The State of Texas intended to kill Ramiro Gonzales on July 13. Mr. Gonzales, who is 40, has been on Texas’ death row for 16 years. He is guilty of having raped and murdered a woman named Bridget Townsend when he was 18 years old and has been incarcerated his entire adult life. For most of that time, he has lived knowing that he may one day have to lie down, say his last words and participate in his own killing.
I learned of his case a week before his scheduled execution, when news outlets reported that he hoped to donate a kidney before he died. I worked for five years as a palliative care physician on Rikers Island, the main site of the New York City jail system. Over that time, I took care of several patients who needed organ transplants and a few who wanted to donate their organs to people they loved; in all circumstances, incarceration made the onerous transplant process effectively impossible. As a result, I petitioned for patients who needed organs in urgent situations to receive compassionate releases from jail so their lives could be saved.
My work at Rikers was premised on two related ideas. First, that all lives are fundamentally and equally valuable; and second, that the value of each life is, paradoxically, most self-evident in the places — like Rikers and death row — where American society consistently behaves as though the opposite were true. Jails and prisons are places where the sanctity of life transforms from a philosophical concern into an obvious truth, both indisputable and urgent. To spend time in an American carceral institution is to witness extreme disregard for human life and, simultaneously, powerful resilience against such indifference.
Punishment is designed to constrain people, not to help them grow. And yet people can grow and change and come to know themselves better even in small, dark spaces. This has been the case for Mr. Gonzales. His attempt to donate a kidney represents something beyond a modification of the simple logic of an eye for an eye. It is an expression of hard-won self-knowledge and the good he has found in himself, commingled with remorse.
The idea occurred to him when, through a friend, he learned of a woman who needed a kidney. That friend, a Jewish cantor, subsequently wrote a letter on Mr. Gonzales’s behalf, stating, “It is my impression that his wish to do this has been out of his hope of saving a life after he has taken another. He knew that his altruistic action would not stop his execution. He only wanted the chance to help another human being in need.” The standard procedure for lethal injection would mean Mr. Gonzales would be highly unlikely to be an eligible donor after death.
In the months leading up to his scheduled execution, Mr. Gonzales was assessed at a hospital and found to be an ideal prospective donor, especially since he has a rare blood type that makes him a potential match for people who are less likely to find one. He had not yet been formally paired with a recipient, however. In June his attorneys asked the Texas Board of Pardons and Paroles for a six-month delay of his execution for the purpose of completing the donation process.
On July 11, Mr. Gonzales was allowed extended visiting hours so he could begin saying goodbye to his friends and family. At midday, he got word that the board had summarily dismissed his request to delay the execution. Unmoved by his desire to atone, they were, in effect, also unmoved by the very real consideration that his donation would likely save an innocent life.
The appeal to the board was not the only effort that Mr. Gonzales’s attorneys had put forward to delay or halt his execution, however. They also filed an application with the Texas Court of Criminal Appeals to revisit problems with his original trial. He received the death penalty based on an expert’s assessment of his likelihood of future dangerousness; that assessment was premised partly on false testimony given at his sentencing, which was recanted by the state’s trial expert, who no longer stood by it. Mr. Gonzales was preparing to say goodbye to his parents across the glass in a visitors’ booth when he learned that this appeal had been successful. The captain in charge told him that because his stay had been granted, the rest of his visit time that afternoon would be canceled.
By that time, I had read everything available to read about his case and had reached out to his legal team, hoping to speak with him before he died. I cried when the execution was called off, overwhelmed by the same mixture of relief, gratitude and anger that I felt when my sick patients would be released from Rikers so they could die free. Saving a life, or preventing a death behind bars, can feel like a minor mercy when it is delivered as a concession to procedural justice. And still, it is a mercy.
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I met with Mr. Gonzales at the end of August. I was interested in his decision to donate a kidney. I also wanted to understand what made his life meaningful and valuable to him, and how his sense of belonging in the world coexists with remorse for the harm he caused. I have spent a lot of time in my life speaking with people who have hurt others. Some were in denial about that harm, and some were sick with regret; still others had figured out how to take accountability for their worst actions without becoming entirely reduced to them and had grown wiser and better in that process. Mr. Gonzales seemed to be in this third group. I wanted to know how he’d gotten there.
Mr. Gonzales murdered Ms. Townsend when he was just a few months past his 18th birthday, after a childhood marked by sexual abuse, parental abandonment and grief. He left school when he was 16 and started using drugs after the death of a beloved aunt. Ms. Townsend was his drug dealer’s girlfriend, and she had caught him trying to steal from the dealer’s home. He confessed to the murder a year and a half after it occurred. Mr. Gonzalez told me that he’s tried to apologize to Ms. Townsend’s family but that “they don’t want to hear it,” a fact he accepts. “Obviously, of course, I can’t really articulate my remorse,” he said. “What sucks the most is I’m the reason that someone can hate with such a passion, and hate can actually deteriorate the soul.” He was, he said, depriving the Townsend family of “fulfillment.”
“I think there was a period where I was like, ‘Hey, you know what? I don’t care about life. Just execute. It doesn’t matter. I have no meaning,’” he said when I asked if he had ever felt that he deserved to die. Getting to death row, he said, is what changed that. “It actually helped me to construct what life was — what it really was. What meaning really is, what remorse really is. What it means to give back.” How could he give back, he wondered, if he was killed?
He remembers feeling scared when he arrived on death row. But the other men on the unit, some of whom had been there for decades, talked to him through the cell walls and began sending him gifts, unbidden: clothes, stationery, stamps. “The philosophy was, like, ‘Look, when you’re new, we just want you to know that regardless whether you accept it or not, you’re part of the community now. We’re all here to fight for our life,’” he said.
Friendships on death row are lifelines that enable people condemned to isolation to feel love and connection; they’re also bonds that are painfully broken when a community member is executed. “You know, from time to time, I’ve been close to all of them,” Mr. Gonzales told me. “At the same time, I’ve purposely distanced myself as well. Because you don’t want to make best friends — well, you just don’t want them to be executed.” One of his dearest friends, Rolando Ruiz, was executed in 2017. His closest friend, Kosoul Chanthakoummane, was executed two weeks before my visit. Mr. Gonzales described living in a haze of grief when we met.
Mr. Chanthakoummane was, Mr. Gonzalez said, an incredible artist. After we spoke, I found some of his art on the internet, and his drawings are, indeed, extraordinary: intricate illustrations that are conceptual, political, evocative. Mr. Gonzales also draws beautifully. I have seen portraits he made with a ballpoint pen that are so vivid and detailed that they look like photographs. And then, the day that I visited the prison, I happened to see another death-row prisoner show a piece he had made to a television crew that had come to interview him. It was a perfectly constructed papier-mâché globe made from toilet paper rolls, with a clasp at the center, that, when unlatched, opened to reveal a papier-mâché crucifix, complete with a small papier-mâché Jesus. The contraption was beautiful and clever. I couldn’t make sense of so much talent concentrated in such a small group of men, men who had discovered they could make art this way while ostensibly cut off from everything beautiful. What inner resources had they found that weren’t available to them before?
Hearing about the camaraderie and creativity of the death-row community reminded me of a unit of men I used to take care of on Rikers. Many had been trapped together in pretrial detention for years. In November they would decorate their dismal cinder block space for holidays with bits of toilet paper and fabric and magazine photos and coloring book pages ferreted away from art therapy sessions. Jail makes magpies of everyone, and everyone is always collecting and hiding and hoarding, but from Thanksgiving through Valentine’s Day, people would share their treasures, and the dorm would be tinseled with the best stuff. It was very sweet and festive and, in its way, excruciating.
“The incarceration part never changes,” Mr. Gonzales told me. “It feels like just yesterday. You know? It’s hard to articulate, just that lapse of time.” Nonetheless, he said, every day feels busy. “It’s ironic, because, like, I have nothing but time. But at the end of the day, I’m like, ‘Man, I wish I had more time to write or to draw, to do whatever.’” He used the word “exceed” a lot; he spoke multiple times about how he felt driven to exceed his circumstances, to transcend his struggles.
Mr. Gonzales radiates the particular clarity and nonjudgmental generosity that I’ve known only in long-termers, people who have survived decades in prison. He made death row sound simultaneously like a torture chamber and a monastery. “Freedom is not a place,” he explained thoughtfully. “Just because you’re out there doesn’t mean you’re free. Just because I’m in here doesn’t mean I’m locked up. I’ve learned the true sense of freedom internally, that that’s where it comes from.”
Mr. Gonzales came to the idea of donating a kidney as a kind of atonement to the universe for the violence he had committed, even if the family of his victim was not prepared to receive his remorse. “You take a life from the world, you know how precious it is, you realize just what you’ve taken. So how do you give back? Like, there’s no amount of labor, there’s no amount of restitution that I could give that could bring that back. So the only thing that I really thought about was, ‘Look, I can actually do this,’” he said.
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“Who arbitrates life and death in a society where nobody gets it right?” Mr. Gonzales asked when we spoke. It was the right question. I find myself now in the familiar, strange position I’d sometimes land in when I would advocate for a patient to receive compassionate release from jail. To put his exceptionalism in high relief runs the risk of reducing his unit mates to the background; that makes it seem I am talking about who deserves to live instead of whether we all do. I do not want to speak about the sanctity of life by demonstrating that one man has earned the mercy of the State of Texas, although I believe that he has. We all are worthy of living, and even though the state has been threatening to kill him for 16 years, Mr. Gonzales radiates that truth more visibly than most of us.
Months after his execution was stayed, it is still unclear whether the Texas Department of Criminal Justice will permit Mr. Gonzales to donate an organ. He cannot do so without its consent and assistance. It’s hard to imagine the justification the department might employ if it denies his request, now that the execution is indefinitely delayed. In refusing to allow Mr. Gonzales to give a kidney to a stranger, the state would also be denying a lifesaving organ to an innocent person. The sanctity of that person’s life must seem, to the department, theoretical or abstract; or, to put it another way, it must seem less real than the risk perceived in allowing Ramiro Gonzales this opportunity for grace.
Rachael Bedard (@rachaelbedard) is a physician, writer and activist.
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