VAN BOVEN: Dealing with PTSD

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By Robert Van Boven

OP-ED:

On Friday, December 19th, millions of Americans were exposed on the "Dr. Phil" show to the antithesis of service many of our wounded warriors have received upon their return to civilian life. The honorable Rep. Bob Filner, chairman of the House Committee on Veterans Affairs, decried that "the American people assume we (the VA) are taking care of our kids ... we are not."

He pointed out that the nearly one million new veterans from the wars in Afghanistan and Iraq are dealing with a backlog of nearly 800,000 benefit claims. Moreover, Mr. Filner cited unethical conduct at the VA including shredding and deceitful post-dating of many hundreds of benefit claims at several sites. He further pointed out notorious VA communications to conceal suicide rates and encourage alternative diagnoses to post-traumatic stress disorder (PTSD), thereby threatening health care benefits for many thousands of returning soldiers suffering from PTSD. Unfortunately, congressional oversight is hindered, according to Mr. Filner, because it depends upon self-disclosure of wrongdoing by the VA, and "if they want to cover-up, they can cover-up."

Just as intrinsic failures of self-regulation by lending institutions set the stage for the nation's economic debacle, insulated cultural problems at the VA are in need of reform and stronger external oversight, beyond the VA's own inspector general.

Although the VA has a budget of nearly $100 billion, the "system is designed not to help them (veterans) but to support the bureaucracy," according to Col. David Hunt of FOX News. For example, at Central Texas Veterans Hhttp://www.washingtontimes.com/admin/news/stories/352665/#ealth Care System, suppression and inaction to disclosures of fraud, waste, plagiarism, and cronyism fell upon deaf ears to protect the inner circle of involved management and shortchange victims of traumatic brain injury (TBI). Consequently, attempts to bring to light misdoings by management at the only dedicated TBI brain imaging and treatment research program in Texas resulted not in remedies, but reprisals and covert plans for considering closure of the program without explanation.

Thus, such a burial would also conceal the transgressions. The VA modus operandi prevailed, characterized by Mr. Filner, as "Deny, deny, deny, then cover-up, cover-up, then down play it, then hopefully years later people will forget about it." Fortunately a unified protest to the possible shutdown of the TBI Program last week from Sen. John Cornyn and Reps. John Carter, Lloyd Doggett, Michael McCaul, and Lamar Smith may thwart the tactic of "throwing the baby out" (closing the TBI program) and keeping the dirty bath water (managers responsible for misconduct and mismanagement).

As we celebrate the New Year and a new beginning for our nation, let us pray and remember the over 4,200 men and women who perished in battle in Iraq and Afghanistan, the over 140,000 soldiers who cannot be with their families at this time, and pledge our commitment to our wounded warriors so that they may achieve recovery and lead fulfilling lives.

The Rand Corp. estimates that nearly 300,000 returning soldiers suffer from PTSD or depression and up to 320,000 have sustained TBI. The Institute of Medicine has also recently underscored long-term consequences of TBI including dementia, depression, impaired family relations, and unemployment. According to National Alliance to End Homelessness, nearly one out of four homeless (1-out-of-3 men) in America are veterans though they only represent about 11 percent of the general population. The next wave of potential homeless must not follow this horrific fate for their service to our country. We are in dire need of sensitive methods to diagnose and treat TBI. Speak out for increased accountability, transparency, and integrity in our VA system, in service to those who risked their lives so that we can enjoy our holidays and freedom. Our heroes deserve no less.

Dr. Robert Van Boven is a neurologist-scientist and serves as director of a VA TBI program in Texas.