Fort Lewis' wounded share medical-care grievances
Idaho National Guard Sgt. Jane Sullivan is a tough soldier who spent a year in Iraq, repairing Humvees and occasionally pulling gunner duty on convoys at risk of insurgent attacks.
Instead of going home to Idaho, the 58-year-old has spent 15 frustrating months in the medical hold unit at Fort Lewis recovering from back injuries suffered in Iraq, a heart condition and other medical problems that have left her in a wheelchair.
She's received conflicting and confusing opinions from Army doctors about whether she needs back surgery, she said. So far, there's been no surgery. And bitter despair has set in as the Army moves toward making her take medical retirement.
She wonders when — or if — she will ever return to her civilian job as a forklift driver.
"Have I been depressed? Yes," Sullivan said. "Have I been angry at the system? Yes, totally. You broke me as a soldier. Fix the problem."
Sullivan is one of about 175 Army Reserve and National Guard soldiers assigned to Fort Lewis' medical hold unit.
The quality of care provided these ailing soldiers — and thousands of their counterparts at military bases around the country — is under increased scrutiny after Washington Post reports about bureaucratic and other obstacles facing recovering soldiers at Walter Reed Army Medical Center in Bethesda, Md.
The Defense Department announced recently it will launch a broader inspection of medical care at Fort Lewis and 10 other bases around the country. Sen. Patty Murray, D-Wash., a vocal critic of the Bush administration's treatment of wounded soldiers and veterans, sent two staffers this week to meet with soldiers and officials at Madigan Army Medical Center, located at Fort Lewis.
More than a half-dozen reserve and National Guard soldiers voiced their concerns to The Seattle Times about their treatment in the medical hold unit. They say it sometimes takes weeks to start physical therapy or get an appointment with a specialist. They say caseworkers sometimes seem more like adversaries than advocates.
They also complain that the Army sometimes unfairly discounts their injuries — or ignores them altogether — in figuring disability ratings that help determine future health and pension benefits.
On Monday, Fort Lewis and Madigan Army Medical Center leaders heard complaints in several meetings with soldiers in the medical hold unit.
"Oh, they got an earful," said Capt. Mary Maddox, 51, who served in Kuwait while suffering from a degenerative disc disease and returned in August 2004 with other medical problems that have been difficult to diagnosis.
"I was told I was a very angry person. I told them that I have every right to be angry. ... The biggest problem with Madigan is that they are understaffed and overworked, and I ended up getting bounced from clinic to clinic."
Madigan officials, citing confidentiality rules, would not comment on specific cases.
Col. George Giacoppe, a Madigan hospital official, said he is disturbed by any reports of delays in medical treatment. But overall, he said, Madigan has set up a quality, efficient system to care for the hundreds of injured Army and Reserve soldiers at Fort Lewis.
"I think that the medical care is good," he said. "We have come a long ways."
A Fort Lewis spokesman added that post commanders have long emphasized keeping an open dialogue with soldiers, demonstrated by this week's meetings.
"The reason that we believe we have a program that works is that we have a program that stays engaged with people at all times," said J.C. Matthews, a Fort Lewis spokesman. "These meetings just don't take place in the wake of stories in The Washington Post."
Fort Lewis officials are also briefing National Guard officials who have heard from complaints from their soldiers.
"Some of these things may be resolved on a case-by-case basis. Some may be systemic," said Command Sgt. Maj. Anthony Hines of the California National Guard, who met last week with soldiers in the unit. "Right now, we are just in the stage of putting the information together, and will work with the command there [at Fort Lewis] to try to resolve them."
A collection point
Medical hold units at Fort Lewis and other Army posts began filling up in recent years, as American troops were sent in large numbers to Afghanistan and Iraq. As early as 2003 and 2004, news stories chronicled problems at Fort Lewis and bases about soldiers left in limbo as they endured months of outpatient care away from families.
Fort Lewis emerged as a collection point for injured and ailing National Guard and Reserve soldiers from around the West and elsewhere in the country. Though some were wounded in combat, others suffered accidents or illness while deployed overseas.
At its peak in 2005, there were more than 400 soldiers in the medical hold unit.
Madigan officials said there have been many improvements to the system through the years.
For example, they said the hospital had only two caseworkers to advocate for medical-hold soldiers at the time of the Sept. 11, 2001, terrorist attacks. Now, there are 18. All of the case managers currently have loads well below their maximum limits, according to Madigan officials.
The hospital also launched a new system that has allowed hundreds of recovering soldiers to return home and receive treatment from private health-care providers or Veterans Administration hospitals.
Medical bureaucracy
That home health-care plan enabled Spc. Steve Layne, an Idaho National Guard soldier who served in Iraq, to mend a torn rotator cuff at home.
After his return, Layne was often irritable, angry and forgetful. The symptoms were first thought to be from post traumatic stress disorder, but Layne's wife, Pamela, suspected a possible brain injury from a bomb attack on his vehicle.
"I knew something was wrong. His memory was really bad," she said.
In December of 2006, after more than a year of home convalescence, Layne was sent to the Fort Lewis hold unit for evaluation. He was only supposed to be there about two weeks. He still hasn't returned home.
Layne says her husband has foundered in the medical bureaucracy. She tried to work closely with a caseworker but said that relationship soured after her persistent calls. "He just didn't want to deal with it, so I called the commanding officer," she said.
As the weeks dragged on, Madigan referred Layne to the VA hospital in Seattle, where he was diagnosed with a traumatic brain injury. Giacoppe said the VA has some of the best resources to assess such injuries.
Pamela Layne hopes to finally get her husband home in the next few weeks, so he can begin physical therapy. "I want people to know that if their loved ones are there, they will have to fight for their care," she said. "If they do not, they will get lost in the system."
Still, soldiers inside the medical hold unit say that pushing too hard — for themselves or others in their unit — can get them branded as malcontents.
Sullivan says her advocacy earns her a reputation as a troublemaker. She complains that a January talk at her trailer with a visiting colonel was cut short by a unit officer, and that she sometimes is not invited to attend town-hall meetings where soldiers in her unit air their views.
Army officials say that no one in the unit is cut out of the town-hall meetings.
Sullivan said her back was first injured when her Humvee came under attack in Iraq and it may have been aggravated by heavy lifting in her mechanic's job. She was placed in the medical hold unit when she collapsed at Sea-Tac Airport after arriving from Iraq.
Due to her inactivity, she's gained more than 50 pounds. Her weight — and heart condition — increase the risks of stroke.
Her habit of smoking on a deck outside the trailer — rather than in a designated area — has gotten her in trouble. She was given a letter of reprimand, and warned that she could face the military justice system and a less than honorable discharge if she continues.
In the weeks ahead, Sullivan expects to finally return home.
But she is not happy about her Army disability review. She was given a $21,000 buyout but granted only a 10 percent disability rating for her medical retirement — too low to qualify for full Army medical and pension benefits. So, she's planning to fight the ruling..
"We soldiers are not asking the government for a whole lot," Sullivan said. "We want to keep our dignity. Keep our sense of patriotism. We want to keep our self-respect."
Hal Bernton: 206-464-2581 or hbernton@seattletimes.com
Madigan Army Medical Center at Fort Lewis serves more than 60,000 people, including active-duty military personnel, their families and other retired military. It is staffed by civilian and Army medical staff.
Medical Hold Units: There are two medical hold units at Fort Lewis, where soldiers are assigned while receiving treatment for injuries or illness.
One unit consists of about 60 soldiers, most of whom are active-duty Army.
A second unit includes about 175 National Guard and Army Reserve soldiers, as of this week. Seven were classified as war wounded, while the rest suffered other types of injuries or illness, according to J.C. Matthews, a Fort Lewis spokesman.
These soldiers are considered on active duty and continue to draw military pay during their recovery.
Disability Boards: After a year in the medical hold unit, soldiers may go through a medical evaluation board that determines whether or not they can continue their military careers.
If doctors deem them unfit for duty, their cases are reviewed by a second board that determines the terms of their medical retirement. They set a disability rating that helps determine retirement and Army medical benefits.
Soldiers whose illness or injury results from their military service may also apply for a separate rating to receive Department of Veterans Affairs disability payments.
Source: Madigan Army Medical Center