Here is a thoughtful and worried note from Noel Koch, who recently left his position at the Pentagon overseeing the "wounded warrior" program, about "warrior transition units," or WTUs, which he says that despite their publicity have become dumping grounds for soldiers who never should have been recruited-and most, he reveals, have never seen combat.

By Noel Koch
Best Defense guest columnist

Our men and women in uniform today represent the finest fighting force ever fielded. The only problem? There aren't enough of them.

The evidence has been multiplying and cascading down on the Pentagon since the beginning of the wars in Iraq and Afghanistan. It includes the assignment of military duties to extravagantly paid private contractors because there are not enough soldiers to perform these duties; the use of "stop-loss" orders to keep personnel past the end of their contracts, at which point their service is no longer "voluntary"; and, because "stop-loss" is not a sufficient expedient, the call up of National Guardsmen to deploy, at the age of 45 or 50, to Iraq or Afghanistan.

These desperate attempts at patching institutional shortfalls have human consequences: spouses are deployed multiple times as marriages falter and fail and children grow up with a parent they scarcely know; soldiers take their lives in record numbers, their deaths lamely assigned to "relationship problems"; and, most tellingly, recruiting NCOs commit suicide because they can't bear the brutal stress put on them to bring in more people when qualified people are unwilling to join the military. The Army says it is meeting its recruiting quotas, but many of those recruited are unfit for service.

The evidence for that can be found in the failure of our Warrior Transition Units. Over the past eleven months my colleagues and I spent countless weeks visiting these units and hundreds of hours talking to the men and women in them. The WTUs were created following the discovery of substandard conditions in temporary quarters at Walter Reed Army Medical Center. They were intended to assist with the healing of combat-wounded service personnel. Yet the majority of the people in these units today are not combat-wounded. To the contrary,most have never left the country.

To understand how this happens, recall the stressed-out recruiting sergeants. To meet their quotas people who are physically unfit; mentally unfit; emotionally unstable; or, who have criminal histories and disciplinary problems are recruited. Commanders refuse to deploy with these people. So, commonly, they are put in the Warrior Transition Units, which is why these are called "warehouses" and "dumping grounds."

Here's a snapshot: I am in a room with 35 soldiers. The one first in front of me is glassy-eyed, staring into the middle distance, and I have to raise my voice to get his attention.

Wilson, what are you doing here? "I'm schizophrenic, sir." How old are you? "Nineteen, sir." You haven't been downrange, have you, son? "No, sir."

Smith, why are you here? "I'm bi-polar, sir." How old are you? "Twenty, sir." Have you deployed? "No, sir." Same glassy-eyed look.

The next youngster is also twenty. He suffers from depression. He can't be deployed.

And so on. Some are physically unfit. Some exhibit mental health problems. Others are disciplinary cases. All dumped in the WTUs. Oddly enough, many tend to get quite comfortable in these units and are adept at finding ways to remain in them for months reaching into years, as they dream up new complaints. Meanwhile, the limited numbers of personnel who actually are combat-wounded feel stigmatized by being lumped together with people they consider malingerers; they don't want to be in the WTUs, but would rather be sent back to their regular units to heal. So, in the end, the entire purpose of the WTUs is defeated.

About the glassy-eyed look? Here's a snapshot from another WTU session. A visibly agitated soldier tells me, "A lot of times I run out of my meds when the dispensary is closed and I can't get a refill when I need it." I ask him what he is taking, and he tells me Percocet. I ask him how many he takes that he can't time his refills with the dispensary schedule. He says he has a jar of the stuff that he takes when he needs it. This turns out to be a common problem, and an uncontrollable one in the WTUs.

In Vietnam the enemy turned our war fighters into drug addicts. Today, their caregivers are doing it.

These, in aggregate, are the results of going to war with insufficient manpower. These are the evidences of the failure of the All Volunteer Force. There was a time when the draft bound our nation together. Many believe that any attempt to restore it today could risk tearing us apart. Still, more and more people, quietly, are coming to the conclusion that careful consideration has to be given to restoring the draft.

The alternative is to continue to rely on that less than one percent of the American population that currently defends the nation to produce our war fighters and the question that prompts is simple enough: Are we going to continue to send these few back to the battle again and again and again until their marriages collapse, and their children are resentful strangers to them, and they are either battle-crazed or suicidal or homicidal - the way we do now? And how long can we depend on that expedient?

How long can we afford to delude ourselves about the efficacy of the All Volunteer Force?

All the problems noted here were regularly recorded and reported to the appropriate officials in the Defense Department.

Noel Koch served as the Obama Administration's first Deputy Undersecretary of Defense heading the Office of Wounded Warrior Care and Transition Policy. He is a Vietnam Veteran, served as Special Assistant to two Presidents and as Principal Deputy Assistant Secretary of Defense for International Security Affairs and Director for Special Planning in the Reagan Administration.

U.S. Army

 

MOOJ KILLER

11:26 AM ET

June 16, 2010

Connection?

While I can understand the frustration with the Wounded Warrior units being a dumping ground, I fail to see how that is the all volunteer military's fault. It seems to me to be the fault of both the commander that dumped the service person and the commander of the WW unit that accepted them. Piss poor leadership is the problem there.

 

JPWREL

11:54 AM ET

June 16, 2010

AVF needs to go

The AVF is contrary to the principles of democratic country in which all of it citizens that are physically and mentally able should be expected to contribute in some capacity to the nations well being for some period of time. As Maj. Burgoyne stated in Tom’s column yesterday the very highest caliber type of people that qualify to attend the most demanding academic institutions are missing in action when it comes to the armed forces. However, merely being brilliant at advanced mathematics or organic chemistry does not mean you are capable of solid leadership, but some of these people could potentially be superb leaders and make a substantial intellectual contribution to a force in desperate need of some fresh talent and ideas. My hope would be that the AVF be disbanded over a period of years and a new National Service Act be passed that would address these issues. No doubt here would be all kinds of issues and problems in implementing such a change but nothing so dramatic that it could not be worked out.

 

BLACKADDER60

4:05 AM ET

June 17, 2010

Compulsory military wouldnt work

Do you think that it would work, politically? Conscripting and sending an entire generation of youngsters into the meat grinders the US starts allover the world? Consider sending the women too! It would create an outrage, sending only men would be discrimination and create an even greater outrage. No elected politician will want to touch that potatoe.

Theres a far better alternative than scraping the AVF.

Namely that americans wake up and realize that the world WILL still turn without the US army twirling it, the tide WILL come in without the US navy pulling it. This planet have had an advancing civilization for MILLENIAS before there even WAS an USA.

What Im trying to say is: "YANKEE GO HOME" and you will have soldiers enough, if DEFENCE of your country is the concern, sending troops oveseas isnt "defence" its outright agression.

 

BLACKSHYLD

7:54 AM ET

June 17, 2010

The US Military is at war...

America is at the Mall...

There is a reason why our leaders can initiate and then mismanage conflict with little outrage by the American people, because for most Americans it will never affect them, they never have to worry about the pressures of service, they will never see combat, they will never see their sons and daughters sent to war, or receive them in a flag covered coffin.

For some reason it is up to 1% of the population to constantly bleed again and again so that the rest of us can sit back and reap the benefits of being the world's sole super power. Americans, humans in general, are very self centered people usually and they will not act until it affects them.

I can assure you if a draft of some sort was reinstated there would be a lot fewer politically apathetic citizens to say the least. One of two things will happen, a larger segment of the population will stand up and serve our country in the service or they will stand up and serve our fighting men and women by keeping our leaders accountable.

We will be far less likely to engage in reckless foreign policy when all our butts are on the line.

 

TYRTAIOS

12:32 PM ET

June 16, 2010

JPWREL - I have seen this

JPWREL - I have seen this before, where mental defectives and malingers are lumped into wards with recovering combat wounded. There is simply no historical evidence that having compulsorily service (or conscription by another term) would see anything different, and in fact, if McNamara's 100,000 experiment is of any use as a historical backdrop - history would be repeated.

If one feels that national service would be done on a level playing field, and would prevent this, than one also is in need of antipsychotic medications to prevent this delusion.

It boils down to a leadership problem that starts at the Pentagon with recruiting standards by those that will never serve with, nor spend the admin down time in command of these non-effectives, but thrust them on the end user, who also finds it convenient to dump them alongside otherwise fine people trying to recover.

Someone once told me it's better to be pissed-off than pissed-on. I am pissed-off and we are pissing on our physically (and mentally) wounded by dumping these described people in them.

 

JPWREL

1:04 PM ET

June 16, 2010

TYRTAIOS, in principle I

TYRTAIOS, in principle I think you make darn good points and I really cannot disagree. It is unjust and demeaning that WW’s must be comingled with the incompetent and dysfunctional cast off’s that should not be part of the armed forces in the first place. The latter should be dismissed from the armed forces with general discharges. Better to be undermanned with good people that fully manned with a portion being incapable. In my view the advantage of a National Service Act would be that induction standards could be radically revised upwards among a larger universe of candidates. The armed forces would not be compelled to play recruiting games that admit less than desirable recruits. The reality is that highly qualified people with superior intelligence are easier to train, and usually make better leaders (not always) yet by and large these people are not part of our armed forces to any great degree. The services seem to be somewhat inbred and like all institutions could probably do with an influx of some new blood and ideas.

 

ERIC_STRATTONIII

5:13 PM ET

June 16, 2010

JPWREL

The Draft would only see these same problems and in larger numbers, while it is horrible to see these folks intermixed with those good troops who have done what is right and expected of them it would only be worse in a draft army. A lot of draftees would not want to be there, it is a gamble who you get since only a small population is picked at a time via lottery, most teens are fat and out of shape, etc...I would love nothing more than to get rid of the disconnect between the civilians and military caste groups, since it seems that more and more the military is becoming a caste. Heck, my whole family has served since my Great Grandfather in the Spanish-American War, but only my brother and I have made careers out of it. Most of the people I work with (I can bet you that your son will attest to this as well) have brothers, uncles, fathers, etc..who have all served. In your son's group, it is quite common to see brothers or sons' galore at different teams but still in the same community.
The only way to get rid of the divide is to make it cost something for the "elites" to join and as far fetched as it sounds, I really think Heinlein had a point on what a "Citizen" should do to earn the right to vote or run for office-join and that EVERYONE fights who is in, no exceptions, no pacifists, etc... I know, a little out of bounds but otherwise, a draft would only give us more of the same unless we made it mandatory that EVERY single male and female at the age of 18 had to serve for two to three years or ever better, do what the Swiss do, but the costs of that would be a wee bit out of our budget, out of the political realm and out of the general populations ideas of good citizenship I am sure.

 

JPWREL

5:35 PM ET

June 16, 2010

ERIC, you know I have a great

ERIC, you know I have a great deal of respect for your views on things but I still think that the draft as imperfect as it was largely worked in the 40’s, 50’s and 60’s. The problem in the 60’s was the design of the system that allowed the wealthy, well connected and academically talented to avoid service and the fact that the war we were fighting was stupid. If you wage wars which cannot engender and keep public confidence your going to have problems conscripts or not. National service would most likely affect the Army more than any other service since that branch seems to have the biggest problem in recruiting top talent. It would allow a major expansion of both the National Guard and Reserves and that is no bad thing. Our SEAL’s will still get their high-octane candidates and the Navy and AF would be able to select high quality inductees from a much enlarged pool. Long service professionals such as you would still receive current pay levels, increases, benefits and retirement but overall personnel costs could be dramatically reduced for short-term inductees. Yes, there would be problems but nothing that could not be sorted out.

 

ERIC_STRATTONIII

7:27 PM ET

June 16, 2010

JPWREL

Thanks, I respect your views as well but I think it has to be an all of nothing, ie; everyone in the US at the age of 18 serves or even goes the Swiss Route where you are in for life in the Reserves or keep the AVF. The Talent pool is way to random with a lottery draft and you would get a higher number of low end people who just do not want to be there and in my opinion, the Army already has a very low ability as it is outside of their actual combat forces.
A draft might force some of the elites to join but many would still get a way out or even worse, do a non-combat job and never stop speaking about their time in the service for political use. The only branch that has had problems in recruitment is the Army, the USMC has had waiting lists! lol Not kidding.
If it was an all or nothing thing, ie; everyone had to serve and no excuse to get out or even a Heinlein type drive of an AVF but with a price, I would support it. Since I do not see either of those ever coming, then I would prefer to just have a better Officer Corps for all branches, a better trained grunt at the ground level (an area the Army really fails in, especially at the support end) and that our Political Leaders (to include our current CNO, he might as well be a Politician, he has just as much integrity as one) would put practical warfighter needs above PC silliness.

 

IRR SOLDIER...

7:49 AM ET

June 17, 2010

Eric, that's why it's called "selective service."

Eric,

I think you are creating a strawman argument here. A draft would not force the military to take anybody off the street. To suggest this misses the point. The military services and DOD set their own accessions criteria based on aptitude, educational attainment, health etc. Any draftee would go through this battery of evaluation and the military services would have the final say whether they gained entry.

JPWREL raises some excellent points and I believe that a hybrid draftee-volunteer Army (like we had from 1948 to 1973) would raise the qualitative value of our entering enlsited cohort. When you look at the educational attainment data for the Army's entering enlisted cohort in the early 1960's, it is nothing short of amazing. In 1964 we had more entering soldiers with college experience (as a %) than we do today, despite the fact that college attendance in the civilian population has more than doubled in the last 46 years. Yes, the Army had its share of HS dropouts but this percentage was in line with the HS graduation rate across the country. In 1964, 39.91% of Army volunteers were HS dropouts but only 28.7% of Army draftees were. This compares with a 36% dropout rate for civilians at the time. Our 1964 entering Army cohort was pretty damn good and you can see a visual depiction of these men in the fine movie, "We Were Soldiers."

 

ERIC_STRATTONIII

10:03 AM ET

June 17, 2010

IRR

No strawman about it buddy , the draft would still be a lottery, ie; random, with the same standards we have today for entry, so nothing would change it somehow to be an increase in quality and to think we would get a better quality troop via a draft is just not realistic. I also do not understand how you make the correlation that by doing random selection and still using the same standards we use for those who make entry in the AVF that we will get a better product somehow, it does not really make sense to me. The education levels of todays AVF enlisted are actually higher than they were in the 60's. The only group that has had even a real problem with recruiting is the Army, we hardly need a draft to cover their needs however.
Sorry IRR, I do not agree, show me how a draft would make a better force vs the AVF? The only benefit would be that the burden would be spread out a bit, most of the recruits are blue collar or middle class right now, but if you read my other posts on that topic you will see that I have little faith that the elites will not find a way around that too. I also fear that since the training currently is so watered down in basic, especially in the Navy, Army and AF, that a Draft would force Pols to water it down even more and I even less faith in my Flag Officers to make training more suited for combat, again with the possible exception of the Marines.
I have posted prior how I think I could support a draft but I really doubt that they would ever go over well, so outside of huge crisis, like N. Korea or worse, I think the AVF is fine and if you want real improvement in the Military, AVF or Draft, start with the Officer Corps.

 

ERIC_STRATTONIII

10:08 AM ET

June 17, 2010

IRR

Also, where did you get the idea that I thought we would be taking anyone off the street? Never said that, I would re-read my exchanges with J again and the last part of your post, compare the HS grads of todays AVF with your Military in the 60's. (I would have just added this on to the last post but the bloody edit button is gone, so sigh...)

 

IRR SOLDIER...

10:14 AM ET

June 17, 2010

AVF Relies on a Narrow, Sliver of the Population

Eric,

The key benefit of Selective Service is that it greatly enhances the pool of people who will consider the military - either by receiving "Greetings for Uncle Sam" or by volunteering in an effort to maintain some control over their entry into the military.

The AVF currently relies on a very narrow sliver of the population to volunteer. Once you look beyond that small universe, there are many talented people who are not influenced by the military's education/adventure/benefits/service sales pitch.

I fail to see how an expansion of the pool of Americans we draw from would not improve the quality of our military. The current AVF is not geographically or educationally representative of the country it is drawn from.

Yes, while the Army may be the only service having overt recruiting challenges, the other services will also benefit from selective service. It is worth remembering that from 1948-1973, the Navy and USAF remained all volunteer and were able to bring in most personnel on a four year enlistment despite abysmal pay. Why? Because people facing selective service valued having some semblence of "control" in how they served and were willing to excahnge an additional two years of their life for this certainty.

 

ERIC_STRATTONIII

11:46 AM ET

June 17, 2010

IRR

The only reason that such a narrow "sliver" as you call it go in is because the poor cannot get in due to not having HS degrees, the rich do not want to do it and last time I checked, the middle and blue collar classes were hardly "slivers", I think they are still the majority last I checked. You want more participation by the elites? Sorry, they will and have alway found a way around service or barring that, a combat job in the service-Gore, Bush Jr., etc...as some recent examples (Sorry, UANG was a cop out in my view). So, unless it is something like everyone and I mean EVERYONE has to do a tour like the Israelis then I do not support it and if you really think that somehow the pool will be that much wider by a draft that is not TOTALLY COMPULSORY for ALL, then I do not see it as a political reality. If N. Korea kicks off, then we will have not choice but again, I fail to see how a draft will magically improve our quality, it might, just might narrow the culture gap a bit due to some being forced into the service but outside of that I see no benefit for quality.
You know, AWOL is a good book to read on this and while I agree with some of the views and ideals in it, again, I have ZERO faith in either my Political or Military Leaders to do the right thing by making training tougher, more combat oriented (sorry, the Army Support Training is a joke and the Navy and AF might as well be fat boy camps with the Co-Ed Boot Camps having more problems than they are worth) and base leadership on warfighting ability over politics. A draft would only make them more involved in the weeds and to be quite honest, would only make the pols and our "glorious" flags all to happy to please them by making training that much easier. You want to make it like the Israelis do it? I am with you, otherwise, sorry, it will not do a thing for us.

 

ADMIRAL

12:49 PM ET

June 16, 2010

The Draft is Slavery

Of course the AVF is a failure. The US has never and will never have a professional military. Why would anyone with half a brain join today? To fight for what? Thr corrupt Pentagon? Idiot generals? Corrupt politicians? Nortrup Grumman? The Empire be damned!

The draft is slavery. Those who propose a military draft for the US Imperial Empire are heartless and cruel war mongers. They have no regard for human decency. To force people to take up arms and kill their fellow man is criminal. The draft is slavery. War is a racket. It is time to shut down the evil empire, not feed it conscipted slaves.

 

TOM RICKS

1:00 PM ET

June 16, 2010

I'd like to get this discussion back on track

How about WTUs as a problem?

Admiral, I wouldn't mind if you took your business elsewhere.

Thanks,
Tom

 

MOOJ KILLER

1:42 PM ET

June 16, 2010

WWB's

About two years ago I was a CO of a HQ company on Camp Lejeune. I had close to 650 Marines in this company, way over T/O. I had a medical Platoon filled with those cases that were not severe enough for the WW Bn on base. When I did get over to the WWB to visit a Amrine from my old platoon that was wounded in Iraq, I was not struck with a sense that it was filled with malingerers such as the article mentions. It was manned by combat casualties that needed more care than could be provided by the parent commands. I think the issue is not the WW units but the personnel used to staff and command them. I have no evidence or studies to back that up but I can't imagine you would send your stellar leaders to that billet or that a good leader would volunteer for it.

As for the Admiral... I think he needs to put down Gen. Smedley Butler's book, "War is a Racket." And then sign off.

 

BG GARY CHEEK

2:29 PM ET

June 16, 2010

Army WTUs

Tom, please contact me to discuss this in detail if you like. For others on the blog, some things to consider about the Army Warrior Transition Units:

--84% of the Soldiers in Warrior Transition Units have deployed.
--We don't "dump" Soldiers into Warrior Transition Units. The are entry criteria are: minimum of 6 months rehabilitation and complex conditions that require case management. Unit commanders nominate and a general officer approves all entries. The Army implemented this policy in July 2008.
--To give you a sense of the population, 21% of our Soldiers in Warrior Transition Units have non-PTSD behavioral heath conditions, often in addition to others conditions. By comparison, 22% are being treated for PTSD. 63% have an orthopedic condition, the most prevalent condition. Soldiers average about 2 conditions each.
--Approximately 10% of Warrior Transition Unit Soldiers have received a Purple Heart. Approximately 75% are recovering from condtions that resulted from multiple deployments. Others have non-deployment related conditions that range from motor vehicle accidents to serious diseases like cancer.
--Medication management is a challenge. We are continuing to adjust our program and offer alternative therapies for our Soldiers. There are many other initiatives in the works as well.
--We survey our Soldiers in every Warrior Transition Unit every quarter. We have an 80% satisifaction rate, but from their responses learn a lot about how to improve our program. Their NCO leadership and nurse case managers consistently get above 90% approval ratings.
--As an aside, the law (HIPPA) prohibits recruiters from accessing the medical records of potential recruits to verify previous behavioral health issues.

 

TYRTAIOS

3:00 PM ET

June 16, 2010

BGen CHEEK - It is always

BGen CHEEK - It is always good to here from the horse's mouth. But I must also confess to harboring a sneaking hunch that we have been given a description on how it is supposed to work by regulations, followed by statistical data.

The fact is, we keep hearing these stories, stories I've personally heard, and from my distant past 28 plus years as both a combat wounded patient and a field grade commander, I smell smoke and where there is smoke; there is fire?

I respectfully would ask how often unannounced inspections both up front and surreptitious are conducted to measure that guidelines are being followed? After all, we heard much the same thing about Walter Reed earlier on until congress forced the issue and SecDef Gates intervened.

 

HARRIET0352

7:11 PM ET

June 16, 2010

Agree with Mooj Killer

Mooj Killer said, “I think the issue is not the WW units but the personnel used to staff and command them. I have no evidence or studies to back that up but I can't imagine you would send your stellar leaders to that billet or that a good leader would volunteer for it.”

WWBN-E is not filled with malingerers. It is filled with injured Marines who come there hoping to heal and go back to the front with their units. Mooj Killer is correct when he says that the issue is caused by the personnel used to staff and command these units. He doesn’t have evidence, but I DO have evidence. Sadly, many military leaders with stellar careers have been deliberately looking the other way when given the chance to view the evidence. If you want a study or an investigation with true results, you need to go outside the military and you need to offer the wounded warriors entry into a witness protection program. Everyone is scared to say what’s really going on because they’ve seen what happens to the few willing to stand up and speak out.

 

TYRTAIOS

7:38 PM ET

June 16, 2010

HARRIET0352 - a question?

HARRIET0352 - This is good that the Corps' administered program is not being used to dump undesirables among the worthy. Just as importantly however, you have raised, and seconded another troubling issue, of the less than stellar staff looking-out and advocating for those trying to rehabilitate. Can you elaborate and give specific examples, perhaps some shame shined down . . . say Camp Lejeune way, might spark someone’s interest? Perhaps I could even drop a dime?

 

HARRIET0352

7:56 PM ET

June 16, 2010

Satisfaction survey results are not always what they seem

BG Cheek, I have not done the research on all areas mentioned in your statistics. I must take exception to the 80% satisfaction rate and the 90% approval ratings you mentioned. I will direct you to a blog that explains my position. I’m sure you will find all of the entries interesting, but the one that focuses specifically on satisfaction surveys can be found here: http://www.fellednot.com/apps/blog/show/3650358-are-we-entitled-to-our-own-opinion-

 

J.D

6:49 AM ET

June 17, 2010

concur

after having seen a NE USA WTU with BIG problems....I concur with "where there is smoke there is fire"....break break...let's all just admit that we went to war with the Army we had, not with the Army we needed.....and have been playing band-aid catch up ever since.....we simply didn't know what we didn't know, we didn't admit it to ourselves nor were we even self-aware enough to admit it, and are now doing the best we can to keep our collective heads above water.....(pardon all the cliches, but they are applicable)......ideally, 10-15 years from now when we are "sort of" back to normal (in terms of the Afghan and Iraq efforts), we will have learned from our past, made the strategy/policy/resource adjustments, and be better off to address the unknowns we will face in the future....

 

IRR SOLDIER...

8:54 AM ET

June 17, 2010

Some thoughts on BG Cheek's response ...

While I am heartened to see a General Officer take such a personal interest in this issue, I am not convinced that the selective use of favorable statistics can mitigate the grave concerns many have with the WTU concept or its implications for wounded personnel.

At the risk of sounding too blunt, the WTU concept has had almost 3 years to get its act together. Despite the time and inordinate personnel resources dumped into the WTU experiment, it has has failed to show a sufficient return on Investment (ROI) or justify its large (and growing) budget.

We have a steady stream of documented WTU calamities: Ft. Stewart, Ft. Bragg, Walter Reed (x2), Ft. Carson and Ft. Benning - and these are just the ones we know about because they attracted national media attention. I can only imagine what else is taking place without any outside attention whatsoever.

To expand on a previous point, there is no evidence to suggest that the WTU concept has assisted in soldiers' recovery or rehabilitation. In fact, there is evidence that the attitude of the cadre and their ignorance of medicine and mental health may adversely impact the well being of patients. To reiterate, underutilized combat arms personnel have no business being assigned to medical centers to "command" grieviously injured soldiers whose sole "duty" is to heal.

The cadre could best be utilized in filling the gaping holes in our institutional Army. As General Dempsey's recent letter to GEN Casey documents, TRADOC is suffering an acute shortage of NCOs and officers to train soldiers, develop doctrine and refine lesson learned. The WTU cadre are needed to perform these tasks that only personnel with their skills can accomplish. Infantry and Artillery personnel are not required at medical centers to perform tasks the Army Medical Department carried out with honor prior to 2007.

The structural deficiencies of the WTU concept are well documented in a piece that appeared in the December 2009 issue of CNS Spectrums titled, "Crisis in Army Psychopharmacology and Mental Health Care at Ft. Hood." For this article, the authors surveyed 310 WTU cadre (non medical) and revealed that a significant subset are not confident that PTSD is a "real illness". On a 1-10 scale (1 - little or no confidence; 10 - extremely confident), 18% of WTU cadre answered with a "1" - little or no confidence that PTSD is a "real illness." In the same survey of 310 WTU cadre, 41% of them reported that they believed that "more than 50% of soldiers claiming PTSD are faking or exaggerating"! Tell me again what these ignorant cadre are doing in medical centers wearing the MEDCOM patch??? What value do they bring? How does placing wounded and tormented soldiers under the command of cadre who doubt their diagnosis aid their healing?

While BG Cheek cites the role of Nurse Case Managers in his reply, this arrangement is problematic as well. There is documented tension between the Nurse Case Managers and the cadre. In the December 2009 CNS Spectrums article, 138 WTU Nurse Case managers were surveyed. On a scale of 1-10 (1-little or no confidence; 10 - extremely confident), 75% of the surveyed nurses rated their "confidence in the knowledge and ability of WTU cadre to recognize and monitor mental illness and their treatments in soldiers" at a "5" or less

The WTU idea was ill-conceived and is a failure. Unfortunately, the current Army Chief of Staff, GEN George Casey, treats the decisions of his predecessor similar to "papal infallibility." Instead we continue to misallocate critical resources and impede healing because senior leaders are unwilling to say "we made a mistake."

 

HARRIET0352

10:57 AM ET

June 17, 2010

Tyrtaios - in answer to your question

I would love to give you specific examples. I have an arsenal of documentation to back up specifics that have taken place over the past year, however my particular case has been going on for over 18 months. I spent the first 4 or 5 months trusting the system and fully expecting the Marines to take care of their own, something they proudly proclaim to do along with a shout "Semper Fidelis". Unfortunately, I did not document as much during the first few months, but once I realized there were huge problems, I did pay attention and document. I made sure I had sound information. I presented it to a retired colonel who agreed I had solid information and helped me to bring these facts to the attention of people who needed to be informed. In my naivity, I honestly thought the problem was coming from one man, and that as soon as everyone found out about this man's actions, he would be dealt with accordingly. The shocking part was finding that everyone looked the other way. Even more shocking, to find that things began to get worse.....with obvious retaliation. That just made me more determined to move forward. I've dealt with many individuals in very high positions both inside and outside of the USMC. The more I pushed, the worse things got. If they are reading this comment section, they are likely sweating profusely waiting for me to name them outright, or they are busy planning their next step in discrediting me and my Marine. I feel like I am living in the middle of a John Gresham novel, unable to trust anyone, and am becoming more and more disillusioned with our military and our lawmakers. I find it appalling that so many people would not only look the other way, but try to set my Marine up for a fall to discredit him so I will go away. There has to be someone with enough power and credibility who is wiling to take a stand and get these issues out in the open, but for now, I only see people looking the other way, with enough power to make sure that my voice is never heard. I'd love to name names but I wonder how quickly my Marine's situation would become worse. People should lose their jobs, but sadly, I know they won't. It's so much easier to discredit an "ignorant" civilian than to change an entire system. What keeps me from running to what appears to be the only door left unopened and use the media?? My Marine. His life is far more important than any of this and I don't want to see the military put one more nail in his coffin. As it stands now, it may already be too late to help him.

 

IRR SOLDIER...

1:35 PM ET

June 16, 2010

WTUs are a Failure ...

Tom,

Thanks for posting this important piece. As Mr. Koch alludes to, the WTU concept was an ill-conceived, knee jerk response to Walter Reed. Like many hasty decisions made by GEN Peter Schoomaker, the second and third order consequences were never considered (see: the unwarranted firing of MG George Weightman).

The WTU concept is deeply flawed because it inserts a "shadow" combat arms chain of command into military medical centers. The mission of these medical centers is to heal and/or rehabilitate wounded soldiers. There is no "combat" mission and the injection of underutilized, ranger-tabbed officers and NCOs into a clinical environment degrades patient care and disrupts the continuity of care. Was Walter Reed woefully undermanned from 2003-07? Yes. Walter Reed was simultaneously subjected to an A-76 review process and a dramatic military-civilain conversion. There weren't enough "green suit" people to run the facility properly and provide adequate oversight to medical hold patients. This said, the tragedy at Walter Reed did not justify stripping the Army Medical Department of command and control of its patients. Furthermore, some WTUs fall under seperate courts-martial convening authorities than the medical center they are housed at. See the case of 1LT Elizabeth Whiteside as an example of how dysfunctional this arrangement can be. When WTU cadre dismiss the Chief of Psychiatry's diagnosis as "psychobabble", you have a problem.

One of the driving rationales for the WTUs was the erroneous and offensive notion that the Army Medical Department (AMEDD) was insufficiently empathetic to its wounded patients. This is poppycock and the AMEDD faithfully performed this role during all of our previous wars. I am quite interested in learning how an SFC who served in combat with the Infantry or a CPT who led a Medical Platoon in a Cavalry Squadron, are insufficiently empathetic to wounded combat arms personnel. Color me skeptical.

WTUs are an egregious misallocation of desperately needed combat arms NCOs and officers. As we learn that TRADOC is less than 40% filled on its authorized CPT authorizations, it's inconceivable that we would divert these critical officers to major medical centers when they have no medical training or experience.

From my experience at Ft. Lewis and anecdotal reports, the WTU cadre seem to look for things to do and impede patient care. This distracts truly wounded soldiers from their primary mission - to heal!

It's important to also recognize that in some cases bona fide criminals were assigned to WTUs. MAJ James Momon who was accused of accepting huge bribes as a contracting officer in Iraq was assigned to the WTU at Ft. Belvoir after his arrest.

Finally, it's important to recognize that this is the first modern American war where we have decided as a matter of policy to assign critically injured personnel to medical centers nearest to their UNIT OF RECORD rather than their HOME OF RECORD. To me, the question has to be asked if this decision is a wise one and if this social distance/isolation contributes to adverse outcomes and disciplinary problems. For example, if a severely injured soldier (who will not be RTD) was assigned to Ft. Bragg but hails from Seattle, should they have to stay at Ft. Bragg for treatment? Would it not make more sense to have them sent to Ft. Lewis where they have the stabilizing influence of friends and family? Would it make more sense to have wounded native Californians recuperate at Balboa Medical Center in San Diego rather than have them waste away at Ft. Hood forgotten by their former units that may or may not still be overseas? This question must be asked. In Vietnam we used HOME of RECORD rather than UNIT OF RECORD to regulate our severely wounded patients. As a result, many soldiers wound up in navy hospitals and Marines in Army hospitals, but we got them as close to home as we could. Maybe there is something to learn from this past practice.

 

HARRIET0352

7:18 PM ET

June 16, 2010

Home of Record regulation for help is a no-brainer!

IRR said, “it's inconceivable that we would divert these critical officers to major medical centers when they have no medical training or experience.”

Exactly! The military does not need to run the unit for wounded warriors. These men should lead victory units. Leadership is so afraid that one of the wounded warriors might sneak their way out of their obligation. The wounded will heal much more quickly in a place where trained professionals with compassion want to help them recover. Most wounded warriors want to go back to their units. Sadly, by the time they have wasted away with no purpose, and no real treatment, and been devastated by the boot camp mentality of the unit’s leadership, all they want to do is go home. They have lost interest in serving, and in living altogether. (hint - suicide rate)

I also agree that the wounded warrior needs to be assigned to a medical center nearest their HOME OF RECORD! That’s a no brainer for all the reasons stated. It is my belief, however, that these units DO NOT WANT family involvement. I just spent 18 months, climbing up the proverbial side of Mt. Everest, barefoot, in a blinding storm, trying to get involved in my warrior’s recovery. I believe more time was spent keeping me out of the picture than time has been spent to plan strategy for the ongoing conflict in Afghanistan.

 

SOLDIERSDIARY

1:42 PM ET

June 16, 2010

WTUs

This is only anecdotal evidence, but I agree with the problems of putting those who are not combat wounded into WTU. BDE, BN, and Company Commander's are sometimes judged on the percentage of their Soldiers they can deploy, send them to WTU be it for a short term injury, or mental issues, then they are off your books and you have deployed a higher percentage. I saw this in practice and was disgusted by it. When the Soldier was better and fit for deployment, he came out of WTU and was deployed...but never should have been there in the first place (BTW, he was a good Soldier, wanted to deploy, but got injured in his off time and had surgery scheduled two weeks after the unit was leaving...he also had a previous deployment under his belt).
That is what we got when the BDE CDR and BN CDR set a goal of "98% of the unit will deploy."

@Tom: I thought we all agreed to get Admiral off the net a couple months back.

 

WOMBAT

5:13 PM ET

June 16, 2010

Admiral

I too thought that we had given him an Undesirable Discharge.

 

TOM RICKS

3:16 PM ET

June 16, 2010

General Cheek's response

I've sent General Cheek's response to Noel Koch and invited him to reply.
Best,
Tom

 

SAILHARDY

3:59 PM ET

June 16, 2010

volunteer army?

Perhaps it's time to address part of our problem with illegal aliens by beginning to recruit them for duty in our armed services, perhaps in foreign legion battalions.

 

MOOJ KILLER

4:09 PM ET

June 16, 2010

alien recruitment

We do currently have a great system for allowing LEGAL aliens to join the military and they get the added incentive for a streamlined path to citizenship. I think that is awesome and I have had over 10 Marines who were able to become citizens this way. Here is just one example and this Marine is a true stud.

http://vacouncilofchurches.org/cms/index.php?option=com_content&task=view&id=159&Itemid=44

But as for units comprised entirely of immigrants... not a good thing at all.

 

WOMBAT

5:16 PM ET

June 16, 2010

Great Idea

The Romans did that, and rewarded these new recruits with citizenship. Before they knew it Romans decided to let the "barbarians" have the honor of defending the empire, stopped volunteering, and in the 4th century AD the "barbarians" took the city and Rome fell.

 

ERIC_STRATTONIII

5:18 PM ET

June 16, 2010

We have had Legal Immigrants in our ranks for a long time

Like Mooj Killer said, it is a good idea and helps, but no thanks to a Foreign Legion, we have something pretty close to the ideals of that anyway in history and discipline, called the USMC. I do think we should open it up to recruiting more from overseas though, if they can speak English, sign up for 4 years and they get citizenship and the Vet Pckg when they are done.

 

ERIC_STRATTONIII

5:21 PM ET

June 16, 2010

Good Point Wombat but

One, we are a nation of Immigrants
Two, we are not Rome
Three, we would never do it on that scale
I think, to our detriment, you will see the caste system we slowly see developing now become even more evident in the future.

 

CAPTAIN PETE

5:53 PM ET

June 16, 2010

NAVY WTUs

I spent 2 years at the Navy's WTU in Norfolk (big-time hidden injury discovered after several months working on a different problem) after a tour with Army Civil Affairs in OIF (05-06). There were a few non-deployers in my Unit but they had been injured in predeployment training. Everybody else had been injured or wounded in Iraq or Afganistan.
We were all reservists and the non-hackers were sent home from pre-deployment training in almost every case. They were not much in evidence in my Unit.
We were pretty well-managed adminstratively and medically, with case managers following appointments, scrips, etc; and med hold orders and the disability evaluation system working systematically if not always (IMHO) fairly in each individual sailors' case.
I did not see much evidence of over-prescribing pain meds. Actually, there were more problems from under-prescribing them for some of our folks.
IRR Soldier, I agree with your comment WRT HOR vice UOR assignment to WTUs. At the time I was assigned to Norfolk, the Navy had a WTU there and one in San Diego. I live in Texas but was an East-Coast sailor so chose Norfolk. The distance, and the Navy's practice of renewing med hold orders every 90 days, were the worst things about the WTU experience. Besides the surgeries and the Physical Theratorture.

 

HARRIET0352

6:53 PM ET

June 16, 2010

Is Koch Serious?

It’s obvious to see why Noel Koch lost his job, and that he is bitter about it. I find it very insulting to read that this man actually thinks he can convince us that our wounded warriors are just a bunch of misfits who should have never been admitted to the military. I don’t know the details behind Koch job loss, but thank goodness someone had the sense to have him step down. He obviously is not suited to oversee a program for wounded warriors if he has such a low opinion of them, and therefore, should have never been placed in such a powerful position. From what I have read of his career, he has served in many important positions. I am also thankful for his service, especially during the Vietnam War, but it seems like maybe he would be better suited for a different job.

Koch did have a few things right. There are not enough people willing to serve in the military. Military families are definitely suffering. Suicides rates are increasing. I’m also sure that there are a few recruiters who are more concerned about meeting a quota than meeting the standards for one qualifying to serve in our Armed Forces.

It is amazing that he and his colleagues could have spent countless weeks and hours, over an eleven month period, and come out with the summation that the WTU’s are dumping grounds for the common criminal who should have never been admitted into the military. This tells me that he isn’t very capable of gathering facts.

His view is quite a contrast to the one currently being painted with the propaganda that is typically put out for us to read. Lately, we have been inundated with “feel good stories” about soldiers suffering with PTSD, who have been treated with "no stigma" and are now happily back on duty.

That NY Times article on the ‘warehouses of despair’ really shook people up! It was actually quite funny to see those articles pop up almost daily, by the military leadership, in an attempt to fool the ignorant public, and yet so very sad to come to the realization that the American people can’t trust anyone to be honest anymore.

Koch is right about one more thing. There are some glassy-eyed guys in the WTU’s but the reason you can find them in abundance is because the only real treatment being offered is that of pills. Lots of pills. Pills that further debilitate and lead the warrior farther from recovery.

We’ve got a crisis on our hands. As long as people are more concerned about their own careers than the lives of our wounded warriors, we are just going to watch this problem grow bigger and bigger. When the troops fighting the war in Afghanistan return, will they be treated for PTSD or just cast aside, doped up with pills, and labeled as “criminals” who should have never been serving in the first place?

 

FREEMANMF

6:56 PM ET

June 16, 2010

Can't Chapter them Out

Mr. Koch's article illustrates a lager problem, that effects WTUs and Regular units--It is brutally difficult to kick people out. The arcane bureaucratic traps that have to be run to get a Soldier who is unfit for service out of the Army simply takes longer than a unit's dwell time, in many cases. I have deployed Soldiers in my unit that had substantial mental problems and were unfit for service. I have seen Soldiers that I wanted to Chapter out, subsequently commit severe crimes. Spending every other year in Iraq does not allow me the time to develop sufficient expertise in the inane Chaptering process, and doesn't leave me a enough time to Chapter Soldiers out. The Army must simplify and expedite the process of removing Soldiers unfit for service; otherwise, we will continue to pay unfit Soldiers to retard our Army and train our energy and resources.

 

MALICEIT

9:10 PM ET

June 16, 2010

MY TAKE ON WAR.

Ironically i agree. For US its simpler to maintain large force that cant fight rather then set up small battalion groups that would be extremely effective and flexible for any given task. I honestly think that Pentagon's hard-line elite doesn't think that new innovation technology can make 100 people just as effective as a 1000 but it costs a lot more. I remember great article on this site about the issue:
http://www.foreignpolicy.com/articles/2010/02/22/the_new_rules_of_war
This would also give 1million soldiers that are actually highly trained ability to have far more time at home then in the actual field of duty. As for the WTU problem: it shouldn't exist in the first place since there will be no need for cannon-fodder and hopefully there will be no need to have soldiers that are unfit for the duty.
I would love to hear response to this from you, Mr. Ricks, on my post if you have time of course.

 

SOLDIERSDIARY

4:56 AM ET

June 17, 2010

Questions and the Fisher House

"We survey our Soldiers in every Warrior Transition Unit every quarter. We have an 80% satisifaction rate."
How relevant is this? I would think success of the WTUs should not be based on a survey of satisfaction...while important to maintain good facilites, properly man it, and so forth, do those actions lead to success of the WTU?
Can you tell us what the Objectives and Desired Effects of WTUs are? How do you measure success of the WTU program? Do the surveys get to those who have been transitioned out?

On the Home of Record vs Unit Station debate; I would think it should be a matter of where the best facilites are; and where that Soldier wants to go. His HOR may have parents and siblings, but the wife and kids may be at the unit. If the proper medical care is not available in say rural West Virginia or Rural North Dakota, the solution may not alwyas be to send that soldier home. Alos, keep in mind that many bases have specific housing for families that come to military bases to be with their wounded warriers (e.g. Fort Campbell and the Fisfer House http://www.fisherhouse.org/theHouses/kentucky).

 

IRR SOLDIER...

8:00 AM ET

June 17, 2010

Clarification on Home of Record Patient Regulation

SoldiersDiary,

Good comments. I just want to clarify what I mean by Home of Record patient regulation. I'm not talking about sending severely wounded personnel willy-nilly to any hospital near their home. I am talking about getting them to the nearest military medical center - regardless of service - that has the resources to mee their needs. Example: your hypothetical wounded soldier from West Virginia who is assigned to Ft. Hood, TX. This patient should ideally be at Walter Reed or Bethesda. In reality, many injured personnel are sent to a WTU at the location of their former unit - thousands of miles from home without adequate support services.

I recognize that we can't have a military medical facility in every state. We can and must do better. Getting our native Californians back to Balboa Naval Medical Center for recovery rather than Ft. Stewart is a step in the right direction. These were pretty common sense policies from prior conflicts that we discarded in 2003. Get the injured as close to home and let them heal.

Why does today's Army insist on exerting so much control over its people? I mean, if we were willing to assign our wounded troopers to Navy facilities in 1969 to get them close to home, why can't we do that today?

 

CONNIE MORALEZ PIPER

7:01 PM ET

June 17, 2010

I used to work at the Fort Bragg (NC) WTB

I took the time to read every entry posted and found them all to be thought provoking and valid - even "The Admiral" when he commented on governmental corruption. Since this is a Foreign Policy publication and I am studying Diplomacy & Conflict Resolution at George Mason Univ (courtesy of BG Gary Cheek and Mr. Frank Bryceland), please allow me to initiate my entry from a FP standpoint & I will continue to offer my insight on the WTU issue.

Since I am pressed for time (working on a paper for school right now) I will be as brief and succinct as possible - and hopefully not offend anyone. As I mentioned, I respect what everyone had to offer, especially the honorable Marine's mother. God Bless, you Ma'am - I have a good understanding of how you feel because my (last) Husband was with CAG and 7th Special Forces (A True Warrior) and tragically did not survive his injuries. So, undoubtedly, my heart goes out to you and your brave son.

I personally believe the most pressing & relevant concern/question should be why our forces are increasingly (and unnecessarily) involved in so many conflicts, wars, "humanitarian assistance" missions, natural disaster/crisis relief, insurgencies, ad nauseum? There was a brilliant piece in the Marine Times written by a Gunnery Sgt who was just plain fed up with Washington (i.e. the Presidents and their Cronies) putting our Forces at risk and stretching them so thin that the effects of this are extremely detrimental (and numerous) and we will suffer for decades,

I say "why don't these people who fan the flames of war go on missions (like my Husband and his Teammates did) and look at the enemy in the face and kill them (or train them depending on the situation?) I'm not speaking of the few civilian officials who actually go to Afghanistan/Iraq to visit the troops (it's kind of them to do this).... I'm speaking of the ones who make decisions that send our forces into harm's way and have not never stepped foot in a combat/war zone or an out-lying camp to see the the absolute hardship and deprivation, especially in mountainous, treacherous and challenging terrain. I have about 2,800 photos of my Husband with all his gear (SF Commo guys carry a LOT) and he's in the mountains full of snow. Have you ever just tried walking on a slick, ice/snow covered sidewalk?? Well, imagine what our Forces in A'stan are going through fighting in extreme conditions. And yes, they DO engage in firefights in the winter-time, just not as many.

Well, my point is...who is going to keep us out of these wars - and bring some sanity to America's Foreign Policy - so that we don't have SO MANY wounded, hurt, ill, incapacitated Soldiers/Marines to take care of??

Yes, this is a highly complex question since we all know that American/Western interests are selfish - we always want what someone else has and this causes problems (quite simply). However, this is where the State Department and numerous agencies and organizations (NATO, EU, OSCE, UN, even all the world-wide Intelligence Agencies, etc.....) should be SO MUCH more proactive, less territorial and selfish, and just DO THE RIGHT THING. It should not be so difficult when you have the Soldiers'/Marines' best interests at heart.

A few examples: Foreign Relations Council and any other entity that decides to give billions of dollars to Israel in foreign aid. Quite simply...STOP DOING IT. This is one GREAT reason that Sept 11 happened. UBL stated numerous time throughout one of his speeches a few years ago that what angers the Arab/Muslim world is that the U.S. is such a big supporter of Israel. Yes, this opens a can of worms, but it is a fact - I know everyone is busy, but take a moment just to google some credible (and international) sources and just read a bit on this. Do you know HOW MUCH HEARTACHE this will save us all (if we cut their foreign aid?) Imagine how we could spend that money? Just for starters: Schools for girls in Afghanistan (Please read "Three Cups of Tea and "Stones Into Schools")

The Legal Community (ESPECIALLY the JAG): Stop with the asinine ROE's that are endangering, hurting, and getting some of our Forces killed. Yes, I get it with COIN and DIME - but these Law Makers are so out of touch with reality that it is extremely HARMFUL and DEBILITATING.

My best friends husband (SF) was the lead man going through a door in search of an HVT and as soon as he entered, he was shot and did not survive his wounds. He did manage to kill the ones who did this though before he lost too much blood. Why did he have to die?? Because he had been told by his Team Leader and Team SGT not to put charges on the door - because when it blew in - it might injure someone on the other side !!! A very good man lost his life that day and a wonderful woman lost her husband. God forbid you kill the enemy - the Afghan Coward was hiding behind a woman. I seethe when I think of this and all the other abominable things I hear and read about. Oh yes, when I was working in the WTB I heard many accounts (by Purple Heart Warriors) like they were told not to shoot Iraqi insurgents (that they were watching) placing IED's in the ground. Someone seriously needs to hold these law-makers accountable for many unnecessary deaths and INJURIES of our Forces.

The Military Industrial Complex: Please, someone, keep them in check. They are mostly making Billions off of our Marines' and Soldiers' lives. There is a German saying "For every two who fight, there is a third who laughs." I could elaborate greatly on this but I have gone on too long already. I think most of you all know where I'd go with this anyway.

The Political Machine: Why don't we hold certain groups/individuals accountable for getting us into all this trouble? Why don't Americans take a scrutinizing look at not just "who is in charge, but who is influencing and manipulating those who we think are in charge? I mean groups like the Bilderbergs, the Neo-Cons, international financiers, statesmen, and the power & war mongers of the world?? If Americans (the Free World for that matter) kept these individuals in check, we probably would not have our forces in so many conflicts around the world. Where is State Dept, and what are they doing?? What are the "Diplomats" doing??" Obviously someone is asleep at the wheel or our fighting forces would not be so sorely strained in so many conflicts. Did you know that just our Special Forces are in 47 countries around the world? GEN Michael Repass just stated this recently in a news article. Which brings me to:

The Generals and Leaders: Of the ones who I have personally met through an extremely difficult situation, I found them to all be exceedingly kind and patient with me...and sadly, I can be difficult.

GEN Gary Cheek still keeps in touch with me via email just to see how I am doing and wrote many emails to me to help me through a bad time. He and Mr. Frank Bryceland are the main reason I am in Grad school at GMU. GEN Peter Chiarelli answered more than a few of my emails - especially one where I pleaded about something. GEN Repass took the time to write me a letter of recommendation, Mr. Jim Gunlicks, and GEN Mulholland are also extremely kind and thoughtful men. GEN Huntoon is another gentleman who helped me. Please, I am not naming all these gentlemen to "name drop" I just want to convey that when you really need help and you ask for it, top leadership in the Army will do anything to help you - as busy as they are. (My problems were multi-faceted and - yes - it took all these gentlemen for me to wade through layers of bureaucracy) - but my situation has gone on for more than a year and is just about over...thank God.

Holistic/Alternative Medicine and Therapy: The medical professionals (military & civilian) should team up on this one. There are so many other things we can be doing with our (truly wounded) Warriors other than conventional medicine/treatments. Unfortunately this will be an uphill battle because the drug companies, the FDA, Insurance companies, etc.. will fight this because it is less money in their pockets. (I'm trying to keep all this short).

Who had the idea of the small Battalion groups that are effective and flexible? This sounds exactly like Special Operations and units which are being trained in COIN and Irregular warfare. GREAT IDEA !! But, sadly, there are not enough men (sorry ladies there are some places we just do not belong) to go around to do these kind of missions. It has to do with the moral fabric of our nations...look at the "raw material" the recruiters are dealing with. I don't have to wax on about this because some of you all are the experts on this dilemma. I feel I can have a bit of a say in this because I try to do my part by working as a Role Player with the Special Forces exercise, "Robin Sage." I can only say that it really does take special men to conduct these types of missions and fight in this type of Persistent Conflict/Engagement because, increasingly, they are also expected to be Diplomats, Trainers, and Educators - in addition to surviving in harsh, inhospitable and deadly environments. Which leads me to:

The National Service Act: AWESOME IDEA but most Americans are apathetic, lazy, self-gratifying, and could care less about what our Forces are experiencing because they are too busy watching "Desperate Housewives", chomping on Cheez Its and Hotdogs, and guzzling beer. I really think the idea of having more legal Immigrants, these "political refugees," and even "Illegal" immigrants or those who seek to come to America (and are not criminals in their own country), should be allowed to serve in our military. Many times, their work ethic is better and they are extremely hard-working. I have direct experience with this since I lived in England, Turkey, Germany, and have traveled throughout Latin America. Over the years I have met a number of Soldiers and Officers in foreign military services and they are quite motivated and intelligent. Heck, you'd have a lot of Translators and Interpreters this way also (with those who have good language skills). Let us see how long (how many decades) it will take for State Dept to figure out how to do this. This is another BIG problem, we are this lumbering giant tripping over our own feet many times. If we boosted the numbers of our forces in this manner, we would not be stretched so than and would not have to deal with STRESS in the Forces, Family problems, ETC......

Oh yes, Harriet? (The brave Marines Mom) the WTB that I was at had a Family Program. I was the FRSA Family Readiness Support Assistant and I can say that I did my VERY BEST attempting to involve the Soldiers and their Family Members whether it was a Mom, Fiance, Wife, or Brother of a Wounded Warrior. I really did go out of my way - and I ended up getting myself in trouble because I didn't always do things "The Army Way." But I never did anything illegal or wrong, I just did too much, believe it or not. Anyway, the Army really does try its BEST to do as much for Families as they can - I suppose you just have to trust me on this one. Please contact me and I will even try to help you however I can (cmoralez@gmu.edu). My (late) Husband, SSG Christopher Piper was a Marine Corps Scout Sniper in Beirut, Lebanon ( this was way before I met him). So Marines are TOP NOTCH in my book.

Ok, now the WTB issues: I knew there were Soldiers (male and female) that were staying there as long as humanly possible - I tended to avoid these individuals because the money spent on them could certainly have gone to help the truly combat injured Soldiers. However, there were MANY, MANY Soldiers who greatly benefited from the Warrior Transition Battalion. I could relate a number of stories to you! Please, do not consider them a failure. Because some people, officers, medical personnel did not always make the best decisions (in many various cases) is no reason to label the WTU's as failures. Yes, there are some issues, but they are mostly not systemic (in my opinion). From what I noticed, the "malinger" type issues were most problematic. Here, I would not blame leadership in the sense that the Army can only deal with so much. For example: so many people wearing the Army uniform should not even be in it. My Husband broke his wrists once and even when he had his casts on, he ran the 2 mile run and still beat every other guy in his squadron. He would not stay home or take his pain meds either. He insisted on going to work because he could still use his fingertips (his casts covered his forearms up to his knuckles). He was an 18 E (Communications expert) so he dealt with radios, antennas, buttons and switches. This is the kind of man he was...he could still use his fingertips. Yesterday (June 16) made exactly 5 years that he had his life taken from him.

So, I think it's kind of interesting (curious) that I would be writing this type of account to a bunch of people I don't even know. However, "Foreign Policy" is one of my most PREFERRED publications since I love reading about International Affairs and so I thank everyone of you (just in case you took the time to read my account). If you feel like emailing me, I'm at: cmoralez@gmu.edu

or conniemoralez@yahoo.com

 

WJA

7:51 AM ET

June 17, 2010

Sour Grapes?

While the issues here are hard to dispute, one has to wonder why Koch waited until he was out of office to reveal the dirt. Maybe canning him was the best thing for the military if he was aware of these issues and did nothing about it. Now he wants to give the military a black eye. This is a recurring problem with some political appointees in the Defense Department. We, the taxpayers, bear the burdon of these highly paid "experts" who are rarely qualified for the positions they receive. They are then overwhelmed when they realize the scope of what they have been appointed to do and end up failing miserably and blame the institution rather than themselves. Yes, this situation needs to be remedied but rather than lay it all ot there, Koch should propose concreate steps to fix the problem. Good riddance!

 

IRR SOLDIER...

8:02 AM ET

June 17, 2010

Koch Did not Have "Direct Line" Authority over WTUs

WJA,

While Mr. Koch is more than capable of defending himself, it is important to understand that he had no "direct line" authority over the individual servces' WTU programs. These nightmares with their Orwellian terminology are inventions of the services not DOD.

 

ANON

10:04 AM ET

June 17, 2010

Doubling down on Mooj's comments on Camp Lejeune

on how post-surge the medical platoons (particularly 2nd Marines since the regiment hadn't deployed in two years) were bursting at the seams.

http://www.nationaljournal.com/njmagazine/nj_20081122_7953.php

...Capt. Brian Stann, the Marine officer who commanded the holding unit to which nondeployable troops were assigned...

"I had over 300 guys that were suffering from some sort of traumatic brain injury, PTSD, or combat stress," said Stann, an Iraq veteran himself. "We had only two psychiatrists on the entire base. It's not like you're going to get a weekly appointment."

 

CPT SCOTT

11:03 AM ET

June 17, 2010

Clarification

This is from a real live Company Commander who is currently deployed:

Noel Koch is completely correct except for one thing: As a Commander, I did not choose to move my non-deployable Soldiers to WTU, the doctors and nurses at my installation's Soldier Readiness Processing (SRP) site chose for me. If it was up to me, my non-deployable Soldiers (with ailments such as Sleep Apnea and ADD) would have deployed.

About a month before deployment, my Company went through the SRP process, where we updated our wills, got vaccinations, life insurance, etc..., while we were there about 10% of my unit became non-deployable because they had sleep apnea, or recently were prescribed Prozac, or their blood was low in iron. It was not my choice, once the doctors and nurses said these Soldiers were non-deployable, they were automatically moved to the WTU. Almost all of those Soldiers had never deployed, and none of their injuries were combat related. The WTU is a perversion of its original intent.

 

MAPARKER

12:18 PM ET

June 17, 2010

Feedback

BG Cheek, I work one building over from you. I would be happy to swing over and brief you on my wounded warrior concerns from my experience as a wounded warrior advocate. You can contact me via AKO (michael.allen.parker)

I actually agree with some of the points made by Mr. Koch. I honestly believed that the strain to recruit a sufficient number of service members is a major driver in the wounded warrior problem set. This was especially true in recent years. I would agree that many of the recruits were too fragile for service and should have been screened out prior to entry. However, once the military accepts a member into service, after screening them as much as they wanted, they take on the responsibility of providing disability coverage to service member. If the military brings in a fragile individual, and they later break and become unfit, the military still owes them all the disability benefits due under law.

A soldier who enlisted on September 10th, 2001 accepted the chance of a 9-11 event that changed the nature and risk of his future military service. It is too late to claim “ if I had known then what I know now” I would not have enlisted. He must fulfill his promises and obligations. Likewise, the military cannot enlist a member and then, after the revelation of a mental or physical medical condition, renege on its promises and obligation. Unless the enlistee hid a condition and fraudulently enlisted, the military must fulfill its promises and obligations to provide disability benefits as provided for under law. Absent fraud, we would never accept life insurance companies refusing to pay benefits because the insured died soon after buying the policy. The insurance company, like DoD, gets to screen who they will accept. They have the ability to assess the risk as deeply as they want and then make a “buy” decision. Once they accept the risk and bring the member aboard, they must pay if a unfitting, compensable disability develops. The non combat equals misfit/malingerer mantra must stop. At the end of the day, the Services deem who is fit and who is isn't. One does not apply for disability in the military. They are referred by commanders, doctors and personnel commands.

Mr. Koch’s “combat” comments reflect a deeply rooted and misguided culture throughout DoD and Military Services on the appropriateness of disability compensation. Many feel that it is only due (or especially due) for combat disabilities. In fact, the military disability system provides disability coverage, that all responsible adults need, to protect against the loss of employment due to disability, regardless of the cause; save fraud and gross negligence. Disability coverage is even more important now that more military members have family obligations. They take a huge risk when they enlist. Don’t leave them hanging when they get sick , injured or wounded regardless of the condition.

It is important to understand that military members cannot buy commercial disability coverage due to the nature of their employment. The AFLAC duck will not quack for them. The loss of a career due to disability is the loss of a career, period. The DoD Disability Evaluation system compensates for the lost career, not the disability, per se. The VA, on the other hand, compensates based on the severity of the disability. The more years you serve, the more DoD disability compensation you keep (given concurrent receipt (CRDP/CRSC) eligibility). The more severe your disabilities, the more you get from the VA. Don’t confuse the purpose of these two distinct systems.

Federal civil servants, like Mr. Koch has been, have a fantastic disability program. Once they have served for 18 months, if found unfit for their job, they receive 60% of their income the first year and 40% of their income until age 62. They also maintain health insurance. At age 62 they receive a federal retirement as if they had never quit working. This is regardless of the nature of the unfitting disability and whether or not it was directly related to their job. It is disability coverage plain and simple. Military members certainly deserve disability coverage as robust as their civil service counterparts.

The WTU should be reserved for those who need constant care and cannot remain in their units while undergoing disability evaluation. The problem remains the fact that units cannot replace a wounded warrior until they are off their books. This is an especially critical issue for units trying to deploy at full strength. This creates the problem. Either the unit dumps the member into the WTU or they keep them on the roles at the detriment of the unit’s deployable fighting strength. The solution is simple. Allow the non critical wounded warriors to remain in their units. Allow units to double billet any position occupied by a member undergoing disability evaluation. This allows the units to man, train and deploy at full strength. The units can use wounded warriors, secondary to their disability evaluation responsibilities, to perform administrative and support functions (e.g. answer phones, help run ranges) thus allow deployable members to focus on training for the upcoming fight. It could be a win-win if properly structured and managed.

Proper suitability screening of recruits is very important. DoD should certainly do as much screening as they deem appropriate. I would argue they should even do genetic screening to identify individuals who are likely to become unfit in the future. Recruiting and maintaining a fit force must be job one especially when there are force structure ceilings in place. However, once DoD accepts a member, they bought him. They must fulfill their promises and obligations.

It really is all about taking care of soldiers. We should accept nothing less. They are not misfits, they are wounded warriors.

Michael A. Parker
LTC, USA (Retired)
Wounded Warrior Advocate

 

JAFFIR

1:18 PM ET

June 17, 2010

On the other hand

I thought the purpose of a Military was to win wars, not be traumatized about its reality. Yes, heal the wounded, drop a Trident and spend the money if thats what it takes, but hold the command that got them shot up, without winning, accountable. Maybe thats why a jerk like Patton got so far. He was undeniably physically brave, he understood mobility as a substitute for attrition, he made inelegant comments. But he pushed for success on the battlefield.

 

QPZMGR

9:41 PM ET

June 22, 2010

For some reason

For some reason it is up to 1% of the population to constantly bleed again and again so that the rest replica omega of us can sit back and reap the benefits of being the world's sole super power. Americans, humans in general, are very self centered people usually and they will not act until it affects them.

 

DOC42

5:16 PM ET

July 1, 2010

Caring for Injured Navy Resevists???

Tom,

I agree with BG Cheeks, and believe that the Army has made incredible improvements - and continue to strive to provide outstanding support to their wounded.

My concern is the Navy. While working at the Dept of Veterans Affairs, I have heard numerous complaints from Navy Reservists that are being demobilized without receiving the proper care. Does the Navy have a WTU like the Army? I have been told by Reservists that were injured on active duty, come to the VA and complain that the Navy demobilized them, so that they can receive care at the VA. This is concerning... I have heard that the Navy is sending more reservists to war - but not sure if they are providing them with enough support when they return injured?

Thanks,

Concerned Veteran

 

Thomas E. Ricks covered the U.S. military for the Washington Post from 2000 through 2008.

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