Well, it sounds good, anyway, all warm and fuzzy. Words like “support” and “coping” and “choices” and “supportive care” are tossed around casually by the powers that be, almost like they mean it. It’s the Warrior Transition Battalion, or “WTB” in military lingo, a program offered by the U.S. military to wounded warriors and their families, ostensibly to “provide personal support to wounded Soldiers who require at least six months of rehabilitative care and complex medical management. Support comes in the form of a triad of care with a primary care manager, a nurse case manager, and a squad leader — who coordinates care with other clinical and non-clinical professionals.” Sure.
In short, the military pays lip service to being compassionate and nurturing (concepts the military is really not mentally wired to implement), while the soldiers flounder around with various injuries and disabilities, including traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD), trying to meet the high expectations the military order still demands, while being flooded with lots and lots of drugs and very little in the way of actual medical treatment. And punishment for having deficits; there’s as much of that as there are drugs.
My son, Spc. Michael Maxfield, a Purple Heart veteran who joined the Army at 17, was on a tour in Afghanistan, on the recovery crew, until July 2012. Toward the end of his tour, while on a convoy, the wrecker he was driving rolled over a roadside bomb. His vehicle was blasted into the air, and he and his battle buddy of course went up with it – and crashed down with it. His limbs, at least, were intact – but as for his brain, sloshing around in his head as his wrecker left the ground and plummeted back down, as for his back and spine and body, which went through contortions the human body isn’t designed for, as for his mind, his emotions. . . not so much.
So, he ended up at Ft. Bliss, Texas, in the WTB program, with TBI, PTSD, and back and spinal injuries, and began his tenure in this “supportive” and “caring” program. Ten months later, this formerly healthy, high-functioning 25-year-old soldier is on ten different prescribed medications, for sleep, paranoia, anxiety, depression, back pain, high blood pressure and migraines; Many of these drugs, when taken together, have severe contraindications. He takes Zeprexa, an anti-psychotic, prescribed for paranoia; Klonopin, an anti-convulsant, sedative, muscle relaxer and hypnotic; Butalbital for migraines; Zomig, for migraines (which, ironically, has depression as a side effect); Trazodone, an anti-depressant for which suicidal thoughts is a side effect; Lunesta for sleep; Melatonin for sleep, which has side effects that include daytime sleepiness; Baclofen, a muscle relaxer, with side effects that cause impaired thinking; and Meloxicam, an anti-inflammatory for back pain.
He takes blood pressure meds, is on a CPAP sleep apnea machine, and – until recently – was on Percocet, otherwise known as Oxycodone, a heavy-duty narcotic, highly addictive. He took the drug as prescribed, but, suddenly, the military docs at WTB decided he could be addicted, and attempted to transfer him to a substance abuse program. He successfully fought that off, but not without a cost: Retribution by higher-ups toward the soldiers within the WTB program isn’t an alien concept; and failure to toe the line is not considered good soldiering, even within this supposedly nurturing environment, even when the soldiers – many of whom, like my son, are in the process of being medically discharged, or who are candidates for medical retirement – are functioning at a fraction of their pre-injury levels.
Spc. Maxfield, someone who rarely took as much as an aspirin before he rolled over that bomb, is now – along with many of the other soldiers – drugged to the eyeballs. He can’t sleep, or falls asleep in such a stupor he can’t get up for formation – and then is charged with being AWOL. He’s on drugs that impair his thinking, on drugs that keep him up or cause drug-induced, non-restful sleep, on drugs for pain that cause depression, on drugs for depression that make him tired all day, on drugs that put him in a dreamlike state – the supportive program that WTB boasts of is little more than a steady diet of ever more drugs. And then, within this same program – driven by the WTB Command, including squad leaders and platoon sergeants and 1st Sergeants – the soldiers are expected to function like regular soldiers, expected to get up at 5 a.m. for formation when the drugs have addled their minds and bodies, are expected to excel in areas they can’t possibly excel, particularly when plied with mind-altering drugs, drugs, and more drugs, are expected to meet every obligation like a fully-functioning soldier. Formerly high-functioning, punctual soldiers struggle to make it to formation, to remember appointments, to get through every day without being called out by the “supportive” WTB command.
But on the Ft. Bliss WTB website, Sgt. Carlos Clark, a WTB squad leader, made it sound quite pretty, made the military sound like some kind of compassionate support group: “We’re the first line for the Soldiers . . . We handle everything with the Soldiers — educational needs, frustration with medical care, getting to appointments on time. And we’re very realistic with them. When something is beyond their control we help them to cope with the choices that have to be made.”
As we speak, Spc. Maxfield is facing an Article 15 for missing two appointments his Nurse Case Manager failed to inform him of; WTB is threatening to remove him from the program because of the Article 15, which would cause him and his wife and two toddlers to be without military pay; and because of the injuries he sustained in the explosion, his former life, working in the trades, is over.
He and other soldiers are routinely accused of malingering. His back and spinal injuries are being treated with drugs, because what he needs is surgery, but the WTB program doesn’t provide for surgical intervention, and he won’t be eligible for surgery until he’s medically discharged from the military. As one orthopedic surgeon recently told me, it remains to be seen if surgical intervention is even possible at this point; the window of time for surgical treatment may have passed. His neuropsychological evaluation revealed severe cognitive deficits, but specialized TBI treatment is in short supply; his memory is shot, he forgets the names of people he’s known his whole life, words elude him, he’s constantly fatigued and in a fog due to the cocktail of drugs on board, and the “supportive” and “nurturing” WTB program seeks to now punish him for what they created with their prescriptions and negligent medical treatment. This is his story; but it’s the story of many soldiers who are imprisoned in the WTB program.
A few years ago, ProPublica and NPR did an extensive evaluation of the WTB program at Ft. Bliss. The results were not positive.
“At Fort Bliss,” reported ProPublica/NPR, “we found that even soldiers who are diagnosed with such [brain] injuries often do not receive the treatment they need. Most specialists say it is critical for patients who show lingering effects from head trauma to get intensive therapy as soon as possible. In the civilian world, such therapy is increasingly seen as the best way to minimize permanent damage, helping to retrain the mind to compensate for deficits. Yet brain-injured soldiers at Fort Bliss have had to wait weeks and sometimes months just to get appointments with doctors, medical records show. Many have received far less therapy than is typical at well-regarded civilian clinics. In some instances, Fort Bliss medical officers have suggested that the soldiers are malingerers or that the main root of their cognitive problems is psychological.” (Emphasis mine).
Despite the glowing picture painted on Ft. Bliss’ WTB website, my son’s viewpoint seems to be bolstered by other soldiers’ experiences in the program. The staff was found to be untrained or under-trained; treatment was minimal and often delayed; the soldiers were accused of malingering or of having psychological, not medical, issues.
Sgt. Brandon Sanford, 28, a dog handler who survived two roadside blasts in Iraq, “endured a year of balance problems and mental fog before Fort Bliss officials sent him for cognitive therapy.” “Here you have all these soldiers looking for help, and it was just getting swept under the carpet.”
Sgt. Raymond Hisey, 32, a convoy driver in the 1st Armored Division, “survived a roadside blast in Iraq in July 2009 . . . When he returned to Fort Bliss in October, he was diagnosed as having suffered a mild traumatic brain injury and was prescribed several courses of therapy. But a speech therapist cancelled several appointments, he said, and he clashed with the occupational therapist. Hisey was suddenly left without any treatment at all for his symptoms.”
Sgt. William Fraas, an 18-year military veteran and Bronze Star recipient, tried for nearly two years to get help for problems with his balance and vision. “No one listens to the soldier(s) . . . They are there and they are crying for help.”
Blown up in Iraq, Sgt. Victor Medina’s treating physician attributed his “multiple cognitive symptoms including poor concentration, short-term memory loss, and difficulty multi-tasking” to headaches and anxiety; he was accused of malingering. “I can understand being injured by insurgents,” he said. “But I can’t understand being injured by my own people.”
And then there’s Spc. Maxfield, my son, living with pain, in a fog, struggling to rebuild his life with his family, ensnared in a system that he’s finding it increasingly difficult to navigate. I told him what the Ft. Bliss WTB website said about helping soldiers cope when they can’t meet expectations, and he laughed. No, he said, not even close.
Said Lt. Col. Long Pham, Fort Bliss WTB commander, “This is first class. In the civilian sector they wouldn’t do this, but for our Soldiers, we do. Congress has mandated that we do the right thing for Soldiers, and we do.”
What they do is create “monsters” and then punish them for being monsters. What they do is try to pigeonhole the soldiers and their conditions into “psycho” and “faker” slots so they don’t have to actually treat them. What they do is create more anxiety for the wounded soldiers and their families.
Over 20 active duty soldier and veteran suicides a day should tell them something. Until we act – by calling for Congressional inquiries, writing letters, engaging the media – our wounded warriors will be sent out into the world ill-prepared, injured and alone.
First stop, Congressional Inquiry. Count me in.