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PLEASANTON, Texas — The only thing worse than caring for a sick loved one in prison is watching them die of a treatable condition, like hepatitis C.

Families feel helpless as the symptoms escalate — the swelling, the jaundice, the confusion — all from an infection they know could be cured with a short course of treatment with a pill, if only he or she wasn’t incarcerated.

Sick prisoners are often transported to special hospitals, hours away. The facilities limit visits, physical contact, and phone calls. Even figuring out basic information about where a loved one is located, and how they’re doing, becomes arduous.

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Cindy Trevino, for one, only found out her partner, Joe Solis, was dying fourth-hand — a friend’s mother called her mother-in-law. He was throwing up blood.

His liver had become so damaged that blood was barely flowing to that vital organ. Instead, it backed up into the vessels lining his esophagus. They swelled until eventually they ruptured, filling his throat with blood like the walls in a house fill with ice water after a pipe bursts in a winter storm.

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Trevino and Solis used to speak at least every other day, making plans to finally marry when Joe was released from prison, and to travel — anywhere really — out of the tiny south Texas town they lived in their entire lives. But he hadn’t called in at least a week.

Solis kept forgetting, as toxins built up in his brain. When they did get to talk in those final months, he would beg Trevino to get him out of prison before he died there. Then in February 2021, Solis was taken to the prison hospital, where doctors diagnosed him with hepatitis C, liver cirrhosis, and eventually liver cancer. Two months later, he was dead.

Trevino wasn’t by his side. He passed away in a hospital four and a half hours away that could only be visited by appointment. Since then, she can’t stop thinking about prison officials’ promise, days earlier, that Solis would call her as soon as he could. The phone never rang.

“I just wait for a phone call,” Trevino said. “And I know I’m never going to get it.”

Trevino had no idea Solis had hepatitis C when he was sentenced to a total of 15 years in 2016 for sexually assaulting a minor and indecency with another child by contact. It was only in those last few months that she found out. Texas doesn’t test everyone in its care for the virus, and Trevino insists Solis was never told he had it, nor was he ever considered for the treatment that potentially could have saved his life. (Trevino can’t request Solis’ prison medical records because they were not legally married, and the state declined to comment on his death.)

Solis was the baby. He was always joking and making people laugh at family gatherings. He was seemingly never angry — so much so that his sister worried about him making it in prison.

Solis’ loved ones are all still grappling with the fallout of his sudden illness and his death last year. His sister Esther struggled with bouts of depression and anger. His teenage son contemplated dropping out of high school. The family stopped getting together.

“It killed everything,” said Esther Solis. “Everybody’s suffering.”

Experts on grieving say the process of losing a loved one is not the same for everyone. The once-popular theory about the five stages of grief is now passé.

But there’s one thing common to the experience of bereavement: The central task for any grieving person is to accept the reality that their loved one is gone, and they’re not coming back.

Psychologist J. William Worden calls it the first task of mourning. Elisabeth Kübler-Ross, the architect of the outdated concept of five stages, dubbed it the final stage of grieving. Even Sigmund Freud, the famous psychoanalyst, argued nearly a century ago that a central aspect of mourning was decathexis, the process of detaching mentally and emotionally from a person.

“There’s a natural resistance toward acknowledging they’re gone forever — it’s very very powerful and disorienting to do that — and that’s something that everyone that’s grieving has to do,” said Katherine Shear, founding director of the Center for Complicated Grief at Columbia School of Social Work. “It feels so bad to accept it, but actually it’s by accepting it that the process starts to move forward.”

The added challenges of losing a family member or partner in prison — the lack of a proper goodbye, the conflicting information, the feelings of hopelessness — make it all the more grueling to accept the loss. They’re all risk factors for complicated grief, a prolonged process the American Psychiatric Association formally recognized as a psychological disorder in March of this year. The condition is characterized by symptoms such as protracted disbelief surrounding a death, and persistent difficulty engaging with tasks like planning for the future and pursuing interests.

Trevino has never been diagnosed with complicated grief disorder. But it’s been 19 months since Solis died, and some things still haven’t gotten easier.

She can’t watch a football game if Solis’ favorite team, the New York Giants, is playing. She can’t bring herself to dance to Tejano music with her friends, the way she used to so often with Solis. She has the urge to sneak out of gatherings with Solis’ family.

But she can, at least, talk about Joe without breaking down.

When Solis died, Trevino went back to her job as a hair stylist four days later. Any time someone would give their condolences, she would break down, until her boss finally told her she should go home.

It was at work that she’d first met Solis. Back then, nervous, she’d always tried to avoid being the one to cut his hair. She’d slow down, she’d speed up. But he always ended up in her chair.

A few months later, they started dating. By the end of their first date, they were inseparable.

Solis would stay holed up on the phone in his mother’s kitchen for so long talking to Trevino that his mother would yell “Ya” — enough — from her bedroom so she could get some sleep. Soon, Solis moved into Trevino’s home with his 3 1/2-year-old son; she agreed to raise him as her own.

When Solis went to prison, Trevino pledged to stay — until suddenly, he was gone.

When men sit in Trevino’s chair now, they often ask about the ring she still often wears on her left hand. Is she engaged?

Trevino stumbles.

She is. She used to be. It’s complicated. She’s widowed.

“I still think that he’s still here. I still think that he’s still in prison … or he hasn’t called me because they’re in lockdown. Or he doesn’t have enough money to write a letter,” Trevino said. “I just find excuses.”

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