Team Infidel
Forum Spin Doctor
Newsweek
March 5, 2007
By Dan Ephron and Sarah Childress
After returning from Iraq in late 2005, Jonathan Schulze spent every day struggling not to fall apart. When a Department of Veterans Affairs clinic turned him away last month, he lost the battle. The 25-year-old Marine from Stewart, Minn., had told his parents that 16 men in his unit had died in two days of battle in Ramadi. At home, he was drinking hard to stave off the nightmares. Though he managed to get a job as a roofer, he was suffering flashbacks and panic attacks so intense that he couldn't concentrate on his work. Sometimes, he heard in his mind the haunting chants of the muezzin—the Muslim call to prayer that he'd heard many times in Iraq. Again and again, he'd relive the moments he was in a Humvee, manning the machine gun, but helpless to save his fellow Marines. "He'd be seeing them in his own mind, standing in front of him," says his stepmother, Marianne.
Schulze, who earned two Purple Hearts for wounds sustained in Iraq, was initially reluctant to turn to the VA. Raised among fighters—Schulze's father served in Vietnam and over the years his older brother and six stepbrothers all enlisted in the military—Jonathan might have felt asking for help didn't befit a Marine.
But when the panic attacks got to be too much, he started showing up at the VA emergency room, where doctors recommended he try group therapy. He resisted; he didn't think hearing other veterans' depressing problems would help solve his own. Then, early last month, after more than a year of anxiety, he finally decided to admit himself to an inpatient program. Schulze packed a bag on Jan. 11 and drove with his family to the VA center in St. Cloud, about 70 miles away. The Schulzes were ushered into the mental-health-care unit and an intake worker sat down at a computer across from them. "She started typing," Marianne says. "She asked, 'Do you feel suicidal?' and Jonathan said, 'Yes, I feel suicidal'." The woman kept typing, seemingly unconcerned. Marianne was livid. "He's an Iraqi veteran!" she snapped. "Listen to him!" The woman made a phone call, then told him no one was available that day to screen him for hospitalization. Jonathan could come back tomorrow or call the counselor for a screening on the phone.
When he did call the following day, the response from the clinic was even more disheartening: the center was full. Schulze would be No. 26 on the waiting list. He was encouraged to call back periodically over the next two weeks in case there was a cancellation. Marianne was listening in on the conversation from the dining room. She watched Jonathan, slumped on the couch, as he talked to the doctor. "I heard him say the same thing: I'm suicidal, I feel lost, I feel hopelessness," she says. Four days later Schulze got drunk, wrapped an electrical cord around a basement beam in his home and hanged himself. A friend he telephoned while tying the noose called the police, but by the time officers broke down the door, Schulze was dead.
How well do we care for our wounded and impaired when they come home? For a country amid what President Bush calls a "long war," the question has profound moral implications. We send young Americans to the world's most unruly places to execute our national policies. About 50,000 service members so far have been banged up or burned, suffered disease, lost limbs or sacrificed something less tangible inside them. Schulze is an extreme example but not an isolated one, and such stories are raising concerns that the country is failing to meet its most basic obligations to those who fight our wars.
The question of after-action care also has strategic consequences. Iraq marks the first drawn-out campaign we've fought with an all-volunteer military. In practice, that means far fewer Americans are taking part in this war (12 percent of the total population participated in World War II, 2 percent in Vietnam and less than half of 1 percent in Iraq and Afghanistan). Already, the war has made it harder for the military to recruit new soldiers and more expensive to retain the ones it has. If we fall down in the attention we provide them, who's to say volunteers will continue coming forward?
The issue of veterans' care jumped into the headlines last week when The Washington Post published a series about Walter Reed Army Medical Center in Washington, D.C. The stories revealed decay and mismanagement at the hospital, and provoked shock and concern among politicians in both parties. "The doctors were fantastic," a Walter Reed patient, 21-year-old Marissa Strock, tells NEWSWEEK. "But some of the nurses and other staffers here have been a nightmare." Strock suffered multiple injuries, including broken bones, a lacerated liver and severely bruised lungs, when her Humvee rolled over an improvised explosive device on Nov. 24, 2005. She later had both her legs amputated. "I think a big part of [Walter Reed's problems] is they just don't have enough people to adequately handle all the wounded troops coming in here every day," she says. (Walter Reed did not respond to requests for comment about Strock's case.) The Pentagon responded swiftly to the Post series. It vowed to investigate what went wrong and immediately sent a repair crew to repaint and fix the damage to the aging buildings.
The revelations were especially shocking because Walter Reed is one of the country's most prestigious military hospitals, often visited by prominent politicians, including the president. But it is just one part of a vast network of hospitals and clinics that serve wounded soldiers and veterans throughout the country. A NEWSWEEK investigation focused not on one facility but on the services of the Department of Veterans Affairs, a 235,000-person bureaucracy that provides medical care to a much larger number of servicemen and women from the time they're released from the military, and doles out their disability payments. Our reporting paints a grim portrait of an overloaded bureaucracy cluttered with red tape; veterans having to wait weeks or months for mental-health care and other appointments; families sliding into debt as VA case managers study disability claims over many months, and the seriously wounded requiring help from outside experts just to understand the VA's arcane system of rights and benefits. "In no way do I diminish the fact that there are veterans out there who are coming in who require treatment and maybe are not getting the treatment they need," White House Deputy Press Secretary Tony Fratto tells NEWSWEEK. "It's real and it exists."
The system's shortcomings are certainly not deliberate; no organization is perfect. Some of the VA's hospitals have been cited as among the best in the country, and even in extreme cases, the picture is seldom black-and-white. Before he killed himself, Schulze was seen by the VA 46 times, VA Secretary James Nicholson told Congress this month. (He did not elaborate on what care Schulze received.)
Yet, as the number of veterans continues to grow, critics worry the VA is in a state of denial. In a broad sense, the situation at the VA seems to mirror the overall lack of planning for the war. "We know the VA doesn't have the capacity to process a large number of disability claims at the same time," says Linda Bilmes, a Harvard public-finance professor and former Clinton administration Commerce Department official. Last month Bilmes released a 34-page study on the long-term cost of caring for veterans from Iraq and Afghanistan. She projects that at least 700,000 veterans from the global war on terror (GWOT) will flood the system in the coming years.
As it is, for some veterans the wait can be agonizing. Patrick Feges was on hold for 17 months until his first disability check from the VA came through. An Eagle Scout from Sugar Land, Texas, Feges enlisted in 2003 and found himself in Ramadi a year later. In October 2004, a mortar exploded on his base about 50 yards from him, spraying him with shrapnel, slicing his intestines and severing a major artery. Feges lost consciousness and was flown to Walter Reed, where he underwent surgery. Long scars trail down his legs and midsection. At the hospital a fellow Texan came to visit: President Bush stood by his bed and chatted with him.
Feges is a polite 22-year-old with a military manner. He addresses strangers by last name and an honorific, even when prodded to drop the formality. "I was brought up right, sir," he explains. But his voice rises slightly when he describes his ordeal with the VA. A case officer in Houston processed Feges's request for disability in September 2005, then lost his application. Feges was summoned to repeated medical evaluations at the Houston center, but a year later he was still waiting for a check. By then, Feges had been accepted to culinary school in Austin and did not want to put off his studies. His mother, an elementary-school teacher, took a second job at a local McDonald's to help support him.
For discharged service members, the VA serves two functions: it provides medical care for service-related conditions at its clinics and hospitals across the country, and it reviews claims for disability benefits—chiefly, the monthly payments wounded veterans get for the rest of their lives. The review process can be complicated. It requires veterans to prove, through documents and sometimes through the testimony of fellow soldiers, that their afflictions are a result of their time in the military. Feges listed on his application all the ways he'd been affected by the wounds: he'd lost mobility in his ankles and knees, he suffered regular stomach cramps from the intestinal wound, he lost sensation in his hands and legs, he had trouble standing for long periods. NEWSWEEK presented the VA with the names and details of the veterans whose stories are told here, but a spokesman for the agency declined to comment on individual cases, citing doctor-patient confidentiality.
March 5, 2007
By Dan Ephron and Sarah Childress
After returning from Iraq in late 2005, Jonathan Schulze spent every day struggling not to fall apart. When a Department of Veterans Affairs clinic turned him away last month, he lost the battle. The 25-year-old Marine from Stewart, Minn., had told his parents that 16 men in his unit had died in two days of battle in Ramadi. At home, he was drinking hard to stave off the nightmares. Though he managed to get a job as a roofer, he was suffering flashbacks and panic attacks so intense that he couldn't concentrate on his work. Sometimes, he heard in his mind the haunting chants of the muezzin—the Muslim call to prayer that he'd heard many times in Iraq. Again and again, he'd relive the moments he was in a Humvee, manning the machine gun, but helpless to save his fellow Marines. "He'd be seeing them in his own mind, standing in front of him," says his stepmother, Marianne.
Schulze, who earned two Purple Hearts for wounds sustained in Iraq, was initially reluctant to turn to the VA. Raised among fighters—Schulze's father served in Vietnam and over the years his older brother and six stepbrothers all enlisted in the military—Jonathan might have felt asking for help didn't befit a Marine.
But when the panic attacks got to be too much, he started showing up at the VA emergency room, where doctors recommended he try group therapy. He resisted; he didn't think hearing other veterans' depressing problems would help solve his own. Then, early last month, after more than a year of anxiety, he finally decided to admit himself to an inpatient program. Schulze packed a bag on Jan. 11 and drove with his family to the VA center in St. Cloud, about 70 miles away. The Schulzes were ushered into the mental-health-care unit and an intake worker sat down at a computer across from them. "She started typing," Marianne says. "She asked, 'Do you feel suicidal?' and Jonathan said, 'Yes, I feel suicidal'." The woman kept typing, seemingly unconcerned. Marianne was livid. "He's an Iraqi veteran!" she snapped. "Listen to him!" The woman made a phone call, then told him no one was available that day to screen him for hospitalization. Jonathan could come back tomorrow or call the counselor for a screening on the phone.
When he did call the following day, the response from the clinic was even more disheartening: the center was full. Schulze would be No. 26 on the waiting list. He was encouraged to call back periodically over the next two weeks in case there was a cancellation. Marianne was listening in on the conversation from the dining room. She watched Jonathan, slumped on the couch, as he talked to the doctor. "I heard him say the same thing: I'm suicidal, I feel lost, I feel hopelessness," she says. Four days later Schulze got drunk, wrapped an electrical cord around a basement beam in his home and hanged himself. A friend he telephoned while tying the noose called the police, but by the time officers broke down the door, Schulze was dead.
How well do we care for our wounded and impaired when they come home? For a country amid what President Bush calls a "long war," the question has profound moral implications. We send young Americans to the world's most unruly places to execute our national policies. About 50,000 service members so far have been banged up or burned, suffered disease, lost limbs or sacrificed something less tangible inside them. Schulze is an extreme example but not an isolated one, and such stories are raising concerns that the country is failing to meet its most basic obligations to those who fight our wars.
The question of after-action care also has strategic consequences. Iraq marks the first drawn-out campaign we've fought with an all-volunteer military. In practice, that means far fewer Americans are taking part in this war (12 percent of the total population participated in World War II, 2 percent in Vietnam and less than half of 1 percent in Iraq and Afghanistan). Already, the war has made it harder for the military to recruit new soldiers and more expensive to retain the ones it has. If we fall down in the attention we provide them, who's to say volunteers will continue coming forward?
The issue of veterans' care jumped into the headlines last week when The Washington Post published a series about Walter Reed Army Medical Center in Washington, D.C. The stories revealed decay and mismanagement at the hospital, and provoked shock and concern among politicians in both parties. "The doctors were fantastic," a Walter Reed patient, 21-year-old Marissa Strock, tells NEWSWEEK. "But some of the nurses and other staffers here have been a nightmare." Strock suffered multiple injuries, including broken bones, a lacerated liver and severely bruised lungs, when her Humvee rolled over an improvised explosive device on Nov. 24, 2005. She later had both her legs amputated. "I think a big part of [Walter Reed's problems] is they just don't have enough people to adequately handle all the wounded troops coming in here every day," she says. (Walter Reed did not respond to requests for comment about Strock's case.) The Pentagon responded swiftly to the Post series. It vowed to investigate what went wrong and immediately sent a repair crew to repaint and fix the damage to the aging buildings.
The revelations were especially shocking because Walter Reed is one of the country's most prestigious military hospitals, often visited by prominent politicians, including the president. But it is just one part of a vast network of hospitals and clinics that serve wounded soldiers and veterans throughout the country. A NEWSWEEK investigation focused not on one facility but on the services of the Department of Veterans Affairs, a 235,000-person bureaucracy that provides medical care to a much larger number of servicemen and women from the time they're released from the military, and doles out their disability payments. Our reporting paints a grim portrait of an overloaded bureaucracy cluttered with red tape; veterans having to wait weeks or months for mental-health care and other appointments; families sliding into debt as VA case managers study disability claims over many months, and the seriously wounded requiring help from outside experts just to understand the VA's arcane system of rights and benefits. "In no way do I diminish the fact that there are veterans out there who are coming in who require treatment and maybe are not getting the treatment they need," White House Deputy Press Secretary Tony Fratto tells NEWSWEEK. "It's real and it exists."
The system's shortcomings are certainly not deliberate; no organization is perfect. Some of the VA's hospitals have been cited as among the best in the country, and even in extreme cases, the picture is seldom black-and-white. Before he killed himself, Schulze was seen by the VA 46 times, VA Secretary James Nicholson told Congress this month. (He did not elaborate on what care Schulze received.)
Yet, as the number of veterans continues to grow, critics worry the VA is in a state of denial. In a broad sense, the situation at the VA seems to mirror the overall lack of planning for the war. "We know the VA doesn't have the capacity to process a large number of disability claims at the same time," says Linda Bilmes, a Harvard public-finance professor and former Clinton administration Commerce Department official. Last month Bilmes released a 34-page study on the long-term cost of caring for veterans from Iraq and Afghanistan. She projects that at least 700,000 veterans from the global war on terror (GWOT) will flood the system in the coming years.
As it is, for some veterans the wait can be agonizing. Patrick Feges was on hold for 17 months until his first disability check from the VA came through. An Eagle Scout from Sugar Land, Texas, Feges enlisted in 2003 and found himself in Ramadi a year later. In October 2004, a mortar exploded on his base about 50 yards from him, spraying him with shrapnel, slicing his intestines and severing a major artery. Feges lost consciousness and was flown to Walter Reed, where he underwent surgery. Long scars trail down his legs and midsection. At the hospital a fellow Texan came to visit: President Bush stood by his bed and chatted with him.
Feges is a polite 22-year-old with a military manner. He addresses strangers by last name and an honorific, even when prodded to drop the formality. "I was brought up right, sir," he explains. But his voice rises slightly when he describes his ordeal with the VA. A case officer in Houston processed Feges's request for disability in September 2005, then lost his application. Feges was summoned to repeated medical evaluations at the Houston center, but a year later he was still waiting for a check. By then, Feges had been accepted to culinary school in Austin and did not want to put off his studies. His mother, an elementary-school teacher, took a second job at a local McDonald's to help support him.
For discharged service members, the VA serves two functions: it provides medical care for service-related conditions at its clinics and hospitals across the country, and it reviews claims for disability benefits—chiefly, the monthly payments wounded veterans get for the rest of their lives. The review process can be complicated. It requires veterans to prove, through documents and sometimes through the testimony of fellow soldiers, that their afflictions are a result of their time in the military. Feges listed on his application all the ways he'd been affected by the wounds: he'd lost mobility in his ankles and knees, he suffered regular stomach cramps from the intestinal wound, he lost sensation in his hands and legs, he had trouble standing for long periods. NEWSWEEK presented the VA with the names and details of the veterans whose stories are told here, but a spokesman for the agency declined to comment on individual cases, citing doctor-patient confidentiality.