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        <title>Comments for Juxtaposed...</title>
        <description>We&apos;re the Military and Airpower Guys of Jonah Goldberg of National Review Online + a stray we found wandering around looking lost.  All original material JHD, BHD, JR, WT,  and KA 2003-2010</description>
        <link>http://www.thedonovan.com/archives/2007/02/juxtaposed.html</link>
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            <title>Juxtaposed...</title>
            <description>This nice chirpy news release regarding not just Walter Reed, but Bethesda as well, popped into the box yesterday. NEWS RELEASES from the United States Department of Defense No. 198-07 IMMEDIATE RELEASE February 20, 2007 Media Contact: (703) 697-5131/697-5132 Public/Industry(703) 428-0711 Department to Review Military Medical Rehabilitative and Administrative Care The Secretary of the Army and the Secretary of the Navy have begun a review of the medical care provided at Walter Reed Army Medical Center and the National Naval Medical Center to those wounded in service to their country. To complement these efforts an independent review group will be...</description>
            <link>http://www.thedonovan.com/archives/2007/02/juxtaposed.html</link>
            <guid>http://www.thedonovan.com/archives/2007/02/juxtaposed.html</guid>
            <pubDate>Wed, 21 Feb 2007 07:01:08 -0600</pubDate>
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            <title>Comment from MaryAnn on 2007-02-22</title>
            <description>
                Points taken, Ry.
            </description>
            <link>http://www.thedonovan.com/archives/2007/02/juxtaposed.html#comment-56981</link>
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            <pubDate>Thu, 22 Feb 2007 03:28:31 -0600</pubDate>
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            <title>Comment from ry on 2007-02-21</title>
            <description>
                I disagree a little bit that it isn&apos;t dollars.  The infrastructure, and I&apos;m talking people as well as buildings, costs a lot.  Dedication by service members only goes so far.  The &apos;I&apos;ve got three kids, one is about to start college, one needs braces, and the youngest one nees glasses, oh, and one&apos;s in the oven.&apos; situation comes up.  They leave for more money, less stress, and more time with the clu.  

The fix for the un-navigable paperwork sea is either a professional or volunteer permanent staff that does this all the dang time.  Proll&apos;y a mix of both---able to ramp up to meet demand and keep Congress happy about cost.  

Facilities in some instances are less than what they should be.  Repairs cost money.  People to do the repairs cost money.  

Money isn&apos;t the cure all, but it&apos;s a start.  It&apos;s not something anyone should be able to use as a get out of jail free card.  But righteous anger doesn&apos;t put steak on the plate.  

Since what I thought of for WRAMC is now kaput(they&apos;re on it) I&apos;m having to think different.  WRAMC is the current target, while other stuff continues to be similar without notice.  
So I propose:
a)  Since repairing facilities is a problem, you can only keep so many &apos;facilities managers&apos; on staff, we organize local groups and businesses to tackle that.  It&apos;s like cleaning a house.  If you&apos;ve neglected it for a while it seems like an impossible job.  Once you&apos;ve got it right it&apos;s a whole lot easier to keep up.  Secondary:  money is left for other things---like fixing med gear, psych staff, and managers for the paperwork sea.
b)  We don&apos;t think of this as a once off.  We need long term charity org to be there for things like paperwork and entropy enduced repairs that go out of budget for a given facility(like a Veteran&apos;s home).  

I&apos;ve already talked to SA&apos;s Holly.  Need to follow up on that.  We need help here people.  Gov&apos;t will do what it does.  We, those who actually give a ----, need to fill in the cracks where gov&apos;t fails as it is fated to always do.  Some people can do more than others.  But it takes a coordinated initial effort to make anything happen.  Let&apos;s pull together and make something happen.  Nashing teeth and calling for heads leads nowhere.  
respectfully, 
gollum           
            </description>
            <link>http://www.thedonovan.com/archives/2007/02/juxtaposed.html#comment-56973</link>
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            <pubDate>Wed, 21 Feb 2007 19:54:34 -0600</pubDate>
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            <title>Comment from MaryAnn on 2007-02-21</title>
            <description>
                <![CDATA[<blockquote>" ...and a lot of what's goofed there isn't related to dollars for facilities.

It's related to caring for the farking soldier."</blockquote>

Amen. 

It's a matter of the people doing the jobs caring.  Or not. Period.]]>
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            <link>http://www.thedonovan.com/archives/2007/02/juxtaposed.html#comment-56961</link>
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            <pubDate>Wed, 21 Feb 2007 15:10:59 -0600</pubDate>
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            <title>Comment from kat-missouri on 2007-02-21</title>
            <description>
                I am going to post something on this tomorrow.  I am on the other end: care giver.

However, having just helped someone with a process problem, I can tell you that a major malfunction is the 1st Sergeant and his minions (up or down the chain of command) are not long term &quot;employees&quot; who have a lot of knowledge about the system.  Those are very few and far between.  usually, these people down at that level are just passing through.  Probably there less than a year and probably gets about the same kind of training without a chance to practice it and make it happen with a mentor.

On the admin side, it&apos;s not like being a tanker or artillery or even a rifleman.  At least as a tanker you get trained on a field where you practice shooting targets before you actually go into combat.  You are drilled until you know exactly how to operate your machine, even in the heat of battle.  Not so the paper pusher.  He isn&apos;t practicing jack.  He gets some squashed together seminars that are supposed to inform him or her how to manage this great morass and all the &quot;check boxes&quot;.

And, as much as you hate going through the system and its paperwork, desperately keeping your eye on the moment you can get out of the machinery, they are too.  Believe me, unless you are truly dedicated to the &quot;mission&quot;, the people they are sticking in there to over see it are equally as desperate to escape it.

I was helping someone walk through the process.  There were changes so I had to read the new documents and reference the websites regarding processing to holding units, etc, etc, etc.  The sergeant who had handed the family the paperwork didn&apos;t know anything and could barely explain the process to the family.  Then he left out some steps or told them it was a &quot;done deal&quot;, so when they were getting shuffled through the beauracracy, they couldn&apos;t figure out why they weren&apos;t in the place they thought they should be (ie, processed out and on their way to outpatient care).

When they tried to find the Sergeant, guess where he was?  Gone.

When they tried to talk to the &quot;case manager&quot; at the hospital, their documents were already in transit to the &quot;case manager&quot; that would handle their case from the &quot;holding unit&quot; process forward.  They had to wait a week before they were contacted by the new case manager.  A week when they didn&apos;t know what to do or where to go and no one could tell them what was supposed to be happening because the hospital worker was not part of the &quot;processing to medical holding unit&quot; process and had no idea how it worked.

But, you kow how I helped them out?  I had computer access.  I had experience with tri-state and military clinics in San Diego as a care giver.  I read the websites and the pamphlets.  I figured out who they needed to contact in order to find out who their case manager was.  That&apos;s all it took, but no one could help them inside the &quot;machinery&quot; because they did not know what to do, were gone, were not part of the &quot;other process&quot; and simply did not want to go outside of their lines.

Still, that was only the beginning.  After they got to the &quot;holding unit&quot;, it started all over again.  The only saving grace was a really dedicated case manager that was overwhelmed with the number of people she had to manage yet still managed to take the time to talk to these folks like humans and explain what was going on.

I told my friends to make sure they wrote a glowing letter about this lady because you don&apos;t meet those kind of people often in this kind of system. 

I have more to say on the matter later.
            </description>
            <link>http://www.thedonovan.com/archives/2007/02/juxtaposed.html#comment-56960</link>
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            <pubDate>Wed, 21 Feb 2007 14:16:07 -0600</pubDate>
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            <title>Comment from FbL on 2007-02-21</title>
            <description>
                <![CDATA[Chuck has a terrific post about his thoughts on this, including taking on blame for what he calls having "left my brothers behind" (a lesson in leadership for WR).

READ IT!

<a href="http://tcoverride.blogspot.com/2007/02/blame-game.html" rel="nofollow">http://tcoverride.blogspot.com/2007/02/blame-game.html</a>]]>
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            <link>http://www.thedonovan.com/archives/2007/02/juxtaposed.html#comment-56955</link>
            <guid>http://www.thedonovan.com/archives/2007/02/juxtaposed.html#comment-56955</guid>
            <pubDate>Wed, 21 Feb 2007 11:07:50 -0600</pubDate>
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            <title>Comment from MajMike on 2007-02-21</title>
            <description>
                i&apos;m agreeing here!!
            </description>
            <link>http://www.thedonovan.com/archives/2007/02/juxtaposed.html#comment-56954</link>
            <guid>http://www.thedonovan.com/archives/2007/02/juxtaposed.html#comment-56954</guid>
            <pubDate>Wed, 21 Feb 2007 11:01:47 -0600</pubDate>
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            <title>Comment from FbL on 2007-02-21</title>
            <description>
                Leadership, leadership, leadership (at all levels).  They definitely don&apos;t have enough money/staff, but they could&apos;ve done a hell of a lot better than they did (most of the problems are just simply administrative/bureaucratic.  And THAT is inexcusable. 
            </description>
            <link>http://www.thedonovan.com/archives/2007/02/juxtaposed.html#comment-56952</link>
            <guid>http://www.thedonovan.com/archives/2007/02/juxtaposed.html#comment-56952</guid>
            <pubDate>Wed, 21 Feb 2007 10:50:15 -0600</pubDate>
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            <title>Comment from John of Argghhh! on 2007-02-21</title>
            <description>
                There are lots of good things going on at WRAMC, my anger obscures that fact.

There is just a common thread among the stories that indicates the leadership there is not doing their jobs properly.

And add to that my annoyance with other issues I&apos;ve run into with the non-deployed/deployable parts of the services in the last two years, and I get a little... frustrated.
            </description>
            <link>http://www.thedonovan.com/archives/2007/02/juxtaposed.html#comment-56950</link>
            <guid>http://www.thedonovan.com/archives/2007/02/juxtaposed.html#comment-56950</guid>
            <pubDate>Wed, 21 Feb 2007 10:39:23 -0600</pubDate>
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            <title>Comment from Barb on 2007-02-21</title>
            <description>
                I also remembered hearing that WR was to be ramped down and merged into Bethesda ... but I agree with John that it is no excuse for the current situation. Cutting corners for any reason at the expense of the troops is not appropriate.  Doing so at the expense of WOUNDED troops is despicable.
            </description>
            <link>http://www.thedonovan.com/archives/2007/02/juxtaposed.html#comment-56949</link>
            <guid>http://www.thedonovan.com/archives/2007/02/juxtaposed.html#comment-56949</guid>
            <pubDate>Wed, 21 Feb 2007 10:32:30 -0600</pubDate>
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            <title>Comment from BloodSpite on 2007-02-21</title>
            <description>
                I have to agree 100% John
And with your friend Hunter as well

If the 1SG did absolutely nothing, toast him. Toast until dawn then turn him over and toast him some more. I&apos;ll bring the spit.

You do not ever stop supporting your boys, no matter what condition they or you are in, nor no matter how much pressure the officer corps places on you (not saying thats the case, just saying it does happen), threats with careers et etc the 1SG is the number uno line man for the defense of a soldiers welfare and moral, period, end of discussion.

Many years ago I had an awesome 1SG who taught me many things about being an NCO. The NCO creed is long. His golden rule was simple. The 4 I&apos;s 

&quot;Never do anything illegal, illicit, insensitive or immoral and you&apos;ll be a good NCO.&quot;

I&apos;m a frequent flyer of the VA here in Fayetteville. My biggest complaint is treating the symptoms not the disease. I can freely walk out with any number of drugs of any sort without the faintest clue as to whats actually wrong with me. Fortunately I managed to obtain one of the few good doctors here.

That being said it&apos;s interesting to watch the World War II guys look at the newest generation of Vets, clean shaved and pink faced sit down beside them. 

Last week on the elevator a older gentlemen helped me with my crutches and hit my floor button.

&quot;What war?&quot; says he.

&quot;Gulf War Episode I, Haiti, Bosnia and a long list of places no ones heard of any more. You?&quot; says I.

He grinned under his white hair. &quot;Navy Aviation Crew member. A long list of places barely read about and maybe see in movies. World War II.&quot;

Old and New meet in a Elevator in a VA Hospital. The Old accepts the new, with a smile and a handshake. 

The problem? The medical service hasn&apos;t changed. Sure the walls get painted, the floors get changed, but the basics are still the basic&apos;s. 

I&apos;ve been a Category 2 since my discharge from the military. With the next round of budget cuts possible, my VA rep is telling I may drop to a 3 or even a 4. 

Enough is a freaking &apos;nuff.

How can I help, and what do you need me to do? 

I&apos;m game for a medical insurrection. I haven&apos;t been part of one of those since 1986 and I got to attend a Senate Sub Committee hearing that my father testified at on Navy Medical Malpractice, courtesy of then SecNav John Lehman and then TN Senator Jim Sasser. 

Having lived through the 8 years of court, legal drama and tooth and nail victory, I can tell you the beast does not change or give in easily. But I&apos;ll give it a shot and may still have some good contacts and know how the game is played, unfortunately.





            </description>
            <link>http://www.thedonovan.com/archives/2007/02/juxtaposed.html#comment-56941</link>
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            <pubDate>Wed, 21 Feb 2007 08:46:50 -0600</pubDate>
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            <title>Comment from John of Argghhh! on 2007-02-21</title>
            <description>
                MM - I don&apos;t care.  Taking care of soldiers is taking care of soldiers, and a lot of what&apos;s goofed there isn&apos;t related to dollars for facilities.

It&apos;s related to caring for the farking soldier.

And *that* is not the fault of anyone except the the President, the Secretarys, the JCS, the Service Chiefs, and their associated minions.

Period.

There isn&apos;t a politician (other than the Courtney Massengale variety) to blame for much of what&apos;s wrong here.

It&apos;s... *US*.
            </description>
            <link>http://www.thedonovan.com/archives/2007/02/juxtaposed.html#comment-56937</link>
            <guid>http://www.thedonovan.com/archives/2007/02/juxtaposed.html#comment-56937</guid>
            <pubDate>Wed, 21 Feb 2007 08:05:12 -0600</pubDate>
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            <title>Comment from MajMike on 2007-02-21</title>
            <description>
                <![CDATA[agreed. agreed. agreed...

and not to be contrarian (just for the sake of contrariness), BUT....

haven't we been trying to close out Walter Reed (due to obsolescence of the physical plant) and open a newer, more modern facility near by?

and hasn't every single round of BRAC stymied every efforts to make old run down places go away, so we could focus efforts on supporting and building up the places best suited to our current (and future) condition?

and hasn't it been local political considerations that cause our elected representatives to micro-manage each and every single buildings and grounds decision, effectively ham-stringing the garrison leadership?

so i'm willing to give the military leaders some slack and mild commendation for doing the best they can with the antiquated facilities (with a constrained O&M budget); while simultaneously promising to take a dump in the coffee cups of the elected legislators who micro-managed us into this particular corner.

just sayin']]>
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            <link>http://www.thedonovan.com/archives/2007/02/juxtaposed.html#comment-56936</link>
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            <pubDate>Wed, 21 Feb 2007 07:57:26 -0600</pubDate>
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