Brennan pushes back on Lieberman over Fort Hood shooting
Posted By Josh Rogin Wednesday, January 27, 2010 - 12:49 PM
In a previously undisclosed letter, John Brennan, the White House counterterrorism advisor, pushes back on complaints on Capitol Hill that the Obama administration has not been cooperative with Congress over the Nov. 5 massacre at Fort Hood, Texas.
"I do not believe this is a fair or accurate assessment," Brennan writes."Starting from the first moments after this tragedy, the President directed us to keep Congress appropriately informed."
Brennan goes on to detail the various briefings members of the administration have given to congressional leaders, committee chairs, and staffers, and promises that more information from the Pentagon, the Office of the Director of National Intelligence, and the FBI is forthcoming.
The letter, addressed to Joseph Lieberman and Susan Collins, is dated Jan. 27 and was exclusively obtained by The Cable. It is ostensibly a response to a Dec. 3 request by the two senators, who cochair the Committee on Homeland Security and Government Affairs, for certain unspecified documents.
To the Army's evident discomfort, Lieberman has suggested repeatedly that the Fort Hood shooting was terrorism, not a random act by a mentally disturbed individual, and vowed to use the committee to fully investigate the incident. The shooter, Army Maj. Nidal Hasan, has been linked to Anwar al-Awlaqi -- the radical Yemeni-American cleric who has since become a top "kill or capture" target for U.S. intelligence agencies and Special Forces teams operating in Yemen -- but Hasan showed signs of deep emotional instability before his Nov. 5 attack.
In his letter, Brennan first refers to the massacre as a "tragedy," but he seems to hedge his language here:
The President has a solemn responsibility to protect this nation from future acts of terrorism. In sharing what we have learned about what happened at Fort Hood, he is confident that we can help prevent such senseless acts of violence in the future."
So which is it? Terrorism or a senseless act of violence?
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This above letter can be found here:
http://www.foreignpolicy.com/images/100127_Brennan_Response_to_Lieberman_and_Collins_1-26-10.pdf
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While I do not like Senator Joe Liberman (I think he is self-serving and is willing to sell his soul to stay in office) Ido agree with his assessment of Maor Hasan's actions. This article, written in November by the same author lays out Senator Liberman's position.
Casey vs. Lieberman on Ft. Hood Massacre
Posted By Josh Rogin Monday, November 9, 2009 - 2:22 PM
Army Chief of Staff George Casey took to the airwaves Sunday to warn the public not to overemphasize unconfirmed reports about anti-American and religious statements allegedly made by alleged Fort Hood gunman Major Nidal Hasan.
"I think we need to be very careful here about speculating based on anecdotes like that," Casey said on ABC's This Week, "We all want to know what happened and what motivated the suspect, but I think we need to be very, very careful here in these early days to let the investigation take its course."
He warned that any effort to prejudge Hasan as a terrorist or as having religious motivations could cause unnecessary and harmful effects for the 3,000 plus Muslims currently serving in the military.
"I think the speculation could potentially heighten backlash against some of our Muslim soldiers. And what happened at Fort Hood was a tragedy, but I believe it would be an even greater tragedy if our diversity becomes a casualty here," Casey said.
Meanwhile, Senator Joseph Lieberman, I-CT, was on Fox news talking all about Hasan's motivations and warning that the attack could be a new model of terrorism on U.S. soil.
"It's clear that he was, one, under personal stress and, two, if the reports that we're receiving of various statements he made, acts he took, are valid, he had turned to Islamist extremism," Lieberman said, "And therefore, if that is true, the murder of these 13 people was a terrorist act and, in fact, it was the most destructive terrorist act to be committed on American soil since 9/11."
Lieberman stated that the evidence was not all in, but he went on to detail each and every reported allegation of Hasan's anti-American behavior, including reports that he compared suicide bombers to U.S. soldiers who have sacrificed their lives in war and that he shouted ‘Allah Ahkbar' during the attack.
"The fact that he did that at the moment of these murders - if that's confirmed, of course - raises genuine concerns that this was a terrorist act," Lieberman said, ""There's concern from what we know now about Hasan that, in fact, that's exactly what he was, a self-radicalized home-grown terrorist."
He promised to start an investigation in his Homeland Security Committee as to Hasan's motives. The Army declined to comment Lieberman's investigation.
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I appreciate General Casey's concerns, but this was an act of terrorism and the sooner folks understand this, the sooner we can learn how to ferret out these single terrorists and stop them in their tracks before they commit another heinous crime.
Thursday, January 28, 2010
Wednesday, January 27, 2010
General finds "McChrystal Ball" in Afghanistan
McChrystal predicts “real progress” in Afghanistan by December
Posted: 26 Jan 2010 02:20 PM PST
With all the talk in Washington about Amb. Karl Eikenberry's leaked cables opposing President Obama's surge strategy, his military counterpart Gen. Stanley McChrystal is right on message, predicting the path to victory will be clear by the time the troops start to leave in the middle of next year.
McChrystal is setting six-month milestones for progress in a talk in Kabul, shown in this video provided by NATO TV:
"I believe that by this coming summer, it's going to be obvious to the people in this room that things have changed, but it won't be obvious to people 3,000 miles or 10,000 miles away," he says in the video, predicting progress just as additional combat troops begin to arrive
"I think by next December, we'll be able to show with hard numbers and things, real progress," McChrystal goes on, without getting into specifics. "We'll be able to go ‘Look, here's more areas we cover, here's this, this, this.'"
Here's the kicker:
"And I think by the summer of 2011, it will be enough progress where the Afghans and the Taliban particularly, believe it, believe they're not going to win," McChrystal says, identifying the breaking point of the Taliban as around the same time U.S. forces are slated to begin withdrawing.
Seeming to contradict himself, McChrystal also speaks at length about the need to have a sustained presence in remote Afghan areas to convince locals to take the huge risk of turning on the Taliban and siding with Afghan and NATO forces. He talks about the need to stay and prove to locals that their long-term interest is in supporting and even defending the government before the coalition can transfer security to Afghan control.
McChrystal also addresses the controversial issue of reintegrating Taliban fighters. Most foreign fighters can't be reintegrated, he says, and most local fighters won't switch sides -- they will simply decide to stop attacking the government forces.
"I think a lot of reintegration won't be formal," says McChrystal. "It will just be, you'll just notice there are fewer of them."
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How does General McChrystal propose to do this? There is an old Arabian proverb that says: "Keep your friends close--hold your enemies closer." And that is exactly what the general and President Hamid Karzai are proposing. Their plan is to woo Taliban fighters away by offering them jobs, security by taking some of them of various hit lists and protecting themagainst retaliation and Karzai even wants to integrate some Taliban leaders back into the political scene.
This plan is going to be presented today in London. The hope is that those participating in the action in Afghanistan will provide the necesary funds (and perhaps troops) to make this work. Special envoy to AFghanistan, Richard Holbrooke agrees with the plan and Britain has announced it will help fund the effort.
Will this work? Only time can tell. Most of the tribes in Afghanistan have little faith in the government and in the karzai government in particular. The tribes themselves have trouble getting along together and within tribges, various factions often have uneasy an easy peace. It has just been announced that the largest Pashtun tribe in a major Taliban area, the Shinwari tribe, has decided to fight the Taliban. This is a significant break-through since this tribe has had members killed when they have attempted to fight back. But they apparently have had enough. We have been promised the Shinwaris a million dollars in various projects. This money will go directly to the tribal leaders and the local Karzai government will be left out of the formula.
Perhaps this is the first glimmer of light at the end of the tunnel and if we had only known that such a prgram would solve the problem, we could have saved nearly 5,000 American lives and tens of thousands of wounded Americans whose lives have been altered forever. And this doesn't even consider the thousand and thousands of Afghans and Iraqis who have been killed. And the fiscal cost would have been far less. This could have meant that billions of dollars might have been available to the people of this nation. Coming up with an affordable health care plan would have been much easier with all this extra money around.
IMHO, we still don't understand these people and neither have others who have come to Afghanistan for various reasons. We simply don't undrstand how deep their religious fervor runs. We think we know the right thing to do--kinda like the power plant we have built in Afghanistan that is too sophisticated and too expensive for the Afghanis to operate. But USAID knew what was best.
Only time and many more casualties will tell.
Posted: 26 Jan 2010 02:20 PM PST
With all the talk in Washington about Amb. Karl Eikenberry's leaked cables opposing President Obama's surge strategy, his military counterpart Gen. Stanley McChrystal is right on message, predicting the path to victory will be clear by the time the troops start to leave in the middle of next year.
McChrystal is setting six-month milestones for progress in a talk in Kabul, shown in this video provided by NATO TV:
"I believe that by this coming summer, it's going to be obvious to the people in this room that things have changed, but it won't be obvious to people 3,000 miles or 10,000 miles away," he says in the video, predicting progress just as additional combat troops begin to arrive
"I think by next December, we'll be able to show with hard numbers and things, real progress," McChrystal goes on, without getting into specifics. "We'll be able to go ‘Look, here's more areas we cover, here's this, this, this.'"
Here's the kicker:
"And I think by the summer of 2011, it will be enough progress where the Afghans and the Taliban particularly, believe it, believe they're not going to win," McChrystal says, identifying the breaking point of the Taliban as around the same time U.S. forces are slated to begin withdrawing.
Seeming to contradict himself, McChrystal also speaks at length about the need to have a sustained presence in remote Afghan areas to convince locals to take the huge risk of turning on the Taliban and siding with Afghan and NATO forces. He talks about the need to stay and prove to locals that their long-term interest is in supporting and even defending the government before the coalition can transfer security to Afghan control.
McChrystal also addresses the controversial issue of reintegrating Taliban fighters. Most foreign fighters can't be reintegrated, he says, and most local fighters won't switch sides -- they will simply decide to stop attacking the government forces.
"I think a lot of reintegration won't be formal," says McChrystal. "It will just be, you'll just notice there are fewer of them."
-------------------------------------------------------------------------------------------------
How does General McChrystal propose to do this? There is an old Arabian proverb that says: "Keep your friends close--hold your enemies closer." And that is exactly what the general and President Hamid Karzai are proposing. Their plan is to woo Taliban fighters away by offering them jobs, security by taking some of them of various hit lists and protecting themagainst retaliation and Karzai even wants to integrate some Taliban leaders back into the political scene.
This plan is going to be presented today in London. The hope is that those participating in the action in Afghanistan will provide the necesary funds (and perhaps troops) to make this work. Special envoy to AFghanistan, Richard Holbrooke agrees with the plan and Britain has announced it will help fund the effort.
Will this work? Only time can tell. Most of the tribes in Afghanistan have little faith in the government and in the karzai government in particular. The tribes themselves have trouble getting along together and within tribges, various factions often have uneasy an easy peace. It has just been announced that the largest Pashtun tribe in a major Taliban area, the Shinwari tribe, has decided to fight the Taliban. This is a significant break-through since this tribe has had members killed when they have attempted to fight back. But they apparently have had enough. We have been promised the Shinwaris a million dollars in various projects. This money will go directly to the tribal leaders and the local Karzai government will be left out of the formula.
Perhaps this is the first glimmer of light at the end of the tunnel and if we had only known that such a prgram would solve the problem, we could have saved nearly 5,000 American lives and tens of thousands of wounded Americans whose lives have been altered forever. And this doesn't even consider the thousand and thousands of Afghans and Iraqis who have been killed. And the fiscal cost would have been far less. This could have meant that billions of dollars might have been available to the people of this nation. Coming up with an affordable health care plan would have been much easier with all this extra money around.
IMHO, we still don't understand these people and neither have others who have come to Afghanistan for various reasons. We simply don't undrstand how deep their religious fervor runs. We think we know the right thing to do--kinda like the power plant we have built in Afghanistan that is too sophisticated and too expensive for the Afghanis to operate. But USAID knew what was best.
Only time and many more casualties will tell.
Tuesday, January 19, 2010
Suicides continue to climb
Back in November, I posted this question a friend had asked me about the status of mental health care in the military—
Do the military medical services still lack the capacity to adequately treat mental problems? As a PTSD sufferer myself I can certainly attest to this paucity of care in the past, but I had believed improvements had been made. Was I wrong?
At that time I wrote that despite the military’s best efforts the suicide rates were still climbing. And my conclusion was that things were not getting better. Well I am sad to say that not only are things not getting better, they are getting worse. It is a long read, but here is what McClatchy News is reporting as of January 15, 2010—
BY HALIMAH ABDULLAH
MCCLATCHY NEWSPAPERS
WASHINGTON -- Eight years of war in Afghanistan and Iraq have etched indelible scars on the psyches of many of the nation's service members, and the U.S. military is losing a battle to stem an epidemic of suicides in its ranks.
Despite calls by top Pentagon officials for a sea change in attitudes about mental health, millions of dollars in new suicide-prevention programming and thousands of hours spent helping soldiers suffering from what often are euphemistically dubbed "invisible wounds," the military is losing ground.
The Department of Defense Friday reported that there were 160 reported active-duty Army suicides in 2009, up from 140 in 2008. Of these, 114 have been confirmed, while the manner of death in the remaining 46 remains to be determined.
"There's no question that 2009 was a painful year for the Army when it came to suicides," said Col. Christopher Philbrick, the deputy director of the Army Suicide Prevention Task Force, in a statement, despite what he called "wide-ranging measures last year to confront the problem."
While the military's suicide rate is comparable to civilian rates, the increase last year is alarming because the armed services traditionally had lower suicide rates than the general population did.
"I look at the numbers of each service, and that rate has gone up at the same rate across the services," Adm. Mike Mullen, the chairman of the Joint Chiefs of Staff, told a gathering of military mental health professionals and advocates last week. "This isn't just a ground force problem."
Some of the suicides are young men, fresh from deployments and haunted by memories, who shoot themselves after they return from their second or third tours in Iraq or Afghanistan, or when romantic relationships turn sour, sometimes due to long separations or post-traumatic stress.
Others are career officers who quietly nurse addictions to drugs or alcohol and finally decide to silence their ghosts.
An increasing number are female soldiers, who rarely committed suicide before but now are killing themselves at a much higher rate.
"There does not appear to be any scientific correlation between the number of deployments and those that are at risk, but I'm just hard pressed to believe that's not the case," Mullen said.
The emotional wounds are so deep and the suicide rates are so high that top Pentagon officials broke a generations-long code of silence on the topic and have started speaking publicly and vehemently about the effects of mental illness.
At Fort Benning, Ga., which defense experts say ranks among the top installations for effective mental health screening, retired Brigade Command Sgt. Maj. Samuel Rhodes' speech to troops about how he considered suicide after serving for 30 months in Iraq encouraged other soldiers to come forward.
The military's shift in attitudes about mental health was evident during last week's joint Departments of Defense and Veterans Affairs suicide prevention conference, where uniformed attendees spoke openly about the stigma of seeking mental health care, the need for policy changes that will make help easier to get and the importance of supporting the families of troops suffering from mental illness.
"It's a joint DOD and VA conference, that alone says an awful lot about where we used to be and where we are now," Mullen said.
With one of the highest suicide rates in the Army, Fort Campbell, a sprawling installation on the Kentucky-Tennessee border that's home to the elite 101st Airborne Division, illustrates the severity of the problem.
"Our issues here at Fort Campbell identically mirror the issues mirroring the Army as a whole. The demographics are almost exactly: white males 18-29 who commit suicide (using handguns)," said Joe Varney, the Fort Campbell suicide prevention program manager.
In 2007, Fort Campbell created a suicide task force after nine soldiers committed suicide, three during the first few weeks of October, and 101st Airborne's commander, Maj. Gen. Jeffrey Schloesser, reached out to soldiers and their families.
"As our soldiers fight terrorism, the sacrifices asked of them and their families have increased significantly," Schloesser said in a letter to troops. "Regrettably, under such circumstances, it is natural for our people to feel the stress of these demands and to be overwhelmed at times. Tragically, these pressures too often end in suicide."
The following year, Fort Campbell's suicide rate jumped to 12.
The base hired a suicide-prevention program manager and dispatched staffers to study trends, increased awareness training for troops and boosted the number of mental health professionals available to soldiers while in combat and after they return. Army officials say those efforts could prove useful service-wide.
Last year, Fort Campbell held a three-day "suicide stand-down," and top officials pleaded with soldiers to get mental help if they needed it and assured them that seeking such help wasn't a sign of weakness and wouldn't affect their careers.
The number of suicides increased to 14 in 2009.
"It's been discouraging to say the least," Varney said.
Stemming the rise in suicides will take more than conferences, task forces, training and studies, said Col. Elspeth Ritchie, the director of behavioral health for the Office of the Army Surgeon General. The military also will have to grapple with the easy availability of handguns, a topic that's sure to be unpopular, she said.
"It's amazing to me when you see Fort Campbell, which is at the top of suicide lists. They have a beautiful gun shop in the middle of the (Post Exchange)," Ritchie said. "I'm troubled by what I see as a mixed message."
Some soldiers who receive counseling are still committing suicide, and many think - with good reason, given previous military policies and attitudes about mental health - that seeking treatment could ruin careers, she said.
"We cannot change stigma until we change policies that contribute to stigma," Ritchie said. "In many ways we talk out of both sides of our mouths."
The Obama administration, at the behest of a small bipartisan congressional group, is reviewing a long-standing unofficial policy that bars the president from sending condolence letters to the families of servicemen and women who commit suicide.
Family members of soldiers who've committed suicide said that changing the policy would go a long way toward removing the stigma because the military already provides a full military burial for soldiers who commit suicide.
"That policy reflects the heartlessness to those who served. They've been inflicted with hidden wounds, but it doesn't mean they're any less lethal," said Kevin Lucey, of Belchertown, Mass., whose son Jeffrey, a 23-year-old Marine, hanged himself less than a year after he returned from Iraq. The government settled with the family for $350,000.
Admiral Mullen, Chairman of the Joint Chiefs of Staff, may well be on the right track when he says he is hard pressed to not believe that the number of deployments affects the number of suicides.
Despite setting up offices and people to study the “Why” of suicides, they continue to climb. Despite stand-downs and new policies to get rid of the “stigma”, our young men and women keep offing themselves. I, for one, think that repeated deployments to wars that seem to have no end in sight have everything to do with what is happening. Many of our young service personnel are on the fourth and perhaps fifth rotation and each time they go they see the same things, are exposed to the same roadside IEDs and suicide bombers and the same endless nothingness of a war. They see millions of dollars being wasted or stolen by governments and unprincipled contractors. They find they don’t have enough “stuff” to do their job and yet they a re sent back again and again. It is like the movie “Groundhog Day” with bullets and IEDs.
And when someone does kill himself or herself, they are treated like a pariah. There is an “unofficial policy” that the president won’t write condolence letters to the families of these war victims. The president is “reviewing” this policy. Reviewing it—Hell do away with it Mr. President. Don’t the figures tell you anything? By not expressing your sorrow and the sorrow of the Nation, you are adding to the stigma. This is an epidemic, just like the H1N1 flu problem—we need to mobilize and use every weapon we have to fight this epidemic.
More importantly, we need to ask ourselves why are we still in Iraq and Afghanistan. And unless we can answer we can actually prove that being there is keeping terrorists from our door, the we need to figure out how we get out with some kind of honor.
Do the military medical services still lack the capacity to adequately treat mental problems? As a PTSD sufferer myself I can certainly attest to this paucity of care in the past, but I had believed improvements had been made. Was I wrong?
At that time I wrote that despite the military’s best efforts the suicide rates were still climbing. And my conclusion was that things were not getting better. Well I am sad to say that not only are things not getting better, they are getting worse. It is a long read, but here is what McClatchy News is reporting as of January 15, 2010—
BY HALIMAH ABDULLAH
MCCLATCHY NEWSPAPERS
WASHINGTON -- Eight years of war in Afghanistan and Iraq have etched indelible scars on the psyches of many of the nation's service members, and the U.S. military is losing a battle to stem an epidemic of suicides in its ranks.
Despite calls by top Pentagon officials for a sea change in attitudes about mental health, millions of dollars in new suicide-prevention programming and thousands of hours spent helping soldiers suffering from what often are euphemistically dubbed "invisible wounds," the military is losing ground.
The Department of Defense Friday reported that there were 160 reported active-duty Army suicides in 2009, up from 140 in 2008. Of these, 114 have been confirmed, while the manner of death in the remaining 46 remains to be determined.
"There's no question that 2009 was a painful year for the Army when it came to suicides," said Col. Christopher Philbrick, the deputy director of the Army Suicide Prevention Task Force, in a statement, despite what he called "wide-ranging measures last year to confront the problem."
While the military's suicide rate is comparable to civilian rates, the increase last year is alarming because the armed services traditionally had lower suicide rates than the general population did.
"I look at the numbers of each service, and that rate has gone up at the same rate across the services," Adm. Mike Mullen, the chairman of the Joint Chiefs of Staff, told a gathering of military mental health professionals and advocates last week. "This isn't just a ground force problem."
Some of the suicides are young men, fresh from deployments and haunted by memories, who shoot themselves after they return from their second or third tours in Iraq or Afghanistan, or when romantic relationships turn sour, sometimes due to long separations or post-traumatic stress.
Others are career officers who quietly nurse addictions to drugs or alcohol and finally decide to silence their ghosts.
An increasing number are female soldiers, who rarely committed suicide before but now are killing themselves at a much higher rate.
"There does not appear to be any scientific correlation between the number of deployments and those that are at risk, but I'm just hard pressed to believe that's not the case," Mullen said.
The emotional wounds are so deep and the suicide rates are so high that top Pentagon officials broke a generations-long code of silence on the topic and have started speaking publicly and vehemently about the effects of mental illness.
At Fort Benning, Ga., which defense experts say ranks among the top installations for effective mental health screening, retired Brigade Command Sgt. Maj. Samuel Rhodes' speech to troops about how he considered suicide after serving for 30 months in Iraq encouraged other soldiers to come forward.
The military's shift in attitudes about mental health was evident during last week's joint Departments of Defense and Veterans Affairs suicide prevention conference, where uniformed attendees spoke openly about the stigma of seeking mental health care, the need for policy changes that will make help easier to get and the importance of supporting the families of troops suffering from mental illness.
"It's a joint DOD and VA conference, that alone says an awful lot about where we used to be and where we are now," Mullen said.
With one of the highest suicide rates in the Army, Fort Campbell, a sprawling installation on the Kentucky-Tennessee border that's home to the elite 101st Airborne Division, illustrates the severity of the problem.
"Our issues here at Fort Campbell identically mirror the issues mirroring the Army as a whole. The demographics are almost exactly: white males 18-29 who commit suicide (using handguns)," said Joe Varney, the Fort Campbell suicide prevention program manager.
In 2007, Fort Campbell created a suicide task force after nine soldiers committed suicide, three during the first few weeks of October, and 101st Airborne's commander, Maj. Gen. Jeffrey Schloesser, reached out to soldiers and their families.
"As our soldiers fight terrorism, the sacrifices asked of them and their families have increased significantly," Schloesser said in a letter to troops. "Regrettably, under such circumstances, it is natural for our people to feel the stress of these demands and to be overwhelmed at times. Tragically, these pressures too often end in suicide."
The following year, Fort Campbell's suicide rate jumped to 12.
The base hired a suicide-prevention program manager and dispatched staffers to study trends, increased awareness training for troops and boosted the number of mental health professionals available to soldiers while in combat and after they return. Army officials say those efforts could prove useful service-wide.
Last year, Fort Campbell held a three-day "suicide stand-down," and top officials pleaded with soldiers to get mental help if they needed it and assured them that seeking such help wasn't a sign of weakness and wouldn't affect their careers.
The number of suicides increased to 14 in 2009.
"It's been discouraging to say the least," Varney said.
Stemming the rise in suicides will take more than conferences, task forces, training and studies, said Col. Elspeth Ritchie, the director of behavioral health for the Office of the Army Surgeon General. The military also will have to grapple with the easy availability of handguns, a topic that's sure to be unpopular, she said.
"It's amazing to me when you see Fort Campbell, which is at the top of suicide lists. They have a beautiful gun shop in the middle of the (Post Exchange)," Ritchie said. "I'm troubled by what I see as a mixed message."
Some soldiers who receive counseling are still committing suicide, and many think - with good reason, given previous military policies and attitudes about mental health - that seeking treatment could ruin careers, she said.
"We cannot change stigma until we change policies that contribute to stigma," Ritchie said. "In many ways we talk out of both sides of our mouths."
The Obama administration, at the behest of a small bipartisan congressional group, is reviewing a long-standing unofficial policy that bars the president from sending condolence letters to the families of servicemen and women who commit suicide.
Family members of soldiers who've committed suicide said that changing the policy would go a long way toward removing the stigma because the military already provides a full military burial for soldiers who commit suicide.
"That policy reflects the heartlessness to those who served. They've been inflicted with hidden wounds, but it doesn't mean they're any less lethal," said Kevin Lucey, of Belchertown, Mass., whose son Jeffrey, a 23-year-old Marine, hanged himself less than a year after he returned from Iraq. The government settled with the family for $350,000.
Admiral Mullen, Chairman of the Joint Chiefs of Staff, may well be on the right track when he says he is hard pressed to not believe that the number of deployments affects the number of suicides.
Despite setting up offices and people to study the “Why” of suicides, they continue to climb. Despite stand-downs and new policies to get rid of the “stigma”, our young men and women keep offing themselves. I, for one, think that repeated deployments to wars that seem to have no end in sight have everything to do with what is happening. Many of our young service personnel are on the fourth and perhaps fifth rotation and each time they go they see the same things, are exposed to the same roadside IEDs and suicide bombers and the same endless nothingness of a war. They see millions of dollars being wasted or stolen by governments and unprincipled contractors. They find they don’t have enough “stuff” to do their job and yet they a re sent back again and again. It is like the movie “Groundhog Day” with bullets and IEDs.
And when someone does kill himself or herself, they are treated like a pariah. There is an “unofficial policy” that the president won’t write condolence letters to the families of these war victims. The president is “reviewing” this policy. Reviewing it—Hell do away with it Mr. President. Don’t the figures tell you anything? By not expressing your sorrow and the sorrow of the Nation, you are adding to the stigma. This is an epidemic, just like the H1N1 flu problem—we need to mobilize and use every weapon we have to fight this epidemic.
More importantly, we need to ask ourselves why are we still in Iraq and Afghanistan. And unless we can answer we can actually prove that being there is keeping terrorists from our door, the we need to figure out how we get out with some kind of honor.
Wednesday, January 13, 2010
Major Hasan--How Did He Do It?
Our local fishwrap, The News and Messenger (January 12, 2009) carried an article that pondered how it was that Major Nidal Hasan was able to get through medical school and a psychiatry residency despite the fact that his performance all along the way was substandard.
Oh, if you only knew!
Let’s start with Major Hasan’s education at the Uniformed Services University of the Health Sciences and the F. Edward Hebert School of Medicine, our nation’s military medical school. Medical students entering the F. Edward Hebert School of Medicine are commissioned as at the entry level (2nd Lieutenant/Ensign) in the Army, Navy, Air Force and Public Health Service. They are paid at this grade for the four (or more) years they attend school but they pay no tuition, laboratory fees, etc. while they attend school. Once they complete school, they are advanced to Captain/Lieutenant and begin their internship and eventual payback for their “free” medical education. At this point, the government (the Armed Forces) has something approaching $500,000 invested in each graduating student. This does not count their pay and allowances. At the current pay scale, new students pay and allowances for four years comes to just over $271,000. Of course, this investment is greater for the student who doesn’t finish in four years as was the case for Major Hasan—the six year tally comes to more than $470,000. So the government has somewhere between three-quarters and nearly a million dollars invested in a new physician before they begin their internship and any specialty training. Hasan was promoted to Captain upon graduation and his annual income for the next four years was more than $385,000 (again, based on the current pay scale). This includes another year of training for master’s degree in public health—the cost of that schooling has not been calculated in this figure.
The Uniformed Services University has never been able to fully quantify just how much it costs to train a medical student because the school does much more than just train physicians. There are numerous PhD programs, research programs and other training courses that impact the cost of operating the medical school. But conservatively the government had something over $1.25 million invested in Major Hasan when he was transferred to Fort Hood.
Despite his poor performance in medical school and his residency program, those in charge of Major Hasan equivocated repeatedly on his Officer Evaluation Reports and on reports regarding his performance during his residency.
On May 17, 2007, Major Scott Moran, an Army psychiatrist and director of Major Hasan’s psychiatry residency training program wrote the following memorandum:
"Consortium Participating Instructions: Uniformed Services University of Health
Sciences, Walter Reed Army Medical Center, National Naval Medical Center,
Malcolm Grow USAF Medical Center
May 17, 2007
Memorandum for: Credentials Committee
Subject: CPT Nidal Hasan
1. I am the program director for NCC Psychiatry Residency Training Program. I
took over as PD in MAR 2007 and was Assistant PD from July 2006. I have
been a faculty member of the residency since July 2004.
2. This memo is based on my personal knowledge of and the documented
incidences in CPT Hasan’s Resident Training File.
3. The Faculty has serious concerns about CPT Hasan’s professionalism and work
ethic. Clinically he is competent to deliver safe patient care. But he
demonstrates a pattern of poor judgment and a lack of professionalism. In
his PGY-2 year, he was counseled for inappropriately discussing religious
topics with his assigned patients. He also required a period of in-program
remediation when he was discovered to have not documented appropriately an
ER encounter with a homicidal patient who subsequently eloped from the ER.
He did successfully remediate this problem. At the end of his PGY-2 year,
he was placed on administrative probation by the NCC GMEC for failure to
take and pass USMLE Step 3 and to obtain an unrestricted state medical
license by the end of his PGY-2 year; as a result he was not promoted to
PGY-3 on time. He did eventually complete step 3 and get a license and was
promoted to PGY-3. He was counseled for having a poor record of attendance
at didactics and lower than expected PRITE scores. One year he failed to
show for his PRITE examination at all. During his PGY-3 year, he was
counseled for being consistently late to NNMC morning report. During his
PGY-4 year, he was discovered to have only seen 30 outpatients in 38 week
of outpatient continuity clinic. He was required to make this missed clinic
time up using his elective. He failed his HGT/WGT screening and was found
to be out of standards with body fat % and was counseled on that.
Lastly, he missed a night of call for MGMC ER and then did not respond to
numerous pages by my office the next day.
4. Take together; these issues demonstrate a lack of professionalism and work
ethics. He is able to self-correct with supervision. However, at this point
he should not need so much supervision. In spite of all of this, I am not
able to say he is not competent to graduate nor do I think a period of
academic probation now at the end of his training will be beneficial. He
would be able to contain his behavior enough to complete any period of
probation successfully. My purpose in writing this letter is to give the
credentials committee the benefit of full disclosure and the opportunity to
modify CPT Hasan’s plan of supervision following initial privileging.
5. I did discuss this memo with CPT Hasan and informed him I would be adding
it to his initial credentialing paperwork.
6. POC is the undersigned and may be reached at 202-XXX-XXXX or email at XXX/
Sincerely,
Scott Moran, MAJ, MC
Program Director
NCC Psychiatry Residency Training"
Despite all of his reservations, Major Moran failed to stop then Captain Hasan from graduating. A careful read of paragraph 4 tells the story. It is this paragraph that lets Major Hasan off the hook as well as the author Major Scott Moran. It equivocates, back peddles, is wishy washy, waffling or whatever name you wish to assign to someone who is protecting himself and is obviously concerned about possible litigation--one of the biggest crimes I believe we face in our society. It keeps us from being candid just when we need to be.
Graduating, promoting and transferring Hasan were major leadership failures from medical school through residency training. I have said it before and I will say it again, physicians don't like to "rat out" other physicians. It is much like the Blue Wall of Silence found among police officers--fellow police officer don't "rat out" fellow police officers and physicians don't "rat out" other physicians.
There is plenty of room for blame here and I, for one, hope that is spread around on those responsible that they are appropriately disciplined. But I'm not making any bets on it--our leaders have become politically correct wimps--always concerned about litigation and their public persona. Where are the George Pattons, Chesty Pullers, and Bull Halseys when we need them? Gone to graveyards everyone.
There have been other instances over the years since the University was opened that medical students did not graduate in four years. How many? I don't know, but unless someone steps in and carefully reviews the procedures at the F. Edward Hebert School of Medicine that are used to determine whether a student graduates, is “rolled back” or is removed from training, there will be other Major Hasans—it is only a matter of time. The University had a major shakeup some fourteen years ago; perhaps it is time for another bottom to top examination.
Oh, if you only knew!
Let’s start with Major Hasan’s education at the Uniformed Services University of the Health Sciences and the F. Edward Hebert School of Medicine, our nation’s military medical school. Medical students entering the F. Edward Hebert School of Medicine are commissioned as at the entry level (2nd Lieutenant/Ensign) in the Army, Navy, Air Force and Public Health Service. They are paid at this grade for the four (or more) years they attend school but they pay no tuition, laboratory fees, etc. while they attend school. Once they complete school, they are advanced to Captain/Lieutenant and begin their internship and eventual payback for their “free” medical education. At this point, the government (the Armed Forces) has something approaching $500,000 invested in each graduating student. This does not count their pay and allowances. At the current pay scale, new students pay and allowances for four years comes to just over $271,000. Of course, this investment is greater for the student who doesn’t finish in four years as was the case for Major Hasan—the six year tally comes to more than $470,000. So the government has somewhere between three-quarters and nearly a million dollars invested in a new physician before they begin their internship and any specialty training. Hasan was promoted to Captain upon graduation and his annual income for the next four years was more than $385,000 (again, based on the current pay scale). This includes another year of training for master’s degree in public health—the cost of that schooling has not been calculated in this figure.
The Uniformed Services University has never been able to fully quantify just how much it costs to train a medical student because the school does much more than just train physicians. There are numerous PhD programs, research programs and other training courses that impact the cost of operating the medical school. But conservatively the government had something over $1.25 million invested in Major Hasan when he was transferred to Fort Hood.
Despite his poor performance in medical school and his residency program, those in charge of Major Hasan equivocated repeatedly on his Officer Evaluation Reports and on reports regarding his performance during his residency.
On May 17, 2007, Major Scott Moran, an Army psychiatrist and director of Major Hasan’s psychiatry residency training program wrote the following memorandum:
"Consortium Participating Instructions: Uniformed Services University of Health
Sciences, Walter Reed Army Medical Center, National Naval Medical Center,
Malcolm Grow USAF Medical Center
May 17, 2007
Memorandum for: Credentials Committee
Subject: CPT Nidal Hasan
1. I am the program director for NCC Psychiatry Residency Training Program. I
took over as PD in MAR 2007 and was Assistant PD from July 2006. I have
been a faculty member of the residency since July 2004.
2. This memo is based on my personal knowledge of and the documented
incidences in CPT Hasan’s Resident Training File.
3. The Faculty has serious concerns about CPT Hasan’s professionalism and work
ethic. Clinically he is competent to deliver safe patient care. But he
demonstrates a pattern of poor judgment and a lack of professionalism. In
his PGY-2 year, he was counseled for inappropriately discussing religious
topics with his assigned patients. He also required a period of in-program
remediation when he was discovered to have not documented appropriately an
ER encounter with a homicidal patient who subsequently eloped from the ER.
He did successfully remediate this problem. At the end of his PGY-2 year,
he was placed on administrative probation by the NCC GMEC for failure to
take and pass USMLE Step 3 and to obtain an unrestricted state medical
license by the end of his PGY-2 year; as a result he was not promoted to
PGY-3 on time. He did eventually complete step 3 and get a license and was
promoted to PGY-3. He was counseled for having a poor record of attendance
at didactics and lower than expected PRITE scores. One year he failed to
show for his PRITE examination at all. During his PGY-3 year, he was
counseled for being consistently late to NNMC morning report. During his
PGY-4 year, he was discovered to have only seen 30 outpatients in 38 week
of outpatient continuity clinic. He was required to make this missed clinic
time up using his elective. He failed his HGT/WGT screening and was found
to be out of standards with body fat % and was counseled on that.
Lastly, he missed a night of call for MGMC ER and then did not respond to
numerous pages by my office the next day.
4. Take together; these issues demonstrate a lack of professionalism and work
ethics. He is able to self-correct with supervision. However, at this point
he should not need so much supervision. In spite of all of this, I am not
able to say he is not competent to graduate nor do I think a period of
academic probation now at the end of his training will be beneficial. He
would be able to contain his behavior enough to complete any period of
probation successfully. My purpose in writing this letter is to give the
credentials committee the benefit of full disclosure and the opportunity to
modify CPT Hasan’s plan of supervision following initial privileging.
5. I did discuss this memo with CPT Hasan and informed him I would be adding
it to his initial credentialing paperwork.
6. POC is the undersigned and may be reached at 202-XXX-XXXX or email at XXX/
Sincerely,
Scott Moran, MAJ, MC
Program Director
NCC Psychiatry Residency Training"
Despite all of his reservations, Major Moran failed to stop then Captain Hasan from graduating. A careful read of paragraph 4 tells the story. It is this paragraph that lets Major Hasan off the hook as well as the author Major Scott Moran. It equivocates, back peddles, is wishy washy, waffling or whatever name you wish to assign to someone who is protecting himself and is obviously concerned about possible litigation--one of the biggest crimes I believe we face in our society. It keeps us from being candid just when we need to be.
Graduating, promoting and transferring Hasan were major leadership failures from medical school through residency training. I have said it before and I will say it again, physicians don't like to "rat out" other physicians. It is much like the Blue Wall of Silence found among police officers--fellow police officer don't "rat out" fellow police officers and physicians don't "rat out" other physicians.
There is plenty of room for blame here and I, for one, hope that is spread around on those responsible that they are appropriately disciplined. But I'm not making any bets on it--our leaders have become politically correct wimps--always concerned about litigation and their public persona. Where are the George Pattons, Chesty Pullers, and Bull Halseys when we need them? Gone to graveyards everyone.
There have been other instances over the years since the University was opened that medical students did not graduate in four years. How many? I don't know, but unless someone steps in and carefully reviews the procedures at the F. Edward Hebert School of Medicine that are used to determine whether a student graduates, is “rolled back” or is removed from training, there will be other Major Hasans—it is only a matter of time. The University had a major shakeup some fourteen years ago; perhaps it is time for another bottom to top examination.
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