[Congressional Record Volume 153, Number 42 (Monday, March 12, 2007)]
[Senate]
[Pages S2996-S2999]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
SUPPORTING OUR VETERANS
Mr. DURBIN. Mr. President, this morning I held a hearing in Chicago
at the University of Illinois, Chicago medical campus. It was a hearing
to discuss the challenges we face with returning veterans from Iraq and
Afghanistan. It was clear from the turnout at that hearing there is an
intense interest in this subject. Much of it was brought on by the
Washington Post front-page story of a few weeks ago about the now
infamous Building 18 at Walter Reed Hospital.
Like many Members of Congress, I have visited Walter Reed many times
to see Illinois soldiers and to check in to see how things were going.
None of us were ever taken across the street to Building 18. I didn't
know it existed. But the graphic images of the building, which was
worse than a flophouse motel with mold on the walls and rat droppings
and evidence of roaches and bugs, where we were housing men and women
who had just returned from battle with their injuries, has really
struck a nerve across America and here on Capitol Hill. It has caused
us to ask important and difficult questions about whether we are
meeting our obligations to our soldiers and to our veterans, also to
ask whether Walter Reed's Building 18 was an isolated example of
neglect or symptomatic of a much larger problem and a much greater
challenge.
Today in Chicago we talked about the returning vets and soldiers from
our perspective in the middle of the country. With the Hines VA
Hospital being one of the larger VA hospitals, and with a lot of
veterans heading back to that part of the country, we have a real
interest in this issue.
It goes without saying we all support our troops. In fact, it is said
so often on the Senate floor it becomes an almost empty cliche. Those
soldiers, the families, the voters, people of this country have a right
to ask each of us: Great. If you support them, what are you doing for
them?
We can talk--and I might at the end of these remarks--about our
policy in Iraq, but for a moment I want to focus on those who serve our
country overseas and come home injured and need a helping hand.
Many of the soldiers who were featured in the Washington Post expose
on Walter Reed had been living in deplorable conditions for months,
sometimes years. They have lived in that condition waiting to receive a
disability rating to begin rebuilding their lives. So after they fight
the enemy, they come home to fight the bureaucracy. Papers are thrown
at them. Some of them are in compromised positions because of their
physical or mental weakness and they have to become advocates in a
system that is not always friendly.
The Washington Post brought to light poor conditions at Walter Reed,
but we have to ask the larger question: What about the rest of the
hospitals? What about the rest of the soldiers and the veterans?
I joined several of my Democratic colleagues last week in
cosponsoring the Dignity for Wounded Soldiers Act of 2007. Our new
colleague, Senator Claire McCaskill from Missouri, who has become a
leader on this issue, joined with Senator Obama of my State in
introducing a bill that calls for more homes for service members who
are still recovering, less paperwork for recovering service members,
better case management to cut through the redtape, better training for
caseworkers, better support services, including meal benefits, for
recovering service members and their families, and job protections for
husbands and wives, moms and dads of wounded service members who have
come to stay with and help take care of their loved ones while they are
recovering.
Mr. President, you served in Vietnam. At the time of your service,
the men and women in uniform were much younger and usually single. Now
the soldiers, guardsmen, and reservists who serve in Iraq and
Afghanistan are older and usually have a family. So when they come
home, their misfortune, their illness, and their injury turn out to be
a family concern.
This bill says we should be sensitive to the family needs of these
returning service members. Many of the returning troops who are injured
need medical attention long after they are discharged. In fact, more of
our service members sustain serious brain injuries in Iraq and
Afghanistan than in any recent conflict we have known. I have seen
several figures about how many Americans serving in the Middle East
have suffered head and brain injuries that require a lifetime of
continual care. The estimates run from 2,000 to 3,000. When you think
of over a million service men and women who have served in that
theater, it appears to be a small number but it is a dramatically
larger number than we have seen in any previous conflict.
In Vietnam, in previous wars, brain injuries accounted for 1 out of 8
or 12 percent of the injuries. In Iraq and Afghanistan, brain injuries
account for 22 percent of the injuries--almost 1 out of 4. Of course,
we understand why, with the roadside bombs, the blasts, and the
concussions to which these service men and women are subjected. It
takes its toll. As many as 2 out of every 10 combat veterans from Iraq
and Afghanistan are returning with concussions in varying degrees of
intensity, and 1.6 million vets have served already in the war. That
means 320,000 people require some sort of screening and treatment for
traumatic brain injury or head-related injury. That number grows with
every new soldier, sailor, marine, and airman deployed.
I am working on legislation now, and I will invite my colleagues to
join me, to focus on brain injury because I think that is the
significant wound of this war that we cannot ignore. The bill which I
am preparing will, among other things, speed up medical research so we
can do a better job of diagnosis and treatment. I might add
parenthetically that treatment will inure to the benefit of many other
people across America dealing with brain injuries or brain-related
problems.
We also in this bill encourage the VA to do more outreach to find
veterans whose brain injuries may have caused problems in their lives
and help bring them back into a system of care and support. The bill
requires the Department of Defense and the VA to work more closely
together to capture and track returning troops with combat-induced
brain trauma and to put money into better equipment for VA medical
centers to improve their testing and treatment.
During Vietnam, one in three Vietnam service members who were injured
died. In Iraq and Afghanistan, it is one in seven. Battlefield medical
care is
[[Page S2997]]
significantly better. The trauma teams in the field who treat our men
and women who are injured are performing miracles every day. But those
injured veterans, once surviving, come home to more challenging medical
care needs.
Let's speak for a moment about post-traumatic stress disorder. With
Vietnam veterans, it is estimated it was as high as 30 percent. That
estimate is given on Iraq and Afghanistan veterans as well. But during
the Vietnam war, it was not discussed.
Today, I had a young man who was a Vietnam veteran stand up. His name
is Ramon Calderon. Ramon has been fighting post-traumatic stress
disorder almost single-handedly since Vietnam. There are so many other
cases of men and women who served there who came home haunted by the
experience. It wasn't considered appropriate to raise that issue when
they returned, so they suffered in silence and many times paid a price:
a failed marriage, self-medication with drugs and alcohol, despondency,
homelessness, and problems that follow when these psychological scars
are not healed. Today we know that many of our returning service men
and women from Iraq and Afghanistan bring home those demons of war in
their heads, and they are trying to purge themselves of that haunting
illness.
A new study that will be released later today by the Archives of
Internal Medicine says we are looking at the high end of the estimate
of 30 percent. About one-third of those who have served in Iraq and
Afghanistan come home in need of post-traumatic stress disorder
counseling, and the sooner the better. The longer this situation
festers, the worse it becomes. Early intervention, early help can save
a life, save a marriage, and turn a life around. The study reports that
one-third of veterans coming back from war who seek care in the VA have
mental health or social issues.
Several months ago I went to the Hines VA Hospital and I was invited
to attend a counseling session. The soldiers who were back from war
said it was OK if I sat in on it. It was late on a Friday afternoon.
These were vets, mainly young men, who had just returned from war. They
came filing into the room, about a half dozen of them, and I could tell
by the look on their face that we had the whole spectrum of emotions.
There were some who were nearly in tears the minute they crossed the
threshold into the room, and there were others with clenched fists and
angry looks on their faces who were suffering from the same problem.
They needed to sit down and talk to somebody to try to get through
another day, another week before they had another counseling session.
That is the reality. The statistics tell us a vivid story. More
injured servicemembers are surviving. More injured soldiers, marines,
sailors, and airmen are coming home, and a larger percentage of them
need help from brain injuries, both traumatic injuries as well as
psychological injuries. The VA needs to be prepared to treat this large
influx of people.
Our medical and benefit systems are not keeping pace with reality.
Remember the promise we made to these men and women? If you will
volunteer to serve America, if you will risk your life, we will stand
by you. We will protect you in battle, and we will stand by you when
you come home. That was the basic promise. But we know, sadly, we are
not keeping that promise at the VA hospitals and even the military
hospitals across our country. Injured troops come home to find in too
many cases substandard outpatient care and a big fight on their hands
to justify the need for ongoing care.
A recent New York Times article featured 2005 data from the Veterans
Affairs that showed a big difference between the average compensation
paid in my home State. It is not news. It has been there for a couple
years now. For 20 years, for reasons no one can explain, a soldier who
was disabled in Illinois received the lowest compensation for an injury
in comparison to another soldier with the same injury in another State.
I was pretty angry about it. Senator Obama, who is on the Veterans'
Affairs Committee, joined me in demanding an inspection to find out why
this was going on, an investigation to get to the bottom of it, and
action. We got a report back from Veterans Affairs, and it wasn't very
satisfying.
It turns out that if a veteran tried to walk through this system
alone without someone by his side, someone from his family or someone
from a veterans organization, they were likely to recover 50 percent
less for their disability than one who took an advocate with him. It
tells you what the bureaucracy does. The bureaucracy shortchanges the
injured veterans. It takes an advocate to stand by their side, and I
will tell you the story of one in just a moment.
Last year we required the Veterans' Administration to send letters to
60,000 veterans in Illinois explaining how they might have been
shortchanged in their disability claims for a variety of reasons. I
want to make sure the VA is tracking those letters and responses and
that they are doing it in a timely fashion. The VA, the Veterans
Affairs Department, is inundated at this point: 1.6 million new
veterans they may not have anticipated just a few years ago. Higher
rates of PTSD and brain injury complicate their task. The VA
Compensation and Pension Claims Division reports a backlog--a backlog--
of 625,000 cases. The average wait to process an original claim at the
VA is about half a year--177 days. Six months to process a VA claim,
and if you are unhappy with the result and decide you want to appeal
it, it will take 2 years--657 days--before you will get an answer on
the appeal.
One of the things I think we should acknowledge is that there are
many wonderful things happening at VA hospitals. The criticisms that we
hear for their shortcomings, notwithstanding there are many dedicated
men and women serving in the Veterans' Administration. I can't tell you
how many returning soldiers have said good things about military
hospitals and the VA. But the fact is, we need to do much more, and we
need to do better.
If we could have gathered together the leaders of the Veterans'
Administration 10 years ago and asked them to predict where they would
be in the year 2007 in terms of their caseload and the requirements
they would face, I don't think any one of them could have predicted
what they face today. By and large, they were dealing with an aging
population of World War II vets and Korean vets, Vietnam vets and
others who had chronic conditions that needed attention.
They were conditions related to their injuries. But they were also
conditions such as diabetes and blood pressure. They were prepared to
deal with the aging veteran population. Then comes the invasion of
Iraq, and everything changes. Thousands of men and women are now in the
VA system with new challenges. Instead of chronic conditions such as
diabetes and blood pressure, the VA now faces the need for acute
rehabilitation. This is a specialty in which there are very few centers
in America on the civilian side that really get high marks.
The VA is being asked to create this kind of specialty in a hurry. It
is not working out very well. I will speak to that in a moment.
I had excellent people speaking today at the hearing.
We had Scott Burton, a former marine who was part of the initial Iraq
invasion. He was discharged in 2004, and he suffers from PTSD. He is
very open about it and is looking for help. He will do just fine, but
he has become an advocate for other soldiers who need to step forward
and acknowledge their need.
We had Katy Scott. Katy's son Jason lost his right eye and right arm
in an IED attack in Iraq. She lost her job because she gave it up
basically to stand by her son's bed at Walter Reed and fight for him
every day. She is a passionate advocate not only for her son but for
all the returning servicemen.
Then we had Edgar Edmundson. He was featured today on the front page
of the New York Times. It is a feature he and his family really were
not looking for. It is entitled ``For War's Gravely Injured, a
Challenge to Find Care.''
The article tells the story of a number of veterans, including SSG
Jaron Behee, who suffered a traumatic brain injury and went to the
Veterans Affairs hospital in Palo Alto, where they said it was time for
him to pick out his wheelchair, which he would be in for the rest of
his life. They told him he wasn't making progress and that the next
step for him was a nursing home. His wife said, ``I just felt that it
was
[[Page S2998]]
unfair for them to throw in the towel on him. I said, `We're out of
here.' ''
Because Ms. Behee had successfully resisted the Army's
efforts to retire her husband into the VA health care system,
his military insurance policy, it turned out, covered private
care. So she moved him to a community rehabilitation center,
Casa Colina, near her parents' home in Southern California,
in late 2005.
Three months later, Sergeant Behee was walking, unassisted,
and abandoned his government-provided wheelchair.
Three months before, he had been told by the VA there was no hope--
pick out your wheelchair, we are sending you to a nursing home.
Now 28, he works as a volunteer in the center's outpatient
gym, wiping down equipment and handing out towels. It is not
the police job he aspired to; his cognitive impairments are
serious. But it is not a nursing home either.
There are other stories. Some were referred to today in the hearing
we had in Chicago. The one I mentioned earlier is one that I think
bears repeating. This involves Edgar Edmundson, 52 years old, from New
Bern, NC. His son, SGT Eric Edmundson, sustained serious blast injuries
in northern Iraq in the fall of 2005.
Mr. Edmundson [the father] was aggressive, abandoning his
job and home to care for his son, calling on his
representatives in Washington for help, ``saying no a lot.''
But even he did not come to understand his son's health care
options quickly enough to ensure that his son was not
``shortchanged'' in the critical first year after his injury.
Mr. President, this is an element we cannot overlook. We cannot play
catchup in this game. Many soldiers with traumatic brain injuries will
deteriorate, and it will be sometimes impossible to recover the ground
they lost if they don't get the right care at the right moment.
Two days before Sergeant Edmundson was wounded near the
Syrian border, he visited with his father on the telephone.
Mr Edmundson urged his son, then 25 with a young wife and a
baby daughter, to ``stay safe.''
In an interview last week, Mr. Edmundson's voice cracked as
he recalled his son's response: ``He said, `Don't worry,
because if anything happens, the Army will take care of me.'
''
While awaiting transport to Germany after initial surgery,
Sergeant Edmundson suffered a heart attack. As doctors worked
to revive him, he lost oxygen to his brain for half an hour,
with devastating consequences.
A couple weeks later, at Walter Reed in Washington, on the
very day Sergeant Edmundson was stabilized medically and
transferred into the brain injury unit, military officials
initiated the process of retiring him [from the active
military].
``That threw up the red flag for me,'' Mr. Edmundson said.
``If the Army was supposed to take care of him, why were they
trying to discharge him from service the minute he gets out
of intensive care?''
Still, he didn't understand that his son's insurance policy covered
private care. He wasn't aware of it.
When Walter Reed transferred Sergeant Edmundson to the
polytrauma center in Richmond, Mr. Edmundson believed that he
was, more or less, following orders.
Mr. Edmundson was disappointed by what he considered an
unfocused, inconsistent rehabilitation regimen at what he saw
as an understaffed, overburdened VA hospital filled with
geriatric patients. His son's morale plummeted and he refused
to participate in therapy. ``Eric gave up his will,'' he
said. In March 2006, the VA hospital sought to transfer
Sergeant Edmundson to a nursing home.
Mr. Edmundson chose instead to care for his son himself,
quitting his job [altogether and he spent full-time with his
son.] For almost eight months, Sergeant Edmundson, who was
awake but unable to walk, talk, or control his body, received
nothing but a few hours of maintenance therapy weekly at a
local hospital.
One day, by chance, Mr. Edmundson encountered a military
case manager who asked him why his son was not at a civilian
rehabilitation hospital. That is when Mr. Edmundson learned
that his son had options. He did some research and set his
sights on the Rehabilitation Institute of Chicago.
He decided that the best place to go--and I agree--was the Rehab
Institute of Chicago, which I think is one of the best in the world.
Sergeant Edmundson is now the only Iraq combat veteran
being treated there.
The first step in his treatment in Chicago, Dr. Smith said,
was to use drugs, technology and devices ``to reverse the ill
effects of not getting adequate care earlier, somewhere
between Walter Reed and here.''
For example, she said, Sergeant Edmundson's hips, knees and
ankles are frozen ``in the position of someone sitting in a
hallway in a chair.'' They are working to straighten out his
joints so that he can eventually stand, she said. They have
taught him to express his basic needs using a communication
board, and they hope to loosen his vocal cords so he can
start speaking.
At least he can communicate. Doctor Smith said, ``He has profound
cognitive disability, but he can communicate, albeit not verbally, and
he can express emotions, including humor and even sarcasm.''
When Sergeant Edmundson's father testified today, along with Eric's
sister, he could not get the words out. This man had given almost 3
years of his life for his son. He knows his son has a major uphill
struggle to make progress. He tried to be as kind as he could to
everybody who helped, but he was also very honest. He expressed the
feelings of a heartbroken father who believes that along the way,
somebody should have told him his son was entitled to even better
specialized care.
Last week, the head of the Rehab Institute of Chicago came to
Washington. I met with her--Dr. JoAnn Smith. She was with Dr. Henry
Betts, who is legendary in our town for his leadership in this
institute. She came with a simple message from the Veterans'
Administration, to tell them that: This is our specialty, this is what
we do--take those who are acutely injured and need rehab and work with
them effectively. She asked if the Veterans' Administration would
please send some patients to the Rehab Institute of Chicago--patients
who could be helped like those I have described in my remarks today.
She said she was heartened.
Dr. Smith was trained in the VA system. She has no prejudice against
them. There was a high degree of acceptance that there is a gap in the
military system's current ability to take care of particularly the
profoundly injured, she said. However, there is still resistance. The
VA doesn't believe there is a problem or any need for rescue by the
private sector.
Should we be debating this at all? If you had a seriously injured
person in your household, would you not look for the best doctor you
could find? Would you not want to send that severely injured person you
love to the best place for them? Don't we so many times express on the
floor of the Senate how much we care for and love these soldiers who
serve our country? Why are they not getting the same thing?
I think that is a challenge we all have to face. We know the VA does
many things and does them well. They can do a lot better when it comes
to traumatic brain injury--the serious injuries the soldiers are
bringing home and the post-traumatic stress disorder. We need to
appropriate the funds. No excuses. We need to make sure the billions of
dollars are there to take care of these soldiers.
Just 2 weeks from now--maybe sooner--the administration will ask us
for a huge sum of money, in the range of $100 billion, a supplemental
appropriation to be spent for soldiers in Iraq. It is likely that at
the end of the day, they will receive every penny they have asked for,
which has been the case for the 4 years of this war. This Senator, as
do many others, believes we have to also consider the funding for our
injured veterans as well. We cannot stand by and allow these vets to
stay in the ``Building 18s'' or those wards where they cannot receive
the specialized care and to deteriorate to a point where their lives
are compromised forever.
We only have a limited opportunity for many of these brave men and
women. We cannot use our own excuses here about budgets and priorities
to slow down our obligation and meet our obligation to serve veterans
and serve them well.
So this hearing today was an eye-opener for me and for Congresswoman
Jan Schakowsky, who joined me, to be in that room with the parents and
the veterans, to hear the stories of the bureaucracy they fought, and
to understand we can do something about it here in Washington.
I know of the personal interest of the occupant of the chair in this
issue. After the Presiding Officer was first elected, after being sworn
in, he came to my office and said he wanted to work on a new GI bill. I
am anxious to work with him in that regard. Having served our country
as he did, he understands better than I do, and better than most, the
obligation we have to the men and women who have served.
Mr. President, I hope we will take this experience of the Washington
Post
[[Page S2999]]
expose and our own personal experiences back home to heart when we
consider the measures that are coming before us. I don't want another
scandal on this watch. I want to make sure this Building 18 doesn't
become another Hurricane Katrina, the ninth ward of New Orleans, LA. It
was an indication of lack of skill, lack of management, and lack of
commitment that led to this situation. Now it is time for Congress and
the President to step up for these men and women who serve us so well.
I yield the floor and suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The assistant legislative clerk proceeded to call the roll.
Mr. REID. Mr. President, I ask unanimous consent that the order for
the quorum call be rescinded.
The PRESIDING OFFICER (Mr. Casey). Without objection, it is so
ordered.
____________________