"Suck It Up!"

by hilzoy

From the Washington Post, another story about veterans' care:

"Behind the door of Army Spec. Jeremy Duncan's room, part of the wall is torn and hangs in the air, weighted down with black mold. When the wounded combat engineer stands in his shower and looks up, he can see the bathtub on the floor above through a rotted hole. The entire building, constructed between the world wars, often smells like greasy carry-out. Signs of neglect are everywhere: mouse droppings, belly-up cockroaches, stained carpets, cheap mattresses.

This is the world of Building 18, not the kind of place where Duncan expected to recover when he was evacuated to Walter Reed Army Medical Center from Iraq last February with a broken neck and a shredded left ear, nearly dead from blood loss. But the old lodge, just outside the gates of the hospital and five miles up the road from the White House, has housed hundreds of maimed soldiers recuperating from injuries suffered in the wars in Iraq and Afghanistan. (...)

They suffer from brain injuries, severed arms and legs, organ and back damage, and various degrees of post-traumatic stress. Their legions have grown so exponentially -- they outnumber hospital patients at Walter Reed 17 to 1 -- that they take up every available bed on post and spill into dozens of nearby hotels and apartments leased by the Army. The average stay is 10 months, but some have been stuck there for as long as two years. (...)

While the hospital is a place of scrubbed-down order and daily miracles, with medical advances saving more soldiers than ever, the outpatients in the Other Walter Reed encounter a messy bureaucratic battlefield nearly as chaotic as the real battlefields they faced overseas.

On the worst days, soldiers say they feel like they are living a chapter of "Catch-22." The wounded manage other wounded. Soldiers dealing with psychological disorders of their own have been put in charge of others at risk of suicide.

Disengaged clerks, unqualified platoon sergeants and overworked case managers fumble with simple needs: feeding soldiers' families who are close to poverty, replacing a uniform ripped off by medics in the desert sand or helping a brain-damaged soldier remember his next appointment.

"We've done our duty. We fought the war. We came home wounded. Fine. But whoever the people are back here who are supposed to give us the easy transition should be doing it," said Marine Sgt. Ryan Groves, 26, an amputee who lived at Walter Reed for 16 months. "We don't know what to do. The people who are supposed to know don't have the answers. It's a nonstop process of stalling.""

That's just the beginning. Read the whole thing. None of the problems discussed in the article are insurmountable. There's too much bureaucracy; no one seems to know what's going on; everything falls through the cracks. Here's one incident:

"One amputee, a senior enlisted man who asked not to be identified because he is back on active duty, said he received orders to report to a base in Germany as he sat drooling in his wheelchair in a haze of medication. "I went to Medhold many times in my wheelchair to fix it, but no one there could help me," he said.

Finally, his wife met an aide to then-Deputy Defense Secretary Paul D. Wolfowitz, who got the erroneous paperwork corrected with one phone call. When the aide called with the news, he told the soldier, "They don't even know you exist."

"They didn't know who I was or where I was," the soldier said. "And I was in contact with my platoon sergeant every day.""

There's a lesson there. When people with enough power pay attention to these things, problems miraculously disappear without a wounded soldier having to travel around in his wheelchair trying to fix them. But whether or not those people pay attention to wounded soldiers' problems shouldn't depend on whether or not their wives happen to meet aides to Paul Wolfowitz. It should be a matter of course. They should make sure that these kinds of nightmares do not exist because there are decent policies in place to prevent them, and then they should check to make sure that those policies are working. Because we owe people who have been wounded in battle better than this:

"Life in Building 18 is the bleakest homecoming for men and women whose government promised them good care in return for their sacrifices.

One case manager was so disgusted, she bought roach bombs for the rooms. Mouse traps are handed out. It doesn't help that soldiers there subsist on carry-out food because the hospital cafeteria is such a hike on cold nights. They make do with microwaves and hot plates.

Army officials say they "started an aggressive campaign to deal with the mice infestation" last October and that the problem is now at a "manageable level." They also say they will "review all outstanding work orders" in the next 30 days.

Soldiers discharged from the psychiatric ward are often assigned to Building 18. Buses and ambulances blare all night. While injured soldiers pull guard duty in the foyer, a broken garage door allows unmonitored entry from the rear. Struggling with schizophrenia, PTSD, paranoid delusional disorder and traumatic brain injury, soldiers feel especially vulnerable in that setting, just outside the post gates, on a street where drug dealers work the corner at night. (...)

Wilson, the clinical social worker at Walter Reed, was part of a staff team that recognized Building 18's toll on the wounded. He mapped out a plan and, in September, was given a $30,000 grant from the Commander's Initiative Account for improvements. He ordered some equipment, including a pool table and air hockey table, which have not yet arrived. A Psychiatry Department functionary held up the rest of the money because she feared that buying a lot of recreational equipment close to Christmas would trigger an audit, Wilson said.

In January, Wilson was told that the funds were no longer available and that he would have to submit a new request. "It's absurd," he said. "Seven months of work down the drain. I have nothing to show for this project. It's a great example of what we're up against."

A pool table and two flat-screen TVs were eventually donated from elsewhere.

But Wilson had had enough. Three weeks ago he turned in his resignation. "It's too difficult to get anything done with this broken-down bureaucracy," he said.

At town hall meetings, the soldiers of Building 18 keep pushing commanders to improve conditions. But some things have gotten worse. In December, a contracting dispute held up building repairs.

"I hate it," said Romero, who stays in his room all day. "There are cockroaches. The elevator doesn't work. The garage door doesn't work. Sometimes there's no heat, no water. . . . I told my platoon sergeant I want to leave. I told the town hall meeting. I talked to the doctors and medical staff. They just said you kind of got to get used to the outside world. . . . My platoon sergeant said, 'Suck it up!'""

Comments

[liberal japonicus]

I suppose we hold on to the little details in order to not be overwhelmed, but this stuck in my mind

When the aide called with the news, he told the soldier, "They don't even know you exist."

Why is that not past tense? Why do I think that there will be a spasm of action, followed by more forgetting and ignoring?

The Post seems to be on this story now. I have to think that at some level, the administration and those who are supporting Bush's continued incompetence blame these men for being wounded. Perhaps, I assume the thinking to be, if these men had performed better, they wouldn't be in this situation. There has to be some underlying reason for treating these soldiers like this, and this is the only thing I can come up with.

[J. Michael Neal]

Christ. The VA was a good medical system; see Kevin Drum on the subject. Then we actually went to war.

[Gary Farber]

"There has to be some underlying reason for treating these soldiers like this, and this is the only thing I can come up with."

I don't know that that's it at all, but there's nothing inconsistent here, I have to say. June:

Washington - Two Senate Democrats on Wednesday criticized a White House plan to cut money intended for food stamps, student loans and farmers to pay for credit monitoring for veterans whose personal and financial data was stolen last month.

[...]

Personal data on about 17.5 million veterans, including their birthdates and Social Security numbers, was stolen last month when a burglar took a laptop containing the information from the home of an analyst for the Department of Veterans Affairs. The analyst was not authorized to take the data home but had been doing so for several years.

The Veterans Affairs Department offered to pay for a year of free credit monitoring for the veterans, which it said would cost about $160.5 million. Last week, the department said it would cover most of that cost by taking money from accounts that pay health and other benefits for veterans.

And we recall Hilzoy blogging on this. Last week:

The Bush administration plans to cut funding for veterans' health care two years from now — even as badly wounded troops returning from Iraq could overwhelm the system.

Bush is using the cuts, critics say, to help fulfill his pledge to balance the budget by 2012.

After an increase sought for next year, the Bush budget would turn current trends on their head. Even though the cost of providing medical care to veterans has been growing rapidly — by more than 10 percent in many years — White House budget documents assume consecutive cutbacks in 2009 and 2010 and a freeze thereafter.

My post was here, incidentally.

[rilkefan]

"Read the whole thing."

It's been a stressful day, and I'm cold sober, and I just can't.

[CaseyL]

Someone has to be directly responsible for the state of veterans' healthcare. And whoever that is has to report to someone, who reports to someone, and eventually it goes to a Cabinet-level someone.

Apparently Wolfowitz didn't ask an aide to follow up or check to see if there were more problems. Was that because he thought the problem was an isolated, one-time instance - or because he didn't want to know it wasn't?

Murtha visits the wounded regularly. Maybe some other congresspersons do, too. And, surely, families of veterans left in such disgraceful conditions wrote to their Representatives and Senators. Did anyone who visited the wounded, or got letters from their families, raise holy hell with anyone in the Veteran's Administration? If not, why not? And if so - and if the VA ignored them - why didn't they raise holy hell on the floor of the House and Senate?

As for the budget cuts... well. What can one say? We know what the Bush Admin's priorities are. Tax cuts come first, second and third, followed by shoveling as much public money as possible to their cronies, followed by more tax cuts.

[Gary Farber]

"And whoever that is has to report to someone, who reports to someone, and eventually it goes to a Cabinet-level someone."

The Secretary of Veterans Affairs, Jim Nicholson, seems worth mentioning here. The Department of Veterans Affairs has been the Cabinet-level Department in charge of veteran's affairs for eighteen years, now.

(President G. H. W. Bush signed it into existence; damn Republicans, always expanding government.)

[Hartmut]

I feel reminded of an old 18th century soldier's song. last stanza (literal translation):

When we are discharged where do we go?
Our strength is gone, our health is lost
They tell us: no nest for the bird.
Take the beggar's bowl for you have been a soldier!

The times they're not a-changing.

[Kevin Hayden]

While it's true that proper attention and funding could improve the image at the flagship hospital of the VA system, it's also true that after the war ends, the political response will fade.

Troops are useful for war. When wars end, they're just another constituency begging for help, competing against K Street lobbyists who provide campaign dollars.

That's always been the reality for postwar veterans and I see no reason to believe that'll change.

Just another ugly reality of war, with the cleanup job falling on underpaid nonprofit agency workers for the next quarter century.

But at least we got those WMDs.

[Bruce Baugh]

I find myself with little left to say that Bruce Cockburn didn't say 23 years ago after traveling in Central America, in "If I Had a Rocket Launcher".

[liberal japonicus]

Here's the next article from the WaPo on Walter Reed. Even more heartbreaking than the first, if that is possible.

[Gary Farber]

"That's always been the reality for postwar veterans and I see no reason to believe that'll change.That's always been the reality for postwar veterans and I see no reason to believe that'll change."

Everyone knows about the Bonus Army, right?

"Just another ugly reality of war, with the cleanup job falling on underpaid nonprofit agency workers for the next quarter century."

One of the innumerable temp jobs I've worked in my life was a few months in '79 (possibly '80) at SEA-VAC, the Seattle Veterans Action Center.

[ScottM]

I was horrified when I heard about this; it sounds like the overflow is where the worst problems are. Even the people who go to the main hospital might not have encountered these problems... which means, I hope, that a little light will help clear this us. Thanks for shining the light Hilzoy.

[Eileen Parker]

I saw your post about wounded soldiers and wondered if you had seen this Sunday's Washington Post story on the wounded :

http://www.washingtonpost.com/wp-dyn/content/article/2007/04/06/AR2007040601821.html

http://www.washingtonpost.com/wp-dyn/content/discussion/2007/04/06/DI2007040601488.html