I was a civilian physician (board certified in Psychiatry and Neurological Surgery) when I wrote this note in March 2015. Working in Behavioral Health at the Eisenhower Army Medical Center at Fort Gordon, near Augusta, Georgia, I was also the Clinical Consultant to ASAP, the Army Substance Abuse Program, at Fort Gordon and I staffed (reviewed) all the cases that presented to the ASAP program.
Four years ago, in August 2011, I staffed a case of a young man with severe alcohol dependence and a history of significant medical complications. I saw him personally, face to face, and strongly recommended he be admitted to the inpatient rehabilitation program at Eisenhower (at that time it was the only inpatient program in the entire DOD). However, his command ignored the recommendation for this highest level of care and would not allow him to be admitted to the inpatient program. The soldier continued to drink and I saw him again about 6 weeks later, in September 2011 and again strongly recommended he be admitted to the inpatient rehab program considering his situation to be dangerous. Again, his command denied the request. A few weeks later, on October 23, 2011 the soldier killed a policeman, J.D. Paugh, and then killed himself.
You can read about the homicide/suicide in the Augusta Chronicle. A subsequent editorial described the disaster as “pure evil” and demanded the military explain how such a thing could happen. The soldier’s name was Christopher Hodges. The history of his attempt to get medical care for his substance use was never disclosed outside of Eisenhower and his command. The Army, to this day, has not accepted any responsibility for this disaster. The family of Christopher Hodges gave permission for this story to be published in an article in USA Today, May 15-17, 2015 written by Gregg Zoroya. The emotional power of the statements of Christopher Hodges’ parents in an accompanying video is very eloquent.
It is not the ASAP program at Fort Gordon that failed to do the right thing. It is the command structure that is responsible for this ongoing negligence. Please refer the following statement in The United States Army Medical Department Journal, October to December 2014. The edition is headed by the banner: “Behavioral Health: Increasing Resiliency and Endurance. In general the articles in the journal are mediocre, at best, but I direct your attention to the opening statement titled “Perspective.” It is written by Major General Steve Jones, the commander of the US ARMY Medical Department Center and School. I will quote the entire closing paragraph of MG Jones’ “Perspective” because it sums up the profoundly arrogant and ignorant position of the command structure of the Army, which includes the office of the Surgeon General as well as the Chief of Staff:
“The Army Medical Department plays an important role in building fitness, resilience and strength, in advising commanders, and serving as a safety net for Soldiers and Families. However [the emphasis is mine], the ultimate responsibility remains with the unit commander, as noted in Change I to Medical Field Manual 8-10, Medical Service of Field Units, dated June 28, 1946: ‘Since the majority of the factors which determine mental health of troops fall within the province of command, the main job of preventive neuropsychiatry must be done by commanding officers of the line.'” [View online.]
Interesting the insight of all levels of command have not changed since 1946.
I would like to hear MG Jones reply to a question: since the suicide rate continues alarmingly high, and since PTSD and substance problems are endemic, and since command thinks “preventive psychiatry must be done by commanding officers of the line,” how is that working for you General?
I would like to share a personal anecdote that is connected to the stories of Stephen Akins, J.D. Paugh and Christopher Hodges. I learned about the death of Stephen while my wife and I were visiting family in Kansas City. I was particularly distressed when Stephen’s mother called me with the news. Shortly thereafter we learned my wife’s mother, Juanita Dantzler, had died in Augusta after a long period of declining health. Subsequently, in the planning of the funeral we asked that in lieu of flowers donations be made to the J.D. Paugh Memorial Foundation. A post on the Facebook page of the Foundation reminded us Juanita and J. D Paugh probably knew each other pretty well. The post is included in this blog: “It is with a heavy heart and a sense of honor that we acknowledge the loss of Juanita Dantzler. She was employed and was a fixture for the Richmond County Sheriff’s Office for 38 years!!! Her service was tremendous to the citizens of said county and even in her passing she and her family are trying to contribute. Her family in her obituary have honored the foundation with donations in her name. Please take a moment to remember this great lady and honor her service. Her family wished donations to come to us in her name and we are honored and humbled by this.”
Finally, I would like to add a note of admonishment. While in Kansas City, on July 4, 2015 I was able to attend a Kansas City Royals baseball game with my son-in-law David and my grandson. I enjoyed the game and the company and the game was highlighted by expressions of patriotism including fireworks after. However, during one of the between inning breaks, while the infield was being raked, they played Bruce Springsteen’s “Born in the USA.” Clearly this was taken by the vast majority of the crowd as a tribute to the occasion and to servicemen and veterans. David noted that most of the people did not really understand the lyrics of Springsteen’s most famous song. So, as a conclusion, I will write out the lyrics, which were before and continue to be, profoundly perceptive.
Born down in a dead man’s town
The first kick I took was when I hit the ground
You end up like a dog that’s been beat too much
Till you spend half your life just covering up
Born in the U.S.A.
I was born in the U.S.A…..
Got in a little hometown jam so they put a rifle in my hand
Sent me off to a foreign land to go and kill the yellow man
Born in the U.S.A.
I was born in the U.S.A…..
Come back home to the refinery
Hiring man says “son if it was up to me”
Went down to see my V.A. man
He said “son don’t you understand now”
Had a brother at Khe Sahn fighting off the Viet Cong
They’re still there he’s all gone
He had a woman in loved in Saigon
I got a picture of him in her arms now
Down in the shadow of the penitentiary
Out by the gas fires of the refinery
I’m ten years burning down the road
Nowhere to run ain’t got nowhere to go
Born in the U.S.A.
I was born in the U.S.A……
I’m a long gone daddy in the U.S.A.
Born in the U.S.A……
I’m a cool rocking daddy in the U.S.A
We have not come so far and have a long way to go.