TIME Veterans

The Damning Data in the VA Wait-List Report

U.S. Department of Veterans Affairs Secretary Eric Shinseki testifies before a Senate Veterans Affairs Committee hearing on VA health care, on Capitol Hill in Washington, D.C., on May 15, 2014.
U.S. Department of Veterans Affairs Secretary Eric Shinseki testifies before a Senate Veterans Affairs Committee hearing on VA health care, on Capitol Hill in Washington, D.C., on May 15, 2014. Jonathan Ernst—Reuters

Problem's depth and duration imperil Shinseki

Facts can be twisted, but it’s tougher to do with numbers. These are the key numbers, and the excerpts from which they’re plucked, in Wednesday’s interim report on wait times at the Phoenix VA. The Department of Veterans Affairs inspector general’s findings make it increasingly clear that Secretary Eric Shinseki’s job is in grave danger:

18 reports

Since 2005, the VA Office of Inspector General has issued 18 reports that identified, at both the national and local levels, deficiencies in scheduling resulting in lengthy waiting times and the negative impact on patient care.

42 facilities

To date, we have ongoing or scheduled work at 42 VA medical facilities and have identified instances of manipulation of VA data that distort the legitimacy of reported waiting times.

1,700 veterans

To date, our work has substantiated serious conditions at the Phoenix HCS [Health Care System]. We identified about 1,400 veterans who did not have a primary care appointment but were appropriately included on the Phoenix HCS EWLs [Electronic Wait Lists]. However, we identified an additional 1,700 veterans who were waiting for a primary care appointment but were not on the EWL.

115 days

VA national data, which was reported by Phoenix HCS, showed these 226 veterans waited on average 24 days for their first primary care appointment and only 43 percent waited more than 14 days. However, our review showed these 226 veterans waited on average 115 days for their first primary care appointment with approximately 84 percent waiting more than 14 days.

1,085 MIA

As of April 28, 2014, the New Enrollee Appointment Request report listed 1,138 veterans who were waiting for an appointment an average of 200 days. However, only 53 of the 1,138 veterans were on the EWL. The remaining 1,085 patients were not on the EWL. Consequently, their wait time prior to being scheduled or added to the EWL would potentially never be captured in any VA wait time data.

66%

It appears that a significant number of schedulers are manipulating the waiting times of established patients by using the wrong desired date of care. Instead of schedulers using a date based on when the provider wants to see the veteran or when the veteran wants an appointment, the scheduler deviates from VHA’s scheduling policy by going into the system to determine when the next available appointment is and using that as a purported desired date. This results in a false 0-day wait time. We evaluated FY 2013 established patient appointments in primary care and determined that for 66 percent of appointments, Phoenix HCS recorded veterans had no wait time.

4 years

Many of these schemes are detailed in the then Deputy Under Secretary for Health for Operations and Management April 2010 Memorandum on Inappropriate Scheduling Practices. The purpose of the memorandum was to call for immediate action to identify and eliminate VHA’s [Veterans Health Administration] use of inappropriate scheduling practices to improve scores on clinical access performance measures. The memorandum discussed many of the same schemes we identified at Phoenix HCS and other medical facilities throughout VHA.

4

The number of times the word “systemic” appears in the 35-page report to describe the problem, including

We are finding that inappropriate scheduling practices are a systemic problem nationwide.

The VA is a huge institution, its 300,000 employees tending to the needs of 230,000 veterans daily. There are bound to be problems of varying scope and size in any such gargantuan place.

What the report makes plain is that the problem, contrary to statements from VA headquarters, is widespread and deep. At a Senate hearing May 15, Shinseki said he was aware of such malfeasance in “a number of isolated cases” that he downgraded to “a couple of cases” moments later. But worse than the problem itself is the fact that it was formally identified in April 2010, along with a call to stop such cheating.

Following the report’s release, Shinseki declared the “systemic issues with patient scheduling and access” it contained “reprehensible” and ordered changes. But it may be too little, too late.

“If Secretary Shinseki does not step down voluntarily,” Senator John McCain, R-Ariz., “then I call on the President of the United States to relieve him of his duties.” The report triggered additional bipartisan calls by lawmakers for the retired four-star Army general to resign. While the IG said it hasn’t concluded whether or not any of the delays contributed to veterans’ deaths, it seems almost moot. Only the living can suffer.

TIME Veterans

Report: 1,700 Veterans Missing From VA Wait List in Phoenix

Veteran Affairs Clinics To Be Audited After Patient Deaths At Phoenix Hospital
Exterior view of the Veterans Affairs Medical Center on May 8, 2014 in Phoenix, Arizona. Christian Petersen—Getty Images

A report found "inappropriate scheduling practices" at Veteran Affairs clinics in Phoenix, Ariz. accused of delaying life saving treatments

Some 1,700 veterans waiting for an appointment at Veteran Affairs clinics across Phoenix, Ariz. were nowhere to be found in the system’s official wait list, federal investigators reported on Wednesday.

Investigators for the Veteran Affairs Office of Inspector General said they had found initial evidence of “inappropriate scheduling practices” in the Phoenix Health Care System, which had led to “significant delays in access to care.”

Although data reported by Phoenix authorities suggested a statistical sample of 226 veterans waited an average of 24 days for their first primary care appointment, the review found that those 226 veterans actually waited on average 115 days to receive a primary care appointment. Only 16 percent got an appointment in 14 days or less, according to the interim report.

Acting inspector general Richard Griffin confirmed in the report that the omission of so many names from Phoenix’s official wait list meant that leaders greatly understated the time patients were likely to wait for their primary care appointment.

Whistleblowers have accused the Phoenix staff of deliberately omitting patients from wait lists and putting them on “secret lists”, delaying urgent treatments that could have saved several veterans’ lives. The report concedes that a “convoluted scheduling process” led to multiple lists of veterans that might explain the allegations of “secret lists,” and said it would review death certificates, medical records and autopsy results to determine whether any veterans had died while waiting for care.

Allegations of delayed care and “secret” wait lists have led to calls for Secretary of Veteran Affairs Eric Shinseki’s resignation and prompted a sweeping investigation of Veteran Affairs facilities across the country. Shinseki called the interim report’s findings “reprehensible” and pledged swift action, but the head of the House Veterans Affairs Committee issued a fresh call for his resignation after the report’s release.

Investigators cautioned that the preliminary findings had not established intent behind the missing names, nor had they proven that the absence of names led to actual delays in treatment. They also noted that Phoenix was not alone in its administrative troubles, adding that a nationwide review of medical facilities “confirmed that inappropriate scheduling practices are systemic throughout VHA.”

The report’s authors also said the Inspector General’s office had received “numerous allegations daily of mismanagement, inappropriate hiring decisions, sexual harassment, and bullying behavior by mid- and senior-level managers at this facility,” that would merit further investigation.

Investigators said they would continue to comb through 550,000 emails and documents obtained from the clinic and interview staffers ranging from clerks to senior managers, before drawing any conclusions about the allegations.

 

 

TIME Military

Iraq Vet Killed In Gunfight With Police Was Turned Away by VA Hospital

Army Specialist Isaac Sims is seen here in a holiday greeting he sent from Ramadi, Iraq in 2009. 1st Brigade Combat Team, 82nd Airborne Division Public Affairs/US Army

Agency, amid overcrowding scandal, says case of Kansas City soldier suffering from PTSD symptoms is under investigation

Correction appended, May 28, 2014

The bloodstained floor of his father’s garage is a long way from the Iraq streets where Isaac Sims served two tours of duty in the U.S. Army’s famed 82nd Airborne Division, but it was there that the violence finally caught up with him.

Tortured by symptoms of PTSD, turned away by an overbooked hospital run by the Department of Veterans Affairs—his mother says she pleaded with doctors to let him sleep on the hospital floor—Sims was shot by Kansas City police on Sunday after they answered a neighbor’s 911 call. Police say Sims was firing a gun from inside his parents’ home and was killed when he moved to the garage and leveled the weapon at the SWAT team.

Family members don’t believe that the 23-year-old veteran was a threat to police. “With his sniper training, if he was shooting at them he would’ve hit them,” his sister Shawnda Anderson told TIME. But everyone could agree that the root cause of the confrontation was that Staff Sergeant Sims was falling to pieces, and felt like he had nowhere to turn.

“He was in so much turmoil from seeing so many dead bodies in Iraq,” said Anderson. Patricia Sims, mother of the dead soldier, put it this way: “The last six months have been such a nightmare for him. The V.A. kept saying, ‘we’ll get to you later.’ ”

Officials at the V.A. hospital in Kansas City referred questions about the case to Washington, where a department spokesperson said that the “matter is currently under investigation.” Citing federal privacy laws, the agency declined to discuss any specifics of Sims’s case.

Still, the reality of V.A. overcrowding has been commanding headlines and driving Congressional hearings for weeks, driven by revelations that some hospitals have falsified records to mask long wait times. As the daughter of a Korean War veteran, wife of a Vietnam vet, and mother of a veteran of the Iraq War, Patricia Sims knows a lot about the V.A. system, and she said Tuesday that the Kansas City hospital is “great compared to a lot of places” in the system. “But they’re slow; they’re overbooked; they put him off and they put him off and now he’s dead.”

She spoke as friends and family members moved dazedly around the scene of the young man’s death in eastern Kansas City. The family car was on blocks—disabled by police during the stand off, she said. Meanwhile, a funeral home was refusing to collect the body on behalf of the family without payment up front. Shawnda Anderson said that her parents weren’t even sure they wanted to pay a funeral home: to bury their son would only confirm that he is truly gone.

According to family, Sims lived an itinerate childhood, traveling the country from one trailer park to the next as his father pursued work as an electrician. A gentle, peacemaking sort of boy, he never grew tall (his sister puts him at 5-foot-3, but according to a Facebook post, he preferred to say 5-foot-5). But he was wiry and dogged, and at 17 enlisted in the Army for what he intended to be a career.

(In 2009, Sims recorded a holiday greeting from Iraq. Watch below)

Instead, after six years and two combat tours, he mustered out, suffering from unspecified disabilities. Unmoored, he began abusing drugs—huffing aerosols primarily—and behaving erratically, his mother said. According to one source who had been briefed on his medical history, Sims suffered “nightmares, flashbacks—just massive Post-Traumatic Stress Disorder,” with symptoms easily triggered, yet seemingly impossible for him to discuss.

In April, after pleading guilty to two counts of domestic violence, Sims came under the supervision of Municipal Court Presiding Judge Ardie Bland. Widely admired for his work with troubled veterans, Bland placed Sims on probation through a program jointly run by the court and the V.A. Launched in 2009, the Veterans’ Treatment Court tries to restore veterans to “law abiding, productive lives within the country they have defended,” according to municipal court spokesperson Benita Jones. The probation was to include intensive treatment, random drug testing, and frequent reviews.

Sims was distraught over the conviction, which crushed his hopes of starting a new career as a police officer, his mother said. Increasingly alarmed by her son’s deterioration, she offered to send him with a blanket to the V.A.’s in-patient mental health facility, reckoning that a soldier doesn’t need a bed to sleep in. Instead, the intensive treatment envisioned by the special court failed to materialize in time.

“We are saddened by such a tragic loss,” Judge Bland said in a statement. “Our hearts must now go out to the family of Mr. Sims with our prayers and support. We will continue our efforts in the Veterans’ Treatment Court, in his honor and in honor of the others that have served this country.”

A memorial fund has been established in Sims’ name at the United Credit Union.

According to police: A neighbor reported shots fired from the Sims home shortly after noon on Sunday. The SWAT team fanned out, surrounding the house, and the inhabitants of the 2300 block of Lawndale Avenue were evacuated to safety. Hostage negotiators quickly researched the soldier’s story in hopes of coaxing him out. But “things went rapidly downhill,” in the words of one witness, and in a spatter of gunfire Isaac Sims went down, dead on the battlefield that had consumed his life.

And there was one more fallen soldier to mourn on Memorial Day.

-with reporting by Karen Ball/Kansas City

Correction: An earlier version of this story incorrectly referred to the Department of Veterans Affairs
TIME Veterans

Who Cares About Shinseki? Let’s Focus on Understanding Vets

Enduring Freedom
Marine General James Mattis, head of U.S. Central Command, visits troops in Afghanistan on Christmas Day, 2011. Marine photo / LCpl Justin Loya

The continuing political struggle over VA chief’s fate risks distorting the public’s view of those who fought

Washington relishes nothing more than dumping someone’s career into a centrifuge and punching “puree”—it separates the good from the bad, and leaves Americans, with plenty of help from the media, to focus on the bad.

Regardless of what happens to Department of Veterans Affairs Secretary Eric Shinseki, the sturm und drang surrounding his VA tenure is doing little to help the U.S. public understand the nation’s veterans at a time when such insight is desperately needed. The high-profile attention on ailing vets can only exacerbate, in the public’s mind, that most of them are coming home broken one way or another.

“We are telling these guys they are somehow damaged,” Jim Mattis, a four-star Marine general who retired in 2013, warned Tuesday. “Only about 15% have ever been in close combat, so when the biggest danger is getting their foot run over by a dessert cart at a [forward operating base] is somehow translated into us giving people money who said `I had to stand on a ramp when a dead guy was put on the airplane.’ Now don’t get me wrong—I respected every one of them—but hey man, this isn’t as bad as Iwo Jima, and those guys came home and raised healthy families, they ran universities, they developed corporations that made America competitive in the world.”

Last month, in remarks following a speech in San Francisco, Mattis urged fellow veterans of Afghanistan and Iraq to fight any suggestion that they are victims. “There is no room for military people, including our veterans, to see themselves as victims, even if so many of our countrymen are prone to relish that role,” he said. “While victimhood in America is exalted, I don’t think our veterans should join those ranks.”

For the 1% of the nation that waged the post-9/11 wars in Afghanistan and Iraq, the VA mess surely isn’t what they had in mind when volunteered to fight. They also fear the shadow it could throw on their service in the public mind. There are concerns that the VA scandal could do to the post-9/11 vets what movies The Deer Hunter, Taxi Driver and Apocalypse Now did to their fathers in Vietnam—paint them with a too-broad brush that unfairly tarnishes most of them.

“For a certain subset of the population, my service means that I—along with all other veterans—must be, in some ill-defined way, broken,” Phil Klay, a Marine Iraq veteran, wrote in the Wall Street Journal over the Memorial Day weekend. “…All of us, especially those who are struggling, deserve a little less pity and a little more respect.”

Views among the vets who served on the front lines—what there were of them, anyway—focus on the disconnect among the troops, the leaders, and the public in whose name both were acting. “The root this discussion seems to be our inability, from the war in Vietnam to the Global War on Terror, to justify these wars,” says Alex Lemons, who pulled three tours as a Marine in Iraq, including one as a scout-sniper. “They don’t fit my grandparents’ experience in the `good war,’ and this leaves open two competing views and two different views of veterans. Look at the Gulf of Tonkin incident and the drumbeat over weapons of mass destruction in Iraq, and you won’t see much difference. Lies were told in order to make the wars possible.”

Perhaps.

Former Army Specialist Cory Isaacs, who spent a year in Afghanistan, said misperceptions aren’t surprising given the nation’s attitude. Many Americans “do not understand the military, we do not like the military, we do not want to be in the military, we do not understand why anyone would want to join the military, perhaps even we feel some residual guilt for treating Vietnam vets as we did, so we pity our vets, or glorify them, or treat them as pawns,” he says. “Rarely do we know them. More rarely do we understand them.”

Fair point.

What’s needed is a simple campaign that sweeps aside such misimpressions, says William Treseder, who spent a decade as a Marine sergeant, including a 2008 tour in Iraq and a 2009-10 stint in Afghanistan. “I suppose it would be too much to ask to have a `Veterans are people, too’ campaign,” he says. “That is something I would like to see.”

Why not?

Military medical professionals stress no one can dismiss the real sacrifices make in war, but that they shouldn’t be used as a shortcut for labels. “Veterans are neither victims nor heroes,” says retired Army colonel Elspeth Ritchie, who served as the service’s top psychiatrist before leaving in 2010 after 24 years in uniform. When she visits the gym at the Walter Reed National Military Medical Center outside Washington, she says she generally sees several amputees working out “with incredibly high spirits. But that’s not everybody,” she cautions. “There’s definitely a subset that’s really struggling.”

Mattis says U.S. society began viewing vets as battered goods when it was seeking to lump them in with the Vietnam war they were waging. “There was a divorce between patriotism and liberalism going back to the ‘60s and ‘70s, and I think part of that divorce meant you had to look at veterans as damaged,” he says. “What we did to our veterans after Vietnam was pretty disgusting, and now it seems we’ve gone along the lines of assuaging guilt” by suggesting they’re victims.

If too many vets see themselves that way “they’ll lose the initiative we all feel when were in control and masters of our own life,” Mattis says. “That is not manly and it’s not in keeping with what made America great…To survive, a democracy to survive is going to have to be defended—and the people who come home from doing it can come home stronger, kinder to their families and their fellow man,” Mattis says. “They can come home with post-traumatic growth.”

Combat changes those involved, regardless of which end of the gun you’re on. But it doesn’t lead inevitably to post-traumatic stress, suicide, divorce, joblessness or any of the other pathologies often linked in the public’s mind with veterans. Yet the concern is that if much of the public believes that to be the case, it will calcify into perception that eventually becomes reality.

100729-A-VO565-001
Vice Chief of Staff of the Army General Peter Chiarelli dedicated a lot of time detailing the mental strains of war, including at this 2010 Pentagon briefing. Army photo / D. Myles Cullen

“I feel partially responsible for this problem,” says retired Army general Peter Chiarelli, who left the service as its vice chief of staff in 2012. “I worked hard when I was vice to bring attention to post-traumatic stress and traumatic brain injury because they were the most prolific wounds coming out of these wars.”

But he fears he may have been too successful in delivering that message. “There’s a view that everybody who comes back from deployment is somehow not able to function properly in society, and that’s just flat wrong,” he says, unable to mask his exasperation. “That has been a double-edged sword—we raised awareness of this whole thing, but at the same time, you’ve got middle-level human-resource managers who automatically throw out the file of some veterans because they just don’t want to have something bad happen in their workplace.”

U.S. society and business prefers to focus on the 80% or so of returning veterans who are doing fine. “But the problems of the other 20% are getting lost,” Chiarelli warns. “We need to get them the care they need so they don’t end up like Vietnam veterans, who were standing on corners with pieces of cardboard and hand-scratched signs saying ‘I’m a vet—help me.’”

It’s not a new problem. “This has been around since the days of the Greeks,” Chiarelli says. “Let’s do something about it this time.”

 

TIME Religion

The Questions We Don’t Ask on Memorial Day

Why can’t we ask if these wars were right or wrong, worth the terrible sacrifices, or what we have learned from them?

Monday was Memorial Day, full of family trips and events, lots of picnics and barbecues with friends and neighbors, and a national day off from school and work. For us it was the Northwest Little League All Star game here at Friendship Field in Washington D.C., a family tradition for many years. My wife Joy, the Commissioner, organized the game day, including a wonderful picnic on a glorious baseball day for players, parents, relatives, and many fans–with 300 hotdogs!

It was also a day to remember all the people who have died in America’s wars. For the families of those war victims and so many of their fellow veterans it was a day of remembering and mourning. In the quiet moments of listening to the national anthem while looking at the American flag, our little baseball crowd with hats off might have been thinking about the meaning of the national holiday. But right afterward it was “Play Ball.”

On Memorial Days I always end up listening to the many stories from the families who lost their most beloved ones and from the veterans whose eyes still tear up when they recall their dearest buddies lost on battlefields far away. The emotion and pain always moves me. And watching all the messages of veterans’ organizations, you also see the incredible pain of those who came back from war with injuries and memories that still afflict their bodies, minds, and hearts. But I also wonder why nobody raises the questions about why all these sons and daughters, brothers and sisters, dads and moms–all these best of friends–had to die in those wars.

So why can’t we ask if these wars were right or wrong, worth the terrible sacrifices, or what we have learned from the wars? What was gained or lost? Who decided to go to war? And why do their families often bear the least consequences for the war decisions?

These are very hard questions, and people get angry when they are raised as some already are in reading this. Some will say it disrespects those who have suffered and died. But to raise the hard questions of why wars were decided and who decided them is actually a way to respect those who paid such a heavy price and perhaps would prevent more such horrible human costs.

I almost never hear veterans speak about the merits of their war, or its cause or purpose, or the strategies and ideologies behind the decisions to go to war. They talk about their friends, their brothers and sisters, their “family” who they lost on the battlefield. And the families of lost servicemen and women talk about how their loss was so devastating and life-changing. Hardly any of the Memorial Day testimonies are to the war; they are to the war victims.

The war in my youth was the Vietnam War and I still hardly ever go to the Vietnam Memorial. The few times I’ve gone there, I felt enormous pain. My generation’s names are etched on that long black wall, and when I read and touch them I feel overwhelmed with grief.

The Vietnam War was based on lies and was exposed as a political and moral mistake, but went on even after we knew it was wrong and destined for disaster. Vietnam’s American casualties were disproportionately lower-income and racial minorities. This war sank into tactics that killed many innocents while damaging the souls of our own soldiers. Vietnam violated our nation’s best values and religious convictions, but even then many were angry when leaders like Dr. King asked hard questions about war.

Iraq was another war based on lies, and morally compounded by being a war over oil. Was this a war of necessity or choice? Again, the casualties were significantly lower-income people and racial minorities who volunteered for the military hoping for future opportunities they didn’t have. Only some brave souls questioned why so few were asked to bear the terrible costs while the rest of the nation went on with life as usual. Afghanistan, begun to bring those who attacked us to justice, became the longest war in our history, again without honest answers to what we really have accomplished.

War has become such a business in America, whose beneficiaries are not the people we remember on Memorial Day. The veterans we honored yesterday are not even receiving adequate care when they come home and are being used as political pawns, as the latest Veterans Administration scandal reveals.

As we remember those who died serving our country, Memorial Day should also be a day when we ask the hard questions about our wars, what we have learned, and whether such painful losses are truly worth the terrible cost.

Jim Wallis is president of Sojourners. Follow Jim on Twitter @JimWallis.

TIME Veterans

Burr Duels With Veterans’ Groups

Sen. Johnny Isakson and Sen. Richard Burr
Senator Richard Burr, R-N.C., at the Senate hearing on Veteran Affairs, May 15, 2014. Bill Clark—CQ Roll Call/Getty Images

Fighting words from senior Republican senator on vets' panel

It’s always touching when a senator championing veterans’ issues fires a broadside at the leaders of groups representing veterans, on the eve of Memorial Day.

That’s what Senator Richard Burr, R-N.C., his party’s ranking member on the Senate Veterans Affairs Committee, did Friday. He issued a letter just before the holiday weekend saying that only the American Legion had the guts at a recent hearing to call for the ouster of Eric Shinseki, embattled chief of the Department of Veterans Affairs, for the lengthy wait times some veterans have had to endure.

The leadership of other government-recognized Veterans Service Organizations—VSOs—have been too busy cozying up to power to do right by their members, Burr said in an “open letter to America’s veterans”:

It became clear at the hearing that most of the other VSOs attending appear to be more interested in defending the status quo within VA, protecting their relationships within the agency, and securing their access to the Secretary and his inner circle… I believe the national and local commanders of every VSO have the interests of their members at heart, and take seriously their commitment to their members and their organization. Unfortunately, I no longer believe that to be the case within the Washington executive staff of the VSOs that testified. Last week’s hearing made it clear to me that the staff has ignored the constant VA problems expressed by their members and is more interested in their own livelihoods and Washington connections than they are to the needs of their own members.

Them’s fighting words from the distant relative of Aaron Burr, the former vice president of the United States famed for killing founding father Alexander Hamilton in an 1804 duel.

With his signature, Burr angered the Disabled American Veterans, Iraq and Afghanistan Veterans of America, the Paralyzed Veterans of America, the Student Veterans of America, the Veterans of Foreign Wars and the Vietnam Veterans of America—all of whom testified before Burr’s panel May 15 without calling for Shinseki to step down.

The VA mess has become a toxic stew featuring lengthy wars, nationalized health care and political opportunism. Republicans see it as a way to bash President Obama and his VA chief, even though the problem has existed for decades. And the medicine to cure the problem—more money—isn’t one the party is eager to embrace. Democrats fear if the problems are pervasive, they’ll hurt their re-election chances in November.

Burr’s letter triggered some tough responses from those he targeted.

“This is clearly one of the most dishonorable and grossly inappropriate acts that we’ve witnessed in more than forty years of involvement with the veteran community and breaches the standards of the United States Senate,” said the VFW’s William Thien, commander-in-chief, and John Hamilton, adjutant general, in a statement.

“Although Senator Burr attended much of that hearing, apparently all he wanted to hear were calls for the VA Secretary to resign,” Joseph Johnston of the Disabled American Veterans said. “Senator Burr may be enamored with the idea that all of VA’s problems and challenges can be overcome by replacing one Secretary, but the plain facts and simple logic indicate otherwise.”

But he didn’t attend the entire hearing, as Paralyzed Veterans President Bill Lawson and Executive Director Homer Townsend, Jr., noted in a letter: “Perhaps you should have shared with all veterans in your `open’ letter that you cared so much about their health care that you were not actually present during the testimony that the VSO representatives provided and you did not ask a single question to gauge our recommendations about how to fix the problems the VA health care system is facing.”

TIME U.S.

Memorial Day Should Be About Forgetting

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VisionsofAmerica/Joe Sohm—Getty Images

We need to move beyond the brutality of history, and that's where backyard barbecues come in as a building block of national morale.

Memorial Day is one of America’s most confusing holidays. Depending on the celebrant, it can be a day of grief, glory—or backyard barbecues.

It’s not a bad thing to have such disparate takes on a day of remembrance. And don’t worry: You’re not a bad person if you choose to sit back and enjoy your day off. But sometimes it pays to think about why we get the day off in the first place and ponder the mysterious forces that bind hot dogs, tears, and flags all together.

Decoration Day, as the holiday was once known, arose in the years after the Civil War as a way to grieve for the 750,000 soldiers who had perished over four bloody years. Families who stifled their mourning during wartime sought public ways to pay tribute to the fallen in peacetime. Understandably, graves become a focus for the bereaved, and mourners took flowers to cemeteries to decorate them.

This practice first received semi-official sanction in 1868 when General John Alexander Logan, the head of a large fraternal organization of Union veterans, designated a day each year “for the purpose of strewing with flowers or otherwise decorating the graves of comrades who died in defense of their country during the late rebellion.” Southerners didn’t take too kindly to this initial effort, but by 1890 all the Northern states had recognized the holiday.

This emphasis on the Northern dead wasn’t just born of sectional spite. The ultimate sacrifice made by hundreds of thousands of men to preserve the Union elevated the value of the nation to its citizens. Lacking the traditional building blocks of other nations (such as centuries of shared history on the land or ancient blood ties), the U.S. had long had a difficult time forging a unifying national culture. The idealistic nature of American nationhood left people hungry for a more flesh-and-blood connection to their country.

It was the Union dead who first seemed to prove that America was more than a mere idea. “Before the War our patriotism was a firework, a salute, a serenade for holidays and summer evenings,” wrote essayist Ralph Waldo Emerson in 1864. “Now the deaths of thousands and the determination of millions of men and women show that it is real.”

James Russell Lowell, the first editor of The Atlantic Monthly, thought that the enormity of the Union Army’s sacrifice also proved something to condescending Europeans. “Till after our Civil War,” he wrote in 1869, “it never seemed to enter the head of any foreigner, especially of any Englishman, that an American had what could be called a country, except as a place to eat, sleep, and trade in. Then it seemed to strike them suddenly. ‘By Jove, you know, fellahs don’t fight like that for a shop-till!’”

The holiday overcame sectional tensions around World War I, when Southerners—though many still revered the heroes of their Lost Cause—rejoined the fold, and the day’s scope was expanded to honor Americans who died fighting in any U.S war. Commemorating the fallen is one way that governments rebuild the morale of nations that have suffered great loss. Even in victory, losses are real to families, and depictions of a triumphant nation thankful for its heroes can be comforting to a populace trying to move forward. The U.S. Marine Corps War Memorial, also known as the Iwo Jima Memorial—which was unveiled in 1954 in Arlington, Virginia, and shows five Marines and a Navy corpsman hoisting the American flag during one of the bloodiest battles of World War II—is the quintessential depiction of perseverance and a classic commemoration of war.

But in the aftermath of no war do grief and glory intersect seamlessly. The needs of the state, bereaved families, and surviving veterans do not always coincide. In his book Remaking America: Public Memory, Commemoration, and Patriotism in the Twentieth Century, Indiana University historian John Bodnar describes the main sides of the late 1970s and early 1980s controversy over the Vietnam Veterans Memorial. On the one side, he writes, were national leaders, many patriotic veterans, and private citizens “who saw in the monument a device that would foster national unity and patriotism.” On the other were veterans who fought in Vietnam, people who cared about them, and bereaved families who were less interested in the memorial being a display of unity or patriotism than an expression of empathy for the soldiers who suffered and died. Empathy is paramount to the monument that was ultimately erected. The memorial—with the names of the fallen etched into black granite walls that sink into the National Mall—wound up symbolizing, in Bodnar’s words, “the human pain and sorrow of war rather than the valor and glory of warriors and nations.”

The annual Memorial Day holiday doesn’t elicit the same depth of emotional intensity as the planning of a permanent, national war memorial. But the interplay between grief and glory is ongoing. The politics and public reaction to war is ever-changing, and families who have lost soldiers in Iraq or Afghanistan are likely to observe the day differently than somebody who has not had a relative in uniform since the Korean War.

Memorial Day also has divided the public in another way: between those who chose to observe the holiday and those who saw it as a chance for leisure time. While there’s no way to accurately estimate the size of each group, historians Richard P. Harmond and Thomas J. Curran suggest it’s likely that the latter always has been larger than the former. And that gap is probably growing wider.

Rather than harangue about some presumed decline of patriotism or gratitude in America, I’d suggest that backyard barbecues are also fundamental to Memorial Day’s building of national morale. Yes, it is absolutely critical to remember the fallen and the wars they died in. But, as the 19th-century French scholar Ernest Renan argued, forgetting is “an essential factor in the creation of a nation.” We also need to move beyond old divisions and the brutality of history. That, my fellow Americans, is where the hot dogs come in.

Gregory Rodriguez is the founder and publisher of Zócalo Public Square. This piece originally appeared at Zocalo Public Square.

TIME U.S.

Heroism Is for War Movies, Not Veterans

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Catherine Lane—Getty Images/Vetta

I was explicitly taught by my leaders and noncommissioned officers that a hero is the last thing you want to be.

“They think I’m some kind of damned hero,” the young veteran, a former airman, said in a hushed tone while ducking his head and quickly glancing behind him.

His voice and body language communicated that he was distressed, but it wasn’t due to a war-related memory. It was ironically caused by one of those obligatory moments at a Memorial Day observance when someone with a microphone solemnly asked all the veterans in the room to stand so that they could be publicly thanked as “America’s heroes.”

The airman was a munitions specialist who loaded ordnance onto Air Force jets bound for remote valleys in Afghanistan. While he was stationed in Afghanistan, he never left the base and spent his time in relative safety compared to service members who left the wire to fight insurgents.

He knew he didn’t belong on that pedestal. But how could he possibly dissuade the well-meaning folks who smiled and clapped for him? They weren’t applauding the man before them. Rather, their applause complied with the now-expected reaction to all veterans.

I, too, have been to events like this one, which the airman described to me after a recent student veterans meeting. It also made me feel uncomfortable to represent all my fellow veterans and the complex and often contradictory emotions wrapped into the ‘veteran’ label. I was a peacetime soldier who served before the start of the Iraq War. I’m proud to have served, but I know that I’m not a hero.

On Memorial Day, when our thoughts will be with our fallen brothers and sisters, I ask you to reconsider excessive use of the word “hero.” Please don’t perceive it as ingratitude. The word is just too intangible and inaccurate, and it has a different meaning to veterans than to the general public. Whether the title is deserved or not, most of us feel uncomfortable with it.

Even America’s newest living Medal of Honor winner, Army veteran Kyle White, feels the same: “I was just doing my job,” he said in an NBC story. “I am still uncomfortable with hearing my name and the word ‘hero’ in the same sentence,” he added in a CNN story. That is not false modesty. Other combat veterans I know feel the same as him.

We all had jobs to do and orders to follow, and we did so to the best of our training and abilities. Like a very large proportion of living American veterans, the airman and I fulfilled our duty without hearing a single shot fired in anger. And, like all veterans, we implicitly understand that we performed our roles in service of a larger mission. At least as important, we were also in service to each other.

Heroism is not a goal for any service member, nor should it be. Point blank, heroism is for war movies. Professionals in this business know that when the American soldier must rely on heroism, it means that something has gone very wrong in the planning and execution of a mission. Soldiers train, plan, and fight in a way that takes heroism out of the equation. I was explicitly taught by my leaders and noncommissioned officers that a hero is the last thing you want to be. This was a cultural norm reinforced throughout training at different levels and extracurricular professional development.

“Hero” has the connotation of a very explicit four-letter word in military culture. A “hero” is someone who recklessly endangers himself or his buddies. Want to go home? Then don’t be a “hero.” Want to get out of that foxhole alive? Well, you’d better hope that you’re not sharing it with a “hero.” “Heroes” draw fire. “Heroes” take unwarranted risks. A “hero” goes out of his way to act or appear heroic. Most who’ve worn a uniform want nothing to do with these people.

When called upon by the direst of circumstances, though, we’re grateful that true heroes in our ranks step forth. I think of men like Sergeant First Class Alwyn Cashe. His uniform soaked in fuel after a roadside bomb explosion, he exposed himself to enemy rifle fire to rescue his soldiers who were trapped in a burning Bradley Fighting Vehicle. While pulling the driver out, his own uniform caught fire. After carrying the driver to safety—while still on fire himself—Cashe returned to the burning vehicle five more times. He would later die in a Texas hospital from burns to 72 percent of his body. He persisted in his rescue effort despite unthinkable pain and danger. No one asked him to; he did it for his soldiers. All six of them survived that day, and three of them are still alive thanks to him. He is a true hero.

So is Sergeant First Class Danny Ferguson, who died while using his body to block a door to protect a room full of soldiers from the shooter at Fort Hood in April. Cashe, Ferguson, and White (even though the status unsettles him) are true heroes. If faced with similar circumstances, who among us would actually muster that kind of courage?

We’re grateful for our heroes. True heroes have qualities we aspire to but hope that we never have to emulate. That’s because the circumstances for heroic action must exist before an individual can come forward to earn the title. Absent those conditions, we’re just doing our jobs like everyone else. Thus, many of us feel uncomfortable when the word “hero” is used loosely because we know better.

So why is there such excessive use of the term? An older veteran suggested to me that this is America’s way of making up for its neglect of Vietnam War veterans. By heaping praise upon a new generation, perhaps America is trying to heal its soul. Perhaps it’s trying to come to terms with its conflicted feelings about the most recent wars. This notion becomes more palpable with messages to “support the troops but not the war.”

The excessive use of the word “hero” also highlights a growing disconnect between those who are personally touched by war and the general population. During previous wars, there was a significantly higher percentage of the population in uniform, and Memorial Day directly touched most American families. Today, less than one half of one percent of our population is in uniform. Memorial Day seems transformed from something intensely personal for those who have lost family members or comrades to a spectacle from which many Americans have become emotionally disassociated.

Some correctly recognize that how we treat our veterans is an important reflection upon our society. But I think there’s a better way to express appreciation for veterans than simply calling them heroes. Help America follow through with its promise to veterans by ensuring that the Veterans Administration is well led, well managed, well funded, and accountable. Increase your support for veterans’ transition to civilian lives and employ them. Help the less fortunate veterans in our ranks. But simplest of all: just say “thank you” to acknowledge our service to America.

We served, and now we’re moving on with the rest of our lives. At the close of the Civil War, General Robert E. Lee’s words to his troops in his last address at the Appomattox Court House still resonate for veterans today, regardless of any one individual’s position on that war or any other: “And if you make as good citizens as you have soldiers, you will do well.” We are doing our best, just like you: we’re sons and daughters, coworkers, and neighbors, and despite stereotypes (both positive and negative), we’re also just as complex. We struggle our best to live to a high standard, but we’re very much human. Some of us are proud of our service, and some of us are trying to overcome aspects of it, but we’re neither heroes nor victims. All of us understand that we were in service to something greater than ourselves.

This weekend, our thoughts will be with those we have lost. That’s the real purpose of Memorial Day. Please save the title of hero for Cashe, Ferguson, and the rest of our dead. They won’t flinch when they hear it.

Mike Stajura is a doctoral candidate at the UCLA Fielding School of Public Health. He served in the U.S. Army from 1995-2002. This piece originally appeared at Zocalo Public Square.

TIME Military

Defense Secretary Hagel ‘Supports’ Shinseki Amid Health Care Crisis

But the Secretary of Defense says anyone responsible for poorly caring for sick, wounded veterans must be held accountable

Secretary of Defense Chuck Hagel lent his support to VA Secretary Eric Shinseki amid an ongoing veterans’ health care scandal, but said in an interview Friday that someone needs to be held accountable for the poor treatment of military veterans.

“Anytime there is an issue or a problem or a veteran doesn’t get service, or certainly if a veteran dies because he or she doesn’t get service, or anytime there’s an issue, there’s no higher responsibility our country has than to these people who serve and sacrifice,” Hagel said during an interview with Charlie Rose on CBS This Morning.

But Hagel stopped short of calling on Shinseki to resign over reports that at least 40 military veterans died while waiting for treatment at a VA health center.

“I support Secretary Shinseki,” Hagel said. “ This is an individual who has the responsibility, as he has said, to be accountable. The President said yesterday that there has to be accountability. There does have to be accountability on — right up and down the line. But I think we’ve got to fix the problem. That’s the real focus here.”

Watch the full interview at CBS This Morning.

TIME U.S.

What the VA Did for My Sick Husband

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RodrigoBlanco—Getty Images/Vetta

Amid scrutiny and furor over misconduct at the government agency, a widow gives thanks to the employees who cared for her husband in his last years.

Two weeks ago my husband of 51 years, Joe, died in his room at the William E. Christoffersen Salt Lake Veterans Home at age 87. He had served in the Navy from 1941 to 1946 and was a proud veteran.

Like others, I am deeply concerned by reports of delayed treatment for our veterans. Indeed, when I was receiving cancer treatments in 2011 and could no longer care for Joe at home, we had to wait nearly a month before a room became available in a VA facility.

But this is not a story of disappointment. It is instead one of deep gratitude for the extraordinary professional and personal care Joe received over the next three years. Of course we must not excuse those who betray their responsibilities to our veterans and our country, but we must also remember and celebrate the legion of VA employees who provide outstanding care to our veterans, day in and day out.

As Joe’s physical strength waned and vascular dementia sapped his memory, VA doctors, nurses and aides were alert to his medical needs. Time and again they took him to the VA hospital for tests, diagnosis and treatment.

More unexpected were the countless ways in which their thoughtfulness helped Joe and our entire family. Every veteran was treated with the greatest respect, even when he or she was being difficult. For example, at first Joe didn’t understand why he couldn’t come home with me and became angry whenever I left him. The staff always took him aside to provide comfort and tell him I would be back soon.

These small personal kindnesses made such a difference.

To the extent possible, Joe and other patients were encouraged to continue a normal life. Many activities and facilities were available at the nursing home, but patients were not confined there. There were outings of all sorts, such as professional sporting events, fishing, horse riding, shopping at a local store and short road trips to see the fall leaves—even after Joe was confined to a wheelchair.

Our family was allowed to visit any time of day or night, and staff would place a call for Joe whenever he wanted to talk to us. When he could no longer come home for the day, special dinners were scheduled at holidays so we could celebrate together. It was the little things that mattered the most, and they were the most unexpected.

What turned out to be Joe’s last treat took place the afternoon before his death. By then he was in hospice care, but did not realize that his status had changed. A nurse noticed that he seemed down and asked what would make him happy. He said he wanted a Coca-Cola and a Snickers bar. She pushed his wheelchair so they could fetch them, then brought him back with her to the nurses’ station, where they visited while he indulged in this special snack.

It is difficult to leave a loved one’s side once you know that the final stages of life are here. But we knew that no matter how suddenly Joe’s final decline might be, there was no danger that he would die alone. The staff made sure that someone would always be with any patient who was approaching death so that this would never happen, and that was reassuring for us. As it turned out, the doctor was able to gather most of his family in time to be with Joe as he slipped away. The last three of us, our daughter and son and myself, whose planes from Illinois, Arkansas and Texas did not get us to the nursing home until many hours after his death. The staff had kept Joe in his room to await us. The chaplain, who had come to work for a normal day, stayed until midnight so that she could comfort us after we said our goodbyes. Only then did the mortician take Joe’s body.

A final tradition, so touching that it brings tears to my eyes as I write, is that whenever a veteran dies, his caregivers line the halls to offer their salute and play “Taps” as his flag-draped body departs.

In our case, there was a postscript. Joe had greatly admired the black Converse sneakers of two of the aides. Many times he sought to purchase them from one or the other, once offering a dollar he’d won at Bingo as payment. Although they always declined, the aides decided to surprise Joe by purchasing a pair for him out of their own funds. But the parcel arrived a few hours too late. When I urged them to return the $60 shoes for a refund, they declined, saying they were meant for Joe. Although most mourners at his funeral didn’t realize it, Joe wore his new black sneakers to the grave.

Sandra Collard has five children, fourteen grandchildren and three great grandchildren. Her husband Joe served honorably in the U.S. Navy during World War II.

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