The cruelty is the point. It's their MO. Hurt those already judged and serving their sentence. It's why I will never work in correctional Healthcare. Each interaction with a health care professional is, in those HCPs minds, an opportunity to punish in invisible ways. I've seen many DOC nurses treat inmates like dogs. By the time they get to outside facilities for care, they're often unnecessarily complicated or half dead, due to the 'care' they get from DOC personnel.
Edit: not just nurses but doctors too
In 2020 during COVID, it often presented strangely with patients on 100% oxygen, no respiratory distress, but still having low O2 sats. They'd sit there for a week and a half with sats in the 70s and were only intubated once they decompensated from there. That 10 or so days of low sats hits every organ in the body but the consensus was to intubate once they were in distress. For those that survived, long covid makes a lot of sense