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Rob Thornton
12-02-2007, 03:35 PM
There is a story carried in today's Washington Post entitled "A Soldier's Officer".


Washington Post
December 2, 2007
Pg. 1

'A Soldier's Officer'

By Dana Priest and Anne Hull, Washington Post Staff Writers

In a nondescript conference room at Walter Reed Army Medical Center, 1st Lt. Elizabeth Whiteside listened last week as an Army prosecutor outlined the criminal case against her in a preliminary hearing. The charges: attempting suicide and endangering the life of another soldier while serving in Iraq.

Her hands trembled as Maj. Stefan Wolfe, the prosecutor, argued that Whiteside, now a psychiatric outpatient at Walter Reed, should be court-martialed. After seven years of exemplary service, the 25-year-old Army reservist faces the possibility of life in prison if she is tried and convicted.

Military psychiatrists at Walter Reed who examined Whiteside after she recovered from her self-inflicted gunshot wound diagnosed her with a severe mental disorder, possibly triggered by the stresses of a war zone. But Whiteside's superiors considered her mental illness "an excuse" for criminal conduct, according to documents obtained by The Washington Post.

At the hearing, Wolfe, who had already warned Whiteside's lawyer of the risk of using a "psychobabble" defense, pressed a senior psychiatrist at Walter Reed to justify his diagnosis.

"I'm not here to play legal games," Col. George Brandt responded angrily, according to a recording of the hearing. "I am here out of the genuine concern for a human being that's breaking and that is broken. She has a severe and significant illness. Let's treat her as a human being, for Christ's sake!".....


At one point, Elizabeth Whiteside almost accepted the Army's offer to resign in lieu of court-martial. But it meant she would have to explain for the rest of her life why she was not given an honorable discharge. Her attorney also believed that she would have been left without the medical care and benefits she needed....


"This superior officer is in the top 10 percent of Officers I have worked with in my 16 years of military service," wrote her rater, Capt. Joel Grant. She "must be promoted immediately, ahead of all peers."

Maj. Sandra Hersh, her senior rater, added: "She's a Soldier's Officer. . . . She is able to get the best from Soldiers and make it look easy."


Much More at either the Washington Post site, or the Earlybird. The Washington Post online requires member Login - but here is the Earlybird link (http://ebird.afis.mil/cgi-bin/ebird/displaydata.pl?Requested=/ebfiles/e20071202564732.html) for those with access.

This is a complicated issue - and I'd say up front to try and get you hands on the complete article before commenting. I posted this because I think it provides us an opportunity to discuss several things about people in war. Here you have a leader who by many accounts was outstanding - then one day, something changed, and she was no longer the same person she had been - at least for a time, she lost control of the reason that had served her and those she led so well.

I once heard a quote attributed to Audie Murphy - I'm sorry I could not find it, so I'll have to para-phrase: "Every man has a well of courage that he can go to, some are deeper then others." I did however find a great site with quotes on courage at the Quote Garden (http://www.quotegarden.com/courage.html).

I think it highlights the kind of extreme questions that our military doesn't have to face (certainly not on a large scale) except in war - lots here to talk about. I'm not entirely comfortable with the way in which the article portrays the military justice system - it my opinion it ignores that our military justice system exists to ensure good order and discipline within the military, and that the arguments that come before it often decide far wider ranging issues - as such I think the article is incomplete in that regard.

However, the article does a good job of raising the issue of how we assess, regard, and care for those with injuries we can't readily assess. MTBI (Mild Traumatic Brain Injury) is not part of the article as far as I know (it does not say if perhaps LT Whiteside ever suffered the type of effects that might lead to MTBI) - but yet many veterans will come home with MTBI that may lead to them exhibiting symptoms of mental illness that in the future may effect them in execution of their military responsibilities, familial, or as a citizen). Our health care system (from culture of the patient to long term care) seems unprepared to meet those challenges - based on the nature of the injuries and the symptoms. Since these types of injuries and illnesses are most prevalent with large scale trauma - the type we would expect to find in war - it would be difficult to design, prepare or sustain a system that would do so prior to war. I'd caveat this by saying that we are learning very fast, and talking to nurses and doctors here in attendance at ILE - there is a great deal of concern, debate, thinking and action regarding ensuring our soldiers get the best care possible - but also that it is contingent on better understanding the causes and effects which lead to treatment options.

The broader context:

We now face a prognosis that the next decades will include persistent conflict, distinguished by more frequent and intense periods of war. ADM Mullen, the CJCS was reported as recently recognizing that in front of an audience at the AWC. What may make this different then say the conflict that persisted throughout the subsequent decades is that the interests of the United States and its allies will be challenged and require U.S. military forces to be deployed to defend those interests. Its expected that it will be violent for some time to come.

I know there are SWC members who will ask how we could commit ourselves to something like OIF again in the immediate future given the domestic political issues we currently face. I'd ask us to consider a few things.

First, I don't think policy makers adequately consider or understand the role chance plays in the commitment of military forces - meaning what you (decision makers) sign up for is probably not always what you get, and that in the interest of pursuing a short term solution, it is easy to lose sight of the long term consequences - as such initial military advice is sometimes abandoned in favor of the decision to pursue the political objective. This is how our system works - the executive and the legislative must accept the risk of using any instrument of national power - but the consequences of military power have a physical manifestation unlike the others.

Second and in relation, I'd say that somethings are going to require the use of military power. This might be an anticipated and developed use of military power, or it might be an unexpected and undeveloped use of military power - might be anywhere in-between. When vital interests are jeopardized by violence on a scale where you might be faced with an existential threat; the existential threat of a friend and ally critical to your state's long term health and goals; or as part of a response that initially did not look to be likely to develop into war (response to large scale natural disaster as an example), but then as conditions change our commitments change.

I know I deviated from the initial, surface thrust and questions posed by the article, but I think we have to consider the issue of courage in war in the larger context of our commitments to the citizens who serve in war as a means to achieve some political end. War is going to be with us whether a person/candidate has an interest in war or not. There are going to be casualties of the type (and not just the individual casualties, but certain ideas as well) the article references and its going to affect our social character. Put another way, the political decisions which lead us to war are going to produce all types of casualties which will have effects on domestic issues as well as FP issues.

A final note on courage - I've been reading Slim's "Defeat into Victory". The magazine Armchair General recently did a section on Slim. On pg. 58 in an article by Frederick Baillergeon, there is a box with the caption: Slim On Leadership. In it, the first quality slim speaks to is Courage, "It (Courage) is the military virtue without which none of the other virtues can exist." I think the way Slim characterized courage is of immense value to us - decisions in war always have consequences, and there must be courage to make them, and courage in the face of the consequences which follow.

Best Regards, Rob

SteveMetz
12-02-2007, 04:01 PM
Interesting and moving story but as a writer of OERs, I wonder if Dana and her readers know that what she quoted is pretty much the norm?

Rob Thornton
12-02-2007, 04:29 PM
Steve - I don't know - certain words are used in the narrative now to qualify and enumerate how a rated officer should be viewed. When it comes down to it though - it depends on the character of the Rater and SR - are they doing those they rate and the Army a favor by providing an honest assessment, or are they sugar coating it? A more quantitative assessment might have been "out of the 10 officers I rate, this officer is number 1" or what have you. CO grades no longer get blocked, so I don't think they don't need to worry about busting profile on them.

However - given the number of U.S. citizens willing to serve in the military, under any conditions - I'd say she was of superior moral fiber then those unwilling to sacrifice something.

I'd also note that duds, are duds, and don't generally get any kind of good reviews these days - conditions have changed the consequences for keeping them in leadership.

So - I'll take the rater and SR at what they wrote - and wonder about what causes people to change, what that means in the face of war, and how are we going to take care of them so that we can sustain a flow of qualified volunteers to fill demanding leadership positions. I hope the reporters follow the story, I think its to our benefit to think about these issues.

Best Regards, Rob

historyguy99
12-02-2007, 04:37 PM
[QUOTE=Rob Thornton;33240]There is a story carried in today's Washington Post entitled "A Soldier's Officer".







Much More at either the Washington Post site, or the Earlybird. The Washington Post online requires member Login - but here is the Earlybird link (http://ebird.afis.mil/cgi-bin/ebird/displaydata.pl?Requested=/ebfiles/e20071202564732.html) for those with access.

I once heard a quote attributed to Audie Murphy - I'm sorry I could not find it, so I'll have to para-phrase: "Every man has a well of courage that he can go to, some are deeper then others." I did however find a great site with quotes on courage at the Quote Garden (http://www.quotegarden.com/courage.html).

Similar semiments were written by Colonel David Hackworth In his autobiography, Aboute Face ="http://www.hackworth.com/awards.html He had concluded; "that a man is like a bottle on the battlefield, fear is what fills him up and fuels him to preform. But some bottles are smaller than others. When a guy becomes unglued during a firefight, its just that his bottle has filled up and overflowed; it's time for him to get away and let the fear drain out." He went on to say, "that from that moment on the man is like a spent cartridge, and no amount of gunpowder will make him a real fighter again."

Jedburgh
12-02-2007, 05:50 PM
Interesting and moving story but as a writer of OERs, I wonder if Dana and her readers know that what she quoted is pretty much the norm?
Good observation. However, even if her earlier rater and senior rater comments are completely honest and substantive, the leadership environment for a med officer at Walter Reed is completely different than that for one serving at a detention facility in Iraq. Like many other combat vs non-combat, strategic vs tactical, etc. positions, an individual may serve with distinction in one, but fail miserably on the other side. Not everyone can make the switch - and attempting to live up to personal performance goals in such a completely different environment can be an incredible stressor upon the one who can't seem to make the adjustment.

SteveMetz
12-02-2007, 05:59 PM
Steve - I don't know - certain words are used in the narrative now to qualify and enumerate how a rated officer should be viewed. When it comes down to it though - it depends on the character of the Rater and SR - are they doing those they rate and the Army a favor by providing an honest assessment, or are they sugar coating it? A more quantitative assessment might have been "out of the 10 officers I rate, this officer is number 1" or what have you. CO grades no longer get blocked, so I don't think they don't need to worry about busting profile on them.

However - given the number of U.S. citizens willing to serve in the military, under any conditions - I'd say she was of superior moral fiber then those unwilling to sacrifice something.

I'd also note that duds, are duds, and don't generally get any kind of good reviews these days - conditions have changed the consequences for keeping them in leadership.

So - I'll take the rater and SR at what they wrote - and wonder about what causes people to change, what that means in the face of war, and how are we going to take care of them so that we can sustain a flow of qualified volunteers to fill demanding leadership positions. I hope the reporters follow the story, I think its to our benefit to think about these issues.

Best Regards, Rob

Point taken. My perspective is skewed--I only rate LTCs so there has been a lot of weeding out by that point. One of mine just came out on the O6 list last week, so I guess I'm not killing them.

Penta
12-03-2007, 03:37 AM
A concern:

Court-martial charges for attempting suicide? I know it's possible.

I do not, however, think it wise.

It's already difficult to get people (especially military personnel) to seek psychiatric help when they need it. And mental illness is going to be one of the signature post-war issues for the current generation.

I'd say there was a significant nolle prosequi interest here that should have been heeded.

120mm
12-05-2007, 07:36 PM
One of my former subordinates was nearly drummed out of the Army because he once answered a hypothetical question about suicide in a class by saying that years ago, during his divorce, he considered the possibility of suicide.

They took away his weapon, while in a war zone, put an armed guard on him 24/7, made him walk around with his boots unbloused and with engineer tape on his helmet on LSA Anaconda, took away any meaningful work and generally harrassed him for a couple of MONTHS, before we were allowed to go home.

And then they harass us in our civilian lives, trying to get us to "admit" we have PTSD/MTBI. I have no idea what their plan is for us, as Reservists, but I'd give large amounts of money that any "help" will be reserved for Active Duty types, but the stygma will be real, and lasting.

I can see the Army Reserve giving us the choice of mental treatment at our own expense, or kicking us out. (Actually, I can see them forcing us to get the help, AND kicking us out. Every day is Blue Falcon day in the good old Army Reserve, dontcha know) They are starting to do that with hearing loss, right now. More and more of us are getting medical review boards. We had two students pulled out of class yesterday to go before a medical review board with little notice.

Tom Odom
12-05-2007, 08:05 PM
Drew

I can only say that in the intel world, one never ever fessed up to such things lest you lose your clearance and thereby lost your career.

Best

Tom

selil
12-05-2007, 08:21 PM
My mother in-law is one of the formost experts in PTSD for the VA (well was she is now retired). She used to work at the VA Hospital in Richmond VA. I have argued with her, pleaded with her, and finally cussed her out in front of my wife. She is sure that all soldiers are broken and we must be fixed. Not nearly house broken enough if we've ever worn a uniform we are surely the victims of violence. From her point of view of course it is valid as she only see's military members once they've had a substantial mental break. If the only sample you've see is 100 percent messed up then .... Still the negatives of trying to find help (other than the bottom of a bottle) are far outweighed by any treatment. And that REALLY sucks.

Ken White
12-05-2007, 09:04 PM
not even Psy 101, I long ago decided that the ideal Soldier, Marine, Sailor or Airman -- anyone exposed to combat with a potential for blood to be seen -- is what I call a controlled sociopath. One who has strong sociopathic tendencies yet can control them to an extent in order to function moderately normally in society. This is the guy or gal who can scrape someone else's body parts off their face and keep going -- and not fall apart over it months or years later.

There have been a slew of studies, some using MRI and PET scans that show some people have an adverse reaction to violence and others can accept it with equanimity. We probably ought to screen for that in IET... :)

Lacking that we will continue to send people who have great difficulty coping with the trauma of combat to war and, given our increasing sensitization and softening as a society, garner more psychological problems in the future than we have done or than we now do. I think there's a cost effectiveness issue in there somewhere.

Not to mention a training, performance and capability issue or two...

wm
12-05-2007, 10:43 PM
I think a valuable study would be to compare the "shock" associated mental issues among first responders (firefighters, police, ER level 1 trauma personnel, EMTs) with those of the military--both qunatiutavely and qualitatively--that is numbers/percentages/frequncy of folks exhibiting PTSD type symptoms as well as the severity and frequency of occurence of the debilitation caused by those symptoms. My armchair theorizing is that the reports on the two groups might be pretty comparable.

If first reponders have a lower incidence rate and/or do better coping, that might also be worth pursuing. We might discover coping mechanisms that would help veterans both before and after suffering the traumatic events that trigger the PTSD.

Such a study would require accurate data, which I am suspicious about finding. I suspect that the medical community might skew its reporting to look much better than it actually is. I would also not put it past the armed services to downplay their numbers while the VA could "cook" its position upward in order to justify bigger budgets.

selil
12-06-2007, 12:24 AM
An interesting item I read a long time ago was that deputies have a lower incidence of chronic stress versus metropolitan police officers. Rural deputies patrol and see incidence of specific incidence violence much like a Marine patrolling off a firebase. Lots of tedium followed by moments of absolute panic (siege mentality?). Metropolitan police officers I'd theorize are more like COIN always in the face of the adversary hooking the bad guys up with one way trips and helping little old ladies out of jams. A more chronic stress I imagine.

Rob Thornton
12-06-2007, 12:38 AM
Evening Wayne,

I think you've got a good idea about a place to start - but one thing I'd say to qualify it is that there may be some key differences. I'm thinking out loud here, but the unpredictable nature of sustained operations might make it more one where the the fire fighter awoke in his own house to find it on fire, then rescued his family, then put the fire out, then settled with the Insurance company and so on.

I don't mean to say that EMS and first responder trauma is not applicable - only that perhaps its a least a little different. I remember my Dad coped with the stress of being a Metro Cop by doing allot of hunting and fishing - it got him out in the woods. Over his 25 year career he did have some life troubles that you might could link to the job (a failed marriage for one), but its hard to say that wasn't just the result of getting married at 19. I think its the intensity and cumulative quality we have to be cognizant of.

We also need to consider scale - just the sheer numbers of men and women exposed to wartime conditions in places that even when somewhat stable are different enough from most of America to have you looking over your shoulder. I think when training is as it should be, and entry criteria are held high, we build the foundations for physical and moral strength to see most people through, but as war is sustained we fight the battle of exhaustion in many ways - while units and leaders are doing their very best to uphold standards, there is still a significant strain on the individual, their families, communities, maybe even the national psyche. One of the things that interests me is how cultural values change over a sustained war - one of the best accounts I've read is Thucydides - war, disease, poverty, famine, atrocity, etc. are accounted for.

I don't know for sure, but my gut tells me the VA is probably underfunded (under or inadequately resourced is probably a better way to say it) to deal with the long term human toll of treating the number of veterans we are going to account for in this long war. I think the Army is starting to get a handle on it - only because I know a few docs and nurses who say there is a big interest in it. I hope the politicians stay committed to veteran programs, like many things associated with war, I think consequences resemble the "iceberg" analogy. Just something we have to deal with, and something that should be considered when contemplating the use of military force to achieve a political end. We'll see these injured young men and women for the rest of our lives, I know for all of us here we hope that our government will sustain the best level of care for them possible long after the public gravity of their sacrifice is left to a wing at a museum, a monument on the mall, and reason to have a BBQ on a Monday.

Best, Rob

Ken White
12-06-2007, 12:52 AM
...
. . .
Such a study would require accurate data, which I am suspicious about finding. I suspect that the medical community might skew its reporting to look much better than it actually is. I would also not put it past the armed services to downplay their numbers while the VA could "cook" its position upward in order to justify bigger budgets.

and so right, I'll bet... :wry:

slapout9
12-06-2007, 01:01 AM
Believe it or not Traffic Accident Investigators often have problems not because of the danger they are in but from the never ending amount of blood and gore that they can see over a 20 year period.

Rob Thornton
12-06-2007, 02:54 AM
Hey Slap,
We had some Washington State Troopers come in and do one of our quarterly safety briefs back in 2002 - they brought in some serious photos - it was very sobering. I think it goes beyond just the actual gore, often its the type of casualties. Seeing a child dead has a more emotional impact then seeing a grown man. I guess that could be because you reflect upon the own things you value most as a parent, and the the idea that those things could be torn away from you in that way is hard to swallow - it tends to stay with you longer.
Best, Rob

Ken White
12-06-2007, 04:43 AM
Believe it or not Traffic Accident Investigators often have problems not because of the danger they are in but from the never ending amount of blood and gore that they can see over a 20 year period.

Seeing war casualties doesn't bother me. Guess it's a sort of "goes with the territory" syndrome. However, I can recall vivid details of two traffic accidents I saw up close. Maybe it's the incongruity; you expect people to be hurt and killed in war but a traffic accident in a peaceful area seems to be worse somehow.

wm
12-06-2007, 01:46 PM
We also need to consider scale - just the sheer numbers of men and women exposed to wartime conditions in places that even when somewhat stable are different enough from most of America to have you looking over your shoulder. I think when training is as it should be, and entry criteria are held high, we build the foundations for physical and moral strength to see most people through, but as war is sustained we fight the battle of exhaustion in many ways - while units and leaders are doing their very best to uphold standards, there is still a significant strain on the individual, their families, communities, maybe even the national psyche.
Rob, Slap, Ken--
Part of my reason for suggesting a look at the first responder community is the issue of scale and continuous contact with tragedy. I sometimes wonder how those folks can continue to go to work day after day, night after night, given the horrific stuff they deal with. I complete agree with folks' points about what I'll summarize as a "shattering of our sense of the normal." This "out of the normal" becomes the normal for those folks who routinely work trauma events. Ever notice how "warped" a sense of humor health care workers have?

Here's a couple of other semi-related items--not about PTSD issues, but about "Staying the Distance" and morale in trying circumstances:

A sidebar related to health care workers (credibility claim: my wife's a nurse): Acute care workers usually get to see their patients recover and go home. Long term care (nursing homes) workers aren't so lucky--their charges just get worse and worse intil the day they day. This is not a trauma issue, but a different form of job-related stress that may be the reason why we hear about the cases of elder abuse in nursing homes (relates to the lashing out against "civilians" done by troops in the COIN world).

And one other on customer service employees:
The turnover/churn rate in customer service related jobs (particulalrly call center folks) is probably one of the highest of any occupation. I think this has to do with the attitude displayed by those that call and complain--when your clientele doesn't value you, you tend not to value yourself and look for work elsewhere to boost your self esteem. Think about this in the context of folks at home judging the job being done by our deployed forces as a reason associated with our reported declining enlistment/re-enlistment/officer retention crises.

Tom Odom
12-06-2007, 02:02 PM
Believe it or not Traffic Accident Investigators often have problems not because of the danger they are in but from the never ending amount of blood and gore that they can see over a 20 year period.

Slap,

My post-Rwanda issues--severe depression which I came to call "the Beast"--all dealt with sense saturation with violent death on a scale that cannot be fully described. In contrast, when I had the opportunity to follow up on ops which resulted in lots of dead bad guys, I was quite happy. For me it was very much a case of who was getting killed, not that killing was happening.

Best

Tom

slapout9
12-06-2007, 02:24 PM
Slap,

My post-Rwanda issues--severe depression which I came to call "the Beast"--all dealt with sense saturation with violent death on a scale that cannot be fully described. In contrast, when I had the opportunity to follow up on ops which resulted in lots of dead bad guys, I was quite happy. For me it was very much a case of who was getting killed, not that killing was happening.

Best

Tom

Hi Tom, yea there is something about the situation that affects the effects that follow. Some people deserve to die and in that sense it's almost a relief as opposed some senseless act or acts that make a person feel entirely different about the situation. One issue as has been pointed out LE and Military are macho occupations so admitting something bothers you is somehow related to not being tough. As opposed to doing the right thing and face the problem with proper help and come out a stronger person....so it goes.

Penta
12-06-2007, 05:44 PM
Drew

I can only say that in the intel world, one never ever fessed up to such things lest you lose your clearance and thereby lost your career.

Best

Tom

I pray that changes.

I'll be blunt: Hell yes, I've considered suicide. Been hospitalized for it. I was 15 at the time; teenage stuff plus disability stuff equals one screwed up mind.

I have depression. It helped make college hell for me, but though I will admit there are days it feels otherwise, generally speaking, I'm stable (I could never call myself normal), if vigilant. I take my meds religiously, see the usual professionals like clockwork.

But I'm open about all this. Nobody could ever coerce me with it - and my usual habit when I have depressive episodes is to shut up about anything and everything, not talk.

So why should my mental health issues, so long as they remain treated and stable, be any bar to a clearance? Something happens, I'd give up any clearance temporarily.

And moving aside from me...How the hell does that idea make any sense?

You say "You have a mental illness, you lose your clearance" is the worst idea. 1 in 5 Americans have depression. Shouldn't we be encouraging people to get help?

We don't pull clearances from alcoholics or those with drug problems instantly - we condition their clearance eligibility on getting help, I'm given to understand.

If you say "If you've had suicidal ideations or depression or any other mental illness, no clearance for you", what does that do except give people lots of motivation to leave their issues untreated, hide them from everyone (usually badly), and lie to you?

(Actually...Does anybody know the current policy? I remember hearing they were taking out the mental health questions to encourage people to get treatment, but then I never heard anything more about that.)

wierdbeard
12-06-2007, 06:17 PM
My two cents worth or actually more of observations really, As Tom says you'll lose your career (apologies for paraphrasing), while in theater thay hound us to take meds or go to talk to someone because as they put it, we're outside the wire all the time and it has to be stressful, DUH! I had a pretty good idea of what to expect when i signed up, I felt that we were adequately trained to deal with whatever was thrown our way if I felt it were an issue I would go see someone. Upon return I was required to take a quiz based on time outside the wire, actions seen and levels of personal danger, based on the results I was told by the individual that administered it that I had PTSD and needed to go to counseling, not something that i felt was necessary nor warranted. While using the VA medical system for other reasons I continually heard from just about every doc that i should enroll in the PTSD study, after speaking to a VA case manager I was told that, (paraphrased) The VA has recieved a grant for the study of PTSD/MTBI, but in order to continue funding they have to have over 90% of returning vets enter into the program, whether or not they stay in the program was not of consequence. Personally I find that if the VA wants to study this and they have funds great! but not at the cost to my career. While we are being continually told that mental health issues are no longer the death knoll for Intel personnel, the reality is service members that do take part or admit to problems, find themselves in a not so favorable light. Regardless of what the rules say the mindset does not change overnight. Well i may have rambled on a bit there so I apologize now.