The Best Way to Honor Those Who Never Came Home: Take Care of Those Who Did

Michelle Obama, in her Open Letter to Veterans, published on Sept. 30, 2013, says, “If you are a veteran who is uninsured and hasn’t applied for [Veteran’s Administration] coverage, you may be eligible for [Obama] care through the VA.”

Yet the VA states if you have non-service related ailments or injuries, you don’t qualify for free coverage with the VA, fees and co-pays would apply.

The HealthCare.gov website Mrs. Obama recommends veterans go to stipulates that veterans who are enrolled in the VA system are considered “covered” and therefore do not qualify for care under the new health care law. Similarly, veterans who may be enrolled in Tri-Care, the military health care system, do not qualify to use the new Health Insurance Marketplace.

It’s no secret that “there are an estimated 1.3 million uninsured veterans,” according to Mrs. Obama’s letter. What may be a secret are the estimated 400,000 veterans suffering from Traumatic Brain Injury (TBI) – a leading cause of Post Traumatic Stress Disorder (PTSD), which can lead to social, physical, mental and emotional health complications, including suicide – which claims the lives of 22 veterans every day based on the VA’s own data reported by 21 states from 1999 through 2011. That’s one veteran every 65 minutes.

Mrs. Obama doesn’t even mention these two devastating conditions for veterans, their families and loved ones. The VA backlog and ill-equipped and trained VA service providers barely make a dent in helping those afflicted with TBI and PTSD.

What is the best way to honor our fallen heroes?

“Take care of those who came home,” is the answer given by Dr. Chrisanne Gordon, founder and chairwoman of the Resurrecting Lives Foundation and physical and rehabilitation physician. Who could disagree with making sure veterans, our most noble of citizens, who write a blank check to every man, woman and child in America for everything up to and including their lives, are cared for when they make it home alive?

Dr. Gordon, on her website, states that, “It is estimated that only 36 percent of the veterans returning from the Iraq & Afghanistan wars actually receive treatment through the Veterans Administration, although all are eligible.”

That’s only 792,000 out of 2.2 million returning veterans.

How will the Affordable Care Act provide relief for veterans if the VA can’t do it? How can Obamacare hope to even scratch the surface of treating ailments the government already can’t get out of its own way on?

The HealthCare.gov website claims that if a veteran can’t afford private health care coverage they “may be eligible for Medicaid.” The website also says that “if you’re a veteran who isn’t enrolled in VA benefits or other veteran’s health coverage, you can get coverage through the Health Insurance Marketplace.”

But is the Marketplace ready for these special needs patients? And if they are, can the veteran not enrolled in VA health care afford it?

“Getting coverage,” means “paying” for coverage through the Obama Care Marketplace. Why would a veteran, who qualifies for VA coverage, not go to the VA? It doesn’t make sense.

It’s as if Michelle Obama is trying to get “caring for veterans” points with a health care merry-go-round that will deposit the veteran exactly where s/he got on!

Veterans need to be directed to the VA, and then some need to have their hands held to even get them to sign up. Medicaid should cover the non-service related costs should the poor veteran not be able to afford these costs, however, because the Supreme Court ruled last year it would be up to the states to decide whether or not to implement Medicaid expansion, an estimated 284,000 poor veterans, who would have qualified for Medicaid under the expansion, will not be able to access it.

Obamacare has NOTHING for the veteran, nor should it. But why the smoke and mirrors towards those who already are faced with a daunting, bureaucratic labyrinth and well deserved mistrust of the efficiency of a government program?

It’s a shame that in this age of returning veterans with complex health care issues we can’t find a better way to address their needs than with just a confusing “open letter” to them about something that can do nothing for them.

What we need is to allow veterans to seek out treatment at any municipal health care facility, just like Medicaid patients can do. Restricting care for veterans only through the ridiculous bottleneck of Veterans Administration facilities, which are inaccessible to most veterans who tend to live far from these facilities, for an estimated 400,000 suffering the effects of service-related TBI alone, is trite, myopic, unnecessary and a dishonor to their sacrifice.

I am the author of “Saving Grace at Guantanamo Bay: A Memoir of a Citizen Warrior,” and three times mobilized U.S. Army Reserve Major (Retired). Author web page: http://sbpra.com/montgomeryjgranger/ Twitter @mjgranger1

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Force-Feeding Gitmo Detainees is Legal, Moral and Ethical

Recently, U.S. Federal District Court Judge, Gladys Kessler, found in favor of a motion filed by attorney’s for Gitmo detainee Abu Wa’el Dhiab who asked that the intubation to keep him healthy and alive be stopped.

Why? The detainee’s attorney and liberal left, Islamist apologists say that force-feeding violates international law and “could amount to torture.” Although the judge stopped short of using the “T” word, she described force-feeding as “a painful, humiliating and degrading process.”

I was present when the very first two detainees at the military detention facility at Guantanamo Bay, Cuba were force-fed back in early 2002.

Not only weren’t these self-starving unlawful combatants not eating, they were also not drinking anything. A person can go for several weeks without eating before killing themselves or causing irreparable organ damage, but if a person were to go without drinking for just a few days there would be no turning back once vital organs, such as the kidneys or liver, shut down.

WASHINGTON, DC - JULY 24:  Supporters of closing the Guantanamo Bay Naval Base detention facility hold signs and pictures of prisoners being held at the facility while sitting in the audience during a hearing of the Senate Judiciary Committee July 24, 2013 in Washington, DC. The committee heard testimony from a panel of witnesses on 'Closing Guantanamo: The National Security, Fiscal, and Human Rights Implications.' Credit: Getty Images

The military medical Standard Operating Procedures at Gitmo (which I helped write for the detainee mission) mentioned nothing about thirst strikes. We hadn’t thought about it. We only had protocols in place for a hunger strike. So when two hunger strikers were identified as having not had anything to drink for two days we performed an intervention, Gitmo style.

No, we didn’t waterboard them and say “suck it in!”

We appealed to their sense of religion first, if they had any. The detainees claimed to be Muslims, so we approached them with the Navy Muslim chaplain assigned to detainee operations, who spoke with the detainees through an interpreter about Allah’s instructions through the Quran that they should not willfully harm themselves.

The truth is most detainees were only pretending to be Muslims, their murderous and hateful values were acquired through Al Qaeda, the Taliban or other Islamists. In fact, the new official name for self-starvation at Gitmo is “Long Term Non-Religious Fasts.”

That failed to get the desired response, so we told them we would have to give them fluids intravenously. One detainee resisted to the point of physical refusal. We strapped him to a litter and then pushed fluids.

GUANTANAMO BAY, CUBA - JUNE 27:  (EDITORS NOTE: Image has been reviewed by the U.S. Military prior to transmission. ) A Public Affairs Officer escorts media through the currently closed Camp X-Ray which was the first detention facility to hold 'enemy combatants' at the U.S. Naval Station on June 27, 2013 in Guantanamo Bay, Cuba. The U.S. Naval Station at Guantanamo Bay, houses the American detention center for 'enemy combatants'. President Barack Obama has recently spoken again about closing the prison which has been used to hold prisoners from the invasion of Afghanistan and the war on terror since early 2002. Credit: Getty Images

After several more days they were still not eating and refused to drink. We kept pushing the intravenous fluids, but it was becoming clear that we were going to have to intubate them and force nutrition into their stomachs before permanent organ damage, and then death occurred.

You see there are no military medical protocols that allow detainees to harm themselves, including self-starvation. The procedure for intubation, or forced feeding, is unpleasant, to be sure, but slowly dying because your body is feeding off of itself to the point of organ failure would probably be just a bit more uncomfortable, even torturous.

I pray you THINK about that for a moment. Is it absurd to tell someone to stop saving someone else’s life because it is potentially torturous to do so? We KNOW what happens to the body when it is not fed and nourished properly – it feeds on itself and then shuts down.

I know what you’re probably thinking: “So let the damn bastards starve themselves! It’ll save us taxpayers money and the bloodthirsty Islamists will get what they deserve – a painful and agonizing death! Remember Sept. 11! Remember Benghazi! Death to Akbar!”

A hooded demonstrator is seen at a protest calling for the closure of the Guntanamo Bay detention facility infront of the White House on May 18, 2013 in Washington, DC. Credit: AFP/Getty Images

We need to take a step back and then remember our values. We are the good guys. No matter what anyone else tells you, especially the left liberal, Islamist apologist uber-politically correct crowd who only want to manipulate American political will via self-starving unlawful combatant detainees, we have ethics and morals to uphold, even in the face of absurdity.

U.S. military personnel are trained to care for, and to treat with respect and dignity, any unlawful combatant that we detain, including those who wish to slowly and painfully off themselves. The majority of the U.S. military personnel working at Gitmo are professional, hard working, loyal and trustworthy individuals, who will never, ever disobey their orders to care for the detainees appropriately.

Because of this commitment to honor and integrity, International Committee of the Red Cross physicians with whom I worked at Gitmo and in Iraq told me, “Nobody does [detention operations] better than the United States.”

The Gitmo detainees are LUCKY to be ALIVE, as any or all of them could have been legally killed on the battlefield. They are even LUCKIER to have been captured by the U.S. rather than some other group with far less compassion and humanity (i.e. Al Qaeda, Taliban, or other Islamists); one that might, say, behead them, hack them to death, blow them up or drag them naked and lifeless through the streets, like they did to Daniel Pearl and Lee Rigby.

In this photo reviewed by US military officials, two feeding tubes and cans of Ensure are seen in the US Detention Center at Guantanamo Bay, Cuba, March 29, 2010. Detainees on hunger strikes or not eating are given enhanced nutrition via the tube. (Photo: AFP/Getty Images)

The irony drips, in thick globs, as our sworn enemy insists on being slowly and painfully allowed to die because the method being used to keep him alive is tantamount to TORTURE.

I wonder what George Orwell would say about this? I wonder what someone in a coma would say if they could, about being forcibly fed while medical science sorts out the cause of their coma? Did you know they also intubate premature infants? Ever hear that called torture?

Of course not! The act of self-starvation is a CONSCIOUS DECISION made for POLITICAL reasons by a desperate person, in this case an illegal combatant detainee.

Judge Kessler has ordered a temporary cease and desist to the forced feeding of Abu Wa’el Dhiab, and has forbidden his forced removal from his cell at Gitmo for that purpose.

I’d like to see her medical professional credentials, or her crystal ball, which she can guarantee no permanent or life-threatening damage will be done to the detainee during the time the restraint is in effect. The appellate court that sent the original appeal to end the force-feeding back to the District Court mentioned that the force-feeding procedure would “probably be allowed if it is just to prevent injury or death.”

People dress in orange jumpsuits and black hoods as activists demand the closing of the US military's detention facility in Guantanamo during a protest, part of the Nationwide for Guantanamo Day of Action, April 11, 2013 in New York's Times Square. (Photo: AFP/Getty Images)

It used to be that courts never interfered with military procedures, policies or laws. Gitmo has risen to a level of incalculable interference by the federal court system because President Barack Hussein Obama mentioned, bathed in both pre- and post-election naïveté, that he would CLOSE Gitmo within a year?

Could it be that he and U.S. Attorney General, Eric Holder re-wrote the Military Commissions Act of 2006, to include rights and privileges for unlawful combatant detainees virtually identical to what you or I would enjoy in a U.S. Federal court of law?

Back to the intubation: We had the Navy Muslim chaplains and interpreter bedside with the two self-starving detainees before going ahead with the procedure, done in a private section of the detainee medical facility (an integrated and climate controlled tent system called Deployable Medical System), with low lighting and near whispering conversation.

The Muslim Navy chaplain, through the interpreter, tried to convince the detainees that their self-starvation was against Allah’s wishes, and that it would not be pleasant, and would they please reconsider.

They quietly and timidly refused, and then the Navy nurses, assisted by corpsmen, with a physician standing by, gently placed the feeding tubes through the detainee’s nostrils and then down their throats into their stomachs.

The detainees moaned slightly, winced some, and then opened their eyes wide when the nutritional liquid was slowly poured into them. So tell me, what exactly is inhumane, unethical or immoral about that?

I am the author of “Saving Grace at Guantanamo Bay: A Memoir of a Citizen Warrior,” and three times mobilized U.S. Army Reserve Major (Retired). Twitter @mjgranger1

Congress Reacts to Military Mental and Brain Health Issues: Will You?

When U.S. senators from two political parties come together to introduce legislation, without argument or hesitation, one should take notice.

In the current climate, when political opposites attract one might think money, prestige, or influence are involved, but in the case of the bill to improve military mental health evaluations for service members, Sen.s Rob Portman (R-Ohio) and Jay Rockefeller (D-W.Va.), no such benefits await them. They appear to have only altruistic and patriotic motivation for seeing that our heroes receive the comprehensive medical attention they need and deserve.

The Medical Evaluations Parity for Service Members Act of 2014 (S. 2231 or MEPS Act,) states that before anyone can become enlisted or receive a commission in the armed forces of the United States they shall receive a “mental health assessment” that will be a “baseline for any subsequent mental health evaluations.”

Alex Burgess gets emotional while visiting the gravesite of an old friend who was killed in Iraq, in section 60 at Arlington Cemetery, May 27, 2013 in Arlington, Virginia. For Memorial Day President Obama layed a wreath at the Tomb of the Unknowns, paying tribute to military veterans past and present who have served and sacrificed their lives for their country.  (Photo by Mark Wilson/Getty Images)

This would bring mental health and “brain health” issues to parity with the physical evaluations conducted prior to admittance into the military.

If passed, the law would also include a comprehensive physical and mental and brain health evaluation when the service member comes off of at least 180 days of active duty or separates from the service. This would include screening for Traumatic Brain Injury, recently found to cause most instances of Post Traumatic Stress, which could lead to Post Traumatic Stress Disorder. TBI is a “brain hurt” as opposed to a “mind hurt” issue that is more physiologic than mental.

We are finally addressing TBI issues, the signature issues of our returning heroes. Brain injury is not synonymous with “mental illness,” and the treatments for mental illness are often detrimental to TBI, hence the distinction is very important.

It is estimated that over 400,000 Global War on Terror veterans suffer from TBI, and most go undiagnosed and untreated, which leads to PTS and then possible PTSD.

AP photo.

Veteran and former U.S. Army Military Police non-commissioned officer, Curtis Armstrong was given a routine exit physical which didn’t connect the dots between his symptoms of memory loss, headaches, and thought process problems, since identified as being associated with TBI.

We can all imagine that if you’re not looking for something, and don’t know what it looks like even if you were, you’re not going to find anything. That’s exactly what happened to Curtis, and hundreds of thousands of his comrades.

The Resurrecting Lives Foundation, founded by Dr. Chrisanne Gordon, has been trying to gain the attention of politicians in Washington, D.C., for several years now. They have a panel of experts and have been advocating for the establishment of proper screening and treatment for veterans with TBI. Moving forward, the most encouraging event to date has been the MEPS Act introduction in the Senate.

When I inquired as to the catalyst for Sen. Portman’s introduction of the MEPS bill his staff replied:

“[T]he MEPS Act is a response to the clear need for better monitoring and assessing of service members’ mental health. While recent tragedies like the shootings at Fort Hood and the Navy Yard raised the profile of these issues, the need to address it has been apparent for far too long…Last summer, Senator Portman’s [Homeland Security and Government Affairs Committee] subcommittee held a hearing on improving access to health care, including mental health care, for rural veterans. To help correct this, Sen. Portman introduced an amendment to the FY14 defense authorization bill requiring [the Department of Defense] to report on the current status of telehealth initiatives within [the Department of Defense] and plans to integrate them into the military health care system. Sen. Portman and Sen. Rockefeller also attempted to introduce language requiring mental health screenings for exiting service members. This language is now included as part of the MEPS Act.”

At the risk of seeming too giddy about these latest developments, which bring not just mental health, but “brain health” issues of military personnel into a broader light, it has been far too long that these issues have stayed in the shadows.

Soldiers like Curtis deserve better, and we as a country need to pay close attention to how we can help. Encouraging our own legislators, local, state and national, to support and pass the MEPS Act is just a start; there needs to be more resources allocated to ensuring our best and brightest are also well cared for, especially after their deployment service has ended.

AP

Among the several professional organizations endorsing this bill is the Academy of Physical Medicine and Rehabilitation. According to Dr. Gordon, rehabilitation specialists would be included in the evaluations and in the program of reintegration.

“Sen. Portman did that, inviting collaboration with the private sector – the way to solve the TBI epidemic,” she said.

We can’t afford a legacy of forgotten warriors. We cannot endure the nightmare of neglected veterans. We are better than that. We, each of us, have an obligation to care for those we depended on to protect our ideals and us. Nothing less than a full accounting of every suffering veteran should be acceptable.

The Veterans Administration can be a hero here instead of the villian. If Secretary of Veterans Affairs retired general Eric Shinseki would pay attention to what’s going on in Congress, he could beat legislators to the punch: He could ask for funds to implement the essence of the MEPS Act within VA policy and practice.

Beginning with the new fiscal year in October 2014, he could seize the initiative in the war against mental and brain health issues in the military. You could suggest this to your legislators when you encourage them to sign on as co-sponsors and then pass the MEPS Act.

It’s important to remember that enshrining mental health evaluations for military personnel in law would ensure implementation in a timely manner, but if the MEPS Act gets held up in committee or is defeated, having the VA move forward with policy and practice changes through budgetary requests for fiscal year 2015 would honor the commitment our heroes deserve and should expect.

I am the author of “Saving Grace at Guantanamo Bay: A Memoir of a Citizen Warrior,” and three times mobilized U.S. Army Reserve Major (Retired). Twitter @mjgranger1.