Still Fighting: the war at home

What if this were YOU or YOUR SOLDIER? After combat service, in THIS economy?

2009-01-07T19:42:00.001-05:00

MSC's Soldier Advocacy Group is in the process of trying to help Sgt. Boyle (see article below). The Department of Defense recognizes that PTSD (and TBI) causes what it calls "disinhibatory" behavior in combat veterans--which frequently manifests itself as post-deployment misconduct. It further recommends that Commanders refer soldiers exhibiting this behavior be referred to a Medical Evaluation Board for a medical discharge from the Army, if possible (as opposed to being administratively discharged).

Soldiers with PTSD are at a higher risk for suicide, unemployment, drug and alcohol abuse, partner violence, and homelessness. Soldiers who are given a general discharge are not guaranteed VA benefits, particularly those who are discharged for "patterns of misconduct."

Could you imagine if your spouse returned from combat and was suddenly discharged from the military and you and your family were left with no benefits and your soldier was not guaranteed medical and mental health treatment from the VA? And on top of that, he or she had to pay back, potentially, thousands of dollars for a re-enlistment or enlistment bonus?

Congress could direct the DoD to explain why it acknowledges that PTSD (as well as Traumatic Brain Injuries) causes misconduct while simultaneously administratively discharging soldiers diagnosed with PTSD for misconduct. It could direct the DoD to change its regulations to close this loophole. Congress has not.

Please call or email or send this article to your Senator or U.S. Representative and ask them to end the DoD's Misconduct Catch-22. (Find your federal representatives at www.congress.org).

PTSD victim booted for 'misconduct'

By Kelly Kennedy - Staff writer
Posted : Wednesday Jan 7, 2009 12:55:53 EST

After serving two tours in Iraq — tours filled with killing enemy combatants and watching close friends die — Sgt. Adam Boyle, 27, returned home expecting the Army to take care of him.

Instead, service member advocates and Boyle's mother say his chain of command in the 3rd Psychological Operations Battalion at Fort Bragg, N.C., worked to end his military career at the first sign of weakness.

In October, a medical evaluation board physician at Bragg recommended that Boyle go through the military disability retirement process for chronic post-traumatic stress disorder — which is supposed to automatically earn him at least a 50 percent disability retirement rating — as well as for chronic headaches. The doctor also diagnosed Boyle with alcohol abuse and said he was probably missing formations due to the medications doctors put him on to treat his PTSD.

But in December, Lt. Gen. John Mulholland, commanding general of the U.S. Army Special Operations Command, signed an order forcing Boyle out on an administrative discharge for a "pattern of misconduct," and ordering that the soldier pay back his re-enlistment bonus.

Last year, after a number of troops diagnosed with PTSD were administratively forced out for "personality disorders" following combat deployments, the Defense Department changed its rules: The pertinent service surgeon general now must sign off on any personality-disorder discharge if a service member has been diagnosed with PTSD.

"Not even a year later, they're pushing them out administratively for 'pattern of misconduct,' " said Carissa Picard, an attorney and founder of Military Spouses for Change, a group created in response to the personality-disorder cases. "I'm so angry. We're seeing it all the time. And it's for petty stuff."

In Boyle's case, according to Picard and Boyle's mother, Laura Curtiss, the soldier had gotten in trouble for missing morning formations and for alcohol-related incidents such as fighting and public drunkenness.

"The whole thing is absurd to me," Picard said. "They acknowledge that PTSD causes misconduct, and then they boot them out for misconduct."

Please read the rest of the story here: http://www.armytimes.com/news/2009/01/military_ptsd_discharge_010709w/

As always, your ally in change,

Carissa Picard
President
Military Spouses for Change

The Politics of War

2008-01-07T14:00:00.000-05:00

On January 3, 2008, military blogger Major Andrew Olmsted was killed in Iraq. Andrew wrote a blog to be published in the event of his death. While Americans were losing interest in Iraq, Andrew was trying to find the right words to express the peace he had made with the possibility of his death there.

Like many who have written about Andrew Olmsted’s remarkable final words, I did not have the honor of knowing Andrew personally but wish now that I had.Andrew’s blog is replete with self-deprecating humor, which I immediately find endearing. Andrew is also very clear about his reason for being in Iraq--which transcends the politics of war:

“Soldiers cannot have the option of opting out of missions because they don't agree with them: that violates the social contract. The duly-elected American government decided to go to war in Iraq. (Even if you maintain President Bush was not properly elected, Congress voted for war as well.) . . . Whether or not this mission was a good one, my participation in it was an affirmation of something I consider quite necessary to society. So if nothing else, I gave my life for a pretty important principle; I can (ifyou'll pardon the pun) live with that.”

At the same time, he writes that he hopes his death can be a reminder to others about the true costs of war—the costs that Americans, academics, and politicians tend to overlook when calculating the pros and cons of military engagements. The trouble, of course, is that there are no figures for these costs, no meaningful measurements. I believe that numbers alone are insufficient. The value of a human life, and the value of Andrew’s life, cannot be properly expressed by a number, any number.

At the end of his blog, Andrew worries about the suffering his wife will endure and wishes he had been a better husband. It is official. I adore Major Andrew Olmsted. A man I never met and never will. Which brings me to another soldier I posthumously adore: Specialist Justin Rollins.

Justin was part of the 82nd Airborne Division when his team found a litter of motherless puppies. They rescued the puppies and brought them back to their camp. Justin had his picture taken that night holding one of the puppies--a glimpse of the human heart beating beneath all that army-issued gear.

The following day, Justin was killed by a roadside bomb.

My husband asks me why I do things like this: cut Justin’s photo out of the paper and put it on our refrigerator, print out Andrew’s final blog. I do it because I have to. I do it because I don’t want to reduce a human life to a single digit. I do it because it isn’t about what we are losing when a solider dies, it is about who we have lost.

I just wish every other American was doing it too. If they were, maybe Iraq would still be the number one issue on voters’ minds in November and I would have less people to adore after they have died.

"War is an ugly thing, but not the ugliest of things. The decayed and degraded state of moral and patriotic feeling which thinks that nothing is worth war is much worse. The person who has nothing for which he is willing to fight, nothing which is more important than his own personal safety, is a miserable creature and has no chance of being free unless made and kept so by the exertions of better men than himself."

John Stuart Mill

Thought you would appreciate this...

2007-12-04T18:27:00.000-05:00

http://www.emancipatingme.blogspot.com/

Blaming the Victim

2007-12-03T22:08:00.000-05:00

In 2006, Congress ordered the Secretary of Defense to assess the mental health needs of the Armed Forces and the ability of the DoD to meet those needs. As a result, the DoD created a "Mental Health Task Force" which concluded:

the system of care for the psychological health that has evolved over recent decades is insufficient to meet the needs of today's armed forces and their beneficiaries, and will not be sufficient to meet their needs in the future.

The unmet mental healthcare needs of the men and women we send to wage war in other countries are causing them to wage their own wars, within themselves and with others, in this one.

For example, 1st Lt. Whiteside faces criminal prosecution for trying to kill herself while serving in Iraq. Granted, when she had her psychological breakdown, she waved a gun around at her fellow soldiers to keep them away so she could successfully shoot HERSELF (TWICE) in the stomach. She did not, however, actually harm anyone else.

Research by CBS news revealed that an average of 120 veterans committed suicide every week in 2005. SEVENTEEN VETERANS COMMITTED SUICIDE EVERY DAY THAT YEAR.

I wonder how many service members and veterans attempted to kill themselves the day that Lt. Whiteside tried to kill herself? I wonder how many succeeded?

Iliona Meagher has been compiling data on PTSD-related incidents around the United States since 2005 for ePluribusMedia. PTSD that is undiagnosed, mismanaged, or untreated can, in its most extreme form, manifest itself as violence towards one's self and/or towards others. We don't keep official records of these casualties.

Americans like to keep the ugliness of war contained so as to maintain an illusion of civility. This illusion is hard to maintain when the people we send away to fight these wars actually come back; living testaments to what our country has instructed them to do in its name.

In short, we have evolved enough as a species to feel shame about engaging in acts of war but we haven't evolved enough to avoid these acts in the first place. When we SEE the men and women who have been broken, physically or psychologically, by combat, the degree to which we have failed to be civilized is hard to accept.

In the book, "Just and Unjust Wars," the author wrote, "what we often think of as inhumanity is really just humanity under pressure." Our wounded warriors reflect the side of human nature in general, and America in particular, that Americans do not want to think about.

So rather than take responsibility for sending these men and women to another country to do something that is really quite brutal and inhumane (if necessary), we ignore, minimize, or villify the men and women who, in a very normal fashion, were traumatized by what we told them to do or made them witness. The more our institutions make their problems about THEM, the less uncivilized and inhumane and unreasonable WE are.

Hence the appeal of the refrain, "he volunteered to join the Army." Which is kind of like saying that a woman asked to be ganged raped because she went to a guy's apartment after a movie. Maybe she did go to his apartment thinking about maybe having sex with her date, that doesn't mean that she wanted five of his friends to have sex with her too. She TRUSTED her date to keep the evening between the two of them only.

Well, a service member likewise joins with the very honorable intention of protecting our country and defending our constitution. There is TRUST that you will not be EXPLOITED or ABUSED when you join.

Perhaps you should be thinking that for these men and women, their trust has been violated, and if you feel betrayed, imagine how they (and their families) feel after five years and multiple deployments?

My point is this: our discomfort with our wounded warriors makes us even less civilized, not more. The very people whose wounds make us feel the least amount of pride individually are giving us an opportunity to do something to feel the most pride collectively. By tending to the wounds of those who remind us of our inhumanity, we become more humane. That means we have to do more than just bring our troops home, we have to take care of them when they are here.

Pretending we don't see them, or trying not to think about them, does not make them go away; it just makes it easier not to care.

Old Problem ~ Freakishly God-awful new twist

2007-11-29T20:45:00.001-05:00

Just go to the site.
I can't bear to type it again (not for fingers/time, just makes me too freakin angry) -- a military family is currently being forced:

out of their home on post -- weeks before Christmas with no warning & no place to go
out of their sole income, out of the military to which they've committed their lives, with three deployments of sacrifice
into a fight for their immediate future -- for no reason.

Well, one reason: One bad leader. And one colonel us diagnosis. Proven, confirmed by doctors to be false.

But all it takes is one bad leader. And, in this case, another to stand by and do nothing.

We could use ANY ideas; please check it out.

My extremely amateur page, w/a rundown of the details, is at -
http://military.medicine.issues.googlepages.com/examples

New blogger here!

2007-11-28T23:39:00.000-05:00

Yes, there's a new face on this blog.
Which is a very good thing, because RaginRanger and I are too paranoid after our experiences with the military medical system (and too beat down by current medical messes, story to follow), to write nearly as much as we'd like.
Carissa, on the other hand, is a freakin powerhouse of expression-- a proud military wife whose husband will deploy again in a few short months. She also is a lawyer, mother & gifted organizer-- in the leadership of VMFP (Veterans & Military Families for Progress) and the Founder/President of MSC, Military Spouses for Change, at the link above.
As anyone who's been in the military knows, it's a full-time job just being a supportive spouse alone. The fact that Carissa has been the driving force behind a new, nonprofit organization to empower military wives, along with her family obligations, speaks volumes about her level of passion and devotion to do all she can to do right by troops & the wives who go through everything alongside those troops.

We are thrilled and honored to have her as a contributor.
I also hope her postings will shame my depressed, sorry ass into pushing the "post to blog" button more often instead of stewing in silence :-)
Her postings about her organization, he life as the wife of an Army Blackhawk pilot, and news of interest to military spouses are on her blog:

http://militaryspousesforchange.blogspot.com
milblog listed at http://www.milblogging.com/listingDetail.php?id=2253

Why I have a bee in my bonnet...

2007-11-28T12:00:00.000-05:00

Yes, I wrote that. I say things like "aren't you the cat's pajama's?" too. It's part of my charm.

Anyway.

I go on and on and on about this Presidential Forum on Veterans, Wounded Warriors, and Military Families. I work tirelessly. I blog. I email people and call people and network and research and write and constantly look for another reason why America should care, the candidates should care, the networks should care...

I believe our service members do the work that needs to be done, that others don't want to do, that others don't want to think needs to be done... the dirty work of war that continues among men today (I use the word man in the general sense). Yet for this work, they are not adequately compensated, nor are they justly rewarded. In fact, we have evolved just enough as a species to feel shame for these acts of war but not enough to avoid engaging in these acts. So now our "warriors" are relegated to the status of "necessary evil" and all that is associated with that is easily demonized or quickly dismissed.

An example, I think, of how the military is marginalized and unappreciated by both parties:

http://www.dailykos.com/storyonly/2007/11/9/204920/645

First, that broke my heart.

Then it just pissed me off.

So I keep writing. And blogging. And work on helping others find their voices to share their stories. Because the military and veteran community should NOT be marginalized. It should not exist in the shadows of a great nation. It should not be a tool for abuse by a great nation nor should it be abused BY a great nation. It should be a reflection OF a great nation and that is what I plan to make it.

(Cross posted http://www.vetvoice.com/showDiary.do?diaryId=153)

Failing Our Veterans - washingtonpost.com

2007-10-19T23:03:00.000-04:00

Failing Our Veterans - washingtonpost.com

Special thanks, from the bottom of my heart, to Lynne Morgan for a powerfully worded letter to the Editor, as posted on WaPo 17 October. I don't often hear anyone fed up with the systematic lack of priorities in DC in general, especially concerning the disconnect between all the pride, outreach & passion when political-types *talk* about service, vets, sacrifice (rah rah, shish boom bah, here's a flag) and the realities we face (sorry dude, the HMO/contractor/big-airplane-maker/Pentagon-gardener's-nephew's-union has a lobby & a ton of cash--unlike YOUR sorry ass who was merely patriotic-- why don't you just go ahead and suck it up some more?)

For all those who didn't make it that far in the Oct. 14 front-page article "A Wife's Battle," in the 43rd paragraph we learned that, in a city where the rich ride in limousines and federal workers get 48.5 cents a mile, disabled veterans are still paid the 1977 mileage reimbursement rate of 11 cents a mile...

It's hard to find great examples like that! I mean, ones that actually show proportionality so the problem is *clear* to anyone with a brain... something that can't be spun so it just sounds like whiny "Yeah man, us against The Man"... (It's not like we get f'in royalties on all those political speeches, nor any of the other times troops are there in the background, smiling, staring, nodding off, adding "national security authenticity" or whatever)

Enormous priority on Bosses' well being, at the workers' expense, is the way of the world, I know. It sucks, but it's not something that keeps me up at night in the course of normal industry.
The reason it's so heinous in our, um... industry, is that we who are entrusted with ANY sort of leadership & responsibility over troops are instilled from Day 1 with the sense that we have a moral obligation--almost a sacred duty--to take care of the troops under us.
There is NO upper limit when it becomes acceptable, in our world, to live it up and let the little people fight it out amongst themselves. The E-4 in charge of 2 lives, E-7 in charge of 30, O-3 legally responsible for 120 troops + their families... up to the O-8 commanding an entire division (~20,000) & beyond: we have one basic responsibility to push ourselves to make sure we're providing the best training, equipment, environment & care available. If we don't get our staff to get its head out of its ass to take care of something, this sort of honor-code says it's us, the boss (& staff if necessary) who go without heaters, food, ammo, *whatever* until we make shit happen.

Obviously the political world works differently, which is exactly why most troops prefer to avoid anything to do with politics, politicians, policy, or anything that takes such a mental re-set button to understand, much less navigate.
No troops, except perhaps the senior leaders who interface daily with, say, the senior civilian Chain of Command, should *have* to be concerned with a single matter of politics. Now we are.
Sometimes it's easier not to know. Not because we're dumb little simpletons, but because it's too damn hard to be "in the moment" enough to function & stay sharp in military stuff, while also doubting and second-guessing. The House-Divided-Falls and all that. Focus, compartmentalize, train, mission, bring people home alive, and screw the rest-- at least for now. Yes, some officers have flirted with political issues--often to their own detriment--out of either ambition or necessity as they find the Pentagon ever more politicized... BUT, that's been widely criticized both inside the military *and* among the soldier-scholars whose work revolves around this "Professional Military Ethic" (PME)... which is a can of worms I'll definitely punt for now)

blah. i feel catharsed, or whatever the hell a "catharsis" might be in verb form. but also in need of sleep after a good laugh. E! channel had SNL's episode w/SNOOP DOG(G?) hosting the other night, and i hope to heaven that it taped ok! Is there any not-so-cheesy way to sign off?... probably not. more later.

VA: 10 patients died under care of former surgeon at IL hospital - Boston.com

2007-10-19T22:10:00.000-04:00

VA: 10 patients died under care of former surgeon at IL hospital - Boston.com

Ten patients died under the care of an embattled surgeon during the roughly 20 months he worked at a Veterans Affairs hospital in southern Illinois, according to a letter released Friday.

But wait -- sh*t happens... people die in hospitals, right?

Durbin said last month VA officials told him nine veterans -- all in some way linked to [Dr.] Veizaga-Mendez -- died at the hospital during a six-month period ending in March, during which the hospital would have expected only two deaths.

Hmmm. 9 deaths for this doc, compared w/his peers' average of 2. Now this is starting to sound like a doctor near and dear to us Fort Campbell vets "lucky" enough to have seen Dr. Tw----e at Blanchfield/BACH. A proud combination of "inept" and "obstructionist"... with dashes of passive aggression to make the mix really fun. We only managed to get any help w/that after the Scandal Of Which We May Not Speak, which wasn't even (directly) medical. But not until he'd severely screwed us up.

I wonder how this punk finally got in trouble?

[He] worked at the Marion hospital from January 2006 until he resigned Aug. 13, three days after a Kentucky man apparently bled to death after undergoing gallstone-removal surgery Veizaga-Mendez performed.

Ew.

The article follows with more buzzwords: new concerns about overall "quality of patient care", "lax patient safety", investigations of the vetting process & doctor qualifications, yadda yadda.

I don't usually have the heart or energy to blog much anymore; every story seems like another droplet in a really big monsoon--something I can't change, but have to live with the consequences--while meanwhile there's some asshole of a weatherman smiling on tv insisting it's only a passing drizzle.

Hopefully [sic] getting into the habit of posting articles like this, keeping commentary to a minimum to try to avoid it snowballing into a rant, will wind up being healthier than closing the page and pretending to ignore it, then having it build up inside and turn cancerous.

More Quickies later :-)

--> Does anyone know what studies have been done on the correlation between blogging & depression, or how soothing/maddening the blog tends to be (compared with other forms of writing or expression)?

public interest

2007-04-28T17:27:00.000-04:00

It seems the WASHINGTON POST is expanding beyond the WRAMC trouble. So this isn't exactly a "hotline" but it will attract attention.

http://www.washingtonpost.com/wp-srv/nation/walter-reed/index.html

Tipline: Share your experience with the military or VA health care systems with Post reporters: (202) 334-4880 or militarycare@washpost.com

Through Your Lens: Send us your photos and videos chronicling experiences you or a family member have had in the military and VA health care systems: walterreed@washingtonpost.com

They stick some in the corners
Still others in the hall
And they're lying in there
They're dying in there
Don't you care at all?
— William Fick

• Fighting Walter Reed After Fighting the War, April 8, 2007
• Delayed Benefits Frustrate Veterans, April 8, 2007
• Q&A Transcript: VA Disability Benefits, April 9, 2007

more hotlines

2007-04-21T10:08:00.000-04:00

Other numbers troops and family members can call with concerns about military medicine issues:

1-800 497 6261 Deployment Health Support Directory

____________________________________________________________________________________________________

If a troop feels they have been retaliated against, DoD wants to hear about it: [FULL PAGE LINK]

Defense Hotline Reprisal Complaints: WHISTLEBLOWER PROTECTION INFORMATION

You may also call the Defense Hotline at (800) 424-9098 to discuss your case with an investigator if you have additional questions or concerns. Persons who are hearing impaired or have speech disabilities may also contact us through the Federal Relay Service at (800) 877-8339 (additional information regarding the Federal Relay Service may be obtained through it's website www.gsa.gov/frs).

Complaints should be submitted via mail or fax transmission. Our address is: DEFENSE HOTLINE, THE PENTAGON, WASHINGTON DC 20301-1900. Our commercial fax number is (703) 604-8567. Our DSN prefix is 664.
[FULL PAGE LINK]

trust

2007-04-17T16:27:00.001-04:00

Who can an injured soldier trust these days? Well, for starters, themself - but there are other organizations to help.
But how do I check out these organizations and hotlines?
Call a hotline anonymously and check out their procedures, find out who they report to, where they're located.
There are some hotlines set-up as scams - little spy networks, but I trust that there are good hotlines available for soldiers, too.
1-800-984-8523 seems to be a good one for soldiers/families to call - I'm not going to pretend to know what good any hotline will or won't do for any particular situation, but troops' medical care is a hot topic now and we should keep it that way until some good changes come about.

transition points

2007-04-16T11:42:00.000-04:00

Not every Military Base has a VA transition center. Campbell has one -
there are VA counselors on site, a DAV rep, and a VFW rep. Having these
resources is a big help, not only to MEB troops but also for anyone else
leaving the service. VA claims are settled faster, and having claim
specialists helps troops prepare VA claims more accurately and completely.
Places like Benning and Riley don't have this convenience available -
but the help is available on-line and even over the phone.

The Walter Reed "Tiger Team" is visiting every medical facility but I
don't know how much impact a two-day guided tour will have on the MEB
process for troops going through the transition.

show me the money

2007-04-10T13:16:00.001-04:00

Below is a link to a page that helps calculate disability pay from the
Army and VA, and how those payments relate to one-another.
I have only included the severance pays from the Army - it is the most
common form of Army Medical Separation Compensation. About 90% of all
medical separations are severance based (0% - 20%). Retirement is
effective from 30% and higher. Retirement warrants an entirely separate
calculation process.

Hotline

2007-04-06T18:29:00.000-04:00

The Army has put up a hotline for soldiers and family members to call with concerns about the MEB/PEB process.
The number is 1-800-984-8523
Overseas DSN: 312-328-0002
Stateside DSN: 328-0002

email: wsfsupport@conus.army.mil

Link to [Flyer]

Flyer Text:
The purpose of the hotline is two-fold:
-To offer wounded, injured, or ill Soldiers and their family members a way to share concerns on the quality of patient care.
- To provide senioer Army leaders with visibility on medically-related issues so they can properly allocate resources to better serve Soldiers and families.

The hotline is an avenue to gather information about medical care as well as suggest ways we can improve our medical support systems.

The hotline has not been established to circumvent the chain of command, but rather to give Soldiers and family members an additional means to resolve medical-related issues. Any type of retribution directed towards those who use the hotline will not be tolerated.

-End flyer text

I wonder how flooded this phone line has been.
I'll be calling soon . . .

quantify your quality of life

2007-03-28T16:57:00.001-04:00

The MEB tries to assess troops condition by assigning a number - a percentage - to which that troop is unable to perform "normal" activities.
Unfortunately disability rating has become quite murky.
There are Functional Assessments available for the military to use and more accurately assess a troop's disability, but not too many troops go through those assessments. Instead, the MEB generates a percentage based on medical records.
Activities of Daily living are a decent measure for a troop to describe how an injury affects them on a daily basis. [This page] has an ADL worksheet that a troop can use to better describe their limitations. A form such as this can be very helpful in a situation where a troop may disagree with what the MEB states.
This form makes a great attachment to any MEB Appeal.

matters of time

2007-03-27T11:00:00.001-04:00

GonzoGate has eclipsed the WRAMC problems in the news. The media only has the attention span that Nielsen Families provide. Fortunately there are still many Veteran Advocacy groups working very hard to make sure the military medical mess can keep the attention it needs in order to create positive change for troopsvets/patients. I have a list of links posted on the sidebar of this blog, but here they are again: [LINKS]

what's it take

2007-03-25T02:26:00.001-04:00

http://www.thenation.com/doc/20070409/kors
Is America in denial?
I hope not. In fact, I don't think it is. I think some politicians are in denial, or they're just good liars - that's a tough one.
I've said before that I probably wouldn't believe the stories I tell if I hadn't lived them - the medical treatment of troops in the military is literally unbelievable. This story makes me very sad.
I won't do it much justice trying to describe it, but it illustrates how medical conditions are used by MEB officials to kick troops to the curb and leave them behind.
If I hadn't seen this happen I might not believe it myself - but now I encourage all troops to tape record conversations with their providers - it's perfectly legal - just watch out - THEY might say you're paranoid or something . . .

a bitter taste

2007-03-14T18:24:00.000-04:00

If the administration was going to address problems "quickly" they would have done so when the first casualties returned from the war back in 2001. For almost SIX (6) years this problem has been brewing. It's past brewing, it's rotten. Ever forget that the coffee pot was on? After a few hours of baking, the coffee gets bitter, acidic and dry - it doesn't taste so good anymore - but it'll sure deliver a good WAKE-UP!!!! on the taste buds.

It's gonna take a lot of cream and sugar to sweeten that coffee. And the coffee was hot - it burnt a lot of people, all the way to the heart.

In a perfect world the system would really only need some minor correcting. But we live in an invented world - one corrupted by some serious political BS.

My prediction: Few, if any, individuals will be held accountable for their wrong-doings and failures as leaders/humans being; more systematic procedures (read: additional bureaucracy) will be created to ensure better treatment for troops/vets; a few featured troops/vets will be treated wonderfully and be seen on TV; the long-term outcomes will be very slow and painful for the majority of troops and vets.

Why so bitter? Not bitter, I'm an idealist at heart, really, but I've seen how money flows and how policies get muddled by politics. Sad.

More money will be spent on investigating and creating additional "checks" (bureaucracy) for the system than will be spent within the system - where it would benefit the individuals in need.

But I remain hopeful that eventually troops and vets will get the care they need.

easy off

2007-03-12T14:08:00.000-04:00

Kiley got let down easy. He started this whole mess when he was the commander at WRAMC just a few years ago. His successor looked up to Kiley for help - and got none. When Kiley's successor retired, Weightman entered the fray - and bore the shame of Kiley's mess when he was fired - relieved of his command - just six months into his tour.
And Kiley sat at WRAMC and tried to defend himself, passing the buck all the while. He started this CF (military slang for big mess) and didn't try to fix it even when promoted to a more powerful position with greater capability to make the changes they needed to make.
The Army isn't poor! These troops were outpatients - put them in a hotel! Use a van to transport them. If a patient can't ride in a van then that patient gets priority for a room in near-by barracks. Its not that hard - Generals can make decisions like this, they have that power.

In the wake of all his own damage, Kiley gets to just fade away and will be honored at some dog-and-pony show retirement party. The money spent on his retirement celebration could probably pay for lodging for half the troops that were stuck in building 18 to stay at the Ritz downtown.

playing doctor

2007-03-10T12:11:00.000-05:00

Sometimes I feel like I'm watching an episode of Whose Line is it, Anyway when I'm looking at the standard procedures of evaluating the medical fitness of soldiers in the Army. Total confusion, total "cover my ass," total ad-hoc, and inconsistent application of Army Regulations.
First of all GAO has already called this an "overly complex system" but still the system remains in place, unchanged.
So who determines the actual disability ratings for a soldier? WOW, that's a loaded question.
The Physical Evaluation Board (PEB) is made up of three people, only ONE of the three needs to be a doctor, and they are the final authority for determining the disability rating a soldiers will receive upon exiting the Army. That's according to Army Regulation 635-40 Section IV, Chapter 4-17 paragraph b. Check it out
But where do they get the information to make such an important decision?
Referral to the PEB comes from determinations made by the MEB after a long, often ugly process that soldiers must endure. The system really isn't all that bad - once understood. The problem is that the administrators are corrupt as all hell.
The PEBLOS will tell soldiers things like "the VA will take care of you," or any other of a series of lies that will encourage soldiers to hurry-up and leave the military, even if the soldier will lose benefits in the process.
One PEBLO had the audacity to tell me that my wife "didn't deserve a second opinion," and that she just needed to "learn to deal with her disability."
So who are these PEBLOS who "play doctor" or try to "play god" with patients' medical care, future benefits, and their lives - they are AGENTS OF A GOVERNMENT SYSTEM. They don't represent anyone's interest accept the Army's - and that means saving money - even at soldiers' expense.
And to make matters worse, severely injured soldiers at Army Community Hospitals, like at Fort Benning (Martin ACH), Ft. Campbell (Blanchfield) and many others, are seen by Primary Care Providers (PCMs) who are General Family Practicioners, Physician Assistants, or Nurse Practicioners. These PCMs write the MEB - the document used by the PEB to determine the disability rating a soldier will receive. These PCMs are NOTORIOUS for falsely recording patients' conditions. These PCMs lack the specialized training often required to properly describe and document the ACTUAL condition that a soldier suffers - yet the PCM can over-rule the opinion of any specialist, and the PEBLO will send the botched MEB forward. Sure a soldier can appeal - but why put a soldier through the extra work of appealing, why not just properly document the condition in the first place.
My opinion, and I share this with many others, is that the "agents of the system" (PCMs, PEBLOS, etc.) hope that soldiers will quit asking for help, will get worn down by the system, accept defeat, maybe even believe that the VA will help. They want the soldier to sign away their benefits and leave the Army.
One quality control mechanism I propose is instead of rating a hospital's performance on how fast soldiers get booted, rate that hospital NEGATIVELY for every appeal it generates. Army Medical Command Officials should want to know why certain hospitals have left more soldiers dissatisfied than other hospitals. HOLD THE LEADERSHIP ACCOUNTABLE!!

equivocation

2007-03-09T08:56:00.000-05:00

Back when I was at School equivocation was as bad as lying.
How times have changed.
This morning I read in the Leaf Chronicle about Med Hold at BACH and yesterday about BACH's eagerness to hear suggestions for change.

Sugestions for change need go no further that the Complaint Box at the Patient Representative's office. Or even the notes from past Town Hall meetings with patients in Medical Hold.

The majority of providers at BACH are WONDERFUL - I personally had great experiences with my providers.

The providers who accept roles as administrators become a problem. As an administrator priorities CAN shift from patient care to systematic MANAGEMENT - and all too often the two clash.

Case managers may not be overworked - but their loyalties are to the process before the patient and that is a major systematic problem that must change.

And while BACH will, only with threat of exposure, allow patients to seek treatment outside the walls of BACH, BACH providers are known to prevent follow-through of this outside care. BACH's non-specialized general practitioners often over-rule the recommendations for treatment made by Vanderbilt or other MEDCEN specialty-trained doctors.

Most disturbing has been BACH's management of complaints made by patients. The leadership's actions have made no changes to quality of care concerns brought by patients.

Instead of closing Open Investigations, BACH allows the providers in question to deploy. Deploying the problem only drags the investigation. Worse yet, if that provider is under investigation they are now exposing deployed soldiers to known and unnecessary risk.

But none of that is in the articles in the Leaf Chronicle. The BACH leadership carefully crafted their talking points to avoid more in-depth questioning.

After major lawsuits BACH built a new "Mother-Baby Unit." Spouses can sue for malpractice, service members can't.

So, applying the backward logic so prevalent in the Military, especially the Military Medical System, it would appear that all "questionable providers" see the most vulnerable and voiceless soldiers while all the reputable providers see the other patients.

Like I said, I had an awesome experience at the hospital. I was fortunate to not have an administrator operating on me.

monetary and staff problems at WRAMC

2007-03-08T22:34:00.000-05:00

But these problems only came to this point because of leadership failures. Somewhere in the chain of command or concern a leader failed to provide accurate reports and another failed to inspect within their sphere.
The Army probably doesn't need more money - but there needs to be accounting of Total Military spending to ensure proper spending priorities. I'm one of those guys that worries about contractors over-charging for services and lining the pockets of corporate execs at the expense of Military Readiness Spending. I would rather have had more bullets, even toilet paper for that matter, than to have Internet and satellite TV available.
But the Military spends the money congress sends (or the prez pushes) on "stuff," I'd really like to know what "stuff" is. Half of the "wazzuu" expensive toys we take to the sandbox suck. They break or just don't work with other systems already in place. Computer programs don't share the same platforms - but what difference does it make when the sand ruins the electronics.
I'm sure Walter Reed could have found money SOMEWHERE to make sure soldiers were well cared-for. The Army CAN authorize TLA - Temporary Lodging Allowances - to house soldiers in adequate living conditions. But in order to save money the administrators (they don't deserve to be called leaders anymore) tucked the troops away and hoped that no one would look.

ARMY MEDICINE EXPLAINED?

2007-03-08T10:21:00.000-05:00

This links to a page that helps explain the Army Medical Separation Process.
It can only HELP explain the system - the system is so confusing that even the administrators make mistakes sometimes. Actually I think they "make mistakes" on purpose, but that's my cynical nature, I guess.
What is the difference between the MEB, PEB, and MMRB?

PUBLIC AWARENSS

Hey, don't get confused yet. I still haven't SCRATCHED THE SURFACE of the VA stuff yet.
AND REMEMBER, THE VA IS A TOTALLY DIFFERENT SYSTEM, AND COMPLETELY SEPARATED FROM THE ARMY SYSTEM.
BUT YES, ABSOLUTELY, BOTH NEED TO BE FIXED!!!!

Making the problem worse

2007-03-07T14:27:00.000-05:00

Everyone's hoppin' and poppin' in DC now trying to looks busy, trying to look like they care, trying to make it look like they have been doing their jobs all along.
Stop trying to cover your tracks!! You're wasting time generating lies for press releases, just fix the problems.
The major problem that is destroying the medical system right now is the leadership. It just plain sucks. And there is no accountability of that leadership. The President answers to NO ONE - he's made that crystal clear, but with all that authority, where is his responsibility.
And then the head of the VA has obviously had his head up someone's ass, if not his own.

After meeting with the president, Nicholson defended the Veterans Administration, but acknowledged there is room for improvement.
"When you're seeing over 1 million patients a week, you have to be very good, and if there is any one patient who doesn't get the care that they deserve, that's unacceptable," Nicholson said
He said his agency is hiring 100 new patient advocates who will help troops returning from war deal with the bureaucracy.
"The American people can feel very good about the health care system that their VA is providing to veterans," Nicholson said, "but if there is a case where a veteran gets lost in the system, or suffers anxiety or their family does as a result of something we're not doing, that is unacceptable."

From:

Bush: No Tolerance for Medical Neglect

By DEB RIECHMANN

The Associated Press
Wednesday, March 7, 2007; 1:46 PM

By saying a patient is not getting the necessary care he is basically admitting that his whole organization is a failure.

And now he's hiring 100 more "advocates." The VA doesn't have advocates. The VA has bureaucrats. If a patient is to have a proper advocate - a person who will actually look out for the Patient's BEST INTEREST - not the interest of the institution, then that advocate cannot come from within the VA PERIOD!

The DAV (Disabled American Veterans) and the VFW help Vets fight the VA bullshit - THEY have advocates and representatives that act on patients' behalves.

And why are we changing the subject to the VA, anyway? Their system is in desperate need of repair, too, but Walter Reed is TOTALLY separate from the VA.

The problems at WRAMC are with ACTIVE DUTY Soldiers - and WRAMC is supposed to help them heal to a STABLE STATE where then the VA can help provide further medical care after the soldier leaves the service.