On Veterans and the VA

Hello again.  Last Monday was Memorial Day, and I inadvertently took the day off from the blog.  Instead, in honor of our veterans, we plied our neighbors with beer and cider and burgers.  I don’t believe that any of them were veterans.  In fact, in my personal life, I really don’t know anyone involved in the military.  That doesn’t mean, though, that I don’t have a few thoughts about it.  I actually meant to write this column for Memorial Day, but as I mentioned, I was too busy eating and drinking.  So, I’ll share them now.  And yes, at least some of them have some connection to end of life care, albeit a tenuous one.

So, first off, let’s talk about the fact that I really don’t know anybody involved in the military, at least nobody who has served in last 40 years.  My kids’ school had a poster honoring our veterans, and students and teachers brought in pictures of family members who served or are serving.  There were five pictures, and four of them were of grandfathers (or great-grandfathers) who were in WWII.

So, what’s up with that?

We live in a fairly affluent, fairly liberal, (slightly less) fairly diverse suburb.  I’m sure there are people involved in the military, I just don’t know them.   But my point is that I think it’s very interesting that the men and women who go into the service do not come from all over.  They come from certain parts and pockets of our country.  Joining the armed forces  can provide amazing opportunities that for some people would otherwise be out of their reach.  But, of course, it can also exact excruciating sacrifices.  And not all of our communities are affected equally.

I know that observation isn’t mind-blowing.  But for me, and possibly for you, too, it’s important to remember that wars aren’t just fought on TV.  People come home injured, physically and emotionally, and it affects them and everyone they love and their entire community.  And sometimes they don’t come home at all.  Often, it is the communities that have few resources to spare that are hit the hardest and most often.  For those of us, like me, who are fairly oblivious to those sacrifices, they are hypothetical.  But for many parts of the country, they are anything but.  And it seems very unfair that the burden isn’t shared more evenly.

At least, though, it seems like as a country we have gotten better at supporting our vets, at least attitudinally, even if we don’t support whatever war we are waging at any given time.  I’ve had a couple of Vietnam Veterans as patients lately, and they were seriously traumatized by both their experiences during the war, and the reception they received afterward.  They could never move beyond it.  It’s horribly sad.

And that, of course, brings us to another sad story: our VA system.  Even I, who has a second home under a rock, have heard about the scandals affecting the VA.  I know the VA can do wonderful things.  A fair number of our patients are veterans (usually older ones), and the VA provides them with medical care and nursing homes and burial benefits.  (I’m sure they provide other benefits, too, but that’s what’s relevant for our hospice patients).  However, the men I’ve talked to don’t seem to be very pleased with their experiences.  One of my patients, who can barely move off of his sofa, still troops over to the VA every month or so for tests and medical care.  He waits there all day long, surrounded by patients who are screaming in pain, despite the fact that he made an appointment a month earlier.  I couldn’t tell which was worse for him: traipsing around the hospital all day long when he can barely breathe, or listening to the wails of those worse off than he is.  I had another patient who was counting the days until he had Medicare so that he could stop going to the VA.  He felt that the care that he received there was inadequate, and was hoping to get a second opinion that might give him a second chance.  I don’t know if his care was inadequate or not, but the thought that he might die because he couldn’t get the care that he needed was eating him up inside.

He never made it to Medicare–or back to the VA.  He declined too quickly.  He was only in our program for a week.

These are just anecdotes.  I certainly don’t mean to bash the entire VA system, of which I know very little.  I know it is very large and does a lot of good.  I’ve been involved with some researchers and physicians who work at the VA, and they have all been excellent and dedicated.  It just appears that the system is not meeting the needs of our servicemen and women.  And that….I mean, come on.  These veterans have agreed to give life, limb and soul for our country, no questions asked.  The least–the very least–we can do is guarantee them quality, timely care when they come home. That is the only just and moral response to their sacrifice.

I know no one disagrees with me on that point.  It would just be nice if the system served veterans as well as they deserved to be.  It really is shameful, in the truest sense of the word, that it doesn’t.

*******

Over Easter we drove out-of-state to visit family and on our way home we stopped at a rest stop.  Headed toward the door, I was in the lead, (as always, racing for the bathroom) with my two girls and husband a few steps behind me.  Two men and a woman, all dressed in army fatigues, were approaching the door as well.  We were almost there at about the same time, and one of the guys and I both put our arms out to get the door.

At the last minute, I decided to speed up.

I held the door open for the soldiers  (and my husband and kids, too, of course).

Those of you who know me know that my physical stature is anything but imposing.  My eight year old is almost as tall as I am, and she’s of average height.

The incident was, in a word, awkward.  The troops and my husband looked embarrassed.  Luckily for me, I don’t happen to embarrass easily.   It would have been a perfect social psychology experiment.

“Thank you,” the three people wearing fatigues said to me.

“No, thank you,” I said.

And I meant it.