Psyche, Science, and Society

Gen. Kiley: Urine Man or Torture Man?

John Aravosis of AmericaBlog reminds us that the new, as of yesterday, head of Walter Reed Medical Center is the man who ignored complaints of conditions there for five years. In particular, New head of Walter Reed let soldier sleep in his own urine.

"In 2004, Rep. C.W. Bill Young (R-Fla.) and his wife stopped visiting the wounded at Walter Reed out of frustration. Young said he voiced concerns to commanders over troubling incidents he witnessed but was rebuffed or ignored. 'When Bev or I would bring problems to the attention of authorities of Walter Reed, we were made to feel very uncomfortable,' said Young, who began visiting the wounded recuperating at other facilities.

Beverly Young said she complained to Kiley several times. She once visited a soldier who was lying in urine on his mattress pad in the hospital. When a nurse ignored her, Young said, "I ' went flying down to Kevin Kiley's office again, and got nowhere. He has skirted this stuff for five years and blamed everyone else' ."

But he does look good in a uniform: Meet Urine Man. Surely that’s more important than the poor soldier lying in his urine.

Of course, those of us opposing psychologist participation in the torture and abuse at Guantanamo (and elsewhere) know Kiley as the guy the American Psychological Association brought in to the 2006 APA Convention sing the praises of the psychologists in the Guantanamo and Iraq Behavioral Science Consultation Teams (BSCTs). A colleague at the Convention recalls being told “hat an impressive spectacle ‘the General’ had made with his military entourage.” No concern for the detainees at Guantanamo being abused by Kiley’s BSCTs. Power trumps morality and decency yet again.

So the question of the day: Is Kiley best described as “Urine Man” or as “Torture Man?”

UPDATE: See the Washington Post editorial: Not ‘a Good-News Story’: Why is Gen. Kiley back in charge at Walter Reed?:

[Y]esterday, the Army announced that Maj. Gen. George W. Weightman, the head of Walter Reed since August, had been relieved of his command. His temporary replacement? None other than Gen. Kiley.

Here’s where the story stops making sense. Much of The Post’s article detailed the abuse by omission that Gen. Kiley, not Gen. Weightman, committed, first as head of Walter Reed, then in his current post as Army surgeon general. Gen. Weightman, who very well might deserve his disgrace, has commanded Walter Reed for only half a year, while Gen. Kiley, now back in charge of Walter Reed, headed the hospital and its outpatient facilities for two years and has led the Army’s medical command since. Rep. C.W. Bill Young (R-Fla.) and his wife say they repeatedly told Gen. Kiley about unhealthful conditions in outpatient facilities.

While Gen. Kiley was ignoring Walter Reed’s outpatients, he was assuring Congress that he was doing just the opposite. A staffer for Rep. Thomas M. Davis III (R-Va.) told us yesterday that Gen. Kiley told the House Committee on Oversight and Government Reform in 2005 that the performance of the medical holdover program, which covers 69 of the 76 residents of Building 18, “is a good-news story.” In response to questions Mr. Davis submitted, Gen. Kiley stated, “the Army Surgeon General has made their care the medical treatment facilities’ top priority.” At best, Gen. Kiley was ignorant of the conditions at Walter Reed.

UPDATE II: Rep. Slaughter (S: NY) has called for Urine Man, aka Torture Man, aka Gen. Kiley to be fired as temporary head of Walter Reed.

I am pleased that you recognized the severity of the situation at Walter Reed and moved quickly to address it. However, I am very concerned with the Army’s decision to place Lt. Gen. Kevin C. Kiley as the temporary head of Walter Reed. As the Washington Post has reported, most of the problems with outpatient care at Walter Reed began during Lt. General Kiley’s first command there in 2003. Lt. Gen. Kiley and his staff were routinely made aware of the deteriorating conditions during his tenure, but chose to do nothing about it. In fact, Lt. Gen. Kiley reportedly dismissed concerns raised by Members of Congress, veterans organizations, and even the spouse of the former Secretary of Defense.

I have very little confidence that Lt. General Kiley, given his track record as previous Commander of Walter Reed, is capable of providing the leadership needed to fix Walter Reed’s broken bureaucracy and shoddy infrastructure. I strongly urge the Department of Defense to rescind Lt. General Kiley’s assignment, and place Walter Reed in charge of an effective leader.

Update III: Whatever we call him, Kiley’s gone from Walter Reed, as this Army Press Release reports. Also gone is the Secretary of the Army, as the administration tries to pretend it cares.

1 comment March 2nd, 2007

Ava Lowery: How This Must End

Young director Ava Lowery has created a video to encourage people to attend the antiwar rally this Saturday in Washington, D.C. In her YouTube description she says:

Over 3,046 U.S. Troops have died in Iraq. Thousands more have been wounded and tens of thousands of Iraqis have been killed. We already know how this war must end. Now it’s time for us to stand up and do something! Join us on the streets of DC this Saturday, January 27th, to tell the new Congress: Act NOW to bring the troops home! We the people have the power to control our country’s path. It’s up to use to use that power.

How This Must End

Remember as you watch it that there are hundreds of thousands of Iraqi scenes like the American ones shown here.

1 comment January 22nd, 2007

Washington Post on Appeal for Redress

Tuesday’s Washington Post had a sympathetic portrait of the sailors behind the Appeal for Redress signed by over 1,000 active -duty service-people and presented to Congress yesterday. The Appeal:

As a patriotic American proud to serve the nation in uniform, I respectfully urge my political leaders in Congress to support the prompt withdrawal of all American military forces and bases from Iraq . Staying in Iraq will not work and is not worth the price. It is time for U.S. troops to come home.

1 comment January 17th, 2007

Appeal for Redress to be handed to Congress today

Today is the day that 50 active Officers will hand in the Appeal for Redress from the War in Iraq.

Meanwhile, in Virginia:

Several dozen service members joined peace activists today to call for an end to the war in Iraq, part of a nationwide effort that links a growing group of active-duty protesters to the peace movement…

“We served in combat and we’ve seen the futility of this war,” said Sgt. Jabbar Magruder of Los Angeles, a member of the National Guard who served 11 months in Tikrit, a town northwest of Baghdad. “The soldiers want to resist. The soldiers want to come home now. We need the citizens to back us.”

Add comment January 16th, 2007

Paula Caplan: For Anguished Vets, the Listening Cure

Psychologist Paula J. Caplan has sent me the following article which was published in the Washington Post in 2004. It discusses the difficulties facing returning vets, expected, as they are, to forget the horrors they’ve experienced and return to “normal life.” The essence of her point:

We need to let returnees say they were scared and let them know that’s not crazy. We must also allow them to tell proud war stories when they want to. When they wish to talk, we must find non-psychiatric, non-pathologizing opportunities for them to do so openly, while also supporting them if they choose to see a therapist. And when they need silence, we must respect that, too.

Here’s the whole article:

For Anguished Vets, the Listening Cure

By Paula J. Caplan
Washington Post, Sunday, September 5, 2004; Page B02

In 1996, in his late twenties, Robert joined the Army Reserve to get help with college tuition. The reserve’s demands weren’t much of a hardship — until 9/11, when his life was turned upside down. First assigned to full-time duty as an airport guard, he was sent to Kabul eight months later. In Afghanistan, he counted the minutes until he could get back home. But when he did, half a year later, he found himself “all at sea.” The people around him, he felt, “acted like I’d never left. For them, nothing was different.” His feelings of turmoil were exacerbated by an uneasy sense that he had no right to them, as his unit had been shot at only once.

When he couldn’t shake feelings of depression after nearly a year at home, his sister finally suggested that he see a therapist. It seemed like the obvious solution to her, and I can see why. After all, we sent many Vietnam and Gulf War vets behind psychotherapists’ doors to deal with their anguish, and we’ve come to think it’s the best thing to do. Unfortunately, in our over-psychologized society, we’ve also come to think that it’s the only thing to do.

We’ve failed to learn what the vets of previous wars have taught us — that although therapists clearly help some soldiers, there is only so much emotional damage from war they can fix. Leaving this work to psychotherapists alone may be not only harmful to the soldiers but also dangerous for us as a nation, because it helps hide the consequences of combat, making it easier for us to go to war again the next time.

Simply sending frightened, angry soldiers off to therapists conveys disturbing messages: that we don’t want to listen, that we’re afraid we’re not qualified to listen, and that they should talk to someone who gets paid to listen. The implication is that their devastation is abnormal, that it is a mental illness, and this only adds to their burdens. Yet since there’s intense debate even among experts about the definition of mental illness, it’s all the more important for the rest of us to let returnees know that we don’t consider them weak or crazy for having problems.

According to U.S. Army reports, the suicide rate for American soldiers in Iraq is 17.3 per 100,000, nearly five times the rate for the Gulf War and 11 percent higher than for Vietnam. As of March this year, seven soldiers had committed suicide after returning from Iraq. Clearly, the emotional casualties of this war are already extremely high, and it is likely that the longer troops remain in Iraq and Afghanistan, the worse they will get.

Many soldiers’ first instinctive response to witnessing the horrors of war is to repress their feelings and never talk about them. Traditional prescriptions for men to be tough intensify the expectation that, no matter how soldiers suffer, they should handle it alone. As more women take on combat roles, the same expectations now also apply to them. So, having seen a buddy blown to bits or realizing that they have killed an Iraqi child, many soldiers choose to suffer in silence. Some do so to protect their loved ones. Others fear the pain of telling their stories and not being understood.

That’s what happened to one soldier serving in Iraq with whom I talked. He described how hard it was to sympathize with his fiancee in Dubuque when she wrote about daily frustrations like her car overheating, even as he was reeling from the shock of being reviled as an invader and occupier by the Iraqis around him. “It’s hard to have any long-distance relationship,” he told me, “but from Dubuque to the war in Iraq is impossible.” After a three-week leave, he was headed back to the war zone, his engagement ended.

Help for traumatized troops must really begin on the battlefront. Yet the military’s response has been largely inadequate, even misguided. When soldiers have breakdowns in combat, military therapists give them a little rest and a chance to talk with a counselor, then send them back into the fray, rationalizing that this helps prevent “survivor guilt.” But sending psychologically fragile soldiers back into combat is wrongheaded; they’ll likely feel guilt no matter what. Instead, therapists should advise commanding officers that these are the last people who should be sent back into battle. They should also seek ways to help the soldiers handle survivor guilt, such as pointing out that their deaths would not guarantee that others would live.

One military program, called Operational Stress Control and Readiness, or OSCAR, provides treatment in combat zones that includes antidepressant medication, usually Prozac. Though no one would begrudge a soldier anything that might dull the terror of combat, the truth is that the feelings they experience don’t disappear and will have to be dealt with eventually. And there’s something Brave-New-World-like about sending people into situations where they’re endangered and feel helpless, and then when they crack, giving them drugs to change their brain chemistry so that they can return to battle.

The military also touts its debriefings for soldiers heading home. With these programs, which often last 10 days or fewer, it hopes to decrease the violent behavior some soldiers exhibit when they get back home. The Army increased its counseling after three soldiers back from fighting in Afghanistan were accused of killing their wives in 2002. Returnees are alerted that they may have nightmares and short tempers, reminded that their wives have been making all the decisions and may not want to give up that power, and warned that their young children might not recognize them. That’s a good beginning, but for many, the debriefings are inadequate, and their very brevity can imply that this should be all they need to “get over it.”

But even with forewarning, the reality of having your child fail to recognize you can be devastating. Some counseling may work for some soldiers, but other advice — buy some flowers for the wife, take the kids to Chuck E. Cheese — may fail to smooth the troubled waters of homecoming. It’s no easy matter to know what will help, but even though the answers are neither simple nor obvious, the ongoing project of seeking them is a social responsibility.

Every one of us needs to shoulder a bit of the burden of helping our soldiers and our returning civilians with their reentry into ordinary life back in the United States. In June, I was at the bank when I heard a customer with red crew cut hair boast, “We were with the 82nd that got Saddam.” When the bank teller expressed awe, the soldier retreated a little, saying, “Well, I didn’t actually see him. But some of our guys did.” Another customer said, “Thanks for keeping us safe,” and the soldier straightened up and boomed out that he was headed for Afghanistan soon. “Gonna get bin Laden,” he declared loudly.

As he walked past me on his way out, I remarked quietly that I was frightened for him. His straight-as-a-board posture vanished, and he said, “I got stabbed in Iraq. We’re sitting ducks. And it’s weird being home. Can’t stop watching my back.” Given a chance to voice anything other than the expected bravado, out came his natural feelings of vulnerability. We need to let returnees say they were scared and let them know that’s not crazy. We must also allow them to tell proud war stories when they want to. When they wish to talk, we must find non-psychiatric, non-pathologizing opportunities for them to do so openly, while also supporting them if they choose to see a therapist. And when they need silence, we must respect that, too.

In any case, a recent study in the New England Journal of Medicine revealed that enormous numbers of soldiers won’t see therapists. It showed that 38 percent of soldiers thought to be mentally ill did not trust therapists, 50 percent worried that seeing one could harm their careers and a full 65 percent feared being seen as weak. Realistically, these barriers to therapy won’t be overcome anytime soon.

So we citizens must accept the social responsibility of telling returnees not only that we will listen but that we will listen for as long as they want to talk about how it felt to be over there and how it feels to be back. We need to tell them not to censor themselves for fear of upsetting us, offending our sensibilities, making us feel helpless to help them or making us angry at them. If we fail to do this, then we become complicit in concealing some of war’s most devastating consequences. And to refuse to face these fully is to increase the chances that we will go to war again.

Author’s e-mail:

paulajcaplan@yahoo.com

Paula Caplan is spokeswoman for the Association of Women in Psychology and the author of “They Say You Are Crazy: How the World’s Most Powerful Psychiatrists Decide Who’s Normal” (Addison-Wesley).

1 comment November 29th, 2006