Tuesday, May 6, 2008

The House Veterans Affairs Committee chairman accuses VA of criminal negligence, he should have included the DoD as well.

Dr. Ira Katz got caught lying to the press about suicide rates for veterans so he is now standing before the man. Of course James Peake, Veterans Affairs Secretary, defended Katz because he is largely responsible for the scandalous lack of preparation to handle troops returning from OIF/OEF with neurological and psychiatric problems. James Peake was the US Army Surgeon General from 2000 to 2004. During his tenure, his senior staff officers rejected the implementation of programs that would have dealt not only with mental health issues but also traumatic brain injury. US Army clinicians and researchers attached to Walter Read Army Medical were prepared to implement technology and protocols to deal with these issues before the Afghanistan deployment. AMEDD, the Army Medical Department, represented that they were prepared in 2002 even though it was not; and still isn't.

It is time for the Senate and House to call to account the entire chain of command from DoD and US Army Medcom as they have been responsible for one of the largest medical disasters in US history. Between 400,000 and 750,000 troops have been injured, gone unidentified and are untreated. No one knows who they are. Our jails, homeless shelters, drug rehab clinics and morgues will fill with veterans from these conflicts. This is a crime. It is medical negligence on a grand scale. It is time to go back an investigate the actions and lack of action taken by the DoD and US Army from 2001 forward. Senior officers, the rank of colonel or higher, responsible for epidemiology, traumatic brain injury and mental health should be called before the public, made to explain themselves, and summarily fired. If they are a member of the allied medical professions, their licenses should be revoked.

US Air Force Medcom should be empowered to take over these programs without the oversight of DoD or the involvement of the Joint Services “Red Cell.” The Air Force should further be directed to use the civilian medical sector, particularly the nation’s research hospitals, to treat the massive backlog of wounded active service members and veterans. (The VA should be left to deal with the aging veterans of past wars. It will take years to cure its gross mismanagement.) A hub and spoke system should be implemented similar to the highly successful NCCN cancer program. The objective would be to treat simple cases as close to the veterans homes as possible and complex cases at our finest medical centers that have the resources to handle the most complex injuries.

The $900MM of funding that congress allocated for mental health and traumatic brain injury is being squandered. Research has been delayed and solutions gone unimplemented. The Army’s objective has been to use faulty screening instruments (ANAM), faulty research (the problems related to TBI are transient and stress related), and faulty clinical practice (12 beds for patients in a vegetative state when there is need for 400 – the poly trauma centers are not what they were cracked up to be) in order to demonstrate that they are doing everything. It is pure nonsense.

This is not to say the VA, US Army, and US Navy don’t have some extraordinary practitioners. The field medical personnel of these wars should be lionized as they have demonstrated the resolve to do the undoable. Regrettably, these gallant men and women are not in-charge. Many are separating from the service as quickly as is practical due to incompetent leadership. People like the disgraced general, Kevin Kiley, are in-charge. Follow the party line, don’t report the wounded and don’t treat them. God forbid the Army may have to pay disability for injuries that don’t involve an amputation or blindness. TBI is like a sports injury. Sure! If they understood how serious many sports concussions can be, they would shut up. These blast injuries are far more complex and more serious, but research was repeatedly disrupted or blocked. I will not bother to rant about mental health as the military posture is so outdated it defies comment.

Call your congressmen and demand action. The current buffoons that have abused our troops will exit with this administration, but our active service members and veterans need help now.

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