Veterans for Common Sense

September 24, 2008 – The dominant media storyline about the Iraq war holds that the decisions about how to conduct it pitted ignorant civilians — especially the president and secretary of defense — against the uniformed military, whose wise and sober advice was cavalierly ignored. The Bush administration’s cardinal sin was interference in predominantly military affairs, starting with overruling the military on the size of the force that invaded Iraq in March 2003.

But it’s not just the media that peddles this story. As Bob Woodward illustrates in his new book, “The War Within: A Secret White House History 2006-2008,” it also resonates among many senior uniformed military officers.

The plausibility of the narrative rests on two questionable principles. The first is that soldiers have the right to a voice in making policy regarding the use of the military instrument — that indeed they have the right to insist that their views be adopted. The second is that the judgment of soldiers is inherently superior to that of civilians when it comes to military affairs. Both of these principles are at odds with the American practice of civil-military relations, and with the historical record.

In our republic the uniformed military advises the civilian authorities, but has no right to insist that its views be adopted. Of course, uniformed officers have an obligation to stand up to civilian leaders if they think a policy is flawed. They must convey their concerns to civilian policy-makers forcefully and truthfully. But once a policy decision is made, soldiers are obligated to carry it out to the best of their ability, whether their advice is heeded or not.

Moreover, even when it comes to strictly military affairs, soldiers are not necessarily more prescient than civilian policy makers. This is confirmed by the historical record.

Historians have long recognized that Abraham Lincoln’s judgment concerning the conduct of the Civil War was vastly superior to that of Gen. George McClellan. They have recognized that Gen. George C. Marshall, the greatest soldier-statesman since George Washington, was wrong to oppose arms shipments to Great Britain in 1940, and wrong to argue for a cross-channel invasion during the early years of World War II, before the U.S. was ready.

Historians have pointed out that the U.S. operational approach that contributed to our defeat in Vietnam was the creature of the uniformed military. And they have observed that the original — unimaginative — military plan for Operation Desert Storm in the Gulf War was rejected by the civilian leadership, which ordered a return to the drawing board. The revised plan was far more imaginative, and effective.

So it was with Iraq. The fact is that the approach favored by the uniformed leadership was failing. As the insurgency metastasized in 2005, the military had three viable alternatives: continue offensive operations along the lines of those in Anbar province after Fallujah; adopt a counterinsurgency approach; or emphasize the training of Iraqi troops in order to transition to Iraqi control of military operations. Gen. John Abizaid, commander of the U.S. Central Command, and Gen. George W. Casey, commander of the Multi-National Force in Iraq — supported by Secretary of Defense Donald Rumsfeld and Joint Chiefs Chairman Gen. Richard Myers — chose the third option.

Transitioning to Iraqi control was a logical option for the long run. But it did little to solve the problem of the insurgency, which was generating sectarian violence. Based on the belief by many senior commanders, especially Gen. Abizaid, that U.S. troops were an “antibody” to Iraqi culture, the Americans consolidated their forces on large “forward operating bases,” maintaining a presence only by means of motorized patrols that were particularly vulnerable to attacks by improvised explosive devices. They also conceded large swaths of territory and population alike to the insurgents. Violence spiked.

In late 2006, President Bush, like President Lincoln in 1862, adopted a new approach to the war. He replaced the uniformed and civilian leaders who were adherents of the failed operational approach with others who shared his commitment to victory rather than “playing for a tie.” In Gen. David Petraeus, Mr. Bush found his Ulysses Grant, to execute an operational approach based on sound counterinsurgency doctrine. This new approach has brought the U.S. to the brink of victory.

Although the conventional narrative about the Iraq war is wrong, its persistence has contributed to the most serious crisis in civil-military relations since the Civil War. According to Mr. Woodward’s account, the uniformed military not only opposed the surge, insisting that their advice be followed; it then subsequently worked to undermine the president once he decided on another strategy.

In one respect, the actions taken by military opponents of the surge, e.g. “foot-dragging,” “slow-rolling” and selective leaking are, unfortunately, all-too-characteristic of U.S. civil-military relations during the last decade and a half. But the picture Mr. Woodward draws is far more troubling. Even after the policy had been laid down, the bulk of the senior U.S. military leadership — the chairman of the Joint Chiefs of Staff, Adm. Mike Mullen, the rest of the Joint Chiefs, and Gen. Abizaid’s successor, Adm. William Fallon, actively worked against the implementation of the president’s policy.

If Mr. Woodward’s account is true, it means that not since Gen. McClellan attempted to sabotage Lincoln’s war policy in 1862 has the leadership of the U.S. military so blatantly attempted to undermine a president in the pursuit of his constitutional authority. It should be obvious that such active opposition to a president’s policy poses a threat to the health of the civil-military balance in a republic.

Mr. Owens is a professor at the Naval War College and editor of Orbis, the journal of the Foreign Policy Research Institute.

September 22, 2008 – The United States must be better prepared to provide not only care for physical wounds but also better mental health support for soldiers returning from Iraq and Afghanistan, according to VFP, citing 6,256 military suicides documented in 2005.

Penny Coleman wishes people would stop thinking of Post Traumatic Stress Disorder (PTSD) in combat veterans as a mental disorder. “It’s not a disorder, it’s an injury,” says Coleman flatly. 

Coleman led a workshop on PTSD and suicide prevention at the Veterans For Peace national convention held in Minneapolis the last week of August. About 20 Vietnam veterans, an Iraq war veteran, and two family members who each lost a sibling (one to suicide following her service in Vietnam and one in combat) shared what works and what doesn’t in treating PTSD in soldiers. What’s clear is that from Minnesota to Alabama to Colorado and Maine, VFP members devote time to helping their fellow veterans cope with combat-related trauma. “Working with other vets is the most healing thing you can do,” said one. 

Penny Coleman was introduced to PTSD through Daniel, whom she married shortly after he returned from Vietnam in 1969.  PTSD often appears some years after exposure to trauma and may not manifest until 10 or more years have passed.

Coleman said she didn’t know how to help him as she watched him disintegrate from the injury to his soul during his tour in Vietnam. His injury would not heal, in fact, it morphed and divided into new illnesses including depression, anger and addictions. After several attempts, Daniel killed himself. 

A writer and photographer who lives in New York, Coleman said it took her a couple decades to realize that she, too, was injured by the experience.  “I couldn’t get him to be present with me,” she said, and she blamed herself at the time for not being able to “fix” him. She found healing by immersing herself in researching “combat fatigue,” “shell shock,”  “post-Vietnam disorder,” and other terms used in other wars and by interviewing vets and family members. While documenting the impact of PTSD she became an advocate for veterans and family members suffering the effects of combat-related trauma. In her 2006 book Flashback: Post Traumatic Stress Disorder, Suicide, and the Lessons of War, she describes the history of PTSD and its psychological and physical toll. 

The VA is in denial about PTSD contributing to the high suicide rate of combat veterans, she says, adding that official counts aren’t accurate. Speaking of Vietnam vets, Coleman said, “There are more suicides than names on the [Vietnam Memorial] wall.” 

Veterans For Peace members agree that the United States must be better prepared to provide not only care for physical wounds but also better mental health support for soldiers now serving or just returning from Iraq and Afghanistan. Coleman cited figures released by CBS News documenting over 6,256 military suicides in 2005.

About 15 percent of the 1.5 million people that have served in Iraq and Afghanistan are returning with combat-related psychological wounds, according to a report by Iraq and Afghanistan Veterans of America (IAVA). Multiple tours and inadequate rest between deployments could increase the rates of combat stress by 50 percent, says IAVA. 

Challenges to getting resources to those who need them

The government has already failed many returning soldiers, as evidenced by the highly publicized poor treatment given at Walter Reed Medical Center in Washington, D.C., Fort Drum, New York and elsewhere. 

Ray Parrish, a Chicago-based veteran and counselor with Vietnam Veterans Against the War, said, “We’re more successful treating each other than the professionals are.” Some of the workshop participants disagreed, stating that non-vets can be helpful mental health providers. There was also some disagreement on the level of support available for current vets and returning soldiers, indicating an uneven national policy.

While the VA hospital in Chicago has launched a pilot ‘peer counselor’ program, according to Parrish, a couple of veterans from Maine said their veteran center had closed 10 years ago and that this is a time when the VA should be ramping up community programs to help the veterans of the Gulf Wars and soldiers returning from Iraq and Afghanistan. 

A veteran from Minnesota lamented that few psychologists are available outside of working hours. Privacy is also a concern that prevents some veterans from seeking help. “We don’t want our co-workers to know we’re in therapy,” she said. She also said therapy may be limited by sick leave rules and insurance. 

There’s a stigma associated with PTSD that can cause shame and isolation. One way Parrish’s community in Chicago has sought to combat this is through an annual “Disability Pride” march modeled after the gay pride marches that are now commonplace in some major cities.

But even when soldiers request mental health services, they face numerous roadblocks. The VA has underestimated the numbers of soldiers who would need care and has not allocated all the money Congress earmarked for mental health services. The Army told the VA to stop assisting soldiers with benefit paperwork at Ft. Drum because the numbers of disabled were too high. 

And then there was the January 2007 suicide of Jonathan Schulze of New Prague, Minn. The Marine veteran of the Iraq war said he felt like killing himself and asked to be admitted to the mental health unit at the VA in St. Cloud, but he was put on a waiting list. After his funeral Schulze’s father told reporter Kevin Giles, “He was a delayed casualty of the Iraq War.”

Other health-related sessions at the conference dealt with Agent Orange, depleted uranium, grieving and healing, alternative therapies, military sexual assault, and memoir writing.

September 19, 2008 – Some 400 representatives from the Army, Department of Veterans Affairs, Department of Labor and Social Security Administration, among others, are meeting in Leesburg, Va., this week to discuss ways to improve the care of wounded and ill Soldiers.

Many of the discussions have centered on revamping the Medical Evaluation Board process by which wounded and ill Soldiers are screened to determine whether or not they’re fit to continue to serve, said Brig. Gen. Gary Cheek, the Army’s assistant surgeon general for Warrior Care and Transition.

“Members of the MEB determine whether or not a Soldier is fit or unfit for service,” Cheek said. “Then, the Soldier goes before a Physical Evaluation Board, which gives him a disability rating.” Because of the two processes, “there’s confusion and duplication of effort,” he said, adding “We need to get the military completely out of the disability process and allow the Veterans Administration to be a single source of benefits.”

Why?

Today military medical experts are saving Soldiers’ lives on the battlefield, evacuating them quickly to Landstuhl Regional Medical Center in Germany and Walter Reed Army Medical Center in Washington, D.C., and others, to receive the best care possible. Then, those same medical professionals who saved the Soldier are making evaluations as to whether or not the Soldier should be retired from duty. They go from being angels “to being the enemy,” Cheek said.

In July, the Army chief of staff issued a message to Army leaders indicating there had been “an explosion of Soldiers in warrior transition units” over the 16-month period since the WTUs were created – from some 5,000 to 12,000, said Lt. Col. Michael Mixen, chief of Plans and Policy for the Warrior Care and Transition Office.

“The numbers were way up,” Cheek said. Simultaneously, WTU cadre were rotating out of the WTUs for other assignments. Suddenly, there were too few people caring for too many Soldiers.

The Army’s then-vice chief of staff, Gen. Richard Cody, sent a message to Army leaders advising them to fix problems as quickly as possible, Mixen said.

Attendess at the WCTO conference focused on the VCSA’s imperatives, Cheek said, including “right-sizing” the WTUs to ensure the right Soldiers were being assigned to the units – those who were expected to require at least six months of rehabilitation; that there was an appropriate number of cadre to support them; and that Soldiers received orders assigning them to the WTUs in a timely manner.

Commanders were also briefed on “a comprehensive Army mental-health strategy, which is to be announced at this year’s AUSA [Association of the U.S. Army] conference [in Washington, D.C.], in October,” Mixen said.

Discussion groups addressed whether or not the Army has enough available doctors in specific specialties to care for Soldiers, and they talked about developing a comprehensive plan to help Soldiers transition from medical rehabilitation to civilian life, developing Soldiers’ life skills and occupational skills to provide them the best chances for future success.

Great strides have been made since the WCTO was established some 19 months ago, Cheek said.

“We tend to focus on the negative, but in a little more than a year and a half we’ve gone from no focus on warrior care to an organization of 35 separate, fully staffed groups.

Recent changes include the addition of retention NCOs as part of WTUs, to encourage Soldiers who want to remain on active duty to stay in service or enter the reserve component.

Personnel NCOs from brigades, battalions and companies who support the WTUs have been trained on the different types of computer software used to track and record the care of warriors in transition, Mixen said

Additionally, retired Gen. Frederick Franks Jr. — former commander of Training and Doctrine Command and also of VII Corps during the first Gulf War — has been hired to conduct an external review of the MEB process, Mixen added.

Meantime, Army leaders are looking at ways to get current legislation governing the MEB process changed, to transition it from the Army to the VA.

Lt. Col. Marie Dominguez, special assistant to the secretary of veteran’s affairs at the VA’s central office in Washington, D.C., is among the many people working to improve the MEB process. One of the recommendations is to have a physician complete a profile of the Soldier to determine whether or not he’s ready to begin the MEB process.

Under the current system, a subspecialist [in a particular medical field] now writes a profile for one condition, when the Soldier may well be suffering from several conditions, Dominguez said. The MEB process is slow today because the starting time isn’t appropriate. “Sometimes it bleeds into the Soldier’s rehabilitation/treatment phase; it’s started too soon.”

“The ideas we discuss this week will go into a report for consideration for implementation by Army leaders and could be forwarded to Congress in order to change the big impediments – the ‘rocks’ – to the MEB process,” Cheek concluded.

Until then, medical facilities across the Army are working to streamline their own MEB processes.

At Fort Bragg, N.C., Womack Army Medical Center personnel are reducing the number of medical-evaluation boards to support wounded and ill Soldiers, according to Lt. Col. Niel Johnson, chief of the Department of Deployment Health.