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Army Hospital Struggles to Provide Iraq Veterans Adequate Care

February 19, 2007 at 12:44 PM EDT
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JIM LEHRER: Now a look at the care wounded Iraq war veterans are receiving. Judy Woodruff has that story.

JUDY WOODRUFF: Walter Reed Army Medical Center in Washington, D.C., was long considered one of the finest American military hospitals. Almost a century old, it has treated soldiers and Marines returning from war, veterans, presidents and world leaders.

Since the wars began in Afghanistan in 2001 and in Iraq in 2003, Walter Reed has treated over 5,000 wounded servicemen and women. But a new investigation by the Washington Post has revealed a troubling side of the hospital, its facilities and procedures.

While receiving treatment at Walter Reed, service members have been housed in buildings, including one with a rodent infestation. Army Specialist Jeremy Duncan can stand in the shower and see through to the room above him. And his room has a mold problem.

And Army Staff Sergeant Dan Shannon, who lost an eye and sustained brain injury in Iraq, said when he arrived at Walter Reed, he was given a map of the facilities and told to find his room on his own. He says he was often left for weeks without an appointment to see a doctor.

In May 2005, the presidentially appointed Basing Realignment and Closure Commission recommended that Walter Reed be closed.

Compiling the reports

Dana Priest
The Washington Post
[The Army] allowed us to see the good part of Walter Reed... But we discovered this other world, which is actually populated by many more people.

For more on the current situation at the hospital, we turn to Washington Post reporter Dana Priest, who co-authored the two reports.

Dana, first of all, you and another reporter spent, what, four months doing this reporting, and what were the circumstances?

DANA PRIEST, The Washington Post: Well, Anne Hull and myself, we decided that the only way to do this reporting was by ourselves, without the Army, because the Army at Walter Reed really has a very well-oiled public relations machine.

They've allowed us to see the good part of Walter Reed, the medical care which people are not complaining about, the rehabilitation clinics which people are not complaining about. But we discovered this other world, which is actually populated by many more people.

At any one time, there are only about 30 combat wounded in the hospital. But there are 700 living as charges of Walter Reed in one of five buildings, either on post or right off post or in apartments and houses nearby. Nearly 700 in an outpatient world that is quite different -- has quite different standards than the medical facility.

And that's the world that we wanted to capture. And to do that, we visited Walter Reed and Building 18 and other places many times to interview people and to get their thoughts about this.

JUDY WOODRUFF: And just to be clear, you are making the distinction between the surgical inpatient facility and the outpatient.

DANA PRIEST: Right.

'Stories of neglect'

Dana Priest
The Washington Post
When we started hearing these stories of neglect, and in some cases indifference, it was unbelievable. And we wanted to gather many more anecdotes before we put it together.

JUDY WOODRUFF: Now, what did you find?

DANA PRIEST: Well, what we found, first of all, was so surprising to us that we -- that's why we spent four months. In part, like many Americans, we know Walter Reed as the crown jewel of medicine. We think that the American -- we know that the American people support the troops, no matter what they think of the war.

And so, when we started hearing these stories of neglect, and in some cases indifference, it was unbelievable. And we wanted to gather many more anecdotes before we put it together.

What we found is that there are people, as the Staff Sergeant Shannon that you referred to, many people who get out of the hospital, they're discharged, they go to live in one of these buildings, but nobody really follows up on them.

In his case, he sat for weeks. A sniper had shot out his eye and part of his brain. He was on heavy medication, like many people coming out of surgery, so he was very much in a fog. And they expected him to remember when his next appointment was.

He has PTSD, like many other people we talked to, and other people with traumatic brain injuries who just couldn't remember things on their own, and they weren't given one person to follow them around. They had, instead, platoon sergeants, who were actually often wounded soldiers themselves, who couldn't distinguish them from others and had stress problems on their own.

JUDY WOODRUFF: Who were in charge of keeping track of a number of these?

DANA PRIEST: Right.

JUDY WOODRUFF: And, again, these are soldiers who are not ready to go home yet. The Army is hanging onto them in some way, is that right?

DANA PRIEST: Well, unlike past wars, the Army wants to try to hang onto as many as they can, in part to fill their ranks, and in part because people want to stay in the Army. So, in order to make that system go from beginning to end, it often takes more than a year to determine whether you can return to duty and then, if you cannot, what level of benefits, medical benefits the government will pay you once you leave.

Conditions at Building 18

Dana Priest
The Washington Post
And as social workers told us, when people start to withdraw, when they feel disenfranchised and alone, they stop seeking the kind of care that they are supposed to be getting.

JUDY WOODRUFF: Now, I want to ask you specifically, much of your reporting focused on this Building 18. You mentioned it a minute ago. We showed the picture; I wanted to show it again. This is a building that is -- I don't know how old it is, but describe some of the conditions in here?

DANA PRIEST: Well, this was a building that was actually built between the two world wars. And it was a quarters for visiting officers and others who came to Walter Reed at the time.

In October of 2005, when the numbers of outpatients grew to almost 900, and Walter Reed no longer had any places for them, they opened this building, and they did a very quick renovation. And they didn't get the main problems.

So you had mice -- you have a mice infestation. You have cockroaches. But you also have rooms like the ones you showed that have mold invading the wallpaper and the walls, and you have an elevator that's broken. The security door in the back didn't work. Hot water on and off sometimes, bad, you know, stains on the carpet, bad mattresses.

But, Judy, more than that, people complained about being isolated. They felt in Building 18 that they were being left alone. And some of them retreated to their rooms, and, you know, people said there's a lot of depression here.

And as social workers told us, when people start to withdraw, when they feel disenfranchised and alone, they stop seeking the kind of care that they are supposed to be getting.

And a lot of the people in Building 18, there are no amputees there, because you had to walk across the street -- you have to walk -- but there were brain injuries. There were people with psychological -- there are people with psychological problems that were living there now, and they had to cope with all that.

JUDY WOODRUFF: You have had a few deaths in this outpatient area.

DANA PRIEST: Right.

JUDY WOODRUFF: You've had individuals who have gotten worse and who just disappeared, was what you reported.

DANA PRIEST: Right. The problem was that, when you get discharged and you enter into the outpatient system, you would think that wouldn't be so hard. You're all on the same post. But it's two bureaucracies, and one does not speak to the other.

In many cases, there was no way to follow a patient who just left and became an outpatient. They're assigned to a platoon, but because the platoons were overworked, some of the platoon sergeants never really knew where they were.

And people called in sometimes. And in Staff Sergeant Shannon's case, he called around. He wasn't sure who to call. And when he finally found someone, they said, "Well, we've have been looking for you." And he says, "Well, jeez, Louise, I'm your patient. Shouldn't you be calling me?"

Dealing with the situation

Dana Priest
The Washington Post
There are a lot of people who care up there and work very hard. But often they got treated, they thought, in a not very compassionate way.

JUDY WOODRUFF: Everybody watching this, everybody reading your report, is asking, how could something like this happen? What does the Army say?

DANA PRIEST: Well, you know, the Army says that they were unprepared for the large numbers, but that's been four years now, so that's not entirely an excuse.

They say they're trying to make things better. They say they dealt with the situation they were given. It's an odd organization in the Army. It doesn't function sort of quite like the Army. And so they just were not flexible enough in making changes.

And they had a population that really, I guess, in some ways, was obviously vulnerable and couldn't stand up for themselves in the same way. And you have people taken out of their normal units, where a creed, a code in the Army is you take care of the people in your units. Well, they didn't have their units. They have these pickup units. Then they had to make do with that.

JUDY WOODRUFF: And the general who oversees the hospital, I noticed, is saying over the weekend they are hiring more people.

DANA PRIEST: Right.

JUDY WOODRUFF: Is that making a difference?

DANA PRIEST: Who knows yet? But that is what Walter Reed has been telling us. When we came to them with these problems, they laid out a number of improvements that they had made, including hiring more staff, to bring down the case manager-to-patient or -outpatient ratio, and those sorts of things.

I think they need more training. The soldiers complained often, and this was very surprising, about being rudely treated by people at Walter Reed, obviously not everybody. There are a lot of people who care up there and work very hard. But often they got treated, they thought, in a not very compassionate way.

JUDY WOODRUFF: Dana Priest, who said that -- you told me a minute ago you cried on some of the days after you were there at the hospital. Thank you very much.

DANA PRIEST: Thank you.