[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.

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