Wednesday, February 28, 2007

Walter Reed: The Continuing Saga

February 27 Army Times -

The story ostensibly portrays many activities that the Walter Reed commander undertook as "CYA". However, I wanted to point out some things that did occur that are obviously not in keeping with the title and implications of the story.

Soldiers at Walter Reed Army Medical Center’s Medical Hold Unit say they have been told they will wake up at 6 a.m. every morning and have their rooms ready for inspection at 7 a.m., and that they must not speak to the media.

“Some soldiers believe this is a form of punishment for the trouble soldiers caused by talking to the media,” one Medical Hold Unit soldier said, speaking on the condition of anonymity.

It is unusual for soldiers to have daily inspections after Basic Training.

Technically, these soldiers are "active duty" which means the military can tell them what they can or cannot say to the media within certain parameters. Most units have a PAO or Public Affairs Office that handles inquiries and directs media. Thus, the command is not outside of what the military does in other units or outside of its pervue. However, the direction to stop talking to the media is very likely in direct reaction to the bad publicity the military medical command received from the Washington Post series of articles and the subsequent internet barrage.

What I find interesting is the comment regarding room inspections. In general, Building 18 has been rather informal. However, the recent Post articles pointed out that soldiers were drinking heavily in their rooms, possible death or injury of one or more from alcohol poisoning or narcotics, under age drinking (against the law even in the military), possible suicides or suicidal tendencies, PTSD events and, of course, the condition of the rooms from the walls, to ceilings to bathrooms and plumbing.

While it may seem harsh from a civilian perspective, particularly in light of the condition of some of the soldiers, it is a rather military response to the conditions. The only way to know is to inspect. That may, in fact, seem like "punishment", particularly to those who were not involved in the original complaint and interview or who do have issues.

Difficulties in this process will still arise because many of the patients are not fit enough or beyond pain meds in order to perform a military type cleaning of their own rooms. Still, there are others who are simply waiting to be processed for reasons only the military can sort out that are not beyond certain capabilities.

On a side note, it has been recommended by the VA and other top psychiatric professionals that getting back to "normal" routine after a traumatic event can be a stabilizing factor. On the other hand, I can't speak for the physical or psychiatric health of all the patients currently residing there. This may be helpful to some and detrimental to others. A more refined process for identifying the "cans" from the "can't" may need to be instigated or is already available. Finally, some are awaiting the completion of their treatment, a Medical Exam Board (MEB) indicating their condition and processing back to their active duty units as "fit". It may be appropriate to maintain "good military order" and not allow soldiers to slip into conditions or activities that would be detrimental to their ability to be deployed.

Like the military instigating across the board actions, the story is also rather broad in its brush strokes implying that these actions are above and beyond or that all those at Building 18 are beyond these capabilities.

Here is another piece of the "good and the bad":

Soldiers say their sergeant major gathered troops at 6 p.m. Monday to tell them they must follow their chain of command when asking for help with their medical evaluation paperwork, or when they spot mold, mice or other problems in their quarters.

"Follow the chain of command" has a lot of implications and purposes. First, this is the military's directive in almost all situations that is supposed to insure good discipline and order. It is also a nice cover to say the military wants "first crack" at fixing things. Obviously, they hadn't done such a good job previously, but the story looks like the first "casualties" of the investigation have already been "re-assigned" or "relieved".

The soldiers said they were also told their first sergeant has been relieved of duty, and that all of their platoon sergeants have been moved to other positions at Walter Reed. And 120 permanent-duty soldiers are expected to arrive by mid-March to take control of the Medical Hold Unit, the soldiers said.

I doubt these will be the last. Officers in the administration will be next, but the process will require a slightly different tact. Needless to say, this has probably ended the career of several administrative officers, some of which may not even know it yet.

Continuing on with the "chain of command" directive, I would like to point out that, even in the military, "follow the chain of command" doesn't mean that you are forever relegated to only speaking with the platoon leader or officer directly above you. It means to follow the process first in bringing issues to your immediate "supervisor", possibly doing so in writing a second time and then seeking out the next "command" element in line, ostensibly until you get results. Much like the civilian world of management, except that breaking that chain can be much more difficult in the military. Still, it doesn't exactly mean "shut up and get back in your place".

The best parts of the article were almost glossed over, probably with no help from the PAO (Public Affairs Office - who apparently declined to return calls). The report indicated:

120 permanent-duty soldiers are expected to arrive by mid-March to take control of the Medical Hold Unit

Without additional info from the PAO, my best guess would be that these are going to be people gathered from multiple units or from a specific MPU (Medical Processing Unit) that have performed very well at their previous stations and will be tasked with quickly sorting out and moving these soldiers either out to MTF (Medical Treatment Facilities = bases with specific clinics or specialists), through their MEB (medical exam board to determine fitness for active duty), to a CHBCO (Community Health Based Care Organization - treatment near home by Tricare networked civilian healthcare), REFRAD (released from active duty) or returned to their active duty or reserve units. There are a lot of places that these soldiers could be, including home, instead of at Walter Reed and building 18.

More "good and bad" news:

They were also told they would be moving out of Building 18 to Building 14 within the next couple of weeks. Building 14 is a barracks that houses the administrative offices for the Medical Hold Unit and was renovated in 2006. It’s also located on the Walter Reed Campus, where reporters must be escorted by public affairs personnel. Building 18 is located just off campus and is easy to access.

You should have read that to mean, who knows when building 18 that actually houses the wounded was renovated, but apparently the administrative building can be renovated to make sure certain officers and administrative personnel are comfortable. It's true that Walter Reed was scheduled to be shut down and renovated completely, which may have led to the allocation of funds to the "must be renovated or repaired" to maintain working order. But, it does seem interesting that funds could be obtained for the administrative area, ostensibly by some officer or manager creating a very convincing power point, budget and improved efficacy numbers, while nearly six years into the war, no one could do the same for a place that is housing a couple hundred wounded soldiers?

This may in fact have been noted by certain people in the command structure since the other "near miss" of the paragraph says:

Building 14 is a barracks that houses the administrative offices for the Medical Hold Unit

That could be a number of things including simply identifying the best and most recently updated building on the premises to house the wounded. It could be some administrative officer got a fire lit under his freshly pressed johdpurs and decided to make the "sacrifice" as a career saving move or an attempt to improve the public image of Walter Reed. Finally, not knowing how the decision was made, it might include a little "up yours" from the brass. The brass may have decided to toss out the administration folks as a little lesson on who they were supposed to be taking care of.

The final note at the end of the article is probably also true. The military medical command wants to salvage its image. Instead of giving a full tour of Malogne House, the good AND the bad, they clamp down like a venus fly trap on rotten meat, effectively shutting out the free flow press.

However, we still have people who have been there and done that, so information will not be stopped at Walter Reed Gate.

On a final note, they are hosting a contest to rename Building 18.

My suggestion, based on the hold overs and conditions? Stalag 18.

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