The Broken Soldier

I do have a serious matter to discuss.  It came to my attention today an NCOIC at Ireland Community is essentially proposing denying care as punishment for arriving too early or too late for appointments.  “Denying care” for want of a better turn of phrase.  Care isn’t given at that time, but at a later time.  Top’s working on it, and hopefully this issue will be handled without several of us having to take it to the two-star.

Many here are highly medicated, have difficulty with mobility, memory, etc.  For those who can’t drive or don’t have cars with them, finding rides to the hospital can be a challenge.  Often these wounded warriors are seeking care to manage pain.  Denying them care, even if only until the next available appointment - which can be a few hours to who knows when? - strains fairness (just a bit) and possibly the law.  Extra duty, loss of privileges, non-judicial punishment, etc., these are appropriate to address the matter.  Denying care, for any amount of time, is not.  And beyond its unfairness and possibly extra-legality, it’s just plain cruel.

“Why don’t you be a real man and post our comments to your site? You know most people reading this think you are a pile of shit. Your site so I suppose yuo can have a one way site. Be a man you little terd. “The Army is picking on poor little Jimmerson Wimmerson.” THe Army has nothing better to do than to conspire against poor wittle Jimmerson. You fat slob”

Found the above comment waiting for moderation.

I’ll do my best, “Lyle,” to address your concerns in the order they’re written.

Re: Comments, clearly I do post comments.  Yours is number 8 if memory serves, and I did, against better judgment, recently open all posts to comment.  However, I do moderate so as to separate comments from spam.

Re: Most people reading this site think, that’s an interesting statement.  I wonder from which segment of your battered colon you pulled that one.  I seriously doubt the statement was driven by any standard form of knowledge justification, but I guess when one’s brain is housed in one’s ass, elbow deep colon-wading is as good a method as any.

But to correct you, on content, not your spelling or grammar and every other solecism your comment contains (as I’d like to get to bed sometime before my natural death), most people reading this site are family, friends, and or colleagues.  The remainder of my regular readership include Medal of Honor winners, US Senators and staff, presidential campaign staffers, other disabled vets, military members, and the occasional riffraff.  Whether those reading agree or not with my positions, what they think of me personally, etc. is not at issue.  The purpose of this site is to share my experiences with Army medicine with the world in hopes of improving upon it.

Re: Being a man, I have served honorably in two branches of the military - combat medics in both and OCS Candidate in one.  I broke my back in service to this country.  There is nothing unmanly in expecting the government and its agencies to meet its legal and moral obligations to me, and to air instances in which they have not in hopes of bettering the system for posterity.  That I occasionally use this medium to ‘bitch,’ as it were, it is my right.  My spine is sufficient payment for use of 1st Amendment rights relative to you, Lyle, a knucklehead gaining his right to post here by some combo of electricity, internet access, and a third grade education.  Though while we’re on the subject, and talking all tough, I use my full name on this site.  I’m sure a smart fella like you could easily find me and put your theories regarding my lack of manliness to the test.

Re: Conspiring, nowhere have I mentioned conspiracy against me.  Others have suggested it, but not me.  My position is clear.  I have a disabling line of duty injury.  I expect treatment and fair compensation as required by law.

Re: What the Army does with its time, that isn’t my concern beyond treatment.

Re: Fat slob, yes Lyle, I’ve gained quite a bit of weight since my injury.  As I suspect anyone in similar circumstances would.

You’re a funny guy Lyle.  Keep up the good work.

To the rest of my audience, I apologize for the disruption.  I’ll have serious matters to address as treatment plans and medical/physical evaluation boards progress.

… mother fucker throws rank at me for some stupid shit, I’m going to put him through a wall.

I’m having a bad pain day.  A 9 or so out of 10.  So bad I had to go to the emergency room.  The Army’s idea of pain management, for me anyway, is Mobic (an anti-inflammatory) and Gabapentin.  Needless to say, but I’ll say it anyway, it’s insufficient (big surprise, I know).  No narcotics, not even for breakthrough pain.  The ER shot me up with Toradol and Dilaudid.  I’m still in a lot of pain, but if I’m really still I can convince myself I’m too high to care.

I don’t know about you, but when I’m in severe pain I tend not to stand on ceremony.  It all hangs out.  I was trying to make myself comfortable in the extremely uncomfortable ER seats.  Those around me, who clearly fancy themselves as belt-fed hard chargers, kept looking at me.  My head is recently shaved, and I’m in PT gear.  I suspect they mistook me for a boot - as Knox is a basic training base.  That is, until I asked them what their fucking problem was.

Then I got back to the barracks.  I’m in pain and high as a kite.  Almost falling down and passing out.  I have trouble walking most of the time, but it was particularly hard, due to pain and drugs, today.  My hands were full with the PT jacket, my meds and personal effects.  As I made my way to my room, I passed two people.  I did not recognize either of them as I couldn’t see straight.  One of them stopped me, making some smart ass comment about not saluting.  What the fuck?  Hands full.  Hobbling on a cane.  Clearly drugged out of my mind.  Customs and courtesies are fine, but there’s a time to turn that shit off.  That situation is a good example.

And it’s this lack of common sense in applying rules, and of recognition when it’s appropriate to get in someone’s ass about a perceived breach of protocol, among many other things, that makes me glad I’ll soon be using my uniforms as kindling in a post-discharge bond fire.

Today’s the big appointment day.  Five of them beginning at 0930, ending around 1630.  Two with the physical therapist.  Two with social workers.  One with my primary care manager.  I’m not looking forward to any of this.

I woke up this morning with 5 out of 10 pain.  By day’s end, I expect to be close to 10 (or if Spinal Tap rules apply to quantitative descriptions of pain, perhaps 11).  This has been the way of things for the past week.  More activity is my theory, though it’s possible pain and activity increasing together is coincidence.

In a social work appointment yesterday, the nurse stated, “You really seem to be hurting.”  “Yes, I am.”  “No, not just physically.”  “Of course, ma’am.  This injury and the manner with which it’s been handled has destroyed me.  Am I angry?  Yes.  Am I depressed?  Yes.  Do I expect to be jerked around by those who’re supposed to be helping me?  Yes.  I’ve got the double whammy going.  Non-stop physical pain and disability working its magic on my psyche and my physiology.  I’m in constant ‘fight or flight.’  And of course, one of God’s little jokes, the presence of glucocorticoids, one chemical among many in the body’s chemical cascading response to stress, destroy SAM and HPA - the areas of the brain that regulate ‘fight or flight.’  Meaning the more stress, the less able I am, physiologically, to regulate it.”

She promised me the people here are here to help.  I think she believes that.  I would like to, and do to some extent.  But there are those who aren’t here to help.  They either don’t know how to help, or they don’t care to.  Functionally it’s the same.  And it’s what I’ve come to expect of Army medicine.  But today I have no interest in convincing the irrational skeptics (skeptics by ignorance or some other unsupportable suspicion rather than substance) there’s a problem.  Not today.  I’m hurting.  And it’s likely to only get worse.

I wish I were home.  I miss it.  Relative comfort.  Familiar folk and environment.

This is not my home.  Fort Knox.  WTB barracks.  It’s not home in word or feeling.

This place hurts.  From skin to soul.  I’m still unsure why I’m here.  Half want to help, half of them can’t.  The other half doesn’t care.

I have a heavy week upcoming.  Appointments from 9:30 to 4:30 one of the days.  I’m not looking forward to the pain that’s certain to come, or the humiliating neurological problems that may.  That some, those whose jobs it is to help and heal, deny a problem, or perhaps more apt, the problem worsens the foreboding.  All my limbs, no sucking chest wound, no piping hot metal, and all’s well.  Or I’m faking it.  A different standard.  An absence of standard.  This place is foreign.  This isn’t my home.

Had my first ortho appointment this week.  Toon’s clinic.  Bad memories.  Big concerns about going there again.  My concerns were justified.

The man conducting the exam was a captain.  I assumed he was a doctor, though I did find it strange that during the exam he kept referring to print-offs with lumbar and sacral spinal nerve dermatomes.  I later found the man was a nurse.  My orthopedic exam, which will in part determine future care and possibly a disability rating, was performed by a nurse.  A nurse!

Don’t get me wrong, I harbor no prejudice towards nurses or nursing.  Actually, had the man gotten things right I wouldn’t have bothered mentioning his station.  But he didn’t get things right.  Not by a long shot.

I have burning sensations in my feet.  His dad has burning sensations in his feet.  My mom has MS.  His dad has MS too.  Therefore I may have MS.  Got two words: Occam’s Razor.  Or for my nerdier readers (or assholes who write editorials for major print media sources and like using words their audiences probably won’t understand), lex parsimoniae: Entia non sunt multiplicanda praeter nessitatum. 

I have sensation in my legs and feet.  I can distinguish sharp from dull.  Therefore I don’t have radiculopathy or any other peripheral nerve neuropathy or neuritis.

Absent plantar reflex.  That’s new by the way.  Therefore central nervous system rather than peripheral.  In other words, my deficits aren’t related to my injuries.

Now let me tell you what’s really happening.  L5-S1 nerve entrapment revealed by MRIs, contrast dye CT scans, discogram, and confirmed by EMG.  Higher lumbar levels degeneration revealed by MRI.  Depressed or absent achilles bilaterally.  Depressed right side patellar.  Hyper-reflexive left patellar.  Absent plantar.  Burning sensation in both feet.  Pain from low back (bilateral) to right hip, butt, outside right leg to the middle of my calf.  Motor deficits in right lateral toes (dorsiflexion) and right foot (also dorsiflexion).  Guess what can cause those symptoms?  Damage to spinal nerves (peripheral nerves) from lower thoracic to upper sacral.

That he got things wrong isn’t what concerns me.  An honest mistake and a willingness to admit it can be easily enough corrected.  But at one point in the exam the man grabbed me by the arm stating, “Don’t lie to me.”  At that point I wasn’t quite sure how to respond.  Communicating the possiblity of an error is difficult with a medical professional who assumes you’re lying.  So I didn’t bother communicating with him.  I thanked him, shook his hand, and immediately went to my chain of command (who were very supportive).

Today I met with my case manager.  She stated there’s no reason for me to go back to him, but if one comes up, and this sort of thing continues, I’m free to request someone else, file a complaint, etc.  That’s good to know.  While it’s unlikely the medical problems I have can be fully healed, it is certainly possible that I could be further injured - either by improper care or improperly being cleared to return to duty.  I’ll be sure to keep you posted of any further developments.

I’ve been in the Fort Knox, KY Warrior Transition Battalion for four days.  Being away from family, friends, and familiar environs has been difficult.  I’m adjusting.  My battle buddies are helping me adjust.  I’d like to think in some small way I’m helping them too.

The way soldiers care for one and other is truly remarkable.  That this care doesn’t require years of friendship or blood ties to develop is possibly the most remarkable part.  Hearing “We’re here for you brother” bandied about the barracks, the PX, and the hospital isn’t unusual.  And what’s more, the men and women making the statements mean it.

Hardness and obscenity and laughter and good humored ribbing often hide the care and concern we feel (and act upon) for one and other.  Perhaps our way of being sensitive without seeming like pussies.  But the men and women here with me, regardless of where they’re from, their rank, their race, their religion, their education, their background, they’re my family - sans the dysfunction.  For a time I lost sight of what distinguished soldiers from non-soldiers.  As I write this, with a profound want for words describing all that’s good in human nature as revealed in the men and women serving with me, those distinguishing features couldn’t be more clear.

It’s the Saturday.  I leave for Fort Knox on Monday to make a Tuesday morning appointment.  I don’t have readable, usable orders.  I don’t have an itinerary.  I don’t know what to bring (copious civilian medical records, for example).  I don’t have instructions regarding where to go.  Where I’m to stay overnight.  To whom I report.  When I’m to report.  But the orders did have the wrong home address.  That much I could make out.

I was paid yesterday (I assume), but it was less than expected.  Any amount is welcomed and helpful at this point, but when actions are based on information, and that information is wrong, problems are created.  I’m referring to having been told my orders, and therefore my pay, would be backdated to the day the State submitted their request that I be placed on ADME.  That’s June 5th.  Typically I receive about $2800/month after taxes.  I received a little over $4k.  $4k is not 3.5 months of pay at $2800/month.

I looked at my Leave and Earnings Statement.  1.5 months of pay, and an equal amount of allowances.  Though the allowances were rated BAH Type II rather than regular BAH.  BAH Type II, I learned, is given to soldiers on orders less than 30 days in transition (as in a PCS or returning from remote deployment) to a location with no previously established BAH rate.  These conditions do not apply to me.  That they paid me 1.5 months (45 days) of BAH Type II suggests this.  As well, my area has an established BAH rate.

The difference is approximately $900/month.  $900/month multiplied by 3.5 is hardly an insignificant amount of money.  When I asked for help addressing these matters, I was reunited with an old friend: “The Learning Curve.”  I’m a bit too bothered about this to construct some anthropomorphic representation of the Army Learning Curve.  Though if I were so inclined, he or she would be a negatively accelerating blunt object, with limp wrists, a sloped forehead, some form of dwarfism, full frontal lobotomized, multiple trisomic, myopic or possibly blind, pathologically lazy and stupid, and stuck in a bear trap.  Think Ringo Starr in “Caveman” wearing ACUs rather than dead animal skins and you’re pretty close.  Our little friend has been used many times to justify dereliction of duties by various members of the Army for as long as I’ve been a part of the organization.

Something is wrong here.  The wrongness is deep.  “I’m new here” is something one expects of a teenager working the register at Taco Bell.  Not of a officers, commissioned and non, responsible for addressing important issues.  Issues that affect the lives of those appointed under them.  This is the same excuse others within this organization have used to justify having crippled me with their neglect and incompetence.

Got an email today informing me I’m to report next Monday.  That’s good because it’d be impossible for me to get there earlier.  The email included the traffic between the sender and others involved in working my orders.  In reviewing the traffic, I learned many are involved.  Possibly too many given the nature of the work being done.

In a cursory viewing, there were several people working this matter, at least six, in some way or form.  Those working the matter knew as early as the 9th of September that my orders required me to be at Fort Knox by the 17th.  Orders were in the system as early as the 5th of September.  It took until late afternoon on the 16th for the message to find its way to me.  Why?

Nature of bureaucracy?  I don’t believe so.  Inefficiency isn’t implied in bureaucracy, though many joke and possibly truly believe it is.  More hands typically lightens the load, that is, when those hands work in unison.  But it seems to me lightening the load isn’t the purpose of this bureaucracy.  What its purpose is, I can only guess.  But because this matter wasn’t handled efficiently, I draw pay and entitlements for an extra week while not being treated.  Creating further cost to the government (to all tax payers) in the immediate future and, because outcomes worsen as time goes on, probably in the distant future too.

Addendum: Looking over the forwarded email again, there were actually 14 people working on getting my orders to me.  It took 14 people to get my orders from Fort Knox to me.  14.  And when the orders arrived, they were of such poor quality that they couldn’t be read.  Making them practically useless to me.

Three weeks ago my wife and I were discussing Warrior Transition Unit.  Many of the topics have already been covered here.  Our expectations aren’t high.  They’re quite dismal in fact.

Trust is a major issue.  It has been for some time.  It’s induction.  Most in this class have behaved in a dishonest or incompetent way.  It’s reasonable then to infer future dealings with members of this class will be handled dishonestly and/or incompetently.

Sarah was joking around, half seriously, about the possibility of getting orders late, and therefore I would be unable to report as expected.  Not showing up would be used to get me in some sort of trouble.  Possibly pushing me against the wall, perhaps shutting my mouth.  Low and behold I get a call late afternoon from an 1171st NCO.

“… calling to confirm you know you’re supposed to be at Fort Knox tomorrow.”  I got the message after 4 p.m.  I called the messenger back.  She wasn’t in.  I called the people at Knox.  They weren’t in.  I left a message with the doc I’ve been working with that I would not be able to make it Knox tomorrow as was expected of me.

Time will tell whether Phythia to my omphalos stone’s (that’s a little joke) predictions unfold as foreseen.