Fred Swallow, an Iraq veteran who was diagnosed with a traumatic brain injury, said the VA should be doing more for those living in rural areas.
(Photo: Globe Staff Photo / Bill Greene)
We honor our war dead this Memorial Day weekend. The greatest respect we could pay them would be to pledge no more wars for erroneous and misleading reasons; no more killing and wounding except for the defense of our country and our freedoms.
We also could honor our dead by caring for the living, and do better at it than we are right now.
There has been a flurry of allegations concerning neglect, malpractice and corner-cutting at the Veterans Administration, especially for those suffering from Post-Traumatic Stress Disorder - PTSD - or major depression, brought on by combat.
A report released by the Rand Corporation last month indicates that approximately 300,000 Iraq and Afghanistan war veterans suffer PTSD or major depression. That's one of every five military men and women who have served over there.
Last Friday's Washington Post reported the contents of an email sent to the staff at a VA hospital in Temple, Texas. A psychologist wrote, "Given that we are having more and more compensation-seeking veterans, I'd like to suggest that you refrain from giving a diagnosis of PTSD straight out." She further suggested that a diagnosis of a less-serious Adjustment Disorder be made instead, especially as she and her colleagues "really don't ... have time to do the extensive testing that should be done to determine PTSD."
Now, PTSD is not a diagnosis arrived at without careful, thorough examination. But to possibly misdiagnose such a volatile and harmful disorder for the sake of saving time or money is reprehensible.
Veterans Affairs Secretary James Peake immediately said the psychologist's statement had been "repudiated at the highest level of our health care organization." Nonetheless, there's plenty of other evidence to raise concern.
The rate of attempted and successful suicides is so scary that the head of the VA's mental health division, Dr. Ira Katz, wondered in a February email how it should be spun. "Shh!" he wrote. "Our suicide prevention coordinators are identifying about 1,000 suicide attempts per month among the veterans we see in our medical facilities. Is this something we should (carefully) address ourselves in some sort of release before someone stumbles on it?"
This apparent cover-up prompted the House Veterans Committee to hold hearings earlier this month. Representative Bob Filner, committee chairman, questioned Dr. Katz and Veterans Affairs Secretary Peake. "What we see is a pattern that reveals a culture of bureaucracy," Filner angrily said. "The pattern is deny, deny, deny and when that fails, it's cover up, cover up, cover up - there is clear evidence of a bureaucratic cover-up here ..."
Filner raised the question of criminal negligence. "We should all be angry about what has gone on here," he declared. "This is a matter of life and death for the veterans that we are responsible for, and I think there was criminal negligence in the way this was handled. If we do not admit, assume or know, then the problem will continue and people will die. If that's not criminal negligence, I don't know what is."
Secretary Peake said, "I can appreciate that the number of 1,000 suicide attempts a month might be shocking, but in a system as large as ours ... and consistent with the literature, we might well expect a larger number of attempts than that."
The front page of Sunday's Houston Chronicle featured an in-depth study of just one of the suicides - Bronze Star recipient Nils Aron Andersson of the 82nd Airborne Division. "A Victim of the War Within," reads the Chronicle headline.
Andersson returned home from two tours in Iraq and was reassigned to duty as an Army recruiter. "Did he come back different?" his father asked. "I don't think there's anybody who goes over there and fights on the front lines who ever comes back the same."
In March 2007, Andersson sat behind the wheel of his new Ford pick up - less than 24 hours after his wedding - and fired a single round from a .22-caliber semi-automatic into his right temple. He was 25 years old.
"I don't think Aron let the Army down," his father said. "I think the Army let him down. I think the care wasn't there that he really needed."
Only about half of those service members diagnosed with PTSD or depression have sought treatment, and about half of those received what the RAND study describes as "minimally adequate treatment." Minimally adequate treatment for what could be a matter of life and death.
Once upon a time, kids asked their fathers, "What did you do in the war, daddy?" It's a question the next generation could ask all of us who stood by as our government invaded Iraq to start a war whose purpose and rationale keep shifting and whose end is nowhere in sight, and who look now with nonchalance upon the unseen scars of those who are fighting it.
Bill Moyers is managing editor and Michael Winship is senior writer of the weekly public affairs program, "Bill Moyers Journal," which airs Friday nights on PBS. Check local airtimes or comment at The Moyers Blog at www.pbs.org/moyers. A video of the on-air version of this essay delivered by Mr. Moyers can be found on YouTube at http://youtube.com/watch?v=EoTn92RJlbk.