The long-term wounds of Walter Reed

Army is holding back on rating troops’ disabilities to hold down costs, critics say

Despite military officials' "surprise" at recent coverage, Salon exposed inadequate care and an overwhelmed system unfriendly to vets beginning two years ago.

By Mark Benjamin

Feb. 23, 2007 WASHINGTON -- The Pentagon has scrambled this week to contain media coverage of scandalous conditions for war veterans who are outpatients at the acclaimed Walter Reed Army Medical Center in Washington. The lack of services and care, raised by articles in the Washington Post in recent days, were first exposed and brought to the attention of military officials by Salon in a series of investigative reports beginning more than two years ago. Nonetheless, with a spotlight on the problems again now, top officials are claiming they did not know about them. They are also seeking to convey the message that the problems are relatively inconsequential and will be easily fixed.

In a press conference on Wednesday, the highest civilian official in charge of the military medical program, Assistant Secretary of Defense for Health Affairs Dr. William Winkenwerder Jr., said of the failures at Walter Reed: "This news caught me -- as it did many other people -- completely by surprise." At the same time, top brass tried to keep the focus on moldy walls, mouse droppings and other squalid but easily fixed conditions reported on by the Post from Building 18, a 54-room facility just off campus from the main hospital grounds across Georgia Avenue. "We were absolutely disappointed in the status of the rooms and found delays and lack of attention to detail to the building's repairs inexcusable," Gen. Richard Cody, the Army vice chief of staff, said at the press conference.

Winkenwerder referred to the issues raised as "quality-of-life experience" problems for outpatients at Walter Reed and denied there was a systemic problem with military health care. "That is not the issue," he stated.

It was a maneuver with little promise of standing up to scrutiny. What the renewed coverage again dragged out into the open, now four years into the Iraq war, is an ongoing failure to treat a growing number of outpatients in an already overwhelmed military healthcare system. It also points to the issue of compensating veterans for their wounds over the long term, which veterans advocates say has proved to be a complicated, time-consuming process that has pit many injured soldiers against the military in a fight for dollars.

And these problems extend far beyond Walter Reed hospital. Similar disgraces have played out for outpatients recovering at Fort Stewart, Ga., and Fort Carson, Colo., according to other media reports. Steve Robinson, director of Veterans Affairs at Veterans for America, has been visiting soldiers at Walter Reed and at other installations across the country since the beginning of the war. He calls the situation a national failure. >>>cont

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COLATORAL DAMAGE

18 th Feb 2005 it was out there, it was posted at Rebelle, and it will be off the front pages in a week or 2, you can be assured The GOP cares for its military

Expose on Very Serious Problems at Walter Reed: Behind the Walls of Ward 54

Article Title: Expose on Very Serious Problems at Walter Reed: Behind the Walls of Ward 54

http://www.veteransforcommonsense.org/?Page=Article&ID=2852

The facts surrounding the case of Army Master Sgt. James Curtis Coons are very shocking. The full story shown below describes how poorly our Nation's wounded, injured, and ill are treated at Walter Reed Army Medical Center. The bottom line is that WRAMC medical care represents a national disgrace at any time, and it is far worse during wartime.

Behind the walls of Ward 54

They're overmedicated, forced to talk about their mothers instead of Iraq, and have to fight for disability pay. Traumatized combat vets say the Army is failing them, and after a year following more than a dozen soldiers at Walter Reed Hospital, and reporter Mark Benjamin says he believes the soldiers.

Feb. 18, 2005 WASHINGTON -- Before he hanged himself with his bathrobe sash in the psychiatric ward at Walter Reed Army Medical Center, Spc. Alexis Soto-Ramirez complained to friends about his medical treatment. Soto-Ramirez, 43, had been flown out of Iraq five months before then because of chronic back pain that became excruciating during the war. But doctors were really worried about his mind. They thought he suffered from post-traumatic stress disorder after serving with the 544th Military Police Company, a unit of the Puerto Rico National Guard, the kind of unit that saw dirty, face-to-face combat in Iraq.

A copy of Soto-Ramirez's medical records, reviewed by Salon, show that a doctor who treated him in Puerto Rico upon his return from Iraq believed his mental problems were probably caused by the war and that his future was in the Army's hands. "Clearly, the psychiatric symptoms are combat related," a clinical psychologist at Roosevelt Roads Naval Hospital wrote on Nov. 24, 2003. The entry says, "Outcome will depend on adequacy and appropriateness of treatment." Doctors in Puerto Rico sent Soto-Ramirez to Walter Reed in Washington, D.C., to get the best care the Army had to offer. There, he was put in Ward 54, Walter Reed's "lockdown," or inpatient psychiatric ward, where the most troubled patients are supposed to have constant supervision.

But less than a month after leaving Puerto Rico, on Jan. 12, 2004, Soto-Ramirez was found dead, hanging in Ward 54. Army buddies who visited him in the days before his death said Soto-Ramirez was increasingly angry and despondent. "He was real upset with the treatment he was getting," said René Negron, a former Walter Reed psychiatric patient and a friend of Soto-Ramirez's. "He said: 'These people are giving me the runaround ... These people think I'm crazy, and I'm not crazy, Negron. I'm getting more crazy being up here.'

"Those people in Ward 54 were responsible for him. Their responsibility was to have a 24-hour watch on him," Negron said in a telephone interview from his home in Puerto Rico. While Soto-Ramirez's death was by his own hand, Negron and other soldiers say the hospital shares the blame.

In fact, repeated interviews over the course of one year with 14 soldiers who have been treated in Walter Reed's inpatient and outpatient psychiatric wards, and a review of medical records and Army documents, suggest that the Army's top hospital is failing to properly care for many soldiers traumatized by the Iraq war. As the Soto-Ramirez case suggests, inadequate suicide watch is one concern. But the problems run deeper. Psychiatric techniques employed at Walter Reed appear outmoded and ineffective compared with state-of-the-art care as described by civilian doctors. For example, Walter Reed favors group therapy over one-on-one counseling; and the group therapy is mostly administered by a rotating cast of medical students and residents, not full-fledged doctors or veterans. The troops also complain that the Army relies too much on pills; few of the soldiers took all the medication given to them by the hospital.
Perhaps most troubling, the Army seems bent on denying that the stress of war has caused the soldiers' mental trauma in the first place. (There is an economic reason for doing so: Mental problems from combat stress can require the Army to pay disability for years.) Soto-Ramirez's medical records reveal the economical mindset of an Army doctor who evaluated him.

"Adequate care and treatment may prevent a claim against the government for PTSD," wrote a psychologist in Puerto Rico before sending him to Walter Reed.

"The Army does not want to get into the mental-health game in a real way to really help people," said Col. Travis Beeson, who was flown to Walter Reed for psychiatric help during a second tour with one of the Army's special operations units in Iraq. "They want to Band-Aid it. They want you out of there as fast as possible, and they don't want to pay for it." Indeed, some psychiatric patients at Walter Reed are given the option of signing a form releasing them from the hospital as long as they give up any future disability payments from the Army. One soldier from Pennsylvania, who was shot five times in the chest and saved by body armor, told me he would do anything to get out of Walter Reed, even relinquish disability pay. "I'll sign anything as soon as I can get my hands on it," he told me several days before being released from the hospital. "I loved the Army. I was obsessed with it. The Army was my life. Fuck them now."

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