Tag Archives: military medicine

Admiral Ronny Jackson: As Qualified to Head the V.A. as Tom Cruise is to Command the Top Gun School

Dr. Ronny Jackson Briefing

Note: this Post was written before Admiral Jackson withdrew his name from nomination.

Friends of Padre Steve’s World,

President Trump foolishly nominated the White House Physician, Rear Admiral (Lower Half) Ronny Jackson to head the Veterans Administration. That nomination is in the process of coming apart as allegations by over 20 current and former military personnel which detail of Admiral Jackson’s abusive leadership, drunken rampages, and careless dispensing of controlled substances including opioids has come to light. If any of those allegations are true he should not only be removed from consideration for the Veterans Administration position but he should be forced out of the service.

But even if none of those allegations are true Admiral Jackson in completely unqualified to be the Secretary of Veterans Affairs.

From a career standpoint Admiral Jackson is an oddity in military medicine. Most officers who rise to the rank of General or Admiral in the Medical Corps, Medical Service Corps, or Nurse Corps earn their rank in a variety of demanding assignments of increasing responsibility after they are promoted to the grade of Major or Lieutenant Commander in their respective services. Most combine clinical, administrative, and command assignments, serve on combat deployments, and spend extra time to do advanced fellowships in their medical field, or obtain degrees in Medical Administration, Business, or subjects like Ethics. Quite a few take the time to earn higher military education at schools like the Naval War College, Army Command and Staff and War College, the Air War College, or Marine command and Staff College.

Their assignments usually encompass commands of clinics, field hospitals, hospitals, major medical centers, and medical regions which cover half of the United States. The men and women who go through this process have to understand the extremely complicated world of the military and civilian medical systems, insurance programs, veterans medical benefits, and Medicare. These are men and women who are exceptional, honed in combat and erudite enough to understand the complexities of the Veterans Administration. Having served two full tours in Naval Medicine as a Chaplain I know a lot of them and could name five Flag Officers from the Medical Corps and the Medical Service Corps, active duty and retired off the top of my head who would be excellent candidates for the position, as well as a number of exceptional Navy Captains. All of them are far more qualified than Admiral Jackson.

Admiral Jackson has never been in charge of anything more than a medical clinic, the White House is his second clinic assignment despite its rather high profile patient base. From all accounts he is an excellent Emergency Medicine physician, he is a qualified Navy Diver, and he has served in a combat setting caring for the wounded during some of the bloodiest times in Iraq’s Al Anbar Province. That being said he has served in the insular and politicized world of the White House for 12 years, during which time he was promoted to Captain and later Rear Admiral. The White House clinic is the largest that he has ever commanded, a mere 70 people. When I was a 25 year old Army Medical Service Corps First Lieutenant I commanded a Medical Company overseas of 110 soldiers, most of them medics.  When I was a 27 year old Captain I served as a personnel officer for the largest Medical training organization in the U.S. Military. Neither qualify me to command a hospital or oversee an agency as vast as the V.A.

I’m sorry, but by any means that is not a career path that should lead to an appointment that would oversee the largest medical system in the nation.

That my friends is reality even if there were no allegations of abusive conduct or careless distribution of controlled medications; allegations detailed by the Inspector General in 2012 which resulted in a recommendation for his relief and reassignment which did not happen. However, Admiral Jackson is white, male, and Hollywood good looking, and exactly the kind of man that the President hyperventilates about, especially when they engage in hyperbole and lies to describe his physical condition. Admiral Jackson is as qualified to head the Veteran’s Administration as Tom Cruise is to Command the Top Gun School.

Admiral Jackson is not qualified for the head of the Veterans Administration or any higher post in Navy Medicine. His nomination should be immediately withdrawn instead of being allowed to become yet another disgusting political spectacle designed to polarize the nation.

If the GOP Congress had any balls, which they don’t but can be purchased at the National’s Shop, they would tell the President right now to drop this nomination like his trousers at a Playboy Club party.

The President set himself and Admiral Jackson up for this and if he has any sense of honor he would end it now and go back to the drawing board to pick a truly qualified person. Like I said I can name five off the top of my head, he can ask me for recommendations if he wants, and if he picked any of them they would make him and the nation proud.

This isn’t about politics. It is about qualifications and character. Admiral Jackson certainly lacks the qualifications, and very likely the character needed to serve in such a responsible position involving the care of millions of veterans. I’m a combat veteran, and all veterans deserve better.

Peace

Padre Steve+

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Filed under ethics, Military, News and current events, Political Commentary, US Navy

A Good Day to Speak Truth to Power and to be Listened to

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I have been writing about my recent experiences in trying to get help for my own issues dealing with PTSD as well as my frustration with a military mental health system that is, at least in my view, floundering.

That effort over the past month or so has been quite painful, at times humiliating and dehumanizing, and frankly driven me into a depressed and nearly suicidal fog, from which I am slowly emerging.

Today was a good day. Not just for me but maybe for all of those seeking help at our local Naval Medical Center. Instead of being blown off and shunted aside by providers as well as mid and high level administrators I was able to have a long, nearly forty-five minute phone conversation with the Admiral who commands that facility as well as every Naval Medical facility on the East Coast and Europe, with the exception of the Bethesda-Walter Reed complex in Washington DC. Bottom line up front; it was a very good and positive experience for me that I believe will help others get better care.

I have to say up front that I was terrified about asking to talk to him. One of the people on his staff told me that “it would not be a good thing for me to talk to him.” When I heard that comment my heart sank. I didn’t know what to do, I was perplexed because most commanders of Medical facilities in the Navy that I have worked for actually did want to hear about negative experiences of the people that are their customers, most because they care, but if nothing else because they want to make sure that they pass the Joint Commission accreditation that their facilities get every few years. So I wondered if the Admiral actually knew what was going on, at least in regard to the Mental Health Department and the experiences of people like me.

My last Command Master Chief, who read some of my very angry posts on a social media site suggested that I call my former Commanding Officer, a man who helped me a lot, cared about me and who is soon to become an admiral. I finally worked up the courage to call him, not out of fear, but because I felt like I might be bothering him, and would not be worth his time. I left his command a year ago and frankly I thought why should someone moving up in an organization be bothered by the problems of a former subordinate.

However, he was both concerned and helpful. He did not just listen but he took action by contacting the Admiral here. He told him that he knew me and that he knew that it was my desire to make sure that people get the help and care that they need, that I wasn’t just complaining or seeking special treatment.

Yesterday the admiral called me, of course my phone went directly to voice mail so I missed the call, but his message, and the tone of his voice conveyed a sense of care and concern. I called back and got his voice mail. So this morning I called again and was able to share my heart, in a very respectful way with him. He listened and seemed to be attempting to formulate some kind of positive response that would actually help people. He wants to get answers and he told me that he wanted those that come to that facility to be treated as he would want his grandparents treated.

As I said we talked for forty-five minutes and he listened. I have no doubt, within the very real fiscal constraints faced with current budget cuts and the still looming threat of sequester that he will do his best to improve and change the system that is within his control. He also did something that I have never experienced before from a superior officer, he called me “sir” a number of times. I am not used to that and I don’t think that I have ever in all of my reading of military history recall an Admiral or General calling a subordinate “sir.” I was blown away.

That system appears to be undermanned, under-budgeted and overwhelmed. It is struggling and as it struggles, as it reacts to criticism from the media, politicians and advocacy groups, it resorts to protecting itself as any bureaucracy does in such a situation. The Admiral realized this and he encouraged me to call him again on his office number if I see things that he can help. That was very encouraging. I don’t think that I will have to ask him to intervene on my part, but I have an open door to use this relationship to help others.

All that being said, most people do not have the connections that I have in the system, nor are they willing to take the risks to rock the boat. The stigma is great and personal risk can be or at least seem too great to make the effort, so most people just give up. After all the bureaucracy can be unbending and even vindictive in the way that it rebuffs those that try to raise issues. They resist change and try to keep bad news from enquiring superiors. Bureaucracies and those who faithfully serve them do just that. It is part of who and what they are; be they military, other government, business or ecclesiastical organizations. Admiral Alfred Thayer Mahan wrote:

“It [the bureaucracy] tends to overvalue the orderly routine and observance of the system by which it receives information, transmits orders, checks expenditures, files returns, keeps the Service the touch of paper; in short, the organization has been created for facilitating its own labors.”

However, when I first collapsed after Iraq, I decided that I could not be silent and have “sky-lined” myself which probably will not help me get promoted, not that care anymore. I am sure that being so public about my struggles with PTSD, Moral Injury and even my crisis of faith, which left me an agnostic for a couple of years, while serving as a Chaplain in adult and pediatric Intensive Care Units has marginalized me in the Chaplain Corps. I don’t know that for a fact and would hope that it is not the case, but it is the feeling that I get when I deal with most Chaplains.

All of that said, the past few weeks have been some of the most difficult since my return from Iraq. I personally find no pleasure in being anxious, depressed or feeling suicidal and getting even less sleep than my chronic insomnia normally allows.

At least I was listened to, and I really did get the sense that the Admiral that I was able to have such an honest conversation with today, does really care and wants to help improve the system and change the culture.

But that is the thing. This is a systemic and cultural problem, not just in the military or the Veterans Administration, but in society as a whole. In our desire for efficiency, supposed effectiveness  measured by profits and the bottom line; we have forgotten to care about people. Sadly that is statistically verified in poll after poll by people from all parts of the political spectrum. People don’t trust the government, they don’t trust big business, they don’t trust health care systems, they don’t trust the police, they don’t trust the banking and insurance industries and they certainly don’t trust the church or religion in general. Can I get an amen?

Thank you…

But our culture has to change, we have become so materialistic and embrace the most crass forms of predatory Capitalism and Social Darwinism, even in church, that people don’t matter, especially the poor and those with no voice or power, especially those who volunteer to serve the nation and come back broken in body, mind and spirit.

Joshua Chamberlain the hero of Little Round Top at Gettysburg spoke years after the Civil War something that should be a warning to us about how we treat people. Of course Chamberlain was talking about the horror of war, but it can apply to anyone, anywhere:

“But we had with us, to keep and care for, more than five hundred bruised bodies of men–men made in the image of God, marred by the hand of man, and must we say in the name of God? And where is the reckoning for such things? And who is answerable? One might almost shrink from the sound of his own voice, which had launched into the palpitating air words of order–do we call it?–fraught with such ruin. Was it God’s command that we heard, or His forgiveness that we must forever implore?”

His question is as operable today as it was then. There has to be a reckoning somewhere for destroying peoples lives, and further traumatizing them when they seek help, otherwise there is no justice nor anything that resembles a loving God.

We have to start valuing people, regardless of their social status, their race, religion, sexual preference, disability or even their alma mater. If we don’t start caring for people as human beings, then why bother with anything else? It is either about humanity or its not. Those who are comfortable cannot turn a  blind eye thinking that these issues don’t affect them, because they will.

So in spite of being unpopular in some circles I take the personal risk to speak the truth the best and most honest way I can to anyone that will listen. I have to do it, for those that feel that they have no voice, as well as those who I have known who have lost their lives after giving up on the system. I owe it to them. It is now my mission in life and I do that I can both inside the system and outside of it to speak out for those who need it.  I guess I have become something of a liberal social activist, not that there is anything wrong with that.

I can be as persistent and irritating as Mustard Gas; I am doggedly determined to speak out for those that do not feel that they matter or have a voice; and I will stay in the fight until I can’t fight anymore. As Paul Tillich said “It is my mission to comfort the afflicted and to afflict the comfortable.”

I admit that sometimes it is like tilting at windmills, but this week, two men who have the position to influence the system took the time to listen and just maybe at least at some level things will begin to change. I am grateful tonight, maybe I will sleep well…

Peace

Padre Steve+

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Filed under faith, healthcare, mental health, Military, PTSD, suicide, US Navy