical staff told him it was a staph infection, an allergy, a fungus. Five years and countless rounds of antibiotics later, the problem only got worse. A lesion appeared on the outside of Gregg’s ear. 

Prison medical staff sent him to an outside hospital in Jacksonville, Florida, where an oncologist examined his ear and sent him straight to surgery to remove what they told him was a non-fatal basal cell carcinoma, a common form of skin cancer. 

But problems persisted. Gregg continued to get severe headaches. He said he struggled to walk. Discharge kept dripping from his ear. 

Gregg said prison medical staff kept attributing his symptoms to ear infections. Each time, he was prescribed multiple rounds of antibiotics and steroids, to little relief. 

Another six years went by before a nurse referred him to an ear, nose and throat specialist at Reception and Medical Center — a state prison hospital — after noting an abscess above his ear. He finally received a CT scan in late April 2023. 

“I was thinking the whole time — what’s next?” Gregg said.

A couple of months later, the doctor dropped a bombshell, telling Gregg that the tumor was approaching his brain, and he needed urgent surgery to remove his ear. The doctor also called his daughter Kelli Cisko to tell her that her father would need multiple surgeries, she told a PJP editor.

Gregg and his daughter believe that the prison system’s private health care provider, Centurion, failed to intervene soon enough to prevent Gregg’s cancer from becoming terminal. “If he would’ve had the surgery sooner,” Cisko said, “he would not be terminal and there would be no issue. He would be fine.”

Centurion and the Florida Department of Corrections did not respond to questions from PJP editors by the time of publication.  

Documented delays

Even after Gregg received his diagnosis, problems with the coordination of his care continued. 

He said he was referred to an outside specialist, but it took months to get an appointment scheduled, according to internal communications in Gregg’s medical records. At one point, a doctor affiliated with the prison system followed up on his previous referral, writing in a note that an “urgent referral” was needed for Gregg to be transferred to in-patient service. When Gregg finally saw the specialist, the doctor didn’t have his medical records or his CT scans.  

Gregg underwent more CT and MRI imaging. 

In February 2024, a neurosurgery team finally made a plan to admit Gregg to the hospital for possible surgery. But, for “multiple reasons,” a doctor wrote in one of Gregg’s records, “these efforts have been refused by the Department of Corrections and transfer of the patient was delayed.”

“You can’t make sense of it,” Gregg said. “I was ticked off, and I let my daughter take care of it, and I started praying.” 

Angry, hurt, confused

Over the past couple years, I witnessed Gregg continue to suffer as his condition further deteriorated. His constant headaches became debilitating. He lost more and more weight due to frequent vomiting. 

Gregg told me that the only treatment the prison would give him were over-the-counter painkillers.

Barely three months after the corrections department refused to approve his surgery, my friend was taken to an outside hospital. 

After nearly a week there — 14 months after the prison health care provider referred Gregg to an ear, nose and throat specialist — he learned that the cancer had reached his brain and was now inoperable. He was given less than a year to live. 

He remembers the doctor looking him in the eye and telling him, “Only God can determine what time you go.” 

He said his first thought was that he would never see his daughter again.

Recently, I watched as Gregg changed the bandage on his ear. He stood over the toilet as he removed the covering. Fluid rapidly drained from his ear into the toilet. 

The headaches are constant, Gregg told me. Prison medical provides him with 60-milligram ibuprofen tablets every 90 days. His family supplements that by paying for Tylenol, which he can get from the commissary.

I’ve noticed signs that his mind is starting to deteriorate. During some of our interviews he became confused or agitated.

But he still speaks with his daughter three times a day. 

Gregg said he is angry, hurt and confused, but that he trusts his faith and that everything will work out how it is supposed to. 

“When I’ve done everything God wants me to do, [that’s when] I’m done.”

PJP editors Carla Canning and Mason Bryan contributed reporting.

Disclaimer: The views in this article are those of the author. Prison Journalism Project has verified the writer’s identity and basic facts such as the names of institutions mentioned.