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Damage control at Walter Reed.

By The Armorer on February 28, 2007 | | Comments (24)

Things are moving forward at Walter Reed, but it would appear there's an element of "two steps forward, one back" in evidence, as well.

The Army Times is reporting this two steps forward:

The soldiers said they were also told their first sergeant has been relieved of duty, and that all of their platoon sergeants have been moved to other positions at Walter Reed. And 120 permanent-duty soldiers are expected to arrive by mid-March to take control of the Medical Hold Unit, the soldiers said.

Then there's this - which I actually put mostly into a step forward.

Soldiers at Walter Reed Army Medical Center’s Medical Hold Unit say they have been told they will wake up at 6 a.m. every morning and have their rooms ready for inspection at 7 a.m.,

Many of the troops undoubtedly think of this an punishment for those who spoke to the press. There may, indeed, be an element of that in there, in that the command is trying to regain control of the message (hold on, more to follow on that thought). However - I suspect this is also the jump-start of a return to a firmer discipline than that seemingly lax form of discipline that led to the environment at Walter Reed.

One of the things the service learned (and apparently forgot) between how it handled casualties in WWI vice WWII, especially psychiatric casualties - is that the maintenance of military discipline - not fanatical ala Gunnery Sergeant Hartman of Full Metal Jacket but simply firm discipline designed to enforce basic standards of cleanliness, appearance, demeanor - and to keep people usefully occupied with relevant tasks. The key to all that is, of course, good leadership, a quality abundantly absent at WRAMC. Getting those troops back into a routine will be good for them, and for the installation. Of course, the follow-on is that the command must also find a way to break through the logjam of paperwork and find ways to usefully employ those soldiers. And if they can't - it may actually make sense to break them out to less full facilities where they can be given useful duties for those times when they aren't busy trying to fight their way through the paperwork.

Now for one step back. Heck, possibly more, if at least in a different direction. That is the clamp-down on media contact - both by the soldiers themselves, and in more official ways.

The Army Times is reporting that the Pentagon has also shut down media coverage of any and all Defense Department medical facilities. This includes suspending planned projects by CNN and the Discovery Channel. The Army Times quotes a PAO email where the Army's official position is “It will be in most cases not appropriate to engage the media while this review takes place.” This apparently in reference to the panel being convened by DoD to investigate issues at Walter Reed.

I completely disagree. A buddy of mine sums it up nicely:

When will the Army learn that transparency in non-OPSEC issues is a disarming approach? Cover-ups do not work and do not speak well of our REMFs – and I do mean REMFs. This burns my ass…… ML

Gezackly. Better to throw open the doors, than simply ensure that the press will now push harder, and the disaffected soldiery will slip around the corners to talk to them - and you will have completely lost control of the message. And it will be the Army's own damn fault.

Lastly, accountability.

- The 1st Sergeant was relieved.
- The Platoon Sergeants were reassigned.

It may just be an oversight in the reporting by Army Times - but... where is my officer scalp? I *always* want an officer scalp, publicly taken, when things like this happen. Not scapegoat scalps, I want the people who forgot their most basic responsibility to pay the price.

Was the med hold company commander relieved? If not, it must only be because he or she just assumed command and was essentially blameless - in which case there ought to be an amended OER making the rounds for the commander's predecessor. Followed with a show cause for retention letter. And the OER of the rating official who let that company commander get his command to this state should be in receipt of, or pending receipt of, an OER that will guarantee they never command beyond their current level.

There is no way that you relieve a 1SG and reassign all the platoon sergeants and the primary blame doesn't lay squarely on the shoulders of the officer commanding.

Appropriate action may have been taken - and if it was, well, someone ought to report it. I don't have to have the name - I just want to know that officer careers imploded as thoroughly (actually moreso) as the NCO careers did. From where I sit, as a commissioned officer of the United States Army, currently without assignment, there is a disturbing lack of commissioned scalps hanging from the pike at the gate.

And if that is in fact true - it is a failure of leadership at the higher levels at WRAMC. REMFs, indeed.

Sad that an organization that in the balance is full of hard-working, dedicated people who just want to do right by the wounded is being let down by it's commissioned leadership - and if that's not the case, then the PAO needs a new job.

Regardless, more officer scalps please.

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24 Comments

By kat-missouri on February 28, 2007 9:55 AM
I read the same article and said the same thing over at my place. Good thing I came over here to take a look before I went to H&I fires with it. the continuing saga I thought the most itneresting part was nearly overlooked. Even though it is part of the "don't talk to the media" aspect of the story, it is interesting that the administration is getting booted from their newly renovated offices and moving the wounded there.
 
By Leavenworth Centurion on February 28, 2007 9:56 AM
John, My observations and experience of many years, for what its worth: This is a systemic leadership problem within the Medical Department. It has improved somewhat in recent years with an increasingly professional, in the Army sense, Medical Corps, but still suffers from a laissez faire attitude. Doctors want to be doctors, not leaders, so even though they are the commissioned officers, they provide little leadership, discipline, etc. There are exceptions to be sure, but they stand out by so being. The Medical Service Corps officers and the Non-Commissioned officers take their lead from the Medical Corps officers - the standard is set and its very low. I had a neighbor in Germany years ago whose wife had a terrible disease that required long term in-patient care at Walter Reed. He was, therefore, attached to the hospital for duty. The hospital commander had a discipline problem and figured that a hard charging infantry Captain could help him fix it. He was right. Standards were set, discipline was enforced, leaders were held responsible and accountable, soldiers were taken care of. I suspect that things reverted to normal after he left, and see by these accounts that the systemic problem is still present.
 
By JimC on February 28, 2007 9:59 AM
Thank you for the post. Very reasonable, but there is the issue of the poor bastards living in twilight from the opiates and the matter of a guy with three working fingers sitting at desk all day and if his wife didn’t sit with him no one would have checked on him. What useful work can such as they do? Make work is never a solution. And, is there anything useful for them to do? Discipline is one thing, but some of this borders on cruelty and neglect. You are right to point out that this situation cries out for leadership. As one of my old buds said to me a couple of weeks ago they need to put a hard charging combat arms guy in there. It was his experience that if you wanted to fix what was broken quickly and permanently give it to an Armor, Infantry or canon Artillery officer. (MLRS was not really available during his service so I don’t know how he feels about those officers.) I do suspect your suggestions, if acted on, would alleviate the situation. Sadly, I am not holding my breath until your solution is accepted and in place.
 
By John of Argghhh! on February 28, 2007 10:00 AM
Heh. You and Jim Cope are reading from the same sheet of music. For what it's worth - I volunteered for recall to assume command of that company. No call-back yet.
 
By kat-missouri on February 28, 2007 10:06 AM
You know, it is always easier to quickly relieve an NCO in place and shuffle him off to some other desk duty than it is to simply mess with an officer, particularly if you are planning to do something nasty like an article 15, etc. You'd want all the ducks in a row. I did take it from Gen. Kiley's comments in another article that it is likely some others will be hitting ye old career ending bump in the road, but you know he is not going to announce that any more than I'd run out today an announce I was going to fix my problems by effectively firing a supervisor. That is not done until you have done all the things you need to do. I expect John to get his scalps, but a little later and probably with a little less bruhaha since the story may have died a bit by the time the process is done.
 
By Adjutant on February 28, 2007 10:17 AM
I don't know enough about existing manpower at the facility to understand how a whole company of soldiers is going to be part of the solution. That almost sounds like the new troops assigned will become, what, babysitters or jailers? Weird - and obviously my perception has nothing to do with military experience ;-) It will be interesting to see how long we wait to see/hear that career bumps have been generated for officer(s) involved. I agree that we need to be certain that such happens, because it is obvious that this is a failure of leadership. In fact, I want some very high heads to be affected. Because if the top officers in the command didn't know something was wrong, then they seem incompetent to me. And if they did know, and did not have plans in place to address the needs (and trumpet those plans as soon as the news broke), they are stupid. My 2cents worth.
 
By John of Argghhh! on February 28, 2007 10:18 AM
Kat, while you may be correct, it's not needed. A relief-for-cause is not a hard thing to do. And you can still do an Article 15 or such as appropriate. But I don't see this as requiring a judicial proceeding. This is simply administrative. Been there, done that. You just need the 2 Star to agree with you that the performance of the Captain in question rises to the level of relief. It's a little more complicated for higher ranks, but reliefs can be done in a day, and would not prejudice any further actions. I want my scalps. Now. Not that they have any obligation to give them to me, but I want 'em.
 
By MajMike on February 28, 2007 10:37 AM
huzzah! perhaps the light duty tasks they could accomplish could include running a DA level board to review nominations for combat awards and badges and give recommendations... i.e. review for completeness of the packet, and give a sensing of whether the nominated actions rise to an appropriate level of worthiness. (this could potentially eliminate the farcical and capricious manner in which CABs are administered)..
 
By leavenworth centurion on February 28, 2007 10:47 AM
leadership problems are not solved by 0600 formations and gagging the troops. They are solved by... well, leadership.
 
By kat-missouri on February 28, 2007 11:05 AM
I spent quite a bit of time last night reading the MHO/MPU/MEB etc, etc, etc processes. There are quite a number of presentations from the DOD and the specific branches about handling the processing of soldiers out of or back to active duty. In reviewing that, I figure that the 120 that are being sent will either be IR already active and serving in multiple MPUs (Medical Processing Units) or an MPU and Mobile MEB/PDES (exam boards) that already exists that are receiving emergent orders. Otherwise, as a commenter over at my place said, what good will it do? Let's hope no other idiot in the command chain thinks throwing warm bodies at a very public situation is going to solve the problem. Hope they looked around for a successful unit and pulled them to help. One other thing, I was reading all this interesting stuff last night and the presentations I had indicated the MHOs or Medical Hold Overs (units) were for reserve component soldiers. Ostensibly because they are IRR and cannot return to their active duty unit due to medical reasons and cannot be processed back to the reserve unit or REFRAD (released from active duty) until treatment is completed, disability determined and fitness for duty is established. Before I go on to write this in a piece, does anybody know any different? Is an MHO reserve soldiers only? Or, are there other similar units that hold active duty soldiers?
 
By John of Argghhh! on February 28, 2007 11:12 AM
As far as I know, med hold units hold soldiers active duty or not, who are not currently fit to serve with their units. Where possible, active duty troops are sent back to their units on limited duty while they go through board processing. Reservists are going to comprise the bulk of the current med hold population because many don't have units or facilities that can handle them locally.
 
By FbL on February 28, 2007 1:19 PM
Won't have time to search for it until this evening, but I could swear I read something about a CO being relieved over WR.
 
By Grumpy on February 28, 2007 3:26 PM
Thank you, for your post, it was appreciated very much. I could really go off on a rant on this one. This situation did not happen in a vacuum. It also did not happen overnight. In many places such as this, there is some fat in the operation of that particular facility. But there is a certain point, where you can not just cut. It is no longer fat, not even just muscle, but life essential muscle, i.e. heart, lungs, liver, etc. We have been cutting here for a long time. We have cut the infrastructure of the force, BRAC. This is actually where the problem with Walter Reed lives. The military can not keep doing this! We as a nation need to look at the direction of our path. We must pay for this war on terror up front, we can not cut every thing to pay for it. We all must pay for it in one way or another. If this war is so important, bloggers, what is it costing you? I know many of you have served and many are now serving this GREAT nation. Many of you are active duty, reserves, national guard or veterans. Last, but not least, we get to the real unsung heroes, the military familiies, Thank You! Many of you have talked about the volunteers, they are great, but this is NOT a voluntary responsibility. We need to grow an Army and Marine Corps. here in US. Thank you, for your kind attention. As we grow our military, a quote from the past, "The willingness with which our young people are likely to serve in any war no matter how justified, shall be directly proportional to how they perceive the veterans of earlier wars were treated and appreciated by their nation." - George Washington
 
By TheNewGuy on February 28, 2007 6:41 PM
Telling the troops to "use their chain of command" and not to talk to the media is standard procedure... but it makes it look like Walter Reed's leadership has something to hide. Besides, using the chain of command worked out oh-so-well in getting all the problems fixed... Sorry, the commanders blew it on this one, and they need to take their lumps. I agree with the site host; somebody besides NCOs has to go down. Incidently, the "lack of leadership" point is exactly ass-backwards. Physicians don't need leadership... they need support. Here's my take as an ex-military (now civilian) Doc: Want to help me take care of patients? Keep the micro-managing, metrics-driven, admin-heavy medical leadership off my back, and give what I need to take care of people. Don't put me in a position where I bear ultimate responsibility for lives and outcomes, while simultaneously stripping me of any power or ability to control my budget, staffing, or practice environment. I don't think you gentlemen understand how bad it is in the medical corps. Try this link on for size and look around... you'll get a view from the inside. There's a reason why the services are starting to have trouble filling their HPSP scholarships, and it's because military medicine has gone rapidly down hill in the last 10-15 years. The retention rate for docs past their initial ADSC is in single-digits, and money is NOT the reason.
 
By John of Argghhh! on February 28, 2007 8:26 PM
Welcome to the discussion, NewGuy! Oh, and for the record, I was assuming they were going to be MSC scalps, not physician scalps.
 
By Barb on February 28, 2007 11:41 PM
Hi NewGuy - Welcome. I agree with John - when I said failure of command, I wasn't talking about technical staff, but the administrative command.
 
By TheNewGuy on March 1, 2007 12:01 AM
John, Thanks for the welcome. Some of the scalps you're after may actually be physician scalps. Medical center commanders are often physicians (though they can be nurses... topic for another day). Now, admittedly they should be delegating things like facility maintenance, but somebody wasn't minding the store. Frankly, I wasn't surprised by much of anything I read in that article. The military medical system is in deep, deep trouble, and if you think it's bad now, it's going to get even worse in the next 2-3 years. Here's an article about the decline. From my perspective as an ex-military doc (with plenty of friends still on AD), physician retention is horrible, incoming accessions are dropping off, and there's a war on. The title of the article I linked above is partially incorrect; this phenomenon predates our war in Iraq, and represents a general decline in the desireability of military medicine as a career option. Even before the current shortfall in scholarships being claimed, the percentage of DOs to MDs had been rising, and total applications dropping. It used to be that HPSP recruiters could get students to take the scholarship, based soley on the spectre of big debt coming out of school. As word is getting out about the current state of military medicine (and plenty of docs are getting out), the students are figuring it out, and not signing up. here's one more document from an ex-Navy admiral, adddressing the same problem.
 
By Riley8630 <- Corporate Shill on March 1, 2007 12:46 AM
Hello guys! My boss compels me to post theese links on your site: [deleted by the Armorer] Riley8630 [Dude - just say no to bandwidth theft!]
 
By ry on March 1, 2007 2:15 AM
Tired of Dunnigan's discussion boards NewGuy? Long time no see.
 
By TheNewGuy on March 1, 2007 2:35 AM
I'm afraid you've the better of me, Ry. I don't remember us ever having interacted before. I have weighed in at this site on rare occasion, but mostly I lurk. Who is Dunnigan?
 
By ry on March 1, 2007 4:29 AM
YOu didn't post over at the StrategyPage discussion boards before? The handle is real familiar and so is the style.
 
By Cassandra on March 1, 2007 4:58 AM
I was really busy during this whole thing, but recall the spouse telling me he read the commanding general admitting he had never even been inside Bldg. 18 once during his entire time there. That just appalled me. John is right. If he hadn't been inside, one of his immediate subordinates should have - regularly. That is why this happened. My Dad said the exact same thing, and he is Navy, so you have two officers from two other branches saying essentially the same thing: if you don't bother to check on things, they go to hell in a handbasket. I also believe that a general inattention to military medicine contributed to the problem - the really important stuff always gets taken care of but once the emergency's over God help you. You're at the mercy of the system, which has always been pretty messed up.
 
By TheNewGuy on March 1, 2007 12:27 PM
Ry, Maybe my memory is failing as I age (like everything else), but I don't think I've ever posted over at Strategypage before. It's not one of the blogs I read. Can you give me a link to a specific discussion, or recall what it was about? I wouldn't think my usual contributions to be that memorable. Cassandra, The MBWA (Management By Walking Around) concept has been around since the 1980's, but it still holds value. Bottom line: stop answering email, get out of your office, and see what's going on in your organization. A good start would be simply listening to the docs... they'll tell you what they need. Or better yet, get sick and become a patient... without all the general officer, RHIP perks (because everyone falls all over themselves whenever "colonel/general so-and-so" shows up, few 0-6s or general officers have any idea what kind of medical care Airman Jones gets). Forcing a few generals to navigate the Tricare maze, or call for hours to even get through, or wait weeks for an appointment, or bird-dog their own paperwork (as it gets lost again and again)... that might open some eyes.
   
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