Immigration detention centers are infamous for terrible conditions, mistreatment and human rights violations. In 2009, President Obama called for "civil detention" reforms to improve conditions and government oversight. I explore how these reforms, specifically those focused on improving medical care, have transformed immigration detention as an institution, and how detainees have experienced these transformations. I use an ethnographic approach to understand how the rhetoric of health and care, as well as the overwhelming use of psychotropic medication, affect detainees' understanding of themselves and the meaning of their detention experience. My findings will add to scholarly understanding of immigration detention through its examination of civil detention. It will also challenge the acceptance of these reforms as improvements. If, as I contend, these reforms have refined the mechanisms of control and marginalization at work in immigration detention, my findings support an abolitionist critique of detention.