Here we discuss sex and politics, loudly, no apologies hence "screeds" and "attitude."
VA bullied doctors into prescribing narcotics
Wally here filling in for Rebecca. We were at the House Veterans Affairs Subcomittee on Health hearing today. I want to focus on the second panel:
Pamela J. Gray, M.D.
Claudia J. Bahorik, D.O.
Steven G. Scott, M.D., CHief of Physical Medicine and
Rehabilitation Service, Veterans Health Administration, U.S. Department
of Veterans Affairs
Dr. Gray revealed that she and other doctors were bullied into prescribing opiates to veterans by VA and that when she attempted to go through channels to report this, she was instead targeted. No investigation was conducted that she can determine -- the VA's IG is unresponsive to her questions other than to tell her that the physical therapy had not been excessive. "That had never been my complaint," "That had nothing to do with prescribing opiates."
But they fired her for not saying good morning to a nurse. She explained, "So, no, to my knowledge, the issues were covered up, not addressed. And the entrapment issues that I alluded to were these trivial, trivial things that were used against me."
Dr. Bahorik revealed that the VA just wants doctors to dispense drugs and give shots, they don't want to administer treatment. She's also an acupuncturist -- a licensed one -- and the VA has refused, at one center after another -- to allow her to practice this. One would hope that Senator Bernie Sanders was paying attention to that or that it's passed onto him because he supports non-drug models of therapy being provided by VA as well.
As I sat through the hearing, I had to shudder. Hearing about how veterans in pain weren't treated, just given pills and overmedicated, it all reminded me of The Matrix before Keanu takes the pill and leaves that tube. It's as though they're just trying to shut them up, not helped.
Thursday, October 10, 2013. Chaos and violence continue, for the fifth
day in a row there are corpses in the streets of Iraq, Nouri's
government executes more people -- and surpasses last year's total, Ed
Snowden is honored in Russia, the VA's new motto appears to be
"Addiction gets you out the door!," Barack's war on the press and
whistle-blowers gets called out, and more.
We noted something this morning but did so at the end of an entry. Then Glenn Greenwald's Tweets were forwarded:
In the Obama administration’s Washington,
government officials are increasingly afraid to talk to the press. Those
suspected of discussing with reporters anything that the government has
classified as secret are subject to investigation, including
lie-detector tests and scrutiny of their telephone and e-mail records.
An “Insider Threat Program” being implemented in every government
department requires all federal employees to help prevent unauthorized
disclosures of information by monitoring the behavior of their
Six government employees, plus two contractors including Edward
Snowden, have been subjects of felony criminal prosecutions since 2009
under the 1917 Espionage Act, accused of leaking classified information
to the press—compared with a total of three such prosecutions in all
previous U.S. administrations. Still more criminal investigations into
leaks are under way. Reporters’ phone logs and e-mails were secretly
subpoenaed and seized by the Justice Department in two of the
investigations, and a Fox News reporter was accused in an affidavit for
one of those subpoenas of being “an aider, abettor and/or conspirator”
of an indicted leak defendant, exposing him to possible prosecution for
doing his job as a journalist. In another leak case, a New York Times reporter has been ordered to testify against a defendant or go to jail. Compounding the concerns of journalists and the government officials
they contact, news stories based on classified documents obtained from
Snowden have revealed extensive surveillance of Americans’ telephone and
e-mail traffic by the National Security Agency. Numerous
Washington-based journalists told me that officials are reluctant to
discuss even unclassified information with them because they fear that
leak investigations and government surveillance make it more difficult
for reporters to protect them as sources. “I worry now about calling
somebody because the contact can be found out through a check of phone
records or e-mails,” said veteran national security journalist R.
Jeffrey Smith of the Center for Public Integrity, an influential
nonprofit government accountability news organization in Washington. “It
leaves a digital trail that makes it easier for the government to
monitor those contacts,” he said.
It's an important issue and we'll note a whistle-blower later in the
snapshot. For now, Scott Alan McDonald died because of the VA. His
widow Heather McDonald explained what happened to Congress this morning.
Heather McDonald: For 15 years, he served honorably in the
uniform of his country and was proud to serve as a UH-60 Blackhawk
mechanic and Crew Chief for MEDEVAC Unit. Bosnia, Panama, Iraq and
Afghanistan are only a few of the war-torn countries he dedicated his
life to changing. In his career, he experienced heartache, unimaginable
violence, death and the overall devastating effects of war. He saw
many of his fellow soldiers give the ultimate sacrifice -- narrowly
escaping many times himself. He loved his country and what the American
flag stands for. He was a brothers in arms to thousands of fellow
soldiers and a truly remarkable man that never met a stranger. Scott
had larger than life expectations for his children. And because of his
commitment and honor, in January of 2011, we married. On April 30,
2011, Scott's career with the army came full circle and he hung his
uniform up for good. He began seeking the treatment from the VA for back
pain and mental illness. The Chalmers P. Wylie VA Ambulatory Care
Center in Columbus, Ohio immediately started prescribing medications
beginning with ibuprofen, nurofen, meloxicam and graduating to vicodin,
klonopin, celexa, Zoloft, valium and Percocet. This is where the
rollercoaster began. My husband was taking up to 15 pills a day within
the first six months of treatment. Every time Scott came home from an
appointment, he had different medications, different dosages, different
directions on how to take them. And progressively over the course of a
year and a half of starting his treatment, the medications had changed
so many times by adding and changing that Scott became changing. We
researched many of the drugs that he was prescribed online and saw the
dangerous interactions that they cause. Yet my husband was conditioned
to follow orders. And he did so. On September 12th of 2012, Scott
attended another of his scheduled appointments. This was when they
added Percocet. This was a much different medication than he was used
to taking and which they prescribed him not to exceed 3,000 milligrams
of ibu -- acetaminophen, I'm sorry. Again, my husband followed orders.
Approximately zero-one-hundred hours on the 13th of September, I
arrived home from my job. I found Scott disoriented and very
lethargic. I woke him and asked him if he was okay? He told me he was
fine and that he just took what the doctors told him to take. At
approximately zero-seven-thirty, I found my husband cold and
unresponsive. At 35-years-old, this father of two was gone. I ask
myself why everyday. And when I ask the VA why more tests weren't
performed to make sure he was healthy enough, they responded by saying:
"It is not routine to evaluate our soldiers' pain medication
distribution." A simple "I am in pain" constitutes a narcotic and a
"This isn't working" constitutes a change in medication. I was sickened
and disturbed by their response and I decided at that point no one else
should die. I have no doubt that if the proper tests were being
performed on our men and women, I would not be here today -- because my
husband would be. I have no doubt that for thousands of the
soldiers that have fallen after coming home from war would be here
today. [Wiping tears] I'm sorry. As the silent soldiers and spouses of
our military members. we almost expect the possibility that they won't
come home from war. But we cannot accept that they fight there for
their country and after the battle is over they come home and die.
A study published last year in The American Journal of Psychiatry found that, "Among patients receiving care from the Veterans Health
Administration, death from accidental overdose was found to be
associated with psychiatric and substance use disorders. The study
findings suggest the importance of risk assessment and overdose
prevention for vulnerable clinical subpopulations." That study
was published in January of 2012. Does no one in the Veteran Affairs
Department know how to read? Clearly, they don't know how to take
action but are they at least literate?
Nine months before Heather lost her husband, a peer-reviewed, medical
study was published warning of what was taking place. Where was VA
Secretary Eric Shineski? Mismanaging again?
It has been one scandal after another under Shineski. It really is time
he resigned. Heather McDonald was testifying before the House Veterans
Affairs Subcommittee on Health -- US House Rep Dan Benishek is the Chair
of the Subcomittee and US House Rep Julia Brownley is the Ranking
Member -- as part of the first panel retired Air Force member Kimberly
Stowe Green, retired Sgt Joshua Renschler and retired 1st Sgt Justin
Minyard. Panel two was Dr. Pamela Gray, Claudia J. Bahorik, and the
VA's Dr. Steven G. Scott. The third panel was the VA's Dr. Robert Jesse
accompanied by Robert Kearns.
Kimberly Stowe Green's husband, like Heather's husband, should be
alive. He went in for back surgery. That's not usually life
threatening. But what the VA did before that ensured that it was.
Kimberly Stowe Green: My husband Ricky Green died as a result of
the VA's skyrocketing use of prescription pain killers. On behalf of
my husband, my self and our two grieving sons, I want to ask this
Committee to do all that it can to prevent other veterans from dying in
the same manner that my husband died. My husband died on October 29,
2011 -- at the age of forty-three -- four days after lower back
surgery. The Arkansas State Crime Lab and it's medical examiner
performed an autopsy and determined that the cause of death was mixed
drug intoxification complicating recent lumbar spine surgery. My
husband died because of the prescription pain and sleeping medications
that the VA and its doctors prescribed for him and dispensed to him out
of the VA pharmacy. In treating Ricky's service-connected back pain,
the VA doctors wrote prescriptions for the following drugs.
She noted the 2010 VA clinical practice guidelines have not been fully
implemented and they're not being followed. What does Eric Shineski say
to that? More to the point, what does US President Barack Obama say to
that? How many screw ups is Shinseki going to rack up before his
inability to do his job results in his resignation?
Kimberly Stowe Green stated, "Ricky survived serving in combat zones in
his over 20 years of military service but he could not survive the VA
and its negligent treatment of him."
Iraq War veteran Josh Green survived a mortar attack in Iraq and the
pain from the wounds led the VA to prescribe one pill after another --
he was taking 13 pain killers at one point. The result? The VA medical
treatment left him with liver damage and no feeling in his left leg.
(Heather McDonald noted her husband had Stage II liver failure but it
was "only discovered by the coroner.") That is awful and the VA owes
Green much more than an apology. But something else should be
registering. If it's not, let's note this statement from Green about
Percocet, "And what happened was, the more I took it, the less it worked
because my body became tolerant to it.
Do you get it yet?
Do you get the problems that are being created under Shinseki? The
problems that will cost millions to clean up and will be harrowing for
the veterans going through it?
You can't just dispense pain killers like they're Flintstone chewables
or candy out of Pez dispenser. This attitude was overcome long ago
everywhere except the VA. It's why former First Lady Betty Ford went
public and set up The Betty Ford Center.
When it comes to addiction, there may not be a more vulnerable
population than veterans. The reasons for that are they are taught to
mask the pain while serving and, as both widows pointed out, to follow
orders -- the following of orders often carries over the medical
treatment from the VA. The VA doctors are prescribing like it's 1947
and, as a society, we've never heard of pain killer addiction.
People in pain need help and need treatment. They do not, however, need
to develop an addiction because a bunch of lazy or quack doctors don't
want to do their job.
Under Shinseki, the prescriptions are killing veterans, yes. But also
under Shinseki, the prescriptions are resulting in addictions that will
have be treated years from now.
That's unacceptable -- from a health standpoint and from a taxpayer standpoint.
Shinseki is supposed to be on top of things. He shouldn't need a Congressional hearing to take action.
It was really distressing to hear Josh Green detail his objections to
the pills and how, when he would raise these objections, he would be
prescribed more pills.
Iraq and Afghanistan War veteran Justin Minyard suffered from chronic
back pain (tied to a 72 hour continues shift at the Pentagon, searching
for any survivors after the Pentagon was hit on 9-11). The existing
back pain was amplified by his later service in Iraq and Afghanistan.
The treatment? Pills, pills and more pills. That's all the VA offered
him. He explained, "My life revolved around when is my next pill, when
is my next dosage increase and when can I get my next refill? At my
worst point I was taking enough pills daily to treat four terminally ill
Repeating, this isn't just medical malpractice with effects people see
and feel now, this is medical malpractice that is turning veterans into
addicts. That is unacceptable. Civilian doctors prescribing in this
manner risk loss of license and criminal charges but the VA just looks
the other way. The VA motto appears to be: "Addiction gets you out the
Ranking Member Julia Brownley: I think we all owe you deep
apologies for not responding to your needs the way you have defended our
country and, Ms. McDonald, I include you and thanking you for your
service to our country and being married to your spouse and supporting
him through this process -- that you, too, need to be thanked for your
service. So thank you all. I think this is obviously a very important
topic and hearing your individual stories is, I think, important for the
American people to hear. I wanted to ask a question -- my first
question anyway -- and this question is more directed to Mr. Green and
Mr. Minyard. I was wondering about your experiences and maybe
experiences from other wounded warriors that you may know -- regarding
the continuity of treatment from the army to the VA and perhaps from one
VA facility to another VA facility?
Josh Green: I'll answer that. To the best of my knowledge --
again, I've walked alongside countless veterans over the last several
years on a volunteer capacity and walked them through attempting to
navigate the VA health care system to get the best care possible. In my
experience, it takes quite often a door kicker mentality to get
veterans the care that they need. I've hand walked them to a
physician's door, to a social worker's door, to a mental health
practitioner's door and said, "This person needs help today." And
that's the way we've been able to make some things happen in people's
lives. To answer as quick as possible: No. There's not good continuity
of care from one facility to another. There's not good continuity of
care from DoD to VA. You know, as I spoke on my specific experience
leaving DoD and entering VA care, my medications weren't on the VA
formulary so they completely changed my medication regime and put me on
more harmful medications which ended up causing me to backslide in my
recovery which took the army three years to establish. As far as --
There's a veteran that I work with currently that has left Portland, a
VA facility in Oregon and moved into Washington state. And upon
entering Washington state American Lake VA Hospital, he was told that
his medications are not able to be purchased through the American Lake
VA Hospital because they don't have the budget for the non-formulary
medication that the other facility had. And this was again a medication
that took six years to figure out the best thing for him and they're
not going to purchase it anymore which is causing him to backslide in
his pain management. So short answer is no, there's not good continuity
Ranking Member Julia Brownley: Thank you. And I think I said
Mr. Green and I apologize. I meant Mr. Minyard if you had any
additional comments in terms of continuity of treatment?
Justin Minyard: Ma'am, with all due respect, I would not, in my
opinion, and through my experience, I would not place the word
"continuity" anywhere in a sentence that contains other nouns "DoD" and
"VA." To give you a quick answer --
Ranking Member Julia Brownley: Yeah?
Justin Minyard: -- the systems, to me --
Ranking Member Julia Brownley: I hear you.
Justin Minyard: -- don't work.
Help me out here. Since 2009, what presidential cabinet level person is
supposed to have been addressing "seamless transition" from DoD to VA?
That would be Shinseki.
And yesterday, he was just so concerned in the House Veterans Affairs
Committee about the shutdown, he bled for any who suffered, you
understand. He'd just hate to think of anyone not receiving their
benefits or survivors benefits from the VA because of the shut down.
Spare us your crocodile tears, Shinseki.
Heather McDonald: After my husband's death, I did contact the
VA. Almost immediately -- the VA itself told me that I needed to
immediately start the process to claim my husband's death pension to
help my family. What doing that immediately does I don't know. It took
11 months to start receiving any retroactive pay from my husband's
pension. I lost my home. I lost my car. When I asked them during
the-the filing of the claim, the VA asked me whether I felt my husband's
death was service-connected or not? First, that's not my decision.
Every pill he put in his mouth was due to an ailment or an injury he
received either in theater due to his service for his country. So, yes,
that makes it service connected. Why it took 9 months for them to make
a decision and a rating on that? No, I was simply told, "I'm sorry,
Mrs. McDonald, this is the process. It takes time. There's a huge
backlog." I feel like the VA right now is proud of themselves because
they're saying, "The backlog is going down. The amount of claims are
lessening." Well of course they are. Because they're dying. They're
not receiving treatment anymore because they're not here to receive it.
MEPs strongly condemned the recent acts of terrorism and sectarian
violence in Iraq, calling on the authorities "to facilitate a full and
swift independent international investigation (...) and to cooperate
fully with that investigation". All leaders and players in society
should "start to work together to end the bloodshed and ensure that all
Iraqi citizens feel equally protected", adds the resolution. MEPs also
voiced concern about the spill-over of violence from the Syria conflict
And violence today? National Iraqi News Agency reports the corpse -- well the head -- of a 25-year-old woman was discovered dumped in Kirkuk. Alsumaria adds
the head was found in piles of waste next to a building. Corpses
dumped and discarded were one of the most common traits of the 2006 to
2007 period popular known as the "civil war" (ethnic cleansing). They
began popping up regularly in the last months. A new development this
week? Starting Sunday, every day has resulted in reports of at least
one discovered corpse. It was every few weeks, then every two to two
and half weeks, then every two to three days. Sunday, Monday, Tuesday,
Wednesday and today -- five days in a row.
Baghdad, 10 October 2013 – UNAMI notes with concern that between 8
and 9 October, 42 people sentenced to death were executed, among them
one woman, as confirmed by the Ministry of Justice of Iraq on 10
UNAMI reiterates its call on the Government of Iraq to adopt a
moratorium on the implementation of all death sentences, pursuant to UN
General Assembly resolutions 62/149 (2007), 63/168 (2009) and 65/205
(2010), and to consider ratifying the Second Optional Protocol to the
International Covenant on Civil and Political Rights, with a view to the
eventual abolition of the death penalty.
Yesterday's State Dept press briefing found spokesperson Marie Harf
insisting that she'd have an answer today with regards to flights
through Iraqi air space to Syria. She apparently forgot. She did,
however, make time to obsess over Ed Snowden. She's like a cock hound
on him. From today's press briefing:
MS. HARF: Mm-hmm. Back in the news.
QUESTION: Yeah, amazing. He – because we haven’t heard much
from him for quite a while. But his father’s there and it just raises
this issue – number one, if you had anything to say about that, period.
But it raises that issue of he is the father, so it’s an immediate
family member, but is there anything legally that he is precluded from
doing when he’s there? I mean, can he – because after all, Snowden, Jr.,
is on the lam. So can he --
MS. HARF: Is there anything his father is precluded from doing, or else --
QUESTION: Yeah. Like can he meet – would it be a violation of some type of law to meet with his son?
MS. HARF: Not to my knowledge. And the father really isn’t our
concern, and even the father meeting with the son really isn’t our
concern. Our concern really is Edward Snowden returning to the United
States. He’s accused of very serious charges here, and he’ll be accorded
full due process and protections applicable under U.S. law. It’s not
really our – I think our concern about the meeting or our place to
comment on it, and I don’t think we’re focused on his father at all in
any way. I think we would just encourage Mr. Snowden to return.
QUESTION: Yeah. Well, I mean, obviously it would be kind of a
legal question. Is there really something – like, if you were to meet
with, I don’t know, a terrorist to be in collusion with a --
MS. HARF: I will take the legal question. I don’t think there is, but let me ask my experts.
QUESTION: Just for the future, it might be interesting.
MS. HARF: Yeah. No, it’s a good question.
QUESTION: And then also, is there anything – any update on consular access?
MS. HARF: No.
QUESTION: Has he talked with U.S. officials?
MS. HARF: No, he has not.
MS. HARF: Nothing.
MS. HARF: To my knowledge, nothing. No.
QUESTION: So you have --
MS. HARF: Scott --
QUESTION: You have no reaction or – to the visit by – or no comment on the visit of Mr. Snowden to --
MS. HARF: Well, I mean, the reaction is the same it’s always
been. Mr. Snowden needs to return to the United States to face these
charges. Yeah, I really don’t have anything to say about the specific
meeting with his father. It’s just not really what we’re focused on.
QUESTION: He didn’t contact anybody, as far as you know, within the Administration to say he was going?
MS. HARF: His father?
QUESTION: Yeah, the father.
MS. HARF: I do not know the answer to that question. I don’t know --
QUESTION: I’m just wondering if he – if it was perhaps timed by – that he might have had some discussions --
MS. HARF: Did he have to get a visa with --
MS. HARF: I just – I have no idea. I can try to find out. I don’t think so, though.
QUESTION: Okay. I just wondered. He might have had discussions with somebody. He might be carrying a message to his son.
MS. HARF: Not to my knowledge, no. Nothing at all like that. No, nothing.
For the record, any American citizen with a valid passport can travel to
Russia. There's no permission needed from the US government. There is
no war between Russia and the US -- though there appears to be a war
against information and knowledge.
The Voice of Russia reports, "Four whistleblowing advocates from the United States met with Edward
Snowden in Moscow Wednesday and gave him an award for truth-telling. As
seen on the photo published by Getty Images
Snowden received the Sam Adams Associates for Integrity in Intelligence
Award (SAAII) alongside UK WikiLeaks journalist Sarah Harrison, who
took Snowden from Hong Kong to Moscow and obtained his asylum, and the
United States government whistleblowers including Coleen Rowley (FBI),
Thomas Drake (NSA), Jesselyn Raddack (DoJ) and Ray McGovern (CIA)." The Oxford Union explains, "The Sam Adams Associates for
Integrity in Intelligence confers an award each year to a person
exemplifying the courage, persistence and devotion to the truth of CIA
analyst Sam Adams. Many distinguished past award winners include
prominent whistleblowers and former intelligence agents." Caro Kriel (AP) quotes Jesselyn Raddack stating, "He spoke very openly about a whole range of things, a number of which I
won't get into here, but it certainly didn't involve any kind of
manipulation by the Russian government or anyone else for that matter. He definitely is his own person and makes his
own decisions and says and does what he wants to." Raddack is with the Government Accountability Project. Fred Weir (Christian Science Monitor) reports:
Interviewed on the Kremlin-funded English-language television network RT Thursday, the four whistleblowers agreed that Snowden looked "remarkably well" and was in fine spirits "considering the pressures" of his situation. "This
is an extraordinary person. He's made his peace with what he did, he's
convinced that what he did was right, he has no regrets and is willing
to face whatever the future holds for him," Mr. McGovern told RT. Snowden's
lawyer, Kucherena, has told Russian media that his client "has a
girlfriend," is making great progress in learning the Russian language,
and may soon find a job to keep him occupied in Russia. Reached by telephone on Thursday by the Monitor, Kucherena offered nothing but a good-natured scolding. "You
must admit that when American politicians demand that human rights
should be observed and talk about democratic freedoms, it's a sheer
contradiction when we see the fact that everybody is bugged and their
emails are read," he said.
The father of NSA leaker Edward Snowden told reporters in Moscow that he thinks his son deserves a Nobel Peace Prize. He arrived there Thursday
for his first visit with his son since the former government IT
contractor fled the United States after leaking National Security Agency
spy program details to the media. Members of the European
Parliament nominated Snowden in September for the Andrei Sakharov Prize,
which honors figures who stand up to oppressive powers. The prize was
awarded to Pakistani education activist Malala Yousafzai on Thursday.
Edward Snowden’s future and exact current whereabouts remain shrouded
in mystery, but his lawyer Anatoly Kucherena says the former US
intelligence contractor was not in talks to seek asylum in any other
countries and has received several offers of work. Kucherena, speaking to Rossiya-24 news channel alongside Lon Snowden,
said Edward Snowden would be open to extending his one-year asylum
status in Russia.
Lastly, tomorrow is The International Day of the Girl Child. UNICEF notes:
The International Day of the Girl Child is celebrated on 11 October, a
day designated by the United Nations for promoting the rights of girls,
and addressing the unique challenges they face. The inaugural day in
2012 focused on the issue of ending child marriage. As the lead agency
for the Day, UNICEF, in consultation with other United Nations agencies
and civil society partners, selected Innovating for Girls’ Education as
this year’s theme, in recognition of the importance of fresh and
creative perspectives to propel girls’ education forward and building on
the momentum created by last year’s event. As the nature and scale of barriers facing girls becomes more
complex, innovative strategies are needed to give girls an education
that prepares them for the challenges of the 21st century. As the world
evaluates the gaps that still remain in achieving global goals for
gender equality in education and defines an agenda that moves beyond the
Millennium Development Goals, it is critical that innovation brings
about solutions for improving girls’ education that are not only more
creative, but also more effective, efficient, sustainable and just.