Dec 1, VCS in the News: Struggle with Military Over Care Leaves Airman Feeling Abandoned as He Fights Leukemia

The Grand Rapids Press

November 30, 2008 – It’s not how Air Force enlistee Joseph Weston pictured either his military service or his country.

Not long after he began basic training May 31 at Lackland Air Force Base in Texas, Weston figured something was wrong. He was weak and dehydrated. His heart rate soared. He collapsed on his way to Sunday morning church service. On June 9, doctors diagnosed the Cadillac native with leukemia. But his battles were just beginning.

From an isolated room in a wing at the base, he is engaged in a bitter fight with the Air Force over his discharge and health care. That comes on top of ongoing chemotherapy aimed at saving his life. The conflict pits Weston, his family and even his military doctor against an Air Force seeking to discharge him without benefits.

“I feel like I am in a never-ending prison. I’m just trying to get through one day at a time right now,” Weston said.  The military’s contention: Weston’s leukemia preceded the start of his service. It is a critical finding, because it means he will not be eligible for medical benefits upon discharge.

An Air Force review board issued that finding on July 21. An appeal board affirmed it in October.

Weston is appealing that ruling, a decision to be made by a Maryland-based board of the Secretary of the Air Force. He is backed by an Air Force doctor who is his primary physician.

In an appeal letter, cancer specialist Della Howell stated that doctors “would not have been able to make the diagnosis” of leukemia when his military service began.

Leukemia is a potentially fatal condition in which the bone marrow overproduces white blood cells and they crowd out normal cells. Howell based her finding on the typical multiplication rate of leukemia cells. She concluded that a marrow test taken the day he arrived for basic training would have been read as normal.

Weston, 21, spends much of his time alone in a spare, windowless room. At times depressed, Weston says the tension of the legal battle is the last thing he needs as he faces cancer.

“It’s made it 10 times harder,” he said.

Air Force officials would not speak to the specifics of his case.  But in an Oct. 29 decision, a three-member board found there is evidence his leukemia “existed prior to his military service.”

It cited his June 9 emergency room admission with a complaint of fatigue, shortness of breath for two weeks and medical history in which Weston reported dizziness for four weeks.

The board concluded “the preponderance of medical evidence indicates (Weston’s) condition manifested prior to” his military service. It rated Weston “unfit” for duty because of physical disability.

Limbo is tough to take

Cadillac resident Jim Weston said his respect for the military is gone, the result of his son’s ordeal.

“I’m as patriotic as the next guy,” he said. “I’m red, white and blue and support the country. But not any more. It is very, very disappointing.”

Should his son lose, Weston is uncertain how the family could afford future medical expenses. He fears they could amount to hundreds of thousands of dollars and wipe out family finances.

“We don’t have those answers,” said Weston, 49, superintendent for a Cadillac casting factory. His wife, JoAnn, 51, is an appointment coordinator in a dental office.

“It would be devastating for all of us,” JoAnn Weston said.

He sought a career

Joseph Weston’s mother recalled his excitement when he signed early enlistment papers in October 2007, months after graduating from Cadillac High School.

In a state where good-paying jobs are hard to find, he saw the Air Force as a chance to serve his country and earn benefits.

“His plan was to remain and make it a career,” she said. “He really, truly, had a passion for it.”

Weston traveled to Lansing to complete his medical testing, undergoing a thorough physical examination.

On May 26, he went to the Air Force recruiting office in Cadillac and was transported to Lansing, given a blood test and transported the following day to Lackland.

He began boot camp on May 31, exercising with other recruits in 90-degree temperatures.

On June 5, he found himself unable to run. He was examined the next day by Air Force medical personnel after he developed a racing heart.

Two days later, he collapsed as he made his way to Sunday church services. He was admitted the day after to the base hospital, Wilford Hall Medical Center. The diagnosis: leukemia.

Experts take his side

A bone marrow test on June 10 found Weston had 90 percent leukemia cells.

Working backward from that date, cancer specialist Howell calculated Weston would have had 2 percent leukemia cells on May 27. A bone marrow test at that level would have judged Weston normal, Howell said.

“Therefore, there is no way that I can support the classification of this illness as a pre-existing condition,” Howell stated in her letter.

An expert in military disability cases said enlistees enjoy a “presumption of soundness” when they join the military, based on the physical examination required for entry.

According to Arizona lawyer Theodore Jarvi, the Air Force must provide “clear and unmistakable” evidence Weston was diagnosed prior to boot camp to prove its case.

Jarvi, 67, has 27 years of experience in the Air Force Guard and Reserves, including 20 years as a judge advocate, charged with the defense and prosecution of military law. He is past president of the National Organization of Veterans Advocates, a nonprofit group that promotes legal representation for veterans claims.

If he loses, Weston could take his case to the Veterans Administration, Jarvi said.

“He would probably have to fight with the VA five years,” Jarvi said.

Broken bureaucracy?

Paul Sullivan, executive director of Veterans for Common Sense, a veterans advocacy group, says the military faces ongoing pressure to keep down the cost of medical cases.

“It has a lot to do with the money. The military is essentially broke,” Sullivan said.

“The (military) doctors are doing great work. It’s the bureaucracy behind the medicine that is not working.”

But Sullivan said he also is concerned the military has shunned Weston while it contests his case.

“The military should be stepping up to the plate to see that he gets good care,” he said. “It sounds like this person is being railroaded out.”

Encouraging signs

Weston is in the fourth round of treatment that began the day after he was diagnosed, under the direction of cancer specialist Howell.

“He has had a great response to chemotherapy so far,” Howell said.

She expects treatments to continue for three years.

Based on Weston’s age at the onset of leukemia, Howell placed his long-term survival rate at about 65 percent.

Once a week, he enters the hospital for outpatient treatment in which medication is put into a catheter in his chest, with a line that moves it directly to the top of his heart.

His family is encouraged by his response to treatment.

But as he fights a disease for which stress can be one more handicap, they worry his isolated routine is hardly the medicine he needs. He is housed in a wing of the base dedicated to recruits who flunk their drug tests or develop medical issues during training.

He ‘feels like he’s the enemy’

Weston is expected to awake at 4:45 a.m., dress and remain in his room. He is allowed to leave three times a day for meals. He gets one hour a day to use the phone and shower. Lights out at 9 p.m.

Air Force spokesman Kirk Frady said trainees such as Weston “are expected to maintain professionalism” and live by Air Force “core values.”

“Trainees are allowed bed rest if prescribed by the trainee’s doctor,” Frady said.

Asked about the possible physical toll of his predicament, physician Howell said: “I would much prefer to have somebody in an environment where they have family and support around him.”

The National Cancer Institute points to studies that show stress can increase tumor growth and psychological factors like feelings of helplessness can help spread cancer.

“All I can do is provide the best medical treatment possible,” Howell said. “We do what we can for him here.”

His father worries that is not enough.

“The cancer battle has now become almost secondary to winning this fight. My son feels like he’s the enemy within the boundaries of a U.S. military base.”

Added his mother: “We keep telling him to be strong. This kid needs to be around people who love him.”

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