"I am under a lot of pressure to not diagnose PTSD"

A secret recording reveals the Army may be pushing its medical staff not to diagnose post-traumatic stress disorder. The Army and Senate have ignored the implications.

Editor's note: Last June, during a medical appointment, a patient named "Sgt. X" recorded an Army psychologist at Fort Carson, Colo., saying that he was under pressure not to diagnose combat veterans with post-traumatic stress disorder. Listen to a segment of the tape here.

By Michael de Yoanna and Mark Benjamin

Read more: Military, Veterans, Murder, Medicine, Suicide, News, post-traumatic stress disorder, Mental Illness, Army, Iraq War, Mark Benjamin, Michael de Yoanna, Coming home

April 8, 2009 | FORT CARSON, Colo. -- "Sgt. X" is built like the Bradley Fighting Vehicle he rode in while in Iraq. He's as bulky, brawny and seemingly impervious as a tank.

In an interview in the high-rise offices of his Denver attorneys, however, symptoms of the damaged brain inside that tough exterior begin to appear. Sgt. X's eyes go suddenly blank, shifting to refocus oddly on a wall. He pauses mid-sentence, struggling for simple words. His hands occasionally tremble and spasm.

For more than a year he's been seeking treatment at Fort Carson for a brain injury and post-traumatic stress disorder, the signature injuries of the Iraq war. Sgt. X is also suffering through the Army's confusing disability payment system, handled by something called a medical evaluation board. The process of negotiating the system has been made harder by his war-damaged memory. Sgt. X's wife has to go with him to doctor's appointments so he'll remember what the doctor tells him.

But what Sgt. X wants to tell a reporter about is one doctor's appointment at Fort Carson that his wife did not witness. When she couldn't accompany him to an appointment with psychologist Douglas McNinch last June, Sgt. X tucked a recording device into his pocket and set it on voice-activation so it would capture what the doctor said. Sgt. X had no idea that the little machine in his pocket was about to capture recorded evidence of something wounded soldiers and their advocates have long suspected -- that the military does not want Iraq veterans to be diagnosed with PTSD, a condition that obligates the military to provide expensive, intensive long-term care, including the possibility of lifetime disability payments. And, as Salon will explore in a second article Thursday, after the Army became aware of the tape, the Senate Armed Services Committee declined to investigate its implications, despite prodding from a senator who is not on the committee. The Army then conducted its own internal investigation -- and cleared itself of any wrongdoing.

When Sgt. X went to see McNinch with a tape recorder, he was concerned that something was amiss with his diagnosis. He wanted to find out why the psychologist had told the medical evaluation board that handles disability payments that Sgt. X did not, in fact, have PTSD, but instead an "anxiety disorder," which could substantially lower the amount of benefits he would receive if the Army discharged him for a disability. The recorder in Sgt. X's pocket captured McNinch in a moment of candor. (Listen to a segment of the recording here.)

"OK," McNinch told Sgt. X. "I will tell you something confidentially that I would have to deny if it were ever public. Not only myself, but all the clinicians up here are being pressured to not diagnose PTSD and diagnose anxiety disorder NOS [instead]." McNinch told him that Army medical boards were "kick[ing] back" his diagnoses of PTSD, saying soldiers had not seen enough trauma to have "serious PTSD issues."

"Unfortunately," McNinch told Sgt. X, "yours has not been the only case ... I and other [doctors] are under a lot of pressure to not diagnose PTSD. It's not fair. I think it's a horrible way to treat soldiers, but unfortunately, you know, now the V.A. is jumping on board, saying, 'Well, these people don't have PTSD,' and stuff like that."

Contacted recently by Salon, McNinch seemed surprised that reporters had obtained the tape, but answered questions about the statements captured by the recording. McNinch told Salon that the pressure to misdiagnose came from the former head of Fort Carson's Department of Behavioral Health. That colonel, an Army psychiatrist, is now at Fort Lewis in Washington state. "This was pressure that the commander of my Department of Behavioral Health put on me at that time," he said. Since McNinch is a civilian employed by the Army, the colonel could not order him to give a specific, lesser diagnosis to soldiers. Instead, McNinch said, the colonel would "refuse to concur with me, or argue with me, or berate me" when McNinch diagnosed soldiers with PTSD. "It is just very difficult being a civilian in a military setting."

McNinch added that he also received pressure not to properly diagnose traumatic brain injury, Sgt. X's other medical problem. "When I got there I was told I was overdiagnosing brain injuries and now everybody is finding out that, yes, there are brain injuries," he recalled. McNinch said he argued, "'What are we going to do about treatment?' And they said, 'Oh, we are just counting people. We don't plan on treating them.'" McNinch replied, "'You are bringing a generation of brain-damaged individuals back here. You have got to get a game plan together for this public health crisis.' "When McNinch learned he would be quoted in a Salon article, he cut off further questions. He also said he would deny the interview took place. Salon, however, had recorded the conversation.

On the tape and in his interview with Salon, McNinch seemed to admit what countless soldiers not just at Fort Carson but across the Army have long suspected: At least in some cases, the Army tries to avoid diagnoses of PTSD. But McNinch did not directly address why the Army discourages these diagnoses, in either the interview with Salon or the tape-recorded encounter with Sgt. X.

The answer probably has to do with money. David Rudd, the chairman of Texas Tech's department of psychology and a former Army psychologist, explained that every dollar the Army spends on a soldier's benefits is a dollar lost for bullets, bombs or the soldier's incoming replacement. "Each diagnosis is an acknowledgment that psychiatric casualties are a huge price tag of this war," said Rudd. "It is easiest to dismiss these casualties because you can't see the wounds. If they change the diagnosis they can dismiss you at a substantially decreased rate."

A recently retired Army psychiatrist who still works for the government, speaking on the condition of anonymity for fear of retribution, said commanders at another Army hospital instructed him to misdiagnose soldiers suffering from war-related PTSD, recommending instead that he diagnose them with other disorders that would reduce their benefits. The psychiatrist said he would be willing to say more publicly about the cases and provide specific names, but only if President Obama would protect him from retaliation.

Salon has dubbed the soldier in this article Sgt. X because he asked not to be identified for fear that it might affect the medical evaluation process meant to gauge his level of disability. He was highly reluctant to speak, but agreed to do so after learning Salon obtained the recording and other information about it from a medical worker at Fort Carson and a congressional aide.

The sergeant spoke with Salon in the presence of his Hogan & Hartson attorneys who are helping him to secure a proper disability discharge from the Army for PTSD and a brain injury, diagnoses now affirmed by independent doctors. Sgt. X never planned to go to the media -- he says, if asked, he will not talk further about the recording with news organizations.

Sgt. X probably received his traumatic brain injury when his Bradley Fighting Vehicle buckled in an explosion during his second deployment to Iraq in 2005-06. It was the worst of a handful of nearby blasts he'd survived, and it knocked him unconscious for 30 seconds.

When Sgt. X regained consciousness, he saw that the toes of another soldier had been sheared off. The tank hull had buckled and the inside had filled with smoke. Some of his fellow soldiers were soaked in blood..

Even after that, as a point of pride, the crew insisted on accompanying their disabled tank back to their headquarters. Besides causing his brain injury, the blast had exacerbated an injury to Sgt. X's hip, but he faced the problem with little complaint. He numbed the pain with Motrin. "You don't report problems," he said. "It's a stigma."

There is some evidence that Sgt. X's experience with McNinch represents part of a broader scandal, as suggested by the former Army psychiatrist who told Salon about identical problems at another post. Last year, VoteVets.org and Citizens for Responsibility and Ethics in Washington (CREW) released an e-mail from Norma Perez, a psychologist in Texas, to staff at a Department of Veterans Affairs facility there. In addition to the Army, that department also provides veterans with benefits. "Given that we are having more and more compensation seeking veterans, I'd like to suggest that you refrain from giving a diagnosis of PTSD straight out," Perez wrote in the e-mail dated March 20, 2008. She suggested the staff "consider a diagnosis of Adjustment Disorder." As opposed to those with PTSD, veterans with adjustment disorder, a temporary condition, typically do not receive disability payments from the government.

Then-Illinois Sen. Barack Obama fired a letter off to the V.A. about that previous controversy, calling the e-mail "outrageous," demanding an investigation. The Senate Veterans' Affairs Committee last June held a hearing on that e-mail. Perez claimed she sent that e-mail "to stress the importance of an accurate diagnosis." End of story.

VoteVets.org and CREW, the two groups who unearthed the V.A. e-mail, reacted viscerally to this new tape obtained by Salon. "This is further evidence our troops are not receiving the mental health treatment they need and deserve," said Melanie Sloan, CREW executive director. "The president and congressional leaders must hold those responsible accountable and make sure the message is sent far and wide that our returning troops are to be diagnosed as their symptoms, not the military's finances, dictate."

"We've heard all kinds of stories from vets who had trouble getting PTSD diagnoses," said VoteVets.org Chairman John Soltz. "It's crucial that we have department-wide investigations at the Departments of Defense and Veterans Affairs to determine if this came from someone high up, and how many troops and veterans were jilted out of a proper diagnosis from the government."

Many publications, including Salon, and even some government agencies have documented other instances of reluctance to recognize mental wounds caused by war at bases across the country.

• A recent weeklong series in Salon showed how apparent resistance to identifying combat stress ends up grinding down the lowest-ranking troops, sometimes with deadly results. Those articles included, for example, the story of Pvt. Adam Lieberman, who suffered with severe symptoms of PTSD. For two years, the Army blamed his problems on a personality disorder, anxiety disorder or alcohol abuse but resisted diagnosing him with PTSD until after his suicide attempt last October.
• The Government Accountability Office, Congress' investigative arm, last October questioned why 2,800 war veterans were labeled with personality disorder diagnoses, another cheap label the Army has been accused of plastering on soldiers instead of PTSD.
• In November 2005 the Department of Veterans Affairs halted a review of 72,000 veterans who receive monthly disability payments for mental trauma from war. The department wanted to make sure the veterans were not faking their symptoms. Salon first exposed the review that August. Then Daniel L. Cooper, the V.A.'s undersecretary for benefits, told Salon at the time that, "We have a responsibility to preserve the integrity of the rating system and to ensure that hard-earned taxpayer dollars are going to those who deserve and have earned them." The department stopped the process a month after a Vietnam veteran in New Mexico, agitated over the review, shot himself to death in protest. .
• In early 2005, Salon exposed a pattern of medical officials searching to pin soldiers' problems on childhood trauma instead of combat stress at Walter Reed Army Medical Center.

Salon will explore Thursday how the Army was made aware of Sgt. X's tape, how the Senate Armed Services Committee declined to conduct an investigation, and how the Army absolved itself of any blame for wrongdoing. A unit of the Army's Medical Command (which oversees Fort Carson's Department of Behavioral Health) conducted an "informal" investigation last summer that found potential "systemic" problems that could influence diagnoses, but determined that no one in the Army's Medical Command was to blame. In a report dated July 28, it specifically found that no Fort Carson or Medical Command staff "attempted to coerce or otherwise influence" diagnoses. This directly contradicts McNinch's statements on the tape and in his interview with Salon.

If you are aware of a soldier who has served or is serving in the Iraq or Afghanistan conflicts and is having trouble getting a PTSD diagnosis or proper benefits, please contact Mark Benjamin at mbenjamin (at) salon (dot) com.

VA patient tests HIV-positive after clinic mistake

CHATTANOOGA, Tenn. (AP) - The Veterans Affairs Department is investigating whether there's a link between a patient's positive HIV test and unsterilized equipment that may have exposed thousands of veterans to infectious diseases.

The positive test was the first reported since the department warned veterans treated at three clinics that they might be at risk.

The VA previously reported that hepatitis was found in 16 patients, but the agency cautioned there was no way to prove that the patients contracted the illnesses because of treatment at their facilities. ....

Analyst warns eligibility could become flashpoint

(Compiler's note: This is a must read article. This is NOT GOING AWAY!!)

By Bob Unruh

'It is morphing now to include members of the armed forces'

A security analyst who provides intelligence information to a wide range of law enforcement, private corporation and security interests has written in a publicly released "white paper" that the issue of Barack Obama's eligibility to be president could become a "flashpoint" in the United States.

The suggestion comes from Lyle Rapacki, a former police officer who has worked in the field of psychological disorders for years. Since the 1990s, he has provided his analysis in public "white paper" reports and classified documents to various safety and security interests.

Rapacki's report cited the continuing controversy over Obama's birth certificate and a long list of lawsuits that have alleged he is not eligible to be president under the Constitution's requirement that the office be occupied only by a "natural born" citizen.

If the president would be found to be ineligible, Rapacki suggested, there would be a "constitutional crisis" over which of his orders, laws and actions "should be valid."

"If, however, this case continues and Mr. Obama fights revealing his documentation, there are growing concerns of civil unrest, or worse, being unleashed in the streets of our nation," the report said. "The economic crisis could with this type of constitutional crisis could prove to be a 'flashpoint' that would test conventional law enforcement and elements of homeland security."

Rapacki, now vice president of protective services for Southwest Risk Advisors Inc., also has provided reports to InfraGard, an FBI program that collects information about security, terror, intelligence and other issues.

.... Rapacki said one of his areas of work was to look at various issues that could provide the potential for civil disobedience or civil unrest, and he spotted references to concerns over Obama's eligibility and started looking into it.

His concern rose when he reviewed the implications of an ineligible president, he said.

"This could create a constitutional crisis. What does it do to the decisions that already have been made, already done for the economic issues that can't be taken back?" he wondered.

The investigator, who does not take a political stance on the issues, suggested the public dissemination of his concerns would "stimulate thought and discussion."

WND has reported on dozens of legal challenges to Obama's status as a "natural born citizen." The Constitution, Article 2, Section 1, states, "No Person except a natural born Citizen, or a Citizen of the United States, at the time of the Adoption of this Constitution, shall be eligible to the Office of President."

Some of the lawsuits question whether he was actually born in Hawaii, as he insists. If he was born out of the country, Obama's American mother, the suits contend, was too young at the time of his birth to confer American citizenship to her son under the law at the time.

Other challenges have focused on Obama's citizenship through his father, a Kenyan subject to the jurisdiction of the United Kingdom at the time of his birth, thus making him a dual citizen. The cases contend the framers of the Constitution excluded dual citizens from qualifying as natural born.

Further, others question his citizenship by virtue of his attendance in Indonesian schools during his childhood and question on what passport did he travel to Pakistan three decades ago.

Adding fuel to the fire is Obama's persistent refusal to release documents that could provide answers. While his supporters cite an online version of a "Certification of Live Birth" from Hawaii, critics point out such documents actually were issued for children not born in the state.

Some of the worries expressed by the new intelligence analysis were raised earlier by Ambassador Alan Keyes, a plaintiff in a lawsuit challenging Obama's eligibility. That case, now heading for appeal, claims: "If Mr. Obama is not constitutionally eligible to serve as president of the United States, then no act that he takes is, arguably, valid, the laws that he signs would not be valid, the protective orders that he signs would be null and void, and every act that he takes would be subject to legal challenge, both in courts of the United States of America, and in international courts, and that, therefore, it is important for the voters to know whether he, or any candidate for president in the future, is eligible to serve in that office."

The analysis said the issues began as "campaign rhetoric" but now "is moving toward a crescendo."

Rapacki said when California attorney Orly Taitz, who is working through her Defend Our Freedoms Foundation on several legal challenges to Obama, approached Supreme Court Chief Justice John Roberts with a challenge to review the facts, the dynamics of the situation changed.

"Chief Justice Roberts personally agreed to review the legal brief and the complaint saying such in front of the audience," he reported.

"Motions to be heard on this critical constitutional matter have been dismissed already, or not even accepted by courts in many states – New Jersey, Pennsylvania, Ohio, Georgia, Washington, Texas, North Carolina to name a few. But the issue will not go away; it is morphing now to include active members of the armed forces serving in 'Hot Zones' or theaters of combat."

The analysis also noted Taitz had submitted to the U.S. attorney general, the FBI and others requests for investigations.

The intelligence report cited a request already submitted to Washington for a special prosecutor similar to the one appointed during Watergate.

John Eidsmoe, an expert on the U.S. Constitution now working with the Foundation on Moral Law, separately has told WND the request for information is a legitimate course of action.

"She basically is asking, 'By what authority' is Obama president," he told WND. "In other words, 'I want you to tell me by what authority. I don't really think you should hold the office.'

Eidsmoe said it's clear that Obama has something in the documentation of his history, including his birth certificate, college records and other documents, "he does not want the public to know."

What else could be the reason for his hiring law firms across the nation to fight any request for information as basic as his Occidental College records from the early 1980s, he asked.

While an Obama spokesman one time called the allegations "garbage," the president and his team have withheld other comments. But here is a partial listing and status update for some of the cases over Obama's eligibility:

• New Jersey attorney Mario Apuzzo has filed a case on behalf of Charles Kerchner and others alleging Congress didn't properly ascertain that Obama is qualified to hold the office of president.


• Pennsylvania Democrat Philip Berg has three cases pending, including Berg vs. Obama in the 3rd U.S. Circuit Court of Appeals, a separate Berg vs. Obama which is under seal at the U.S. District Court level and Hollister vs. Soetoro a/k/a Obama, (now dismissed) brought on behalf of a retired military member who could be facing recall to active duty by Obama.
  
  
• Leo Donofrio of New Jersey filed a lawsuit claiming Obama's dual citizenship disqualified him from serving as president. His case was considered in conference by the U.S. Supreme Court but denied a full hearing.


• Cort Wrotnowski filed suit against Connecticut's secretary of state, making a similar argument to Donofrio. His case was considered in conference by the U.S. Supreme Court, but was denied a full hearing.


• Former presidential candidate Alan Keyes headlines a list of people filing a suit in California, in a case handled by the United States Justice Foundation, that asks the secretary of state to refuse to allow the state's 55 Electoral College votes to be cast in the 2008 presidential election until Obama verifies his eligibility to hold the office. The case is pending, and lawyers are seeking the public's support.


• Chicago lawyer Andy Martin sought legal action requiring Hawaii Gov. Linda Lingle to release Obama's vital statistics record. The case was dismissed by Hawaii Circuit Court Judge Bert Ayabe.
  
  
• Lt. Col. Donald Sullivan sought a temporary restraining order to stop the Electoral College vote in North Carolina until Barack Obama's eligibility could be confirmed, alleging doubt about Obama's citizenship. His case was denied.
  
  
• In Ohio, David M. Neal sued to force the secretary of state to request documents from the Federal Elections Commission, the Democratic National Committee, the Ohio Democratic Party and Obama to show the presidential candidate was born in Hawaii. The case was denied.
  
  
• Also in Ohio, there was the Greenberg v. Brunner case which ended when the judge threatened to assess all case costs against the plaintiff.
  
  
• In Washington state, Steven Marquis sued the secretary of state seeking a determination on Obama's citizenship. The case was denied.
  
  
• In Georgia, Rev. Tom Terry asked the state Supreme Court to authenticate Obama's birth certificate. His request for an injunction against Georgia's secretary of state was denied by Georgia Superior Court Judge Jerry W. Baxter.


• California attorney Orly Taitz has brought a case, Lightfoot vs. Bowen, on behalf of Gail Lightfoot, the vice presidential candidate on the ballot with Ron Paul, four electors and two registered voters.

In addition, other cases cited on the RightSideofLife blog as raising questions about Obama's eligibility include:

• In Texas, Darrel Hunter vs. Obama later was dismissed.
  
  
• In Ohio, Gordon Stamper vs. U.S. later was dismissed.
  
  
• In Texas, Brockhausen vs. Andrade.
  
  
• In Washington, L. Charles Cohen vs. Obama.
  
  
• In Hawaii, Keyes vs. Lingle, dismissed.

Obama looks at climate engineering

(Compiler's note: Please.... the earth has been cooling now for a few years. Please wake up and get off our backs with regulations, crazy solutions to problems that don't exist and for which you really have not fix, and etc., etc. You're going to have to find another way to gain control and redistribute our people's money. There I said it. I for one am growing very tired of this ....)


WASHINGTON (AP) - The president's new science adviser said Wednesday that global warming is so dire, the Obama administration is discussing radical technologies to cool Earth's air.

John Holdren told The Associated Press in his first interview since being confirmed last month that the idea of geoengineering the climate is being discussed. One such extreme option includes shooting pollution particles into the upper atmosphere to reflect the sun's rays. Holdren said such an experimental measure would only be used as a last resort.....

Hijacked US crew 'retake vessel'

from BBC News

The US crew of a ship hijacked by pirates off the coast of Somalia has retaken control of the vessel, according to Pentagon sources.

Unnamed US defence officials said one pirate had been captured by the crew of the Maersk Alabama, seized earlier in the Indian Ocean.

But the vessel's Danish owners, Maersk, said they could not confirm that the crew had fought off the pirates.

It was the sixth ship seized off Somalia in recent days.

The Associated Press quoted a defence official as saying: "The crew is back in control of the ship.

"It's reported that one pirate is on board under crew control - the other three were trying to flee."

Reports suggest the other three pirates jumped overboard.

Maersk's chief executive, John Reinhart, said he could not confirm that the ship had been retaken, but told AFP news agency he believed the crew was safe.

The ship was attacked by several small boats in the early hours of Wednesday in an incident apparently lasting for about five hours.

Maritime officials said the vessel took all possible evasive action before it reported that the pirates had boarded.

More than 130 pirates attacks, including close to 50 successful hijackings, were reported in 2008, threatening one of the world's busiest shipping lanes.