Troubles At Walter Reed — A Disturbing Report

Circa 2007

Building 18: It’s a structure where holes and peeling wallpaper are normal, where mold infests the air and where roaches go to die.

It’s a brick wall away from drug deals, and only five miles from the White House.

It’s an outpatient holding facility of Walter Reed Army Medical Center.

Nobody guaranteed the Ritz, mind you, but soldiers who come here to rehabilitate—upwards of 700 injured while fighting in Iraq and Afghanistan—might have expected something a bit more upscale.

Some vets have even found that after completing treatment, they’re still not free to go. Their biggest problem, according to reports, isn’t their sub-par living quarters, to which many have been assigned, but the sluggish paperpushing that prevents them from getting out and on with their lives.

In a series of articles, The Washington Post has chronicled Walter Reed’s pitfalls. The paper’s ongoing coverage of the dilapidated outpost station a k a Building 18, and other holding areas for recovering and rehabilitating patients, relied on interviews of soldiers, their families and even staff members to give their accounts of how checking into the facility was a well-oiled process but that checking out was—and continues to be—a nightmare.

On the way in, injured soldiers pass through a process that can take them from the Iraqi desert to a medical center in Germany and on to Walter Reed in Washington DC in as few as 48 hours. But many soldiers and their families told the Post that getting out can take as many as 16 months as they were forced to trudge through paperwork, miscommunication and misinformation.

“I was sick from the standpoint of feeling badly that we were not providing to our wounded troops the end-toend care that they deserve,” said Chairman of Joint Chiefs of Staff Peter Pace at a recent news conference. He added that he had routinely asked vets and their families how they were doing, and felt assured by them that they were receiving the very best care possible. But the issue with Walter Reed isn’t from patients, it’s from outpatients—soldiers who have received care, and haven’t yet been released.

Patients and their families report of how leaving the facility required that they complete a series of 22 documents, which hopelessly bogged down the process. They told of how databases failed to work with each other, often convoluted records or even lose track of soldiers who have spent, in many cases, the last year fighting for their country.

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These kinds of delays have kept them in living quarters such as Building 18, isolated from progress and rehabilitation, and as the Post reported, keeping many soldiers from speaking to case managers for weeks. Some vets would be sick, and yet put in charge of others who were also sick, and would become so frustrated that they would pack their bags and leave without telling anyone.

During a news conference in late February, the Army’s former Surgeon General Kevin C. Kiley questioned Walter Reed’s harsh portrayal saying, “I’m not sure it was an accurate representation.” The Army, however, has not denied any of the report’s allegations. In fact, officials have confirmed the problems and pledged change in the future.

“I think I did something unheard of in this town. I actually thanked the reporters for bringing it to our attention,” Secretary of Defense Robert M. Gates said last March on CBS’s Face the Nation, acknowledging that he now receives updates every two weeks on the progress of corrective action.

“Frankly, like everybody else I was both angered and offended by the fact that we had allowed a situation to develop that made the hospital administration… an adversary rather than an ally,” Gates continued, noting that he still considers the medical staff and care at the beleaguered facility first-class. “The doctors and nurses and staff at Walter Reed are the best in the world. They’re immensely dedicated, they’re immensely talented and we owe a lot to them.”

During congressional hearings, many soldiers, families and current and former staff members staunchly supported Walter Reed’s medical services for saving the lives of veteran soldiers.

Walter Reed employs approximately 600 full-time physicians, 600 military and civilian registered nurses and 550 licensed practical nurses and para-professionals.

“But in several areas relating to service, members recuperating from injury or seeking to move forward with their lives, we have fallen short,” Dr. David S.C. Chu wrote in a late March response in USA Today. Chu, who is undersecretary of defense for personnel and readiness, went on to say: “To those adversely affected, and to the American public, I apologize. We are identifying and correcting the shortcomings.”

Identification may be the easy part. The Post reports have certainly done that through first-hand accounts of individuals who had to live with those shortcomings, work in those environments and struggled to find hope for future.

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“There will be no excuses, only action,” Vice President Cheney told a veterans group shortly after the reports became breaking news. “We’re going to fix the problems at Walter Reed, period.”

President Bush concurred, adding, “Some of our troops at Walter Reed have experienced bureaucratic delays and living conditions that are less than they deserve.” In that same speech to an American Legion meeting in Washington, he added, “It’s unacceptable to me, it is unacceptable to you, it’s unacceptable to our country, and it’s not going to continue.”

Though corrective action has already begun, the trouble spots continue to fall under a microscope.

“There are a number of metrics that can and will be used to measure the success of our efforts. At the top of the list will be customer satisfaction,” said Dr. William Winkenwerder Jr., assistant secretary of defense for health affairs. “Our wounded men and women deserve only the best medicine, treatment and care, and it is the position of Department of Defense that we will do everything in our power to ensure that for them.”

Defense Secretary Gates formed a Pentagon review board of eight members in early March, and scheduled hearings to determine what exactly went wrong in the communication breakdown at Walter Reed, not to mention the environment of Building 18. “Several task forces are assessing the entire spectrum of support to our service members,” Winkenwerder said. “They have short timelines to report findings, and we will have short timelines to implement their recommendations.”

Both the Army and the Department of Defense have stuck to their word that they would act swiftly, setting off the following flood of activity:

March 2, 2007: Army Secretary Francis Harvey was forced out as the head of Walter Reed Medical Center.

March 9: Army Gen. Richard Cody, the vice chief of staff, announced leadership changes to Walter Reed’s medical hold units. Among the changes were the appointment of Army Brig. Gen. Michael S. Tucker as deputy commanding general of Walter Reed, a new position at the medical center, which deals strictly with the administrative process. “He’s going to be the guy that we look to to be the soldiers’ and families’ advocate as they go through inpatient and outpatient, but he’s going to be the ‘bureaucratic buster’… and take on this bureaucracy that at times frustrates our soldiers,” Cody told The American Forces Press Service.

March 11: Lt. Gen. Kevin C. Kiley, the Army’s former surgeon general, who headed Walter Reed from 2002- 2004 and again earlier this year, requested retirement.

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—Maj. Gen. Gale S. Pollock was immediately promoted to the surgeon general position, the first non-physician to hold the post.

March 14: Maj. Gen. George W. Weightman was relieved of his command at Walter Reed.

—The first of two public hearings were held where soldiers detailed their treatment at Walter Reed for three hours before the Pentagon review board.

March 19: Army officials launched a “Wounded Soldier and Family Hotline” to help get information or assistance to those with medical issues.

“Recent events made it clear the Army needs to revise how it meets the needs of our wounded and injured soldiers and their families,” Army officials said in a statement coinciding with the hotline’s launch. “In certain cases, the soldiers’ chain of command could have done a better job in helping resolve medically related issues.

“The Army’s intent is to ensure wounded and injured soldiers and their families that they receive the best medical care possible. The Army chain of command will ensure every soldier is assisted in navigating the military health-care system.”

Secretary Gates acknowledged that the health-care hotline has begun to receive calls, and he noted that having the care of soldiers scrutinized is a positive action in the larger scene.

“We learn from our mistakes,” Winkenwerder said. “In the Department, we have a track record for recognizing how and why things have gone wrong, and then fixing them.”

Vice Chief of Staff Cody took it a step further: “This national dialogue we’re having right now, I think, is very helpful,” he said. “It’s a national dialogue as to what this country owes to these servicemen and women who have raised their right hand during war and enlisted, or raised their right hand again during war and re-enlisted, and said, ‘America, in your time of need, I will go forward and defend you.’

“What does this country owe them when they do get wounded? Certainly not a bureaucratic system that makes them have to argue or stay longer so they get the right benefits and the right security for the sacrifice that they have given.”

by Josh Pate

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