Wednesday, February 21, 2007

The Blame Game

Dr. Harvey issued a statement laying the blame for the outpatient mess at WRAMC squarely on the shoulders of the chain of command.
Army Secretary Francis Harvey blamed a failure of leadership for substandard conditions in a building that is part of Walter Reed Army Medical Center and vowed Tuesday to move quickly to fix the problem.

"We failed here, we failed in having a facility like this," Harvey told CNN. "Unfortunately, it's a leadership problem."
(Emphasis Added)

A commander is responsible for everything his unit does or fails to do. However, the commander of a hospital is bound by several things: patient needs, civilian workforce contracts, available manpower, and of course, budget.

I remember the "fun" we had just trying to go home from WRAMC. The administrators seemed shocked that anyone wanted to go home and stay, as opposed to just living there indefinitely and taking convalescent leave after convalescent leave. We first had to figure out who we needed to see, then get the right papers, then get them signed/filled/stamped correctly, turn them in to the right people, then get more papers stamped/signed/filled, ad infinitum. It was a viscious cycle that made many refer to Walter Wunnerful as a P.O.W. camp--Prisoner of WRAMC. And this was to leave, not stay! Eventually, I had to type and submit my own orders assigning me (detaching me from MedHold and reassigning me) back to Fort Riley. (I didn't "generate" the orders, I actually did the work in the Army system to have the orders cut. Good thing I had done penance as a personnel officer prior to taking command.)

Then I had to clear post, just like any other soldier who had been assigned there, going to various agencies (PX, bank, commissary, library, Medical Records, etc) collecting signatures to prove I didn't have any outstanding debts with them. Lots of fun when all you want to do is go to OT/PT and sleep. The thing is, I wasn't "assigned" to WRAMC. The medhold company cut me orders assigning me to them, but Big Army still tracked me with my unit rear-detachment. Knowing this, I had some wiggle room to bend and twist reality as I saw fit. Having a rear-detachment commander at Fort Riley who truly did care about me and my family made all the difference. I still remember him telling me "Bullshit! You're still on my books, you haven't out-processed here, so you can't in-process there! Screw those monkeys!"--or words to that effect. Knowing that your true chain of command is on your side is a huge determinant of success. (By the way, thanks again MAJ Stowell.)

Believe it or not, the chain of command at med hold actually reviews the lists of people going to morale events--to the Pentagon welcome home ceremony, concerts, movies, even Fran Obrien's--to see if soldiers are able to work. Their thinking: if you can go do this stuff, then you can do work for med hold company. Sitting at a desk doing mindless tasks for eight hours is SO much like visiting the Chairman of the Joint Chiefs for a two hour picnic. It is so bad that they often pair tow cripples together, so they can keep each other awake, despite all the painkillers. It's also pretty common to see spouses just sitting at the desk with their soldier, to make sure that they are okay--often, the soldiers are unconscious or barely conscious, in their painkiller induced stupor--but they do these jobs because someone decided that they couldn't just stay in their rooms, and besides, they manage to have the energy to go on these trips, right?

The med hold company has serious leadership issues. The job is a cast-off position, I think it is given to anyone caught not paying attention at staff meetings. The "Platoon Sergeant" I had was a civilian, who until very recently had been in the Army, and since retired, only to take the same job as a civilian employee. We had our 0700 formation, so he could get accountability, except he wasn't there because his contract listed his hours as 0900-1700. I think I went to two of these formations before I remembered that I was just senior enough (and definitely drugged enough) to blow off all of these formations, if they wanted me, they'd find me. I called in a couple of times after that, just to let them know I was still breathing, but after playing the "You're who? and Why are you calling?" game, I just gave up altogether.

Now, they do have problems that the wounded soldiers themselves cause. The Mologne house was a 24-7 party of sorts while I was there.
"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 Mologne house didn't "let" him have liquor, nor did the hospital--his own "friends" let him have the booze. A lot of these unsupervised young soldiers decide to sit outside the Mologne house and drink. They drink a lot. They are often joined by their wives, girlfriends, and parents, who readily fill their glasses. They are more than willing to share with the other wounded, because, after all, "You've bled for your country, you should be able to drink, right? Who cares if you're underage, or already taking a shoebox foll of meds that all say "do not mix with alcohol."
These soldiers sit and drink, and drink, and drink. Either they buy the booze on post, or at one of the dozens of liquor stores populating the slums immediately off-post. No one has the cajones to tell them to knock it the hell off, or threaten to punish them for endangering their treatment, care, or other soldiers, because after all, these are our wounded heroes, who wants heat from a conrgessman for giving them an Article 15? As far as leadership failure goes, that's called making the easy wrong choice instead of the hard right choice. The only change I've seen to policy regarding the booze is a set schedule for boozing it up--party hour starts at 1600, and the amount of booze allowed in the room is limited to 1 six-pack or 1 bottle of wine, and no hard liquor. This would work, except no one checks up on these things ("Well, I wrote the policy, of course the men will follow it!")

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.

General Cody was on CNN this morning, and admitted he'd never visited the building, didn't even know about it. He apologized for that, and stood there, like a good leader, and shouldered the blame. (Take note, Dr. Harvey--You're in charge of the Whole Army, and if the SECDEF is responsible for Abu Gharib, you are to blame for this, too.) I've yet to see anyone from WRAMC standing there on camera or otherwise taking the blame. The living conditions, the canyon-wide cracks in the bureaucracy, the shoddy maintenance, the pay problems, the uniform issue problems (by the way, officers are NOT authorized a replacement uniform. We have to buy our uniforms, although only the enlisted get a uniform allowance. This makes twice in my career a uniform has been cut off by medical personnel, and twice I've had to pay to replace the uniform.)
The simple fact that it took someone who was taking enough painkillers to hobble a small horse, someone who couldn't use his hands--to figure out how to make a laptop work without a mouse or keyboard and then figure out how to get similar systems into the stumps of the men who need them, and then get the program fully funded by donations--is appalling. there was no one in the WRAMC bureaucracy looking out for the needs of the patients, or trying to anticipate special needs of patients. Everything, even the building repairs, is react, react, react. There is no initiative or anticipation of problems before they arise. There are only unpleasant surprises.

Look at the charities who help the wounded--whether flying them or their families to hospitals, making Velcro clothes so they can dress themselves, helping to take care of the soldier's kids, getting them a drastically discounted rental vehicle so they can get from hospital to hotel and back, et cetera, et cetera, ad nauseam. Every single gap that a charity had to fill equates to a leadership failure--a failure to recognize the unique needs of the soldiers and their families. Please don't misconstrue this as my dislike of charities, the exact opposite is true, they are lifesavers. But when a wounded soldier has to rely on the sympathy and charity of others to simply live day to day, to meet his most basic needs, then the Army, and the government as a whole, has failed them.

As a leader in the Army, who has gone through this system, I SHOULDER PART OF THE BLAME FOR NOT TRYING TO FIX THE PROBLEM. I left my brothers behind, and got myself home. After recovery, I moved on to other things, even though the complaints made today are the same as they were 2 years ago. Families are in the dark, medhold is a ridiculous and poor taste joke and apparent cover-your-ass move by the chain of command. I am an officer. I am a leader. By allowing this to happen, and continue to happen, I am at fault for not getting it fixed earlier or fixing it myself.

Other people who share the blame: The soldiers and family members who didn't use normal channels, like the Inspector General, the Chain of Command, or even letters to congressmen to fix the problem. They ran to the press, and embarrassed the Army. The chain of command, and more to the point, the NCO support channel and "chain of concern." Every Sergeant from the newly-minted Corporal to the Command Sergeant Major is tasked with looking out for the health, safety, and welfare of the soldier, and advising the command on the soldier's needs. As a matter of fact the ONLY role of a Command Sergeant Major is to advise the commander on enlisted matters. Clearly, the ignorance of these issues by the chain of command indicated an extreme dereliction of duty on the part of the Non Commissioned Officer (Hey CSM: maybe if you'd spent more time with the soldiers at the Mologne house, Fisher house, and other places the wounded congregate, instead of chasing me another 25 feet up the hill to the designated smoking area; or making sure that there were plenty of signs in the right areas to tell people they couldn't smoke there.)

Maybe you, hospital commander, and all of your high-ranking staff could move your designated parking spots to the other side of post, forcing yourselves to walk up and down the hill to the Mologne house every day, through winter's ice and snow, spring's rain, and summer's heat, just like the men on prosthetic legs and wheelchairs do. (But hey, thanks bunches for the chain link handrail, it sure does come in handy when trying to pull yourself up the hill.

As a company commander, I made time to walk through my billets, and even in combat I made soldier's living conditions a priority. I agree with Dr. Harvey. The command is to blame for this. I will accept the challenge of fixing it, assuming that I receive the commensurate promotion and pay raise. It'll be fixed in 6-12 months--but I need the authority to hire and fire anyone working on Walter Reed, military and civilian, to move people and organizations as I deem necessary, and the authority top bring in other officers and soldiers who I know will get the job done. (not that it'll happen, but hey, I'd take the job in a heartbeat.

The rooms are getting fixed. Good thing the WaPo sat on this for four months while developing the story. I wonder how many lung infections and other illnesses were suffered in that time because you wanted a better headline. they are truly on the side of the soldier, as long as it benefits them. The fact that WRAMC and even the VA hospitals are like this, and that most people only find out about it in the news is indicative of a much larger problem: the ordinary citizen, Mr. and Mrs. John Q. Public, have never so much as driven by or on one of these facilities. They have no primary or secondary connection with soldiers or veterans, the thought has never occurred to them to bother themselves finding out if the defenders of their freedom are taken care of. They take for granted simple rights like voting, religion, and speech, and never give pause to consider the sacrifices made to ensure those freedoms, or thank the men and women who made it possible, or give two shits about them as they lay dying in some underfunded, understaffed VA "hospital". They spend their veteran's and memorial days watching TV, or cooking out, maybe taking a family trip. Why waste their three-day weekend visiting a hospital? There's a sale at JCPenneys!

With the exception of a very few, and I do mean a minuscule percent of the population, a group of Angels and everyday heroes, America. Just. Doesn't. Care. This will only be of concern to politicians as long as it is politically expedient to garner votes, support, or just good press, then it'll go in the trashheap, just like all the broken toy soldiers.


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