When the Smoke Clears

There’s something building… it’s stirring up inside me like a calling back to a fight I had hoped to walk away from the first time, after the first shoves.

Yes, the press and the left are exploiting this Walter Reed scandal as if it is proof positive about the inaction of the current administration. From what I have seen in my private life, the hell of a VA hospital was embarrassing, but I know that things improved after the turn of the century/administration. I saw it. Improved, but not enough. I used to feel actual fear for my patients if I found out I was going to have to take an emergent case to a VA hospital. I might spend a little extra time doing paperwork in the ER to ensure some basic steps of care were taken.

I’ve a rant coming up, some stories about my experiences as a civilian outside of things, but I’m letting it percolate. It’s not like I didn’t see similar things in private and public hospitals as well, but let me tell you, there are some places where it seems the entire staff, even the cleaning crew, is dedicated to every patient. It CAN be done. For the military, it’s well past time, though the truth is once it goes into place, others will say it proves that socialized medicine will work just fine.

Military hospitals are in a unique position and it’s all thanks to your posturing, postulating politicians. Don’t let them fool you into believing they have been caring about this since day one. A few do, but get caught up in other concerns. Military hospitals have to meet military regs, but first, when operating in the US, they have to meet the incredibly labyrinthine regulations of the civilian world, too. Anyone that has worked on a Joint Commission Task Force combined with HIPPA concerns can tell you about that nightmare. It’s FAR more complicated than you can imagine and it’s all due to governmental oversight, watchdogging, insurance companies protecting their interests in a world of incredibly costly lawsuits that are usually settled rather than go before a jury trial which almost always finds for emotion over justice… (yes, I can tell you.)

However, I cannot fathom what’s going on here other than a tremendous case of burnout on the part of the caregivers trying to fight bureaucracy and just giving up, or else they are all civilian contractors signed on to a job with no desire to go above the bare minimum and eager to hide behind red tape when they have a moment of conscience and clarity.

Last week when I heard one of my young ones had been feeling really sick all day, throwing up, I went to the barracks to check on her, partly because I knew she probably had not been to see anyone out of some of the frustration. It’s what I do. When on maneuvers I go TO the patrol bases for sick call. Understand that this is entirely voluntary on my part and I can walk away at any time. I also have no real authority to institute anything in particular other than life-saving protocols, but try to help where I can. I can also pick out a slacker/malingerer pretty quickly.

I believe that in order to truly help the soldier you need to go to his or her environment, kind of like old fashioned house calls. I know I’m foolish and it’s not the most “efficient” form of healthcare on the surface, but being able to observe the environment is often a key component in helping a doctor zero in on a diagnosis. I’ve gently but firmly given reports to residents that included details that should speed their processes along:

“Also, when we found him, there were small black ants in the bathroom, but none in the kitchen or other parts of the house.”

“Ants? So?” came the sarcastic reply as if I were wasting his time.

“Ants… only in the bathroom… around the toilet…”

“He’s trying to point out something. Listen,” said the attending physician.

“Ants seek out sugar mostly… sugar only in the bathroom… where men pee…”

(cue lightbulb)

Every bit of OTC medication, every glove, every bag of fluids, heck, even my pack to carry it all in comes out of my own pocket. (The Reserves has bought some gauze, ace wraps and a few other wound supplies to replace my used items, to be fair and show appreciation for their efforts.) I do it because I have the chance to. Would it be even better if I could get paid for it? sure.

Certainly I can’t help every single person out there, but I can help those I come into contact with and who fall under my care. The problem, of course, is that success is always punished.

I really cannot imagine that the whole of the staff of Walter Reed is unconcerned, but I don’t know. I’ve a few stories to tell, though none of WR, and they will be coming.

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