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Posts tagged “Veteran’s Health Care

RIP, Ian Long


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This is one of the most difficult posts I will have ever written, or ever feel compelled to write. But what I am about to say must not only be heard, but preserved, if only because the topic is of vital importance.

As you’re undoubtedly aware by now, late last night, Ian David Long drove to the Borderline Bar & Grill in Thousand Oaks, CA. For reasons we will probably never know, he arrived with evil intent. He was armed & he was dressed for combat. He began by shooting the doorman with his Glock 21 .45 caliber semi-automatic pistol. By the time he was finished, 11 others lay dead,  including Ventura Sheriff’s Deputy Sgt. Ron Helus. 10 more were wounded.

In the hours since we have come to learn that Ian Long was discharged from active service with the Marine Corps in 2013. He served one contract, like most Marines and servicemembers. He did nothing that particularly distinguished his brief military career, nor did he do anything that detracted from his service. He was simply your average Marine, like most of those who earned an Eagle, Globe & Anchor before and since.

When I first heard the news this morning, I remarked to my wife (this was before we knew who the gunman was) that I had to begrudgingly give the shooter kudos for round efficiency. See, as a Marine I appreciate good shooting – even if done for evil reasons. Good, accurate shooting under pressure is a skill that every Marine must master. There is no earning that EGA without it.

Of course, now we know the shooter is a Marine.

The news has devastated me.

On Saturday, our Corps will celebrate our 243rd birthday. Personally, I will be in South Philadelphia to join a few thousand other Marines in raising a mug and joining in the cake ceremony. Of all the things that join us as Marines, it is these traditions that go back to the very beginnings of the nation that are the most important. Every Marine knows we were born at Tun Tavern in Philadelphia on November 10, 1775. Ordinarily, this time of year is only exceeded in anticipation among Marines by Christmas.

Now, that excitement is tempered by the realization one of our own has gone off the reservation. To make matters worse, as a former Veteran’s Service Officer for the American Legion, I know there was no need for it. This was the most preventable tragedy imaginable.

It didn’t take long for the media to begin with the “crazy veteran” stories. It feeds an all too common narrative among the non-veteran community that veterans are damaged goods, this misperception that veterans are incompatible with civilization. After all, we do have higher rates of mental illness than the civilian population, so we must be ticking time bombs. An incident like last night shouldn’t be a surprise, according to the talking heads. The surprise should be that it doesn’t happen more often.

First, stop with that nonsense. Yes, veterans have seen and done things that 98% of you cannot even begin to imagine. Yes, those things leave an indelible mark on your psyche. They also form the basis for a bond among us that those of you who have never served cannot begin to imagine. But that does not make us monsters lurking in the shadows, waiting to pounce on you at first opportunity. For the most part, when we take off the uniform, we lead perfectly normal lives. We are bankers, cooks, bartenders, construction foremen, teachers; you’ll find us doing all of the same mundane things you do. The battles we wage with our personal demons are off to the side, leaving you unaffected.

Whatever drove Ian Long to commit his act of premeditated mass murder, to plan it out with the ruthless efficiency of any Marine infantry commander ordering the clearing of a building and execute it with that same efficiency, we will likely never know. The speculation is that he had PTSD. I’m calling bullshit on that media diagnosis right now.

I should know. I am also a veteran with PTSD, like millions of others.

But I also have two other diagnoses, Explosive Personality Disorder, and Survivor’s Guilt, that would be more likely than PTSD to cause someone to do what Long did. PTSD is not the type of mental illness that leads to violence. If anything, left untreated it is more likely to result in suicide than murder. EPD, on the other hand… anyone remember the old  “Hulk” television show? The classic line from that show was David Banner telling the reporter who chased him, “Don’t make me angry. You wouldn’t like me when I’m angry.” Yeah, it’s kind of like that.

But we’ll never know because by all accounts he was not receiving any care for any mental issues. This is despite a visit from a clinician in April of last year, someone I’m certain who was well-meaning but likely totally unsuited to diagnosing a veteran. As mentioned above, we’re expert at dealing with our problems privately. Part of that is learning how to hide the outward signs. I survived for nearly 12 years before a fellow vet convinced me to get help. It was the best thing that could have happened for me, although my fight with the VA to get that care could probably fill a novel.

The VA’s version of care for mental illness is a big part of the reason many veterans, even though they know they need help, do not seek it. I abandoned their treatment regimen not long after beginning it since it basically consists of keeping the veteran doped up on handfuls of pills. But by getting into treatment, I met plenty of other vets who were also dealing with their own issues. Working with them, I found my way back to God and an inner peace. Do I struggle at times? Sure. Do I still wake at night to the sights and sounds of helicopters falling into the water? You bet. Do I still find myself getting melancholy? Sure. Do I still think to myself, “I really should just knock this guy’s block off” a little too often? Probably.

But I don’t just haul off and beat the crap out of the deserving. I was able to get the help I needed. Through my work as a VSO, I’ve helped others get the help they needed. As a veteran, I’ve spent midnight hours on the phone with veterans and their loved ones, defusing crisis situations that most civilians are unequipped to handle, no matter how well-intentioned. The shame of this whole thing is that Ian Long did not get the help he needed, for whatever reason. His demons beat on his soul until finally, he snapped. It shouldn’t have happened. There was no need.

The next bit is for every veteran who made be reading. If you are not a veteran, the language that follows may be a bit salty for your tastes. Bear with me – and please share this part with any veterans you know.

You do not have to suffer alone. In fact, that is the worst thing you can do. Trust someone who’s been where you are, who’s been where you were and who wants you to at least get as far as I have, if not further. Here are some basic life skills for veterans to cope with the civilian world. Don’t get me wrong, I have some great civilian friends. But they will never know the things you do (how the hell could they?).

1: Cultivate and maintain close friendships with at least one older and one younger vet. Your elder has been where you are and can help coach you through it. You can do the same for the younger, and benefit from helping another.

2: Do something creative/constructive. Work with wood, steel, words, music, paint, sculpture, food, whatever you can do. Balance the destructive with the creative. I like woodworking. You might prefer painting. Whatever, just git ‘er done.

3: Have a routine and stick to it. When it gets REALLY dark, stick to it even more rigidly. Concentrate on doing the “next thing.” Even if you have to force yourself. 0700: Reveille is reveille. Make yourself get up. 0705: Your rack must be made…make it. 0710: Wash your nasty ass, etc. Sounds basic, but it works. There’s a reason we spent all those years having our sergeants bitch at us every time we were 30 seconds late for formation, after all.

4: Stay alert when you’re out and about. LOOK for neighbors (anyone in your community) who could use a hand, and help them. Even better if you can do it “on the sly,” and let ’em wonder. You’ll feel better about yourself and your community.

5: Have a couple brothers you can call (and vice versa) 24/7 when it’s REALLY bad, and CALL them. (These can, but don’t have to be, covered in #1…just be sure they’re people who will call you on bullshit if necessary.)

6: When you get the blues, when you start missing friends who will never be coming back, when the bombs are going off around you – when the demons begin whispering in your ear – don’t try to lose yourself in a bottle or some other drug. Go back to the first 5 tips instead. Those demons in the bottle are only going to make you angrier, sadder and start talking to your other demons. Next thing you know, they’re going to be making you say “IT’S TIME TO FUCK SOME SHIT UP” and do something stupid. Like, shoot up a bar full of innocent people, for instance.

Now if you’ll excuse me, I need to go mourn. I’ll be mourning those innocents who lost their lives last night.

But I’ll also mourn the loss of Ian David Long, a Marine left alone to fight an impossible nightmare, on this the eve of the Marine Corps birthday. In many ways, he is a victim, too.

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Ian David Long

 

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An Open Letter of Praise for the VA


Those of you who have been following my blog for a while should know a few things about me. I am a proud veteran, and I have Crohn’s Disease. And I have been an outspoken critic of the Veteran’s Administration, and the Veteran’s Health Care System in particular. But I try to be fair in my criticisms, and when someone does something right they deserve to be recognized. Such is the case with my recent hospitalization at the East Orange VA Hospital. Following is a letter I wrote to the Secretary of Veteran’s Affairs (Des.), David Shulkin and the Director of the New Jersey Veteran’s Health Care System, Vincent Immiti.

Gentlemen,

I am a Cold War era veteran who has dealt with the Veteran’s Health Administration since 1994. Over the intervening years, I have had my share of complaints. I have been either an inpatient and/or outpatient recipient of services at multiple hospitals: Ft. Lauderdale, Wilmington (DE), Philadelphia, New York Harbor and, of course, the Lyons and East Orange campuses of the NJVHCS. I am not writing to tell you that rainbows are blooming over the VHA – only a fool would believe that. But I feel that after years of heaping some well-deserved abuse on what has proven to be a dysfunctional system, my most recent experience is deserving of praise for a job well done.

On Saturday, January 21 of this year I was brought into the East Orange Veteran’s Hospital Emergency Room. I have suffered with Crohn’s Disease since 1994 and this was the beginning of yet another hospital stay for me. I was not looking forward to it, as my previous partaking’s of the VHA’s hospitality always left me feeling more as if I were a POW than a patient. Allow me to say, I was pleasantly (as pleasantly as a hospital stay can prompt) surprised by this admission.

It truly was a night and day experience, compared to all my previous hospitalizations. Whereas in the past, my concerns and questions were met with derision or (even worse) indifference, this time I found the medical staff earnestly answering my questions, explaining the anticipated course of therapy and being attentive to my concerns and those of my family. In past hospitalizations, medications would arrive haphazardly without any semblance of a schedule, nurses would be impossible to find, even when called, and doctors acted as if I, the patient, were a burden they would rather not deal with. The only thing they seemed interested in was prescribing high doses of pain killers and moving on to the next victim.

Hospital cleanliness was always a concern, as I could go days without seeing a mop or broom used. As you’re probably aware, Crohn’s patients in the middle of an extreme flare are prone to having accidental, violent bowel movements. In 2009, after once such episode, the nursing staff did eventually come in to change the bedsheets – but with a set of blood-stained ones. Such was the level of contempt that the overall staff seemed to have for the patients in their care.

As veterans, we do not ask for anything special. Every veteran I’ve ever met is proud of our service to our nation and would gladly reenlist should the nation need our services again. As patients, all we’ve ever asked for is to be treated with the basic respect anyone should give another human being. The anger and disgust many of us feel towards the VHA is rooted in the failure of the VHA to recognize and act upon that humanity.

But as I mentioned, this hospitalization was not only what one would expect at any medical facility, but in many ways surpassed even the highest expectations one could have of any hospital. The staff exhibited all the hallmarks of a professional medical organization: courtesy, attentiveness, compassion and competence. Nurse calls were answered promptly, and if an RN was needed but unavailable, the LPN’s explained the situation. My attending physician not only provided timely and pertinent explanations of my care – in terms a layman can understand! – but proved an exceptional coordinator with the specialists I needed (gastroenterology, pulmonology and cardio). Tests that were performed were explained beforehand, including not only descriptions of the procedures but the reasons for them. The residents, interns and medical students did not treat me as an object of fascination on par with a living cadaver, but as a suffering patient with information they needed to perform their duties. Even the orderlies, janitorial staff and other support staff approached their jobs with a general friendliness and professionalism that made the otherwise dread of a hospital stay comforting.

The change is remarkable. I was going to attempt to single out individuals for jobs well done, but then realized everyone associated with my care deserves special recognition.

I am not a medical professional. I suppose you could say I’m a professional patient, given my history, but that’s the extent of my medical training.  However, my post-military career has been in operations and program management. As such, I can recognize and appreciate when an outstanding manager has taken control of a bad situation and is effecting a complete turnaround.

As I began, I’m not going to gloss over the fact that there are still major problems and deficiencies throughout VHA. However, Mr. Shulkin, upon your confirmation I can think of no better place to start turning around the system than seeking out your best, listening to what they’ve done and implementing those practices throughout VHA. Based on my recent stay, you would do very well to begin with Mr. Immiti. The change he has effected is nothing short of amazing.

I thank you for your time and again, congratulations on a job well done.

Semper Fi and Regards,

Raymond Rothfeldt