Thursday, February 12, 2009

Clean up on aisle 5

Thursday afternoon is my time to clean up after Uncle Sam. That's when I see veterans. Most of the time this is Geezer patrol, my favorite demographic. The WWII guys are generally a lot of fun, they've had time to deal with the horror of their experiences and we're dealing with their cholesterol, diabetes, and arthritis just like the rest of my geezers. The vietnam era guys are usually in some sort of substance abuse recovery, are starting to deal with some of the geezer issues of old age and generally have some sort of chronic pain.

Then there are the folks coming back from Iraq/Afghanistan. These people can't sleep at night between the physical pain and the nightmares. Some of them can't hold a job because the PTSD symptoms of anxiety, irritability, and hypervigilance get in the way. Looking into their eyes is looking into anguish.

When one signs on with the military, one is "guaranteed" health care for the duration of their service. If a service person is injured while in the military, they are guaranteed healthcare for the rest of their lives. The staff of VA hospitals and clinics are quite good and quite committed to their patients, as committed as those found in civilian clinics and hospitals. The problem is the beaurocracy and the lack of forethought on the part of the government when the current wars were budgeted.

Here is an example from today. A 30 year old man came to my clinic for back pain related to a service injury. He also suffers from depression, insomnia, and anxiety. He has scars on his face and neck from burns. He is able to go to physical therapy once a month at the VA hospital in Albuquerque, two hours away. He would like to go to counseling for PTSD. This referral will take approximately 3 months to complete. I requested that he be able to go to a local provider for weekly PT in Las Vegas. It is highly unlikely this will be approved.

The next man was a 45 year old man. He'd had rods inserted into his spine, one of which had slipped and was moving up his back. He told me that since the psychiatrist had given him the right meds, he didn't have to retreat to the woods behind his house to work out his nightmares. He could now manage a long grocery line and a traffic snarl. The surgical referrals I wrote today were for the "Invasive Spinal" clinic, orthopedics for a carpal tunnel release as well as a dermatology referral for laser therapy.

These guys were perfectly healthy, sane, and productive young men before their national guard units were called up. They are the victims, along with the civilians in Iraq and Afghanistan, of the hubris of W, Dickie, and Rummy. Its a picture of waste and half-baked schemes. If you weren't already against the war, an afternoon in my clinic will change your mind. And I don't see the worst of it. We'll be paying for this one for a very long time.

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