Has Dana Priest given us our next issue?

by Sara

Mistreatment of vets coming home from Iraq and Afghanistan did not begin with Walter Reed building 18.  The matter was around a couple of years ago when medical returnees were reported in a Georgia Base -- they were between and betwixt the Military Medical System and the VA system, but they had been warehoused in some old barracks on a post in Georgia.  I think they were world war II barracks. 

Much as it is good that the Washington Post has done this story, it needs doing as local journalism.  Back in the 70's and 80's, when the World War II posts of VFW and AL were really active, the parking lot at the local VA hospital was filled with vans and SUV's with their post numbers on them, they were making sure their local members were getting to their appointments, and they had nice 501 (c) 3 transport to get them to those appointments.  But that generation has died off I think, and nothing has replaced it.  Likewise, nothing has really replaced the power of the old vet's lobby for the kind of care that is needed. 

I actually knew nothing about the VA till AIDS came along, but our first generation of AIDS patients in Minnesota -- well about a third of them were Vets, and in establishing some of the needed services, I came to really respect the VA.  We got a huge influx of vets from Texas because Texas VA did nasty things to people with AIDS, and the guy who introduced me to it all was a Marine from Texas, but who was also originally from Minnesota.  Another person who introduced me was an American Indian who had been in the Marines as a cook, (he had been adopted off the Pine Ridge Reservation as an infant, so raised as an anglo),  and between the two of them and the system, I learned a great deal. 

Unlike any other health system, VA and Military Medical is profoundly politically sensitive.  The AL and the VFW have moved out and off -- and these systems need new advocates.  Newer Vet's groups do not have the kind of local chapters that the AL and the VFW had -- and thus not the same political clout.  In fact, they really were resistant to recruiting the Vietnam Era vets, which is why they don't have them.  They certainly were not interested in Vietnam Era Vets with AIDS, and their issues.  I actually had to get the state Human Rights Commission to clarify with them that vet transport could not discriminate against people with AIDS who otherwise were vets. 

In a state like Minnesota where most of our vets these days are in Greater Minnesota, and our vet hospitals are in St. Cloud and the Twin Cities, the question of transportation to accessing their health care is totally critical.  There is no public transport to either place.  If you can't drive, or get someone to drive you -- tough luck.  No one really considered this when Greyhound was abandoning their lines.  And no one considered what would happen when a 501(c)3 just stopped its works.  And when the WWII VFW Posts went out of business, that's what happened. 

In the meantime, half of our dead are from small town America, a good many of our wounded are also from there, and no one has figured out that where you recruit is where you need to have services.  And the rest of us have not figured out how to make those towns that need these services part of us.  As I said over on TPM's site, the guys who  come into town and pick up the mail and visit the feed store, and then sit around the big table in the town cafe, but who also have E-Mail from Iraq to be read around the coffee table,  These guys are mad as hell and when they learn about Walter Reed Fifth (black Mold) Class -- they are going to get much more erupted.  Perhaps we should just be honest and call it Katrina Class. 

Where is the guy who is going to throw the switch? 

 

Comments

[Jon]

Hi Sara,

Thanks for the post. I agree with you that this is a "sleeping giant" issue. As this story gains wider visibility in the rural communities it could turn many veterans who are currently Republicans away from the Republican party, and more importantly, solidify the well-earned negative image that a lot of veterans who are independents have of the Republican party. This could quite easily be the straw that finally breaks the back of the modern Republican party and consigns them to minority status for a generation. In many rural areas of the country, it is the veterans and the small business owners who are the backbone of the Republican party.

The death of the WWII generation has had a huge impact on local VFW and American Legion posts as you mentioned. And in the rural areas of the country, this impact is not going unnoticed by the surviving veterans, their spouses and their families. VFW posts and American Legion posts are closing or meeting sporadically with a dozen members or less. Gone are the days when all of the political candidates wanted to speak to the VFW or American Legion members at their meetings or breakfasts or dinners or "meet and greets." As you observe, this has greatly diminished the impact of these groups to effectively lobby Congress or even their own state governments for much needed services and support. They are largely becoming "the forgotten veterans."

This post is very timely as many of the WWII and Korean War surviving spouses and veterans have been discussing this issue for several years now. It is an issue that has many groups of veterans scrambling in their attempt to sort out how best to reorganize to more effectively bring their issues to the attention of Congress and their state government. For example, the various retired officer associations and retired non-com organizations are currently working on this issue to ensure that veterans and their spouses are not left behind in their hour of need, especially for those veterans and spouses who are traversing the twilight hours of their lifes when their needs are growing. They also understand more than anymore the committment that the government must make to the returning Iraq War troops and their spouses and families and to the continuing unmet needs of the Vietnam veterans and the 1st Gulf War veterans.

Anger is building among those who are tuned into what is/has happening/happened in Washington with respect to veterans' issues. The backlash will slowly build over time as more and more of those rural veterans, their spouses and their families learn the breadth and the depth of their betrayal by the Republicans while in power in Congress.

[sacrablue]

Transportation to the VA hospital is an issue I am dealing with right now. My son's friend was injured in a training accident before deploying to Iraq. He had surgery when he returned stateside and then waited almost two years for a medical discharge (well beyond his enlistment period). The surgery was unsuccessful and last week he got to try his luck with the VA. My son drove him 100 miles for his 6 am surgery and home again 10 hours later. Complications arose. His arm is still numb and he has lost hearing in one ear. Our local VA hospital was unable to help, leading to a second 200 mile round trip on Friday. Now they expect this vet to make a third trip tomorrow, just to get a CAT scan. One would think he could get it done locally and has the results sent to the VA. This kid is heavily medicated, partially numb and certainly can't drive. My son can't take any more time off work and I can't find any organization that will assist this vet. I'm so frustrated and angry that I haven't slept well for a week. I still haven't heard back from Congressman Doolittle's office and I doubt that I ever will.

My son met several elderly vets at the hospital who had traveled more than 200 miles for their appointments because so many VA facilities have been consolidated and BRAC has closed many military facilities that used to be available to them.

We need to get local media to report on these issues to make people aware of the lip service that is being paid by the phony patriots in the Bush administration.

[mainsailset]

sacrablue, your story brings to mind how, in the end with govt & particularly one run by these compassionate conservatives, it is the kindness of friends and family that is often the only hope these vets are left with. We would all do well to remember your story and choose to become an advocate who offers a ride to the hospital, queries the doctors, helps with the phoning and paperwork...all the things one does for someone you care about.

[bluebleeder]

As I read the first paragraph of this fine post I was jarred by the remembrance of my father's situation at the end of WWI. My father had been on the only troop ship sunk during the First World War, off the coast of Ireland in winter. By a miracle he was pulled out of the water and hospitalized for exposure.

In the hospital he contacted Scarlet Fever and then Tuberculosis. He was in critical condition and there was nothing to be done to save him. As the war wound down he was sent to the large Air Corps base in Texas. Finally, at war's end and the post was otherwise closed, he was put in a barracks with eleven other dying patients and left in the care of a single orderly.

One after another the patients died. When only five men were still alive my father, incredibly, made his was to a train station, got on a train to Minnesota and arrived at his home barely breathing.

That was only the beginning of a remarkable journey that lasted another 70 years of his life, all of it spent with recurring tuberculosis. Many times, perhaps more than a dozen times, my mother was told he would not live through the day or the night. He lived to be 90, lived through the administrations of 17 presidents of the U.S.

Imagine! He was abandoned and warehoused and left to die with a fatal disease on a deserted Army Air Corps base - and this was nearly 90 years ago. How can somewhat similar circumstances still be happening today? I am appalled.

I suppose the answer is that we should not expect anything else under a presidential administration that so thoroughly dislikes and disdains government and which believes its primary responsibility is to give billions to billionaires and create wars for its ego gratification.

(Here in Honolulu it takes me 20 minutes to drive my car to the fine VA facility, or two hours to take a public bus there. Through the Disabled American Veterans organization I can take a shuttle from my front door just by calling ahead.)

[janinsanfran]

We used to have a VA hospital. They closed it. It is prime real estate. Of course, since it is prime real estate, it never had public transit that was any good -- in the 1970s I worked among those who were not yet labeled "homeless" but were, many Vietnam era vets. They couldn't get to the VA and nobody else world deal with them.

This is in Pelosi's district.

[Sara]

Our VA Hospital in Minneapolis is quite good, and also relatively new as Martin Olav Sabo got an earmark on it fairly early in his legislative career. One reason it is good is because it has long been tied to the University of Minnesota Medical School as part of their teaching hospital network -- thus it constantly has teaching practioners and 3rd and 4th year students plus Residents integrated into its staffing. About 18 months ago at least part of the transit problem was helped when the light rail line that ties together down town, the airport and Mall of America opened, and the VA is near a stop on that line. The problem has ceased to be a twin cities problem. But Minnesota is a big state, and more and more the military draws from the small towns and farms -- and for them there really is no public transit at all, particularly since so many of the Greyhound type lines have ceased to exist.

But I really am interested in how we re-focus the line, "support our troops" into practical solutions to all these clearly evident problems, and then make it a political matter. Let me provide another example to make this clear.

I noted in my first post that I came to know the VA because a good many of our AIDS clients were VA patients. Now AIDS is not a Service Related medical condition, but because our VA is part of the teaching Hospital network -- and the U of Minnesota is a leading medical research site (had a huge program in immunology when AIDS arrived), the research and clinical folk wanted all the patients they could find -- so they established a VA AIDS clinic. It made sense -- you always look for a block of patients where some financial source will pay treatment costs, and VA elegiables are just what you are looking for. But what makes sense for cutting edge medical research just does not make sense, or certainly isn't a priority if the mission of serving vets with service connected disability is narrowly understood.

I assume there will be Hearings in Congress on the Walter Reed mess, and it will be important to keep watch and see if they ask the right questions.

[cal]

Off the subject, but, speaking of Dana Priest I thought this statement from an interview by Frontline (not in broadcast) was interesting.

Q: "And then there was Sen. Pat Roberts [R-Kan.], the chairman of the Intelligence Committee, saying: "Right on. We've got to prosecute people who are leakers." So you've got the CIA, you've got the chairman of the committee, and you've got White House -- ... you've got everybody saying --"

Priest: "Well, not everybody. ... The people that you're talking about are all in one party, and they all support each other. They all have the same idea that they don't want this to be public, and that, to me, is the larger issue."

[bluebleeder]

Above I wrote about the early tribulations of my father after WWI. I am a service-connected disabled veteran of the Korean War. As a result I have been a patient in the Los Angeles VA (called Sawtelle - and which is affiliated with the UCLA Medical Center.)

Later I move to San Jose and was treated at the very fine VA clinic there and also at the amazingly superb VA hospital in Palo Alto, affiliated with Stanford Medical Center.

Now I live in Honolulu and am very often treated at the Spark Matsunaga VA Center. Recently the VA flew me to Palo Alto for an operation and, of course, back home again.

Since President Clinton made sure the VA was properly administered, financed, and staffed the VA has been vastly improved. At the institutions in which I have been a patient in the past dozen years, I have been treated far better than I ever was by my previous insurance companies and HMO's.

Now I have lived in these large cities and have my own transportation. Still, there are fine transportation services, and a number of local VA clinics, from cities that outlay the central VA Hospitals.

[bluebleeder]

Above I wrote about the early tribulations of my father after WWI. I am a service-connected disabled veteran of the Korean War. As a result I have been a patient in the Los Angeles VA (called Sawtelle - and which is affiliated with the UCLA Medical Center.)

Later I move to San Jose and was treated at the very fine VA clinic there and also at the amazingly superb VA hospital in Palo Alto, affiliated with Stanford Medical Center.

Now I live in Honolulu and am very often treated at the Spark Matsunaga VA Center. Recently the VA flew me to Palo Alto for an operation and, of course, back home again.

Since President Clinton made sure the VA was properly administered, financed, and staffed the VA has been vastly improved. At the institutions in which I have been a patient in the past dozen years, I have been treated far better than I ever was by my previous insurance companies and HMO's.

Now I have lived in these large cities and have my own transportation. Still, there are fine transportation services, and a number of local VA clinics, from cities that outlay the central VA Hospitals.

[Nellieh]

Today is Thursday, Feb. 22. I read through the USAToday and found nothing about Walter Reed. It must now be a non-story. I guess they milked it for all they could and dropped it. But I did find stories about Nicole and Britney. Now, I could have missed it or passed over it. But if it was there it wasn't as prominent as those two articles. I e-mailed them they ruined my supermarket checkout line reading. If I may comment about the hospitals I have been in. In 1956 prior to discharge I spent 2 months in the Chelsea Naval Hospital near Boston. The nurses, medics and doctors were for the most part, military. The medical treatment was exellent even though they screwed up my operation. For one thing the food compared with what I had for 42 months on a destroyer was superb. I started with the VA in 1956. The administration staff was mostly TERRIBLE for me up to the early '90s. I still had problems with individual clerks and technicians but it wasn't that bad except for the waiting.This was in Cleveland. I had to transfer my job to Pittsburgh to care for an elderly mother and as a result went to the Pittsburgh VA. after I retired, I continued to travel to the Pitt. VA. When asked why , I said the folks there seemed to look for ways to help you as opposed to find ways to dismiss you. Our county has a Veterans Service that provides rides to the Hospital. I don't use it because I am still able to drive and I don't have to spend the whole day there. I can leave when I am done. Now we have an out-patient clinic locally for primary care and only have to go to Cleveland for specialty clinics. All in all, the medical staff has been great. The administration is improving. They had a long way to go.

[N=1]

There are many aspects to the story which remain invisible. One is the role of the Army Nurse Corps in the care or inpatients. There is evidence that the Army has been aggressivly using utilization managment to discharge inpatients faster, and it bears investigating whether patients are actually ready to be discharged and to receive care on an outpatient basis. There are many instances of patients not being diagnosed with PTSD - from the Priest/Hull reports, I am wondering if a prime reason for this is to keep patients eligible for redeployment, regardless of mental illness. A third problem - if Walter Reed is considered to be the crown jewel of Army healthcare facilities, what kind of care is being delivered at all of the other facilities around the country?

My guess is that the Army Nurse Corps, used to inpatient care and battleground medevac care, is overwhelmed and under-resourced with the amount and scope of nursing care that is needed by soldier patients, as they refer to them, of blast injuries, traumatic brain injuries, amputations, complex muskuloskeletal injuries, and acute and chronic mental illness - especially PTSD.
Nursing care is the absolute key critical service which reduces morbidity and mortality (complications and deaths) and which produces the best recovery and rehabilitation.
Last concern is that patients with brain injuries and mental illness and those being given sedatives, tranquilizers and mood-altering or cognition interfering drugs are being given the burden on planning, coordinating and managing their own healthcare when they are least able to do so. Where is the Army Nurse Corps in providing essential nurse case management for these patients? Not providing this, in my opinion, is akin to patient negligence and possibly malpractice for patient abandonment. (If interested, read my blog for a more detailed description of the problems.)

[sacrablue]

A bit of good news: my son got his LTE on this subject published in the Sacramento Bee today.