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It's absolutely about the cruelty.
Realistically, if they took her to the hospital wouldn't she wind up with an absolutely eye watering hospital bill? One that would likely take her the rest of her life to pay off?
Instead, they calculated that the outcome of denied medical care would cost this person more than a lifetime of medical debt - even if the lawsuit against them paid out.
It's not that involved I don't think. It's simply sadism.
Oh BS. Ever been in jail? You're in with some of the dumbest, and incorrigible, members of society. It's stunning how many of those dudes take county jail as a fact of life, totally used to it. They are constantly lying, faking and scheming for anything they can get.
So what's a CO to do? Apparently their default answer to anything is "NO." I have a friend in CO training who has been lauded for denying any and all inmate requests. That job is going to make him a bastard, I can see it.
Then you got the guy they transferred in one day. Dude has a clearly infected tooth, face badly swollen on one side. They packed him full of gauge, gave him a cloth to hold his jaw up, like an old Bugs Bunny cartoon, and 2 Tylenol. Damn.
Point being, jail is a fucked up mess and the CO's are barely brighter than the inmates. Nobody's calculating all that. Hell, if they knew her neck was broken, they also knew they might get their ass sued off.