Monday, March 05, 2007
Not Just Walter Reed; Problem Widespread
............................................... (Above) Family of Roberto Reyes surround him in his Bronx VA hospital bed.
Maria Mendez, aunt of Roberto Reyes, wheels him into the chapel at the VA hospital in the Bronx. Reyes was injured when an IED exploded under his Humvee leaving him partially blind, paralyzed and brain damaged.
Soldiers share troubling health care stories ‘It is just not Walter Reed,’ one veteran says
Michel du Cille / The Washington Post
• OutrageMarch 5: Members of Congress visit Walter Reed Army Medical after allegations of substandard care. NBC's Patty Culhane reports.
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By Anne Hull and Dana Priest
Ray Oliva went into the spare bedroom in his home in Kelseyville, Calif., to wrestle with his feelings. He didn't know a single soldier at Walter Reed, but he felt he knew them all. He worried about the wounded who were entering the world of military health care, which he knew all too well. His own VA hospital in Livermore was a mess. The gown he wore was torn. The wheelchairs were old and broken.
"It is just not Walter Reed," Oliva slowly tapped out on his keyboard at 4:23 in the afternoon on Friday. "The VA hospitals are not good either except for the staff who work so hard. It brings tears to my eyes when I see my brothers and sisters having to deal with these conditions. I am 70 years old, some say older than dirt but when I am with my brothers and sisters we become one and are made whole again."
Oliva is but one quaking voice in a vast outpouring of accounts filled with emotion and anger about the mistreatment of wounded outpatients at Walter Reed Army Medical Center. Stories of neglect and substandard care have flooded in from soldiers, their family members, veterans, doctors and nurses working inside the system. They describe depressing living conditions for outpatients at other military bases around the country, from Fort Lewis in Washington state to Fort Dix in New Jersey. They tell stories -- their own versions, not verified -- of callous responses to combat stress and a system ill equipped to handle another generation of psychologically scarred vets.
The official reaction to the revelations at Walter Reed has been swift, and it has exposed the potential political costs of ignoring Oliva's 24.3 million comrades -- America's veterans -- many of whom are among the last standing supporters of the Iraq war. In just two weeks, the Army secretary has been fired, a two-star general relieved of command and two special commissions appointed; congressional subcommittees are lining up for hearings, the first today at Walter Reed; and the president, in his weekly radio address, redoubled promises to do right by the all-volunteer force, 1.5 million of whom have fought in Iraq and Afghanistan.
But much deeper has been the reaction outside Washington, including from many of the 600,000 new veterans who left the service after Iraq and Afghanistan. Wrenching questions have dominated blogs, talk shows, editorial cartoons, VFW spaghetti suppers and the solitary late nights of soldiers and former soldiers who fire off e-mails to reporters, members of Congress and the White House -- looking, finally, for attention and solutions.
Several forces converged to create this intense reaction. A new Democratic majority in Congress is willing to criticize the administration. Senior retired officers pounded the Pentagon with sharp questions about what was going on. Up to 40 percent of the troops fighting in Iraq are National Guard members and reservists -- "our neighbors," said Ron Glasser, a physician and author of a book about the wounded. "It all adds up and reaches a kind of tipping point," he said. On top of all that, America had believed the government's assurances that the wounded were being taken care of. "The country is embarrassed" to know otherwise, Glasser said.
The scandal has reverberated through generations of veterans. "It's been a potent reminder of past indignities and past traumas," said Thomas A. Mellman, a professor of psychiatry at Howard University who specializes in post-traumatic stress and has worked in Veterans Affairs hospitals. "The fact that it's been responded to so quickly has created mixed feelings -- gratification, but obvious regret and anger that such attention wasn't given before, especially for Vietnam veterans."
Michel du Cille / The Washington Post
Across the country, some military quarters for wounded outpatients are in bad shape, according to interviews, Government Accountability Office reports and transcripts of congressional testimony. The mold, mice and rot of Walter Reed's Building 18 compose a familiar scenario for many soldiers back from Iraq or Afghanistan who were shipped to their home posts for treatment. Nearly 4,000 outpatients are currently in the military's Medical Holding or Medical Holdover companies, which oversee the wounded. Soldiers report bureaucratic disarray similar to Walter Reed's: indifferent, untrained staff; lost paperwork; medical appointments that drop from the computers; and long waits for consultations.
Sandy Karen was horrified when her 21-year-old son was discharged from the Naval Medical Center in San Diego a few months ago and told to report to the outpatient barracks, only to find the room swarming with fruit flies, trash overflowing and a syringe on the table. "The staff sergeant says, 'Here are your linens' to my son, who can't even stand up," said Karen, of Brookeville, Md. "This kid has an open wound, and I'm going to put him in a room with fruit flies?" She took her son to a hotel instead.
"My concern is for the others, who don't have a parent or someone to fight for them," Karen said. "These are just kids. Who would have ever looked in on my son?"
Capt. Leslie Haines was sent to Fort Knox in Kentucky for treatment in 2004 after being flown out of Iraq. "The living conditions were the worst I'd ever seen for soldiers," he said. "Paint peeling, mold, windows that didn't work. I went to the hospital chaplain to get them to issue blankets and linens. There were no nurses. You had wounded and injured leading the troops."
Hundreds of soldiers contacted The Washington Post through telephone calls and e-mails, many of them describing their bleak existence in Medhold.
From Fort Campbell in Kentucky: "There were yellow signs on the door stating our barracks had asbestos."
From Fort Bragg in North Carolina: "They are on my [expletive] like a diaper. . . . there are people getting chewed up everyday."
From Fort Dix in New Jersey: "Scare tactics are used against soldiers who will write sworn statement to assist fellow soldiers for their medical needs."
From Fort Irwin in California: "Most of us have had to sign waivers where we understand that the housing we were in failed to meet minimal government standards."
Soldiers back from Iraq worry that their psychological problems are only beginning to surface. "The hammer is just coming down, I can feel it," said retired Maj. Anthony DeStefano of New Jersey, describing his descent into post-traumatic stress and the Army's propensity to medicate rather than talk. When he returned home, Army doctors put him on the antipsychotic drug Seroquel. "That way, you can screw their lights out and they won't feel a thing," he said of patients like himself. "By the time they understand what is going on, they are through the Board and stuck with an unfavorable percentage of disability" benefits.
Nearly 64,000 of the more than 184,000 Iraq and Afghanistan war veterans who have sought VA health care have been diagnosed with potential symptoms of post-traumatic stress, drug abuse or other mental disorders as of the end of June, according to the latest report by the Veterans Health Administration. Of those, nearly 30,000 have possible post-traumatic stress disorder, the report said.
Surge of new patients
VA hospitals are also receiving a surge of new patients after more than five years of combat. At the sprawling James J. Peters VA Medical Center in the Bronx, N.Y., Spec. Roberto Reyes Jr. lies nearly immobile and unable to talk. [photos above article] Once a strapping member of Charlie Company, 1st Battalion, 5th Cavalry, Reyes got too close to an improvised explosive device in Iraq and was sent to Walter Reed, where doctors did all they could before shipping him to the VA for the remainder of his life. A cloudy bag of urine hangs from his wheelchair. His mother and his aunt are constant bedside companions; Reyes, 25, likes for them to get two inches from his face, so he can pull on their noses with the few fingers he can still control.
Maria Mendez, his aunt, complained about the hospital staff. "They fight over who's going to have to give him a bath -- in front of him!" she said. Reyes suffered third-degree burns on his leg when a nurse left him in a shower unattended. He was unable to move himself away from the scalding water. His aunt found out only later, when she saw the burns.
Among the most aggrieved are veterans who have lived with the open secret of substandard, underfunded care in the 154 VA hospitals and hundreds of community health centers around the country. They vented their fury in thousands of e-mails and phone calls and in chat rooms.
"I have been trying to get someone, ANYBODY, to look into my allegations" at the Dayton VA, Darrell Hampton pleaded.
"I'm calling from Summerville, South Carolina, and I have a story to tell," began Horace Williams, 62. "I'm a Marine from the Vietnam era, and it took me 20 years to get the benefits I was entitled to."
The VA has a backlog of 400,000 benefit claims, including many concerning mental health. Vietnam vets whose post-traumatic stress has been triggered by images of war in Iraq are flooding the system for help and are being turned away.
For years, politicians have received letters from veterans complaining of bad care across the country. Last week, Walter Reed was besieged by members of Congress who toured the hospital and Building 18 to gain first-hand knowledge of the conditions. Many of them have been visiting patients in the hospital for years, but now they are issuing news releases decrying the mistreatment of the wounded.
Sgt. William A. Jones had recently written to his Arizona senators complaining about abuse at the VA hospital in Phoenix. He had written to the president before that. "Not one person has taken the time to respond in any manner," Jones said in an e-mail.
From Ray Oliva, the distraught 70-year-old vet from Kelseyville, Calif., came this: "I wrote a letter to Senators Feinstein and Boxer a few years ago asking why I had to wear Hospital gowns that had holes in them and torn and why some of the Vets had to ask for beds that had good mattress instead of broken and old. Wheel chairs old and tired and the list goes on and on. I never did get a response."
Oliva lives in a house on a tranquil lake. His hearing is shot from working on fighter jets on the flight line. "Gun plumbers," as they called themselves, didn't get earplugs in the late 1950s, when Oliva served with the Air Force. His hands had been burned from touching the skin of the aircraft. All is minor compared with what he later saw at the VA hospital where he received care.
"I sat with guys who'd served in 'Nam," Oliva said. "We had terrible problems with the VA. But we were all so powerless to do anything about them. Just like Walter Reed."
Staff researcher Julie Tate contributed to this report.
© 2007 The Washington Post Company
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