Tuesday, March 13, 2007

Just What The Doctor Ordered

By Sara

Salon's top story yesterday dug another layer off the shameful treatment of wounded American troops -- this time, a special inspection at Fort Benning that was clearly aimed at downgrading injuries in order to send disabled and crippled soldiers back to the front, some for the third time around.

According to Mark Benjamin's story, two doctors came in the week before last and did a one-day special inspection of 75 soldiers, unilaterally declaring them fit for combat, often directly contradicting full files containing years of documentation that said otherwise. As a result, among those who returned to Iraq last week were a 20-year female veteran with a blown disk who was limited to carrying 15 pounds, and enjoined from wearing a helmet because her neck couldn't take the strain; a soldier with three fused vertebrae who lives on a heavy dose of pain pills; and another male soldier who suffers from such severe sleep apnea and narcolepsy that he's not allowed to drive, and must use a CPAP -- a breathing support machine that requires electricity to run -- in order to sleep. (And what's his job in Baghdad this week? Guess.)

Given the interest in military medical issues since Dana Priest broke the story of Walter Reed's now-notorious Building 18 two weeks ago, it's not unreasonable to hope this latest atrocity will spark some fast action in Congress and the Pentagon.

It also brought to mind a personal anecdote I heard last year from a fellow American expat who shared a table with me at dinner on the BC ferry Queen of Oak Bay, on a long evening's cruise between Nanaimo and Vancouver. His story is a wry reminder that, when dealing with the military, what's in the medical records can cut all kinds of ways.

In 1964, my acquaintance said, he entered a certain large state university system with the intention of becoming an English teacher. In the spring of his freshman year, during a routine visit to Student Health, the doctor casually asked him how long he'd had that cough.

"Cough? Yeah, I guess I've got a little one. I had a cold last week. It's about over, though."

"You short of breath?"

"Sometimes. Nothing serious, though."

The doctor ordered him to breathe deeply, listened, and scowled. "I think it's serious. I think you’ve got asthma. Here -- let me give you this prescription. Take it easy with the exercise, and I want to see you back here in three months."

My friend dutifully filled the prescription, forgot to take the drug (he didn't think he needed it, really), and spent the summer doing construction work and surfing (so much for "taking it easy") -- though he did manage to return in the fall for the follow-up appointment. The doctor poked and prodded and listened, and asked a few questions almost as an afterthought.

"Still a bit of a wheeze. I'm going to keep you on that prescription. Be sure you take it, and I want to see you again next semester."

This little ballet went on for the next three years, as my acquaintance moved on toward graduation. The doctor would toss off a few questions, listen a minute, renew the scrip, and insist he return in a few months' time. My friend knew he didn't have asthma, and usually tossed the Rx on his way out the door. But he humored the doctor, and played along. The guy seemed well-meaning enough; and he was good with the guy's various sports injuries, despite his odd obsession with that asthma thing. Whatever.

And then came graduation day -- and, a few weeks later, a summons from his draft board. It was 1968 now, a bad time to be drafted, and my friend was looking around for anything that might get him a pass. But his little fakes and feints failed eventually; and, by and by, he finally got called in for his physical.

To his horror, it went very, very well. He went down the line and passed every test -- and why not, since he was a robust 22-year-old who'd surfed and hiked his way through college. He was getting resigned to the inevitability of his fate by the time he got put in front of a doctor who asked him a few generic questions about his medical history.

"Tuberculosis? Venereal disease? Hernia?"

No. No. No.

"How about asthma?"


"Yeah. You ever been diagnosed with asthma?"

You give people 4-Fs for asthma?

"Yep. Can't send you into the swamps if you've got it. Do you?"

And, all of a sudden, the real intent behind those four years of weird, cryptic, apparently pointless conversations with that doctor at Student Health snapped into full focus in my friend's head….

"Yeah, asthma! Got it bad. Had to take medication for it all through college…it's in my records."

He was given a pass, and shown the door. The draft board never called back.

My acquaintance chuckled at the memory. "I've always wondered how many hundreds of kids got medical deferments because of that one doctor, sitting there in a Student Health clinic, quietly and deliberately creating these little paper trails without us even knowing it," he grinned. "He wasn't the kind of guy you'd have seen out on the plaza protesting -- but he sure did his part to gum up the works of the war machine in his little corner of the world."

In an era when the military is so desperate that people who are living on pain meds, who can't sustain the weight of a helmet on their heads, who can't even drive, are being sent back to the front anyway, mere asthma probably wouldn't be enough to keep an inductee out of the ranks any more. But if the doctors who did these absurd "compliance reviews" at Fort Benning are called to account -- and these worn-out soldiers are brought home for good -- it'll be because those doctors ignored what was in their files. The paper trail is everything. And the sooner you start building your case, the stronger it will be when you need to argue it.

It's something to think about, anyway.

And, by the way -- how long have you had that cough?

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