[Several articles below]
It's not every day one gets to witness a whitewash in action, but Walter Reed Army Medical Center provided just such an opportunity yesterday.
In Sunday's Washington Post, Dana Priest and Anne Hull described the woeful conditions of Room 205 in Walter Reed's Building 18: "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 Army mobilized. Painters were deployed to cover the offending wall with a fresh coat of white semigloss. And television crews were invited in to inspect the result.
"Some of the paint is still wet against that wall, so be careful," Walter Reed public affairs officer Donald Vandrey, standing on the bed in his socks, advised the film crews. "They just finished repainting it about 10 minutes ago."
Mission accomplished?
Lt. Gen. Kevin Kiley thought so. After the media tour of Building 18, the Army's surgeon general gave a news conference. "I do not consider Building 18 to be substandard," he said of a facility Priest and Hull found full of "mouse droppings, belly-up cockroaches, stained carpets, cheap mattresses" and other delights. "We needed to do a better job on some of those rooms, and those of you that got in today saw that we frankly have fixed all of those problems. They weren't serious, and there weren't a lot of them."
Kiley might have had a stronger case if men wearing Tyvek hazmat suits and gas masks hadn't walked through the lobby while the camera crews waited for the tour to start, or if he hadn't acknowledged, moments later, that the entire building would have to be closed for a complete renovation. The general also seemed to miss a larger point identified by other officials: Walter Reed's problem isn't of mice and mold but a bureaucracy that has impeded the recovery of wounded soldiers.
The Army's vice chief of staff, only 24 hours earlier, decried "a breakdown in leadership" for the conditions in the place. And Rep. Tom Davis (R-Va.) noted that "you could put all the wounded soldiers in the Ritz-Carlton, and it wouldn't fix the personnel management and recordkeeping problems that keep them languishing in outpatient limbo out there for months."
"We're not letting soldiers languish," came Kiley's reply.
For all the stagecraft, there was still broken glass in the driveway of Building 18 yesterday, a banana peel on the steps and an empty Budweiser can in the shrubbery. There were signs of hasty repairs: a plumber's truck outside, dust masks and spray cleaners on window sills, rat poison outside the dumpster, and a discarded box proclaiming "Emergency Exit Lighting Fixture." Construction workers came and went.
The base's public-affairs crew arrived 25 minutes late for the tour but got right to work. "Some of these people are not on our list and are not coming in," announced Lori Calvillo, Walter Reed's chief spokeswoman. "C-SPAN, you're not on the list. You're not coming in." She then attempted to evict a Washington Post reporter, who appealed, loudly, to Kiley.
The tour began in the game room, where soldiers shot pool and watched a plasma TV. From there, the tourists climbed a stairwell smelling of chlorine bleach to a floor smelling of fresh paint.
"In the next room, there's a little water drop on the ceiling; you can get a nice shot of it," Kiley joked. Inside Room 416, there was indeed some rainwater dripping into a wastebasket, a missing lampshade, some loose wallpaper and a mirror on the floor but neither rodents nor fungus were visible.
Then it was down to Room 205, crammed with Tilex, sealant, paint rollers, a dropcloth and ceramic tiles. Spokesman Vandrey spoke like a real estate agent: "There was no plumbing leakage in the bathroom. That was all condensation." Outside the room, a man spoke urgently into his cellphone: "The drywall has to dry before they can paint."
A few doors down was Spec. Duncan, in his new room. "Unfortunately, I had to stand up and tell them, 'Hey, the room is messed up,' " he told a Voice of America camera. "I got my point across."
He sure did and that's why Kiley, who was the commander at Walter Reed before assuming his current role in 2004, found himself staring into a bank of 12 cameras yesterday. Missing was Maj. Gen. George Weightman, the current Walter Reed commander "called away to important business," Kiley explained.
At times, Kiley appeared to acknowledge a systemic problem. He promised to "go at this thing soup to nuts," adding: "We're gonna get at it real quickly." But then he quibbled with the scope of the problem. "Some of this bureaucracy, as much as it frustrates us, I'm not sure that's a breakdown in leadership," he reasoned.
He then attacked the "one-sided representation" of the Post reporting. "I do not think that Building 8" he apparently meant 18 "is emblematic of a process of Walter Reed that has abandoned soldiers and their families," Kiley said. "I want to reset the thinking that while we have some issues here, this is not a horrific, catastrophic failure at Walter Reed."
Back in Room 205, the whitewash was almost dry.
source: 2mar2007
The Army's surgeon general yesterday criticized stories in The Washington Post disclosing problems at Walter Reed Army Medical Center, saying the series unfairly characterized the living conditions and care for soldiers recuperating from wounds at the hospital's facilities.
"I'm not sure it was an accurate representation," Lt. Gen. Kevin C. Kiley, chief of the Army Medical Command, told reporters during a news conference. "It was a one-sided representation."
The Medical Command oversees Walter Reed and all Army health care.
Until now, the Army had not challenged any aspect of the Post series. Army and Defense Department leaders have promised to eliminate squalid conditions in Building 18, a former hotel outside the Walter Reed gate where 76 wounded soldiers live as outpatients. They have also promised to address bureaucratic problems in the handling of wounded soldiers.
The two-part newspaper series reported that many soldiers spend 18 months or more at Walter Reed. It quoted many patients and their families describing a bureaucratic indifference to medical needs. And it described rooms in Building 18 with mold, leaky plumbing and holes in ceilings.
While acknowledging "pretty distressing" conditions in some rooms at Building 18, Kiley said the problems were neither widespread nor symptoms of a system that allows soldiers to languish. The building is not "emblematic of a process of Walter Reed that has abandoned soldiers and their families," said Kiley, who was commander at the hospital before becoming surgeon general in 2004.
"I want to reset the thinking . . .," Kiley said. "While we have some issues here, this is not a horrific, catastrophic failure at Walter Reed."
Asked to elaborate on his comments after the news conference at the facility, Kiley said he does not dispute the facts in the Post stories. "It's not the accuracy I question, it's the characterization," he said.
Kiley said the Army is beginning to study ways to streamline the medical bureaucracy, including the process by which soldiers are evaluated and either discharged or returned to active duty. "That's going to take more than a couple of weeks, but we're going to get at it," he said.
Kiley's comments came at the end of a media tour during which reporters and television camera crews were escorted through Building 18 to view conditions and repairs. Rooms had been painted, plumbing repaired and floors disinfected.
"It's not the Ritz-Carlton at Pentagon City, I'll grant you that," Kiley said, surveying the cleaned, repaired and repainted room where until recently Army Spec. Jeremy Duncan lived with black mold and a hole in the ceiling above the shower.
Duncan, who broke his neck while on patrol in Iraq last year, was moved to a new room after the Post story described his living conditions. He said he has not suffered any reprisals. "Believe it or not, people were actually happy about the fact that someone spoke up," Duncan said.
Kiley said that while repairs to Building 18 are nearly complete, the aging facility needs a top-to-bottom renovation. "That's tough to do while you're trying to take care of soldiers," he said.
In another development yesterday, the White House announced that President Bush plans to nominate S. Ward Casscells to replace William Winkenwerder as assistant defense secretary for health affairs. The Pentagon said Winkenwerder's departure was already planned and is not related to problems at Walter Reed.
source: 2mar2007
A top Army general vowed yesterday to personally oversee the upgrading of Walter Reed Army Medical Center's Building 18, a dilapidated former hotel that houses wounded soldiers as outpatients.
Gen. Richard A. Cody, the Army vice chief of staff, used terminology similar to that of a military campaign to describe his plan to overhaul the broken building, including giving it a more "appropriate" name, and the sluggish bureaucracy for outpatient care.
"We own that building, and we're going to take charge of it," Cody said at the Pentagon. "The senior Army leadership takes full responsibility for the lack of quality of life at Building 18, and we're going to fix it."
Cody blamed "a breakdown in leadership" for the troubling conditions but said no one has been fired or relieved of command. He did point to lower-ranking officers and noncommissioned officers lacking "the right experience and the authority to be able to execute some of the missions."
"That's what we're correcting right now," he said.
Cody and William Winkenwerder Jr., the assistant secretary of defense for health affairs, said at a news conference that they frequently visit Walter Reed and were surprised and disappointed by the living conditions and the fact that they had learned about them from media reports. The Washington Post reported Sunday and Monday on the challenges facing outpatients at Walter Reed.
"We get concerns all the time directed to us. But we never got a concern sent our way about this issue, which is a little surprising. I'm not sure why that is," Winkenwerder said.
Standards of medical care at Walter Reed remain high, he said, but he acknowledged: "The trust has taken a hit here. And I think it's our job to repair that trust and to re-earn that trust. And that's what we're going to do."
Rep. Thomas M. Davis III (Va.), the top Republican on the House Committee on Oversight and Government Reform, blasted the Army yesterday, saying in a statement that it has known for years about shortcomings at Walter Reed.
"You could put all of the wounded soldiers in the Ritz-Carlton and it wouldn't fix the personnel, management and recordkeeping problems that keep them languishing in outpatient limbo out there for months while paperwork from 11 disjointed systems gets shuffled and lost," Davis said.
Del. Eleanor Holmes Norton (D-D.C.) echoed Davis's concerns after she toured Building 18 and spoke to soldiers.
"The problem is much more serious than one building," she said in an interview. "It's going to be easy for everyone to duck this problem after the building is fixed if we don't fix the completely dilapidated administrative system."
Norton said that she thinks Congress will have to compel the Army to overhaul its outpatient care system but that immediate steps are needed to help soldiers trapped in the existing bureaucracy.
Army Secretary Francis Harvey said an independent review group of about eight people will be established to look at outpatient care. Winkenwerder said the group would report back to the Pentagon in a "short time frame."
Cody called the state of Building 18 where 76 soldiers live "inexcusable" and said he will "personally oversee" its renovation. He said the building had been upgraded several times and called the furniture "very nice" but said the walls and infrastructure were not "up to speed" and required inspections were not done or were not rigorous enough.
Harvey said the building would be renamed after an Army doctor, medic or nurse who was killed in action.
Cody said the Army will review all its procedures for handling wounded soldiers and their families and will seek to streamline systems for assistance.
Staff writers Steve Vogel and William Branigin contributed to this report.
source: 2mar2007
The White House and congressional leaders called yesterday for swift investigation and repair of the problems plaguing outpatient care at Walter Reed Army Medical Center, as veterans groups and members of Congress in both parties expressed outrage over substandard housing and the slow, dysfunctional bureaucracy there.
Top Army officials yesterday visited Building 18, the decrepit former hotel housing more than 80 recovering soldiers, outside the gates of the medical center. Army Secretary Francis Harvey and Vice Chief of Staff Richard Cody toured the building and spoke to soldiers as workers in protective masks stripped mold from the walls and tore up soiled carpets.
At the White House, press secretary Tony Snow said that he spoke with President Bush yesterday about Walter Reed and that the president told him: "Find out what the problem is and fix it."
Snow said Bush "first learned of the troubling allegations regarding Walter Reed from the stories this weekend in The Washington Post. He is deeply concerned and wants any problems identified and fixed." The spokesman said he did not know why the president, who has visited the facility many times in the past five years, had not heard about these problems before.
Walter Reed's commander, Maj. Gen. George W. Weightman, said in an interview that the Army leadership had assured him that all the staff increases he had requested would be met. "This is not an issue," he said. "This is their number one priority."
He said the Army has agreed to fund what he called a "surge plan" that has been designed for the likelihood that the 21,500-person troop increase underway in Iraq will result in more casualties.
Weightman said case managers have been ordered to call each of the 700 outpatients to ask about problems they may be encountering. He has also put half a dozen senior enlisted officers from the hospital in charge of the outpatients' companies normally in the hands of lower-level platoon sergeants. Also, a medic will be stationed 24 hours a day at the Mologne House, the largest residence on the 113-acre post, to help soldiers with medical or psychological problems.
Harvey said he was surprised and disappointed by the conditions and the bureaucratic delays. "In the warrior ethos, the last line says you should never leave a fallen comrade, and from that facility point of view we didn't live up to it . . . and it looks to me we may have not lived up to it from a process side," he said, adding that conditions at the building are "inexcusable."
"It's a failure . . . in the garrison leadership . . . that should have never happened, and we are quickly going to rectify that situation," he said.
"We had some NCOs [noncommissioned officers] who weren't doing their job, period," Harvey said. He said he and Cody will report regularly to Defense Secretary Robert M. Gates on a plan to fix the conditions.
The Post series documented tattered conditions at Building 18, including mold, rot, mice and cockroaches, but also a larger bureaucratic indifference that has impeded some soldiers' recovery.
At Building 18 yesterday, platoon sergeants with clipboards went from room to room inspecting for mold, leaks and other problems. A broken elevator was repaired, and snow and ice were cleared from the sidewalks.
The secretaries of the Army and Navy announced that they had begun a broader review of Walter Reed and the National Naval Medical Center and that an independent review group will be formed to investigate outpatient care and administrative processes. Walter Reed is set to close in 2011, and the naval facility in Bethesda will be expanded to handle the additional wounded.
Walter Reed's fixes are unlikely to immediately quiet the criticism from members of Congress, who received a flood of calls from the public and veterans groups asking how the problems could have been unknown to officials some of whom regularly visit Walter Reed.
"We need to bring the Army people in and say, 'What the hell is going on?' " said Rep. Bob Filner (D-Calif.), chairman of the House Veterans Affairs Committee.
Speaker Nancy Pelosi (D-Calif.) asked the House Armed Services Committee to investigate outpatient care at Walter Reed. "The treatment reported in The Post of our troops and our veterans is disgraceful," Pelosi spokesman Brendan Daly said.
Several senators, including presidential candidate Barack Obama (D-Ill.) and former presidential candidate John F. Kerry (D-Mass.), announced they are co-sponsoring legislation to simplify the paperwork process for recovering soldiers and increase case managers and psychological counselors. The bill would also require the Army to report more regularly to Congress and the inspector general about the living conditions of injured soldiers.
Jeff Miller (Fla.), the ranking Republican on the House Veterans' Affairs subcommittee on health, said: "The neglect being experienced by some wounded service members is outrageous. The Defense Department is never shy about asking for supplemental funds for operations and equipment; I cannot imagine why housing for recuperating wounded would not be a similarly high priority."
Rep. Thomas M. Davis III (R-Va.), former chairman of what was then known as the House Government Reform Committee, urged the committee to hold a hearing at Walter Reed to give members an "invaluable firsthand look" at how the Army is processing the wounded. "Improvements to date have been episodic, and in some case, short-lived," Davis said in a statement.
Staff writer Ann Scott Tyson contributed to this report.
source: http://www.washingtonpost.com/wp-dyn/content/article/2007/02/20/AR2007022001574_pf.html 2mar2007
IF YOU LISTEN to the PR operation at Walter Reed Army Medical Center, the U.S. military's gleaming flagship hospital offers veterans the best treatment available. What doesn't get mentioned is the bureaucratic contempt and physical squalor that too often await badly injured outpatient soldiers on the Walter Reed campus, the subject of a four-month Post investigation detailed in articles published Sunday and Monday.
Reporters Dana Priest and Anne Hull and researcher Julie Tate spent hundreds of hours inspecting conditions and interviewing injured troops and their loved ones at the Walter Reed outpatient facilities. Their findings: Veterans' rooms are rank; bureaucratic hassles and paper-pushing make the process of repairing buildings, redressing patient grievances and providing veterans with basic goods depressingly inept; administrators' neglect of patients' mental and physical health borders on the criminal; and, most distressing, many veterans leave Walter Reed without the compensation they clearly deserve for their sacrifices.
The walls of one soldier's room were covered with black mold, and the ceiling of his shower had a large hole. Soldiers who lost their uniforms while undergoing emergency treatment on the battlefield have had to present their purple hearts to get replacement clothes. Amputees and patients on taxing drug regimens are required to report for formation early in the morning, even if it means trudging over accumulated ice and snow. Lost paperwork, which in one case resulted in an obviously impaired veteran getting an order to report to Germany, is a constant problem, sometimes forcing soldiers and their relatives to live at Walter Reed for 18 months or longer as their cases are processed.
Most infuriating are reports of official efforts to deny disability benefits to discharged fighters. The Army tried to deny disability compensation to Cpl. Dell McLeod, who suffered a head injury that left him aimless and unable even to count change at the cafeteria. Army officials' argument: Because he had done poorly in high school, his current mental state might not have been caused by the steel door that smashed his skull in Iraq. If the Army determined that he was mentally fit to serve in the first place, it cannot now abscond from its responsibility for the consequences of his service overseas. Cpl. McLeod ended up getting a settlement from the command at Walter Reed despite base staffers' best efforts only after his wife got a congressional staffer involved.
Walter Reed's commander, Maj. Gen. George W. Weightman, says that conditions on the post will improve rapidly. His response is commendable, and it should not be forgotten that thousands of professionals and volunteers, civilian and military, are working hard to help veterans heal and adjust. But it also should not have taken newspaper articles to bring change to outpatient conditions at Walter Reed. And while filthy conditions at Building 18 are a temporary problem for these veterans, lowball settlements may leave soldiers and their families impoverished for life.
source: 2mar2007
Noncommissioned officers moved from room to room of Building 18 of Walter Reed Army Medical Center yesterday with clipboards noting necessary repairs, while workers in protective masks began peeling moldy wallpaper and pulling up old carpet. Elsewhere in the decrepit former hotel that houses recovering wounded soldiers, an elevator was repaired and outside sidewalks were cleared of ice.
The activity came amid a storm of outrage from veterans groups and politicians after a series of articles last weekend in The Washington Post.
source: 2mar2007
Walter Reed Army Medical Center began repairs yesterday on Building 18, a former hotel that is used to house outpatients recuperating from injuries suffered in Iraq and Afghanistan and that has been plagued with mold, leaky plumbing and a broken elevator.
The facility's commander, Maj. Gen. George W. Weightman, said Army staff members inspected each of the 54 rooms at the building and discovered that outstanding repair orders for half the rooms had not been completed. He said that mold removal had begun on several rooms and that holes in ceilings, stained carpets and leaking faucets were being fixed.
Walter Reed, the Army's premier medical facility, has turned into a holding ground for wounded soldiers during 5 1/2 years of sustained combat. Almost 700 outpatients suffering from physical injuries and psychological problems live on the 113-acre military post or in nearby quarters. Many linger there for 18 months or longer as they move through the Army's numbing bureaucracy.
A Washington Post series over the weekend described "The Other Walter Reed," where overdoses, suicide attempts and depression among outpatients are the parallel narrative to the spit-polish hallways of the renowned hospital.
Building 18, in particular, symbolizes the indifference and neglect that many of the wounded say they experience at Walter Reed.
Yesterday, Weightman said a broken elevator in the building had been repaired and soldiers were working to improve the outside of the building, including removing ice and snow. The slippery conditions have kept some soldiers in their rooms. A garage door that has been broken for months will soon be repaired as well.
Spec. Jeremy Duncan, whose room has a moldy wall that was featured in one photograph in the Post series, has been moved to another room while workers make repairs. Duncan will be able to return to his room when the work is completed, Weightman said.
Walter Reed and Army officials have been "meeting continuously for three days" since the articles began appearing, Weightman said. A large roundtable meeting with Army and Defense Department officials will take place at the Pentagon early this morning to continue talks about improvements in the outpatient system, he added.
Weightman said the medical center has received an outpouring of concern about conditions and procedures since the articles appeared and has taken steps to improve what soldiers and their families describe as a messy battlefield of bureaucratic problems and mistreatment.
"We're starting to attack how we'll fix and mitigate" some of the problems, he said.
Social workers will now be stationed around the clock at Mologne House, the 200-room hotel on the post where many of the outpatients live. Plans are being developed to better train other staff members who deal with outpatient needs.
The Army will also consider moving some outpatients to its other medical centers throughout the United States and will determine over the next weeks whether more workers are needed at Walter Reed.
source: 2mar2007
For the past three years, Michael J. Wagner directed the Army's largest effort to help the most vulnerable soldiers at Walter Reed Army Medical Center. His office in Room 3E01 of the world-renowned hospital was supposed to match big-hearted donors with thousands of wounded soldiers who could not afford to feed their children, pay mortgages, buy plane tickets or put up visiting families in nearby hotels.
But while he was being paid to provide this vital service to patients, outpatients and their relations, Wagner was also seeking funders and soliciting donations for his own new charity, based in Texas, according to documents and interviews with current and former staff members. Some families also said Wagner treated them callously and made it hard for them to receive assistance.
Last week, Walter Reed launched a criminal investigation of Wagner after The Washington Post sought a response to his activities while he ran the Army's Medical Family Assistance Center, a position he left several weeks ago. Maj. Gen. George W. Weightman, the commander at Walter Reed, said the probe by the Criminal Investigation Command (CID) "reflects the seriousness with which we take these allegations."
Weightman's legal adviser, Col. Samuel Smith, said that "it would clearly be a conflict of interest" prohibited by federal law, Army regulations and Defense Department ethics rules if Wagner used his position to solicit funds for his own organization.
The saga of the Medical Family Assistance Center is just one example of the problems at Walter Reed, where nearly 700 soldiers and Marines from the wars in Iraq and Afghanistan live as outpatients while recuperating. Some families are happy with the help they received from Wagner and his office, and many soldiers and their families applauded the dedication of workers there. Others said that they had problems with Wagner and that the center seemed chaotic and disorganized.
"We had many family members who came to me because they couldn't get a respectful and compassionate response from Dr. Wagner," said Peggy Baker, director of a charity that helps wounded soldiers, Operation First Response.
Wagner, who has a doctorate in education, resigned his position last month to work full time on his Military, Veteran and Family Assistance Foundation, based in Dallas. The foundation includes the Phoenix Project, which runs marriage retreats for soldiers returning from combat. According to its Web site, the foundation is supported by several corporations, other foundations and individuals.
In a phone interview, Wagner denied he had solicited funds or made contact with donors during office hours. "It's just not true," he said. "I intentionally stayed out of that. I couldn't do that. I couldn't do both." He said he is not paid by the foundation. The documents that would verify that have not yet been filed with the Internal Revenue Service.
Wagner said his superiors "knew of my involvement right from the beginning." Weightman said the command had been unaware of Wagner's Texas charity until recently.
Wagner defended his work at the center. "My only purpose and my priority 12 to 19 hours a day was to assist the families of the wounded," he said. "I saw 6,000 people coming back from Iraq and Afghanistan. I did my best, but I'm not God. What I did there was a job that was superhuman."
Wagner said that the charity was founded by his brother and that he did not officially become its executive director until he left Walter Reed. But fundraising documents from early January, before he resigned, list him as the director, and the organization's Web site called him its executive director months before he resigned.
In a fundraising letter he signed shortly before he quit the Medical Family Assistance Center, Wagner referred to his work at Walter Reed. As head of the center, he wrote, "I have had over a thousand citizens in this great country asking what they might be able to do at Walter Reed for our wounded troops and their families. I found myself telling them that Walter Reed was blessed with the outpouring of the goodness and generosity of the American public and that if they were really interested in assisting, they should look within their own communities."
But, his letter continued, "I realized they were not working with their local communities so . . . I decided to found the Military, Veteran and Family Assistance Foundation to do just this, to do what I am able to help our soldiers reenter their home and local community."
Wagner included an ambitious business plan to take the charity from a $237,000 pilot project in the first year, which ended in August 2006 while he was working at Walter Reed to a $145 million foundation by 2011. He signed the letter "Executive Director and Founder."
Leita Sosin, an 11-year Army veteran who worked in Wagner's office for two years, said she complained to him and to co-workers about his involvement with the charity. "It really broke me to see what he was doing," said Sosin, 29, a former Army operating-room technician. "Instead of working with the families at Walter Reed and with us, he spent all his time putting together the Phoenix Project."
Moscow Spencer, a case manager fired by Wagner in October, also complained to her co-workers. "All day long he'd work on his program," she said. "If someone came in to donate money, he would talk to them about his project."
Sosin said the office was overwhelmed by the number of families who needed assistance and who were confused by the complex bureaucracy. "Everyone needed help, but you couldn't get them the help as fast as they needed it," she said. "Someone like me could scream all day about how it was broken, but no one wanted to take the time to fix it."
She also said Wagner was arrogant toward some staff members and families. "People got hurt in the process, whether it be financially or because he promised a lot of things he never followed up on," she said.
In April, Sosin said, she laid out her concerns in a three-page letter to her superiors. She received no response and resigned. Wagner said that Sosin never complained to him and that he had no idea why she quit.
Poverty among soldiers returning from war is not uncommon. While they continue to live on the Army payroll until they return to active duty or are discharged, some experience a substantial decrease in pay when combat pay or hazard pay disappears.
Some Army families breach the poverty line when a spouse quits a job to help the soldier recuperate; mortgage payments don't stop, and they still need to feed their children. Many turn to the generosity of Americans eager to prove they have not forgotten the troops' sacrifices. While staff members and soldiers acknowledge that some families take advantage of the plentiful freebies at Walter Reed, many others ask for help only as a last resort.
The assistance center is supposed to be the connection between a soldier's family and private donors. Until recently, it did not accept cash contributions but instead matched families' needs for bus or plane tickets, clothing, emergency food vouchers, grants for mortgages or living expenses with organizations set up to help.
According to Walter Reed, 14 families on average seek assistance from the center each day. Although it is difficult to quantify the value of donations, the center received $4,500 worth of phone cards in 2006 and handled $1.9 million worth of donated plane tickets. Weightman said the center's staff was recently increased from five to nine employees, with two people assigned to keeping track of the donations, and training has been improved.
The system for receiving donations is often confusing, even for the staff, Weightman said. "There's too much for any one person to know, but depending on the question, they may know [the answer] or direct you to the person who does know it."
Some soldiers go directly to the many volunteer organizations set up to help the wounded. Last year, Wagner began an effort to funnel all requests and donations through the family assistance center. It was a good idea, said Sosin and others, but because Wagner seemed preoccupied, a bottleneck of requests resulted.
"It was really all at the expense of the service member," said Sandra Butterfield, who worked at Walter Reed as an ombudsman for a Defense Department-funded relief organization. "He decreed that everything had to go through him," and it didn't seem to matter if that slowed the process. Officials, she said, "don't understand what it meant to have no money. Family members changed the sheets, empty the bedpan. But they are leaving their homes across the country. . . . Every day I came home angry."
Some families were also angered by the way Wagner treated them.
"The patient care was absolutely wonderful, but the administration was horrible, especially Dr. Wagner," said Maria Mendez, whose 25-year-old nephew, Spec. Roberto Reyes Jr., suffered severe brain and limb damage when a mine exploded near him outside Baghdad. "It was like running around in circles. He was never around."
"They were unprofessional, discourteous and uncompassionate all in one," Mendez said. "I was very surprised. You figure any family who's gone through such devastation, then faces this, to be treated with such unprofessionalism . . . it's like you're putting salt on the wounds."
Frustrated, Mendez set up an account for her sister, Aida Rivera, Reyes's mother, to pay for her stay at Walter Reed. Rivera eventually got financial assistance from the Army and outside organizations, but she also received a $3,519 bill from Mologne House, a hotel at Walter Reed, for her stay as her son's nonmedical attendant.
Staff members from other offices also complained to the command about Wagner, according to memos obtained by The Post. In one, an employee, who asked not to be named, questioned why a soldier's mother "who had subsisted on dried soups . . . due to her lack of funds" could not get help. Four months after approaching the center, the memo said, the mother had not received the per diem owed her as her child's nonmedical attendant "and has no cash for essentials nor emergencies."
A wife who accompanied her wounded husband, who was based in Germany, said Wagner asked her repeatedly why she did not return to Germany so she could continue working. The woman "reported she felt harassed and bullied but that she held her ground," the employee's memo states.
Wagner said families were often angry at his office, not because it failed them but because they were distraught over their situation. "Their true need is an emotional one. They're going to be angry at somebody. . . . I did my best; no, more than my best."
Staff researcher Julie Tate contributed to this report.
source: 2mar2007
On Tuesday, Feb. 20 at noon ET, reporters Dana Priest and Anne V. Hull discussed their stories describing the care and conditions at Walter Reed Army Medical Center for recovering Iraq war veterans.
The transcript follows:
____________________
Dana Priest and Anne Hull: Greetings all, Dana and Anne here. Thanks for joining and let's get started.
_______________________
Anonymous: First, your work has already yielded important responses from the Army. Well done.
Second, how can those of us interested in serving as patient advocates become involved? I am a retired Army officer with the background and interest in helping these vets deal with the medical bureaucracy you highlighted - obtaining benefits, finding resources for them, and getting them to appointments on time etc.
Fred
Dana Priest and Anne Hull: We've been swamped with people wanting to know how they can help, from those with experience in Army systems to others wanting to donate golf carts to shuttle the wounded around the Walter Reed campus. Walter Reed has also been besieged with people wanting to help. Stay tuned. Call your congressman.
_______________________
Bethesda, Md.: Congratulations on another great investigative piece. It sounds like you really lit a fire under the brass. I know it's early days yet, but does it seem to you like they are intending to respond adequately or are they just doing some cosmetic brushing up?
Dana Priest and Anne Hull: We'll see. They have started looking at Building 18 but the building in just one problem, and frankly symbolic of the larger issues. The system is huge and not very flexible, more funds are needed to care for the physical and psych needs of the wounded, etc.
_______________________
Anonymous: Is the facility being correctly repaired within established building & fire codes and ordinances for permanent upgrade, or given the usual "band-aid treatment" of spit-and-gum, cosmetic window-dressing until The Washington Post "goes away?" This would include widened doorways and ramps for ease of wheelchair users; raised braille lettering on all signage; easily understood evacuation plan maps in each room depicting where the occupant(s) is/are in relation to the fire exits; and better than "manageable" vector and vermin control plan and procedures?
Dana Priest and Anne Hull: This remains to be seen. This morning the ice and snow were gone and the elevator is working and rooms are being inspected. As to the larger issues - keeping the wounded in a building that's not every secure and requires moving across busy Georgia Avenue traffic still need to be addressed.
_______________________
Poolesville, Md.: What happens after Walter Reed closes?
Why is the nation sending men and women to war and then not taking proper care of the injured? (A question for DOD's Dr. Winkenwerder, who seems to want to ever cut medical benefits, higher levels in the Administration, and responsible members of Congress.)
Dana Priest and Anne Hull: The Naval hospital in Bethesda is being expanded and more soldiers have begun to receive care there. Other outpatients facilities are being set up and three are in the DC region.
_______________________
Alexandria, Va.: My brother was seriously wounded in January 2005 and was treated at Bethesda before transferring to Brooke AMC - sounds like he made the right choice there.
Although I appreciate your investigative reporting and the changes it already seems to be bringing to WRAMC, I have to question the flippant way the writing seemed to treat soldiers on medication. Are "gronked out" and "snowed out" part of the Post's style handbook? The use of this language seemed to trivialize their condition.
Thanks for the good work.
Dana Priest and Anne Hull: Didn't mean to offend with the language. Wish we could have used the soldiers' actual language, but we couldn't print it. We tried to stay in the spirit of those doing the talking.
_______________________
Alexandria, Va.: How was it possible that the Hospital commander was so unaware of the conditions you found? I just can't believe that it wasn't obvious to anyone who takes a walk around the site.
Dana Priest and Anne Hull: It's not fair to say the command was unaware of these problems. We have piles of folks who have told us in the last couple of days that they brought their complains - often documented - to leaders of the facility and were always assured that measures were being taken to fix things.
_______________________
Chevy Chase, D.C.: Heartbreaking story. Can you please tell us a little about the new rehab facility that just opened in San Antonio? Does it have no impact on the situation at Walter Reed?
Dana Priest and Anne Hull: It's apparently state of the art and privately funded. Lots of sophisticated proesthetics stuff and sports/rec rehab, in a fanstastic setting. Just opened.
_______________________
Lewes, Del.: The articles were great as far as they went. Do you plan to follow up an in-depth analysis of the military disability evaluation and compensation system? The Army Times had an article highlighting some of the problems on 2-20-07.
Dana Priest and Anne Hull: Coming soon, in the Washington Post. Stay tuned.
_______________________
Bethesda, Md.: About a year ago, after an article in the Post about how lonely some of the recovering vets at Walter Reed were, I called to volunteer as a visitor. I was told 'thanks but no thanks'- that they had more than enough volunteers. So I'm still wondering- how can we volunteer to help out at Walter Reed?
Dana Priest and Anne Hull: Many good volunteer organizations are doing work at WR.
CAUSE
Yellow Ribbon Fund
Wounded Warrior Project
VFW post in Arlington
Operation First Response
many others
_______________________
Great Falls, Va.: Is there anything being done to create a handbook for these soldiers and their families? That would help them navigate the system when they can't get help with a patient advocate.
Dana Priest and Anne Hull: There are actually a couple of handbooks already out there, one put together by Army spouses. The problem is, who thinks about a handbook at 3 in the morning when the call comes in that your soldier has been wounded and is due at Walter Reed in 3 days, and you arrive in Washington to WR a midnight, and you are in grief and disoriented? The Army doesn't often take into consideration the emotional state of someone showing up in the middle of the night to greet their wounded. All the spouses/mothers/fathers we spoke with describe the first few days as incomprehensibly difficult.
_______________________
Alexandria, Va.: How did you originally find out about the conditions at Walter Reed? Did someone give you a tip?
Dana Priest and Anne Hull: All good stories begin when someone sees something broken or injust, and takes a risk to bring this to light.
_______________________
Washington, D.C.: Great story, but I'm wondering how much of this is just a DC thing. Half the apartment buildings in the city are infested with rats and cockroaches. I guess you can't exactly tear the place down and start over, but that might be the only solution to some of these problems.
Dana Priest and Anne Hull: Yes rats are a problem in our city. But shouldnt' extreme measures be taken to keep rats and mice out of a building where inhabitants are bandaged and wounded? There are also rats/mice at Mologne House, the nice hotel on the grounds of WR.
_______________________
Portland, Ore.: What was it like working together on such a large piece? What was the writing process? The voice really is very cohesive throughout and doesn't sound like two different people wrote it (which is amazing).
Dana Priest and Anne Hull: Thank our editor, David Maraniss.
_______________________
Santa Barbara, Calif.: Just wanted to say "thank you" for the excellent series of articles. It's especially gratifying to see that this has lit a fire under the powers-that-be at Walter Reed and above. This kind of reporting, I think, is journalism at its bestexposing inequity and injustice in our system and being an impetus for a change for better.
Just out of curiosity, has there been any negative reaction to your articles? Hard to see how anyone can put a partisan bias or spin to articles like this, though.
Dana Priest and Anne Hull: Most of the emails say "thank you," and most come from vets and families of wounded.
Some emails say we overlooked all the good things done at WR, and the hard work and round-the-clock caring that so many of the staff provide. This is all true, which is why we've written about the valor of WR for the last four years. I had the chance to spend two weeks on the amputee ward four years ago when the war first started - or should I say ended - and the care of the staff and docs was remarkable.
_______________________
Somerville, Mass.: Thank you for this important series. I hope it helps those most in need. From the sounds of it, we should expect to see homeless veterans of this war fairly soon. Although the topic of homeless vets was beyond the scope of your series, did you get a sense of how likely such a terrible scenario could be? Thank you.
Dana Priest and Anne Hull: Not sure of the homeless vet population that could arise but financial woes are very real problems, especially among the older wounded Guard members.
_______________________
Fort Drum, N.Y.: Thank you for these excellent articles. I am the spouse of an OIF veteran who has received outpatient treatment at WRAMC. Your depiction of the bureaucracy at Walter Reed (ie callous, incompetent, and just plain mean) rings true.
Was it difficult to find soldiers/family members to speak on the record? Did anyone receive retribution or punitive action for speaking to you?
Dana Priest and Anne Hull: Those who spoke publicly for the article understood the risk they were taking, but they cared about the dire sitation and took the chance. Others did not want to be quoted directly. We interviewed dozens and dozens who did not want their names used but shared their experiences.
Retribution for those who did speak was a real concern.
_______________________
Anonymous: My fiance was at Walter Reed and stayed at Mologne House for 16 months. I think that you concentrated on the 2% of people that are not doing well in the system compared to the 98% that are recovering and living at Walter Reed just fine. My fiance received great treatment at the hospital. Yes the VA has problems with paperwork but that's not a fault of the hospital. I think if you told Walter Reed about the story you were doing you would have had access to all types of patients...just not the kind that you preyed upon.
Dana Priest and Anne Hull: The Post has done a story on Mologne House. So have lots of others. The civilian-run hotel actually does a great job with its complex guests. It's the aftermath of war and the Army organization that creates the very difficult conditions.
_______________________
Washington, D.C.: This was an extremely illuminating series of articles, but don't the problems you found just scratch the surface? In the long term, what about when these soldiers are no longer active military and they are bogged down in a Veterans Affairs system with a shrinking budget?
Dana Priest and Anne Hull: The very real woes of Iraq war vets who have already begun moving through the VA system are clear.
_______________________
Washington, D.C.: One more question, with military (and VA) hospitals all around the country, why must all of these folks be managed out of Walter Reed? Why not have 3-4 hospitals specialize in processing these cases and spread out the caseload? Unfortunately, it doesn't seem like the number of cases is going to decrease any time soon. (likely not till 2009)
Dana Priest and Anne Hull: they've actually decentralized a bit over the last couple of years so more people are living elsewhere than before. that said, WR sees about 25 percent of Iraq and Afghanistan. My sense is they will be trying to see if they can move more people out of WR into less crowded places.
_______________________
Bethesda, Md.: Your articles were first rate and heart wrenching. Great work.
When Walter Reed is closed and Bethesda Naval expanded , will on-site housing for outpatients be included ?
Also, any idea how much the costs will be for years to come for the treatment and follow-up care these men and women will require?
Dana Priest and Anne Hull: Yes, the housing will be expanded. I don't think anyone right now has a handle on costs. One reason for that is that the budget for health care is scattered in different places and it's in the supplemental budget rather than the regular one.
_______________________
Great Falls, Va.: It is so infuriating to hear these tragic situations developing when there are so many in this community that could help if the Army would let us. This is an organization that is overwhelmed and with proper training and coordination the public could eliminate some of the grief and disorientation these families go through.
Dana Priest and Anne Hull: That's for sure. There isn't any lack of willingness on the public's part to help out. The problem really is that the Army and Walter Reed are not effective in funneling the public's good will to soldiers. This is ongoing and it's one of the reasons we don't have a good answer to the questions so many people are asking, which is: how can I help?
_______________________
Stafford, Va.: My concern is that no doubt many of our troops will suffer from the pain of PTSD. However, popular media, like the Post, have really latched onto PTSD as the mental health "poster child" of this war. Clearly depression, which can exist without PTSD (war or no war) is more lethal and common in the military, yet because it has no clear "cause and effect", no one seems to want to touch it as a news story. Do you think the media's attention on PTSD unintentionally discourages troops to seek help for their less sensational, yet painful, depression?
Dana Priest and Anne Hull: Actually, I think it's tough for soldiers with any kind of mental issue to seek help. It's taboo in the culture still and it's an issue the Army knows little about, clinically speaking. Nor do they employ enough qualified people to handle the problem.
_______________________
Alexandria, Va.: Not to pile on, but I found the tone of your piece somewhat disrespectful too. Massive figure? Yawning hulk? Aaargh! Such descriptions seem inconsistent w/ the goal of showing that the Army is not respecting these soldiers. More respectful vocabulary might help to emphasize the need for them to be treated with dignity while, of course, addressing their medical, financial, and other problems as well.
Would have been interesting, actually, for you to include a line re the impossibility of printing the language the soldiers actually use.
Still, great work. Certainly gives the lie to the idea that the Mainstream Media have become irrelevantnot that I believed that anyway.
Dana Priest and Anne Hull: Hi, it's you again. No disrespect to Dell or his size. He didnt' have a problem with the description nor did his wife, Annette.
As for real soldier langauge, check out a Myspace page.
_______________________
Waldorf, Md.: When was the contact you had with the injured soldiers you highlighted? Hopefully, they are doing well? Your story painted such a bleak picture of their future.
Dana Priest and Anne Hull: We are keeping track on each and every one on a daily basis.
_______________________
Alexandria, Va.: You mentioned separate facilities for Active Duty and Guard Soldiers. The preponderence of those mentioned in your articles were also from Guard units. Do you mean to imply unequal treatment for our National Guard Soldiers?
Dana Priest and Anne Hull: Active duty and Guard live together, they are just in different companies. Active duty is MedHold and Guard and Reservists in MedHold Over.
We spoke with some Guard members who complained that they were give second-class citizen treatment by some staff at WR but we did not find this to be true across the board.
_______________________
South Carolina: I want to commend you for your articles. I am one of the people in article and I applaud you for your efforts and your wisdom on how to set the article in motion. Good Work
Dana Priest and Anne Hull: Hello South Carolina and thank you.
_______________________
Fredericksburg, Va.: Is any action being taken to address the unfair treatment of people like Cpl. Dell McLeod who was wounded and then retired without compensation because of a judgement of "prexisting condition"?
Dana Priest and Anne Hull: Del actually did okay on his disability rating. (Mostly because his wife did so much battling on his behalf, and was definitely a squeeky wheel.) The Army did not rate Dell on Traumatic Brain Injury but gave him 30 percent for anxiety. Dell has to get re-evaluated in a year, and all this could change.
_______________________
Corona, Calif.: Terrific series and one everyone should read. Many of the conditions you report on here exist in other military and VA facilities. What is especially troubling is knowing that budgets to provide promised and needed medical services are underfunded every year. Is your series going to be syndicated so that others around the country can begin to take a look at the state of their community's VA facilities?
Dana Priest and Anne Hull: The story is being picked up here and there by other news organizations, vet groups and mental health advocacy groups.
_______________________
Austin, Tex.: While Rumsfeld, Franks, et al did include a few PowerPoint slides in their pre-war slides concerning Phase 4, did anyone plan for Phase 5, caring for the troops, after the anticipated success?
Dana Priest and Anne Hull: This question was asked by lots of soldiers and health care providers at WR during our reporting.
_______________________
Bethesda, Md.: Just for the record....the war was never officially announced as being ended...get your facts straight especially in responding to a question concerning partisan bias.....shame on you!
Dana Priest and Anne Hull: you know what i meant.
_______________________
Arlington, Va.: How long did you do the research for these articles and why didn't you bring these conditions or at least what you were finding to the attention of the Commander of Walter Reed? Shouldn't this have been something you would want to immediately identify to be fixed?
Dana Priest and Anne Hull: We weren't the first to bring these issues to the attention of the WR command. The last in a long line, in fact. That's why we were contacted. Apparently no or little action was taken when others stepped forward.
_______________________
Springfield, Va.: Noted that your research was done early last year, over four months. Just out of curiousity why did you wait a year to publish these concerns? Is it politically timed and motivated?
Dana Priest and Anne Hull: We spent almost four months reporting the story and then wrote it as fast as we could and it went into the paper!
_______________________
Stony Brook, N.Y.: How has TSGLI, the lump sum disability rider to SGLI effected the economic circumstances of the Reed outpatients?
Dana Priest and Anne Hull: Many of the folks we interviewed are dealing with this issue - especially traumatic brain injury. We did not explore in our pieces.
_______________________
Waldorf, Md.: What is the timeline for Walter Reed to shutdown? It appears the administration has attempted to save money by foregoing maintenance. Great story!
Dana Priest and Anne Hull: 2011 scheduled to close
_______________________
Dana Priest and Anne Hull: Thanks for joining. So long.
_______________________
Editor's Note: washingtonpost.com moderators retain editorial control over Live Online discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions. washingtonpost.com is not responsible for any content posted by third parties.
source: 2mar2007
By Anne Hull and Dana Priest Washington Post Staff Writers Monday, February 19, 2007; A01
The guests of Mologne House have been blown up, shot, crushed and shaken, and now their convalescence takes place among the chandeliers and wingback chairs of the 200-room hotel on the grounds of Walter Reed Army Medical Center.
Oil paintings hang in the lobby of this strange outpost in the war on terrorism, where combat's urgency has been replaced by a trickling fountain in the garden courtyard. The maimed and the newly legless sit in wheelchairs next to a pond, watching goldfish turn lazily through the water.
But the wounded of Mologne House are still soldiers Hooah! so their lives are ruled by platoon sergeants. Each morning they must rise at dawn for formation, though many are half-snowed on pain meds and sleeping pills.
In Room 323 the alarm goes off at 5 a.m., but Cpl. Dell McLeod slumbers on. His wife, Annette, gets up and fixes him a bowl of instant oatmeal before going over to the massive figure curled in the bed. An Army counselor taught her that a soldier back from war can wake up swinging, so she approaches from behind.
"Dell," Annette says, tapping her husband. "Dell, get in the shower."
"Dell!" she shouts.
Finally, the yawning hulk sits up in bed. "Okay, baby," he says. An American flag T-shirt is stretched over his chest. He reaches for his dog tags, still the devoted soldier of 19 years, though his life as a warrior has become a paradox. One day he's led on stage at a Toby Keith concert with dozens of other wounded Operation Iraqi Freedom troops from Mologne House, and the next he's sitting in a cluttered cubbyhole at Walter Reed, fighting the Army for every penny of his disability.
McLeod, 41, has lived at Mologne House for a year while the Army figures out what to do with him. He worked in textile and steel mills in rural South Carolina before deploying. Now he takes 23 pills a day, prescribed by various doctors at Walter Reed. Crowds frighten him. He is too anxious to drive. When panic strikes, a soldier friend named Oscar takes him to Baskin-Robbins for vanilla ice cream.
"They find ways to soothe each other," Annette says.
Mostly what the soldiers do together is wait: for appointments, evaluations, signatures and lost paperwork to be found. It's like another wife told Annette McLeod: "If Iraq don't kill you, Walter Reed will."
After Iraq, a New Struggle
The conflict in Iraq has hatched a virtual town of desperation and dysfunction, clinging to the pilings of Walter Reed. The wounded are socked away for months and years in random buildings and barracks in and around this military post.
The luckiest stay at Mologne House, a four-story hotel on a grassy slope behind the hospital. Mologne House opened 10 years ago as a short-term lodging facility for military personnel, retirees and their family members. Then came Sept. 11 and five years of sustained warfare. Now, the silver walkers of retired generals convalescing from hip surgery have been replaced by prosthetics propped against Xbox games and Jessica Simpson posters smiling down on brain-rattled grunts.
Two Washington Post reporters spent hundreds of hours in Mologne House documenting the intimate struggles of the wounded who live there. The reporting was done without the knowledge or permission of Walter Reed officials, but all those directly quoted in this article agreed to be interviewed.
The hotel is built in the Georgian revival style, and inside it offers the usual amenities: daily maid service, front-desk clerks in formal vests and a bar off the lobby that opens every afternoon.
But at this bar, the soldier who orders a vodka tonic one night says to the bartender, "If I had two hands, I'd order two." The customers sitting around the tables are missing limbs, their ears are melted off, and their faces are tattooed purple by shrapnel patterns.
Most everyone has a story about the day they blew up: the sucking silence before immolation, how the mouth filled with tar, the lungs with gas.
"First thing I said was, '[Expletive], that was my good eye,' " a soldier with an eye patch tells an amputee in the bar.
The amputee peels his beer label. "I was awake through the whole thing," he says. "It was my first patrol. The second [expletive] day in Iraq and I get blown up."
When a smooth-cheeked soldier with no legs orders a fried chicken dinner and two bottles of grape soda to go, a kitchen worker comes out to his wheelchair and gently places the Styrofoam container on his lap.
A scrawny young soldier sits alone in his wheelchair at a nearby table, his eyes closed and his chin dropped to his chest, an empty Corona bottle in front of him.
Those who aren't old enough to buy a drink at the bar huddle outside near a magnolia tree and smoke cigarettes. Wearing hoodies and furry bedroom slippers, they look like kids at summer camp who've crept out of their rooms, except some have empty pants legs or limbs pinned by medieval-looking hardware. Medication is a favorite topic.
"Dude, [expletive] Paxil saved my life."
"I been on methadone for a year, I'm tryin' to get off it."
"I didn't take my Seroquel last night and I had nightmares of charred bodies, burned crispy like campfire marshmallows."
Mologne House is afloat on a river of painkillers and antipsychotic drugs. One night, a strapping young infantryman loses it with a woman who is high on her son's painkillers. "Quit taking all the soldier medicine!" he screams.
Pill bottles clutter the nightstands: pills for depression or insomnia, to stop nightmares and pain, to calm the nerves.
Here at Hotel Aftermath, a crash of dishes in the cafeteria can induce seizures in the combat-addled. If a taxi arrives and the driver looks Middle Eastern, soldiers refuse to get in. Even among the gazebos and tranquility of the Walter Reed campus in upper Northwest Washington, manhole covers are sidestepped for fear of bombs and rooftops are scanned for snipers.
Bomb blasts are the most common cause of injury in Iraq, and nearly 60 percent of the blast victims also suffer from traumatic brain injury, according to Walter Reed's studies, which explains why some at Mologne House wander the hallways trying to remember their room numbers.
Some soldiers and Marines have been here for 18 months or longer. Doctor's appointments and evaluations are routinely dragged out and difficult to get. A board of physicians must review hundreds of pages of medical records to determine whether a soldier is fit to return to duty. If not, the Physical Evaluation Board must decide whether to assign a rating for disability compensation. For many, this is the start of a new and bitter battle.
Months roll by and life becomes a blue-and-gold hotel room where the bathroom mirror shows the naked disfigurement of war's ravages. There are toys in the lobby of Mologne House because children live here. Domestic disputes occur because wives or girlfriends have moved here. Financial tensions are palpable. After her husband's traumatic injury insurance policy came in, one wife cleared out with the money. Older National Guard members worry about the jobs they can no longer perform back home.
While Mologne House has a full bar, there is not one counselor or psychologist assigned there to assist soldiers and families in crisis an idea proposed by Walter Reed social workers but rejected by the military command that runs the post.
After a while, the bizarre becomes routine. On Friday nights, antiwar protesters stand outside the gates of Walter Reed holding signs that say "Love Troops, Hate War, Bring them Home Now." Inside the gates, doctors in white coats wait at the hospital entrance for the incoming bus full of newly wounded soldiers who've just landed at Andrews Air Force Base.
And set back from the gate, up on a hill, Mologne House, with a bowl of red apples on the front desk.
Into the Twilight Zone
Dell McLeod's injury was utterly banal. He was in his 10th month of deployment with the 178th Field Artillery Regiment of the South Carolina National Guard near the Iraqi border when he was smashed in the head by a steel cargo door of an 18-wheeler. The hinges of the door had been tied together with a plastic hamburger-bun bag. Dell was knocked out cold and cracked several vertebrae.
When Annette learned that he was being shipped to Walter Reed, she took a leave from her job on the assembly line at Stanley Tools and packed the car. The Army would pay her $64 a day to help care for her husband and would let her live with him at Mologne House until he recovered.
A year later, they are still camped out in the twilight zone. Dogs are periodically brought in by the Army to search the rooms for contraband or weapons. When the fire alarm goes off, the amputees who live on the upper floors are scooped up and carried down the stairwell, while a brigade of mothers passes down the wheelchairs. One morning Annette opens her door and is told to stay in the room because a soldier down the hall has overdosed.
In between, there are picnics at the home of the chairman of the Joint Chiefs of Staff and a charity-funded dinner cruise on the Potomac for "Today's troops, tomorrow's veterans, always heroes."
Dell and Annette's weekdays are spent making the rounds of medical appointments, physical therapy sessions and evaluations for Dell's discharge from the Army. After 19 years, he is no longer fit for service. He uses a cane to walk. He is unable to count out change in the hospital cafeteria. He takes four Percocets a day for pain and has gained 40 pounds from medication and inactivity. Lumbering and blue-eyed, Dell is a big ox baby.
Annette puts on makeup every morning and does her hair, some semblance of normalcy, but her new job in life is watching Dell.
"I'm worried about how he's gonna fit into society," she says one night, as Dell wanders down the hall to the laundry room.
The more immediate worry concerns his disability rating. Army doctors are disputing that Dell's head injury was the cause of his mental impairment. One report says that he was slow in high school and that his cognitive problems could be linked to his native intelligence rather than to his injury.
"They said, 'Well, he was in Title I math,' like he was retarded," Annette says. "Well, y'all took him, didn't you?"
The same fight is being waged by their friends, who aren't the young warriors in Army posters but middle-age men who left factory jobs to deploy to Iraq with their Guard units. They were fit enough for war, but now they are facing teams of Army doctors scrutinizing their injuries for signs of preexisting conditions, lessening their chance for disability benefits.
Dell and Annette's closest friend at Mologne House is a 47-year-old Guard member who was driving an Army vehicle through the Iraqi night when a flash of light blinded him and he crashed into a ditch with an eight-foot drop. Among his many injuries was a broken foot that didn't heal properly. Army doctors decided that "late life atrophy" was responsible for the foot, not the truck wreck in Iraq.
When Dell sees his medical records, he explodes. "Special ed is for the mentally retarded, and I'm not mentally retarded, right, babe?" he asks Annette. "I graduated from high school. I did some college. I worked in a steel mill."
It's after 9 one night and Dell and Annette are both exhausted, but Dell still needs to practice using voice-recognition software. Reluctantly, he mutes "The Ultimate Fighting Challenge" on TV and sits next to Annette in bed with a laptop.
"My name is Wendell," he says. "Wendell Woodward McLeod Jr."
Annette tells him to sit up. "Spell 'dog,' " she says, softly.
"Spell 'dog,' " he repeats.
"Listen to me," she says.
"Listen to me." He slumps on the pillow. His eyes drift toward the wrestlers on TV.
"You are not working hard enough, Dell," Annette says, pleading. "Wake up."
"Wake up," he says.
"Dell, come on now!"
For Some, a Grim Kind of Fame
No one questions Sgt. Bryan Anderson's sacrifice. One floor above Dell and Annette's room at Mologne House, he holds the gruesome honor of being one of the war's five triple amputees. Bryan, 25, lost both legs and his left arm when a roadside bomb exploded next to the Humvee he was driving with the 411th Military Police Company. Modern medicine saved him and now he's the pride of the prosthetics team at Walter Reed. Tenacious and wisecracking, he wrote "[Expletive] Iraq" on his left leg socket.
Amputees are the first to receive celebrity visitors, job offers and extravagant trips, but Bryan is in a league of his own. Johnny Depp's people want to hook up in London or Paris. The actor Gary Sinise, who played an angry Vietnam amputee in "Forrest Gump," sends his regards. And Esquire magazine is setting up a photo shoot.
Bryan's room at Mologne House is stuffed with gifts from corporate America and private citizens: $350 Bose noise-canceling headphones, nearly a thousand DVDs sent by well-wishers and quilts made by church grannies. The door prizes of war. Two flesh-colored legs are stacked on the floor. A computerized hand sprouting blond hair is on the table.
One Saturday afternoon, Bryan is on his bed downloading music. Without his prosthetics, he weighs less than 100 pounds. "Mom, what time is our plane?" he asks his mother, Janet Waswo, who lives in the room with him. A movie company is flying them to Boston for the premiere of a documentary about amputee hand-cyclers in which Bryan appears.
Representing the indomitable spirit of the American warrior sometimes becomes too much, and Bryan turns off his phone.
Perks and stardom do not come to every amputee. Sgt. David Thomas, a gunner with the Tennessee National Guard, spent his first three months at Walter Reed with no decent clothes; medics in Samarra had cut off his uniform. Heavily drugged, missing one leg and suffering from traumatic brain injury, David, 42, was finally told by a physical therapist to go to the Red Cross office, where he was given a T-shirt and sweat pants. He was awarded a Purple Heart but had no underwear.
David tangled with Walter Reed's image machine when he wanted to attend a ceremony for a fellow amputee, a Mexican national who was being granted U.S. citizenship by President Bush. A case worker quizzed him about what he would wear. It was summer, so David said shorts. The case manager said the media would be there and shorts were not advisable because the amputees would be seated in the front row.
" 'Are you telling me that I can't go to the ceremony 'cause I'm an amputee?' " David recalled asking. "She said, 'No, I'm saying you need to wear pants.' "
David told the case worker, "I'm not ashamed of what I did, and y'all shouldn't be neither." When the guest list came out for the ceremony, his name was not on it.
Still, for all its careful choreography of the amputees, Walter Reed offers protection from a staring world. On warm nights at the picnic tables behind Mologne House, someone fires up the barbecue grill and someone else makes a beer run to Georgia Avenue.
Bryan Anderson is out here one Friday. "Hey, Bry, what time should we leave in the morning?" asks his best friend, a female soldier also injured in Iraq. The next day is Veterans Day, and Bryan wants to go to Arlington National Cemetery. His pal Gary Sinise will be there, and Bryan wants to give him a signed photo.
Thousands of spectators are already at Arlington the next morning when Bryan and his friend join the surge toward the ceremony at the Tomb of the Unknowns. The sunshine dazzles. Bryan is in his wheelchair. If loss and sacrifice are theoretical to some on this day, here is living proof three stumps and a crooked boyish smile. Even the acres of tombstones can't compete. Spectators cut their eyes toward him and look away.
Suddenly, the thunder of cannons shakes the sky. The last time Bryan heard this sound, his legs were severed and he was nearly bleeding to death in a fiery Humvee.
Boom. Boom. Boom. Bryan pushes his wheelchair harder, trying to get away from the noise. "Damn it," he says, "when are they gonna stop?"
Bryan's friend walks off by herself and holds her head. The cannon thunder has unglued her, too, and she is crying.
Friends From Ward 54
An old friend comes to visit Dell and Annette. Sgt. Oscar Fernandez spent 14 months at Walter Reed after having a heart attack in Afghanistan. Oscar also had post-traumatic stress disorder, PTSD, a condition that worsened at Walter Reed and landed the 45-year-old soldier in the hospital's psychiatric unit, Ward 54.
Oscar belonged to a tight-knit group of soldiers who were dealing with combat stress and other psychological issues. They would hang out in each other's rooms at night, venting their fury at the Army's Cuckoo's Nest. On weekends they escaped Walter Reed to a Chinese buffet or went shopping for bootleg Spanish DVDs in nearby Takoma Park. They once made a road trip to a casino near the New Jersey border.
They abided each other's frailties. Sgt. Steve Justi would get the slightest cut on his skin and drop to his knees, his face full of anguish, apologizing over and over. For what, Oscar did not know. Steve was the college boy who went to Iraq, and Oscar figured something terrible had happened over there.
Sgt. Mike Smith was the insomniac. He'd stay up till 2 or 3 in the morning, smoking on the back porch by himself. Doctors had put steel rods in his neck after a truck accident in Iraq. To turn his head, the 41-year-old Guard member from Iowa had to rotate his entire body. He was fighting with the Army over his disability rating, too, and in frustration had recently called a congressional investigator for help.
"They try in all their power to have you get well, but it reverses itself," Oscar liked to say.
Dell was not a psych patient, but he and Oscar bonded. They were an unlikely pair the dark-haired Cuban American with a penchant for polo shirts and salsa, and the molasses earnestness of Dell.
Oscar would say things like "I'm trying to better myself through my own recognizance," and Dell would nod in appreciation.
To celebrate Oscar's return visit to Walter Reed, they decide to have dinner in Silver Spring.
Annette tells Oscar that a soldier was arrested at Walter Reed for waving a gun around.
"A soldier, coming from war?" Oscar asks.
Annette doesn't know. She mentions that another soldier was kicked out of Mologne House for selling his painkillers.
The talk turns to their friend Steve Justi. A few days earlier, Steve was discharged from the Army and given a zero percent disability rating for his mental condition.
Oscar is visibly angry. "They gave him nothing," he says. "They said his bipolar was preexisting."
Annette is quiet. "Poor Steve," she says.
After dinner, they return through the gates of Walter Reed in Annette's car, a John 3:16 decal on the bumper and the Dixie Chicks in the CD player. Annette sees a flier in the lobby of Mologne House announcing a free trip to see Toby Keith in concert.
A week later, it is a wonderful night at the Nissan Pavilion. About 70 wounded soldiers from Walter Reed attend the show. Toby invites them up on stage and brings the house down when he sings his monster wartime hit "American Soldier." Dell stands on stage in his uniform while Annette snaps pictures.
"Give a hand clap for the soldiers," Annette hears Toby tell the audience, "then give a hand for the U.S.A."
A Soldier Snaps
Deep into deer-hunting country and fields of withered corn, past the Pennsylvania Turnpike in the rural town of Ellwood City, Steve Justi sits in his parents' living room, fighting off the afternoon's lethargy.
A photo on a shelf shows a chiseled soldier, but the one in the chair is 35 pounds heavier. Antipsychotic drugs give him tremors and cloud his mind. Still, he is deliberate and thoughtful as he explains his path from soldier to psychiatric patient in the war on terrorism.
After receiving a history degree from Mercyhurst College, Steve was motivated by the attacks of Sept. 11, 2001, to join the National Guard. He landed in Iraq in 2003 with the First Battalion, 107th Field Artillery, helping the Marines in Fallujah.
"It was just the normal stuff," Steve says, describing the violence he witnessed in Iraq. His voice is oddly flat as he recalls the day his friend died in a Humvee accident. The friend was driving with another soldier when they flipped off the road into a swamp. They were trapped upside down and submerged. Steve helped pull them out and gave CPR, but it was too late. The swamp water kept pushing back into his own mouth. He rode in the helicopter with the wet bodies.
After he finished his tour, everything was fine back home in Pennsylvania for about 10 months, and then a strange bout of insomnia started. After four days without sleep, he burst into full-out mania and was hospitalized in restraints.
Did anything trigger the insomnia? "Not really," Steve says calmly, sitting in his chair.
His mother overhears this from the kitchen and comes into the living room. "His sergeant had called saying that the unit was looking for volunteers to go back to Iraq," Cindy Justi says. "This is what triggered his snap."
Steve woke up in the psychiatric unit at Walter Reed and spent the next six months going back and forth between there and a room at Mologne House. He was diagnosed with bipolar disorder. He denied to doctors that he was suffering from PTSD, yet he called home once from Ward 54 and shouted into the phone, "Mom, can't you hear all the shooting in the background?"
He was on the ward for the sixth time when he was notified that he was being discharged from the Army, with only a few days to clear out and a disability rating of zero percent.
On some level, Steve expected the zero rating. During his senior year of college, he suffered a nervous breakdown and for several months was treated with antidepressants. He disclosed this to the National Guard recruiter, who said it was a nonissue. It became an issue when he told doctors at Walter Reed. The Army decided that his condition was not aggravated by his time in Iraq. The only help he would get would come from Veterans Affairs.
"We have no idea if what he endured over there had a worsening effect on him," says his mother.
His father gets home from the office. Ron Justi sits on the couch across from his son. "He was okay to sacrifice his body, but now that it's time he needs some help, they are not here," Ron says.
Outside the Gates
The Army gives Dell McLeod a discharge date. His days at Mologne House are numbered. The cramped hotel room has become home, and now he is afraid to leave it. His anxiety worsens. "Shut up!" he screams at Annette one night, his face red with rage, when she tells him to stop fiddling with his wedding ring.
Later, Annette says: "I am exhausted. He doesn't understand that I've been fighting the Army."
Doctors have concluded that Dell was slow as a child and that his head injury on the Iraqi border did not cause brain damage. "It is possible that pre-morbid emotional difficulties and/or pre-morbid intellectual functioning may be contributing factors to his reported symptoms," a doctor wrote, withholding a diagnosis of traumatic brain injury.
Annette pushes for more brain testing and gets nowhere until someone gives her the name of a staffer for the House Committee on Oversight and Government Reform. A few days later, Annette is called to a meeting with the command at Walter Reed. Dell is given a higher disability rating than expected 50 percent, which means he will receive half of his base pay until he is evaluated again in 18 months. He signs the papers.
Dell wears his uniform for the last time, somber and careful as he dresses for formation. Annette packs up the room and loads their Chevy Cavalier to the brim. Finally the gates of Walter Reed are behind them. They are southbound on I-95 just past the Virginia line when Dell begins to cry, Annette would later recall. She pulls over and they both weep.
Not long after, Bryan Anderson also leaves Mologne House. When the triple amputee gets off the plane in Chicago, American Airlines greets him on the tarmac with hoses spraying arches of water, and cheering citizens line the roads that lead to his home town, Rolling Meadows.
Bryan makes the January cover of Esquire. He is wearing his beat-up cargo shorts and an Army T-shirt, legless and holding his Purple Heart in his robot hand. The headline says "The Meaning of Life."
A month after Bryan leaves, Mike Smith, the insomniac soldier, is found dead in his room. Mike had just received the good news that the Army was raising his disability rating after a congressional staff member intervened on his behalf. It was the week before Christmas, and he was set to leave Walter Reed to go home to his wife and kids in Iowa when his body was found. The Army told his wife that he died of an apparent heart attack, according to her father.
Distraught, Oscar Fernandez calls Dell and Annette in South Carolina with the news. "It's the constant assault of the Army," he says.
Life with Dell is worsening. He can't be left alone. The closest VA hospital is two hours away. Doctors say he has liver problems because of all the medications. He is also being examined for PTSD. "I don't even know this man anymore," Annette says.
At Mologne House, the rooms empty and fill, empty and fill. The lobby chandelier glows and the bowl of red apples waits on the front desk. An announcement goes up for Texas Hold 'Em poker in the bar.
One cold night an exhausted mother with two suitcases tied together with rope shows up at the front desk and says, "I am here for my son." And so it begins.
Staff researcher Julie Tate contributed to this report.
source: 2mar2007
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.
The common perception of Walter Reed is of a surgical hospital that shines as the crown jewel of military medicine. But 5 1/2 years of sustained combat have transformed the venerable 113-acre institution into something else entirely a holding ground for physically and psychologically damaged outpatients. Almost 700 of them the majority soldiers, with some Marines have been released from hospital beds but still need treatment or are awaiting bureaucratic decisions before being discharged or returned to active duty.
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.
Not all of the quarters are as bleak as Duncan's, but the despair of Building 18 symbolizes a larger problem in Walter Reed's treatment of the wounded, according to dozens of soldiers, family members, veterans aid groups, and current and former Walter Reed staff members interviewed by two Washington Post reporters, who spent more than four months visiting the outpatient world without the knowledge or permission of Walter Reed officials. Many agreed to be quoted by name; others said they feared Army retribution if they complained publicly.
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."
Soldiers, family members, volunteers and caregivers who have tried to fix the system say each mishap seems trivial by itself, but the cumulative effect wears down the spirits of the wounded and can stall their recovery.
"It creates resentment and disenfranchisement," said Joe Wilson, a clinical social worker at Walter Reed. "These soldiers will withdraw and stay in their rooms. They will actively avoid the very treatment and services that are meant to be helpful."
Danny Soto, a national service officer for Disabled American Veterans who helps dozens of wounded service members each week at Walter Reed, said soldiers "get awesome medical care and their lives are being saved," but, "Then they get into the administrative part of it and they are like, 'You saved me for what?' The soldiers feel like they are not getting proper respect. This leads to anger."
This world is invisible to outsiders. Walter Reed occasionally showcases the heroism of these wounded soldiers and emphasizes that all is well under the circumstances. President Bush, former defense secretary Donald H. Rumsfeld and members of Congress have promised the best care during their regular visits to the hospital's spit-polished amputee unit, Ward 57.
"We owe them all we can give them," Bush said during his last visit, a few days before Christmas. "Not only for when they're in harm's way, but when they come home to help them adjust if they have wounds, or help them adjust after their time in service."
Along with the government promises, the American public, determined not to repeat the divisive Vietnam experience, has embraced the soldiers even as the war grows more controversial at home. Walter Reed is awash in the generosity of volunteers, businesses and celebrities who donate money, plane tickets, telephone cards and steak dinners.
Yet at a deeper level, the soldiers say they feel alone and frustrated. Seventy-five percent of the troops polled by Walter Reed last March said their experience was "stressful." Suicide attempts and unintentional overdoses from prescription drugs and alcohol, which is sold on post, are part of the narrative here.
Vera Heron spent 15 frustrating months living on post to help care for her son. "It just absolutely took forever to get anything done," Heron said. "They do the paperwork, they lose the paperwork. Then they have to redo the paperwork. You are talking about guys and girls whose lives are disrupted for the rest of their lives, and they don't put any priority on it."
Family members who speak only Spanish have had to rely on Salvadoran housekeepers, a Cuban bus driver, the Panamanian bartender and a Mexican floor cleaner for help. Walter Reed maintains a list of bilingual staffers, but they are rarely called on, according to soldiers and families and Walter Reed staff members.
Evis Morales's severely wounded son was transferred to the National Naval Medical Center in Bethesda for surgery shortly after she arrived at Walter Reed. She had checked into her government-paid room on post, but she slept in the lobby of the Bethesda hospital for two weeks because no one told her there is a free shuttle between the two facilities. "They just let me off the bus and said 'Bye-bye,' " recalled Morales, a Puerto Rico resident.
Morales found help after she ran out of money, when she called a hotline number and a Spanish-speaking operator happened to answer.
"If they can have Spanish-speaking recruits to convince my son to go into the Army, why can't they have Spanish-speaking translators when he's injured?" Morales asked. "It's so confusing, so disorienting."
Soldiers, wives, mothers, social workers and the heads of volunteer organizations have complained repeatedly to the military command about what one called "The Handbook No One Gets" that would explain life as an outpatient. Most soldiers polled in the March survey said they got their information from friends. Only 12 percent said any Army literature had been helpful.
"They've been behind from Day One," said Rep. Thomas M. Davis III (R-Va.), who headed the House Government Reform Committee, which investigated problems at Walter Reed and other Army facilities. "Even the stuff they've fixed has only been patched."
Among the public, Davis said, "there's vast appreciation for soldiers, but there's a lack of focus on what happens to them" when they return. "It's awful."
Maj. Gen. George W. Weightman, commander at Walter Reed, said in an interview last week that a major reason outpatients stay so long, a change from the days when injured soldiers were discharged as quickly as possible, is that the Army wants to be able to hang on to as many soldiers as it can, "because this is the first time this country has fought a war for so long with an all-volunteer force since the Revolution."
Acknowledging the problems with outpatient care, Weightman said Walter Reed has taken steps over the past year to improve conditions for the outpatient army, which at its peak in summer 2005 numbered nearly 900, not to mention the hundreds of family members who come to care for them. One platoon sergeant used to be in charge of 125 patients; now each one manages 30. Platoon sergeants with psychological problems are more carefully screened. And officials have increased the numbers of case managers and patient advocates to help with the complex disability benefit process, which Weightman called "one of the biggest sources of delay."
And to help steer the wounded and their families through the complicated bureaucracy, Weightman said, Walter Reed has recently begun holding twice-weekly informational meetings. "We felt we were pushing information out before, but the reality is, it was overwhelming," he said. "Is it fail-proof? No. But we've put more resources on it."
He said a 21,500-troop increase in Iraq has Walter Reed bracing for "potentially a lot more" casualties.
Bureaucratic Battles
The best known of the Army's medical centers, Walter Reed opened in 1909 with 10 patients. It has treated the wounded from every war since, and nearly one of every four service members injured in Iraq and Afghanistan.
The outpatients are assigned to one of five buildings attached to the post, including Building 18, just across from the front gates on Georgia Avenue. To accommodate the overflow, some are sent to nearby hotels and apartments. Living conditions range from the disrepair of Building 18 to the relative elegance of Mologne House, a hotel that opened on the post in 1998, when the typical guest was a visiting family member or a retiree on vacation.
The Pentagon has announced plans to close Walter Reed by 2011, but that hasn't stopped the flow of casualties. Three times a week, school buses painted white and fitted with stretchers and blackened windows stream down Georgia Avenue. Sirens blaring, they deliver soldiers groggy from a pain-relief cocktail at the end of their long trip from Iraq via Landstuhl Regional Medical Center in Germany and Andrews Air Force Base.
Staff Sgt. John Daniel Shannon, 43, came in on one of those buses in November 2004 and spent several weeks on the fifth floor of Walter Reed's hospital. His eye and skull were shattered by an AK-47 round. His odyssey in the Other Walter Reed has lasted more than two years, but it began when someone handed him a map of the grounds and told him to find his room across post.
A reconnaissance and land-navigation expert, Shannon was so disoriented that he couldn't even find north. Holding the map, he stumbled around outside the hospital, sliding against walls and trying to keep himself upright, he said. He asked anyone he found for directions.
Shannon had led the 2nd Infantry Division's Ghost Recon Platoon until he was felled in a gun battle in Ramadi. He liked the solitary work of a sniper; "Lone Wolf" was his call name. But he did not expect to be left alone by the Army after such serious surgery and a diagnosis of post-traumatic stress disorder. He had appointments during his first two weeks as an outpatient, then nothing.
"I thought, 'Shouldn't they contact me?' " he said. "I didn't understand the paperwork. I'd start calling phone numbers, asking if I had appointments. I finally ran across someone who said: 'I'm your case manager. Where have you been?'
"Well, I've been here! Jeez Louise, people, I'm your hospital patient!"
Like Shannon, many soldiers with impaired memory from brain injuries sat for weeks with no appointments and no help from the staff to arrange them. Many disappeared even longer. Some simply left for home.
One outpatient, a 57-year-old staff sergeant who had a heart attack in Afghanistan, was given 200 rooms to supervise at the end of 2005. He quickly discovered that some outpatients had left the post months earlier and would check in by phone. "We called them 'call-in patients,' " said Staff Sgt. Mike McCauley, whose dormant PTSD from Vietnam was triggered by what he saw on the job: so many young and wounded, and three bodies being carried from the hospital.
Life beyond the hospital bed is a frustrating mountain of paperwork. The typical soldier is required to file 22 documents with eight different commands most of them off-post to enter and exit the medical processing world, according to government investigators. Sixteen different information systems are used to process the forms, but few of them can communicate with one another. The Army's three personnel databases cannot read each other's files and can't interact with the separate pay system or the medical recordkeeping databases.
The disappearance of necessary forms and records is the most common reason soldiers languish at Walter Reed longer than they should, according to soldiers, family members and staffers. Sometimes the Army has no record that a soldier even served in Iraq. A combat medic who did three tours had to bring in letters and photos of herself in Iraq to show she that had been there, after a clerk couldn't find a record of her service.
Shannon, who wears an eye patch and a visible skull implant, said he had to prove he had served in Iraq when he tried to get a free uniform to replace the bloody one left behind on a medic's stretcher. When he finally tracked down the supply clerk, he discovered the problem: His name was mistakenly left off the "GWOT list" the list of "Global War on Terrorism" patients with priority funding from the Defense Department.
He brought his Purple Heart to the clerk to prove he was in Iraq.
Lost paperwork for new uniforms has forced some soldiers to attend their own Purple Heart ceremonies and the official birthday party for the Army in gym clothes, only to be chewed out by superiors.
The Army has tried to re-create the organization of a typical military unit at Walter Reed. Soldiers are assigned to one of two companies while they are outpatients the Medical Holding Company (Medhold) for active-duty soldiers and the Medical Holdover Company for Reserve and National Guard soldiers. The companies are broken into platoons that are led by platoon sergeants, the Army equivalent of a parent.
Under normal circumstances, good sergeants know everything about the soldiers under their charge: vices and talents, moods and bad habits, even family stresses.
At Walter Reed, however, outpatients have been drafted to serve as platoon sergeants and have struggled with their responsibilities. Sgt. David Thomas, a 42-year-old amputee with the Tennessee National Guard, said his platoon sergeant couldn't remember his name. "We wondered if he had mental problems," Thomas said. "Sometimes I'd wear my leg, other times I'd take my wheelchair. He would think I was a different person. We thought, 'My God, has this man lost it?' "
Civilian care coordinators and case managers are supposed to track injured soldiers and help them with appointments, but government investigators and soldiers complain that they are poorly trained and often do not understand the system.
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."
The lack of accountability weighed on Shannon. He hated the isolation of the younger troops. The Army's failure to account for them each day wore on him. When a 19-year-old soldier down the hall died, Shannon knew he had to take action.
The soldier, Cpl. Jeremy Harper, returned from Iraq with PTSD after seeing three buddies die. He kept his room dark, refused his combat medals and always seemed heavily medicated, said people who knew him. According to his mother, Harper was drunkenly wandering the lobby of the Mologne House on New Year's Eve 2004, looking for a ride home to West Virginia. The next morning he was found dead in his room. An autopsy showed alcohol poisoning, she said.
"I can't understand how they could have let kids under the age of 21 have liquor," said Victoria Harper, crying. "He was supposed to be right there at Walter Reed hospital. . . . I feel that they didn't take care of him or watch him as close as they should have."
The Army posthumously awarded Harper a Bronze Star for his actions in Iraq.
Shannon viewed Harper's death as symptomatic of a larger tragedy the Army had broken its covenant with its troops. "Somebody didn't take care of him," he would later say. "It makes me want to cry. "
Shannon and another soldier decided to keep tabs on the brain injury ward. "I'm a staff sergeant in the U.S. Army, and I take care of people," he said. The two soldiers walked the ward every day with a list of names. If a name dropped off the large white board at the nurses' station, Shannon would hound the nurses to check their files and figure out where the soldier had gone.
Sometimes the patients had been transferred to another hospital. If they had been released to one of the residences on post, Shannon and his buddy would pester the front desk managers to make sure the new charges were indeed there. "But two out of 10, when I asked where they were, they'd just say, 'They're gone,' " Shannon said.
Even after Weightman and his commanders instituted new measures to keep better track of soldiers, two young men left post one night in November and died in a high-speed car crash in Virginia. The driver was supposed to be restricted to Walter Reed because he had tested positive for illegal drugs, Weightman said.
Part of the tension at Walter Reed comes from a setting that is both military and medical. Marine Sgt. Ryan Groves, the squad leader who lost one leg and the use of his other in a grenade attack, said his recovery was made more difficult by a Marine liaison officer who had never seen combat but dogged him about having his mother in his room on post. The rules allowed her to be there, but the officer said she was taking up valuable bed space.
"When you join the Marine Corps, they tell you, you can forget about your mama. 'You have no mama. We are your mama,' " Groves said. "That training works in combat. It doesn't work when you are wounded."
Frustration at Every Turn
The frustrations of an outpatient's day begin before dawn. On a dark, rain-soaked morning this winter, Sgt. Archie Benware, 53, hobbled over to his National Guard platoon office at Walter Reed. Benware had done two tours in Iraq. His head had been crushed between two 2,100-pound concrete barriers in Ramadi, and now it was dented like a tin can. His legs were stiff from knee surgery. But here he was, trying to take care of business.
At the platoon office, he scanned the white board on the wall. Six soldiers were listed as AWOL. The platoon sergeant was nowhere to be found, leaving several soldiers stranded with their requests.
Benware walked around the corner to arrange a dental appointment his teeth were knocked out in the accident. He was told by a case manager that another case worker, not his doctor, would have to approve the procedure.
"Goddamn it, that's unbelievable!" snapped his wife, Barb, who accompanied him because he can no longer remember all of his appointments.
Not as unbelievable as the time he received a manila envelope containing the gynecological report of a young female soldier.
Next came 7 a.m. formation, one way Walter Reed tries to keep track of hundreds of wounded. Formation is also held to maintain some discipline. Soldiers limp to the old Red Cross building in rain, ice and snow. Army regulations say they can't use umbrellas, even here. A triple amputee has mastered the art of putting on his uniform by himself and rolling in just in time. Others are so gorked out on pills that they seem on the verge of nodding off.
"Fall in!" a platoon sergeant shouted at Friday formation. The noisy room of soldiers turned silent.
An Army chaplain opened with a verse from the Bible. "Why are we here?" she asked. She talked about heroes and service to country. "We were injured in many ways."
Someone announced free tickets to hockey games, a Ravens game, a movie screening, a dinner at McCormick and Schmick's, all compliments of local businesses.
Every formation includes a safety briefing. Usually it is a warning about mixing alcohol with meds, or driving too fast, or domestic abuse. "Do not beat your spouse or children. Do not let your spouse or children beat you," a sergeant said, to laughter. This morning's briefing included a warning about black ice, a particular menace to the amputees.
Dress warm, the sergeant said. "I see some guys rolling around in their wheelchairs in 30 degrees in T-shirts."
Soldiers hate formation for its petty condescension. They gutted out a year in the desert, and now they are being treated like children.
"I'm trying to think outside the box here, maybe moving formation to Wagner Gym," the commander said, addressing concerns that formation was too far from soldiers' quarters in the cold weather. "But guess what? Those are nice wood floors. They have to be covered by a tarp. There's a tarp that's got to be rolled out over the wooden floors. Then it has to be cleaned, with 400 soldiers stepping all over it. Then it's got to be rolled up."
"Now, who thinks Wagner Gym is a good idea?"
Explaining this strange world to family members is not easy. At an orientation for new arrivals, a staff sergeant walked them through the idiosyncrasies of Army financing. He said one relative could receive a 15-day advance on the $64 per diem either in cash or as an electronic transfer: "I highly recommend that you take the cash," he said. "There's no guarantee the transfer will get to your bank." The audience yawned.
Actually, he went on, relatives can collect only 80 percent of this advance, which comes to $51.20 a day. "The cashier has no change, so we drop to $50. We give you the rest" the $1.20 a day "when you leave."
The crowd was anxious, exhausted. A child crawled on the floor. The sergeant plowed on. "You need to figure out how long your loved one is going to be an inpatient," he said, something even the doctors can't accurately predict from day to day. "Because if you sign up for the lodging advance," which is $150 a day, "and they get out the next day, you owe the government the advance back of $150 a day."
A case manager took the floor to remind everyone that soldiers are required to be in uniform most of the time, though some of the wounded are amputees or their legs are pinned together by bulky braces. "We have break-away clothing with Velcro!" she announced with a smile. "Welcome to Walter Reed!"
A Bleak Life in Building 18
"Building 18! There is a rodent infestation issue!" bellowed the commander to his troops one morning at formation. "It doesn't help when you live like a rodent! I can't believe people live like that! I was appalled by some of your rooms!"
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.
"I've been close to mortars. I've held my own pretty good," said Spec. George Romero, 25, who came back from Iraq with a psychological disorder. "But here . . . I think it has affected my ability to get over it . . . dealing with potential threats every day."
After Spec. Jeremy Duncan, 30, got out of the hospital and was assigned to Building 18, he had to navigate across the traffic of Georgia Avenue for appointments. Even after knee surgery, he had to limp back and forth on crutches and in pain. Over time, black mold invaded his room.
But Duncan would rather suffer with the mold than move to another room and share his convalescence in tight quarters with a wounded stranger. "I have mold on the walls, a hole in the shower ceiling, but . . . I don't want someone waking me up coming in."
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!' "
Staff researcher Julie Tate contributed to this report.
source: 2mar2007
|
To
send Mindfully.org your comments, questions, and suggestions click
here |