In a story published yesterday, Salon reported on a surreptitious tape recording of an Army psychologist telling a patient last June that he had been pressured not to diagnose soldiers as having post-traumatic stress disorder. The soldier, whom Salon dubbed Sgt. X to protect his identity, recorded the Fort Carson, Colo., psychologist, Douglas McNinch, twice describing pressure to label soldiers with “anxiety disorder” instead of PTSD. The diagnosis of anxiety disorder could result in improper treatment and lower disability payments if the Army discharges a soldier from the military. “It’s not fair,” McNinch said on the tape. “I think it’s a horrible way to treat soldiers.”
But neither the U.S. Senate nor the Army apparently agrees with McNinch’s assessment of the treatment that returning soldiers are receiving. By early July, news of the tape recording had made its way to both the Senate Armed Services Committee and the upper reaches of the Pentagon. Despite prodding from Sen. Kit Bond, the Senate Armed Services Committee declined to investigate the tape’s implications. A veterans’ advocacy group then had a combative July 14 meeting at the Pentagon with the Army’s vice chief of staff, at which the vice chief was reportedly dismissive. Two weeks later, the Army issued the results of an internal investigation and absolved itself of any wrongdoing.
Today’s article describes the contentious meeting at the Pentagon, how the tape got to the Senate and the secretary of the Army in the first place, and which Senate aide determined it was not worth investigating. It also details how the individuals assigned by the Army to investigate the tape were connected both to the individual who had allegedly pressured McNinch not to diagnose soldiers as having PTSD and to earlier questionable in-house investigations of Army medical care.
Salon dubbed the soldier who made the tape “Sgt. X” because he is still in the process of being put out of the Army and he fears that if he is identified, it might affect the process meant to gauge his disability. He made the tape during a visit to McNinch’s office in June so he could remember what the psychologist told him — a traumatic brain injury suffered in Iraq has affected his short-term memory. When she heard what McNinch said about PTSD diagnoses on the tape, Sgt. X’s wife handed the tape over to Georg-Andreas Pogany, an investigator with a group called the National Veterans Legal Services Program. The NVLSP is a group of lawyers who take on difficult medical entitlement cases for soldiers, free of charge.
Pogany told Salon that he found the tape shocking. On July 2, he handed it over to the Fort Carson’s post commander, Maj. Gen. Mark Graham.
In a telephone interview, Graham refused to name Pogany as the man who gave him the tape, but confirmed that he had received it and that it set off alarms. “Anytime anyone brings me information regarding the health and welfare of our soldiers, I take it very seriously, as I did this,” Graham said, adding that he has not yet seen the results of Army’s internal investigation.
After receiving the tape, Graham forwarded it up the Army chain of command, where it ultimately wound up in the hands of Gen. Richard Cody, then the Army’s vice chief of staff.
At about this same time, Sen. Kit Bond, R-Mo., a longtime champion of veterans’ issues, also became aware of the tape. Bond’s staff attempted to prod the Senate Armed Services Committee into an independent investigation of the implications of the tape, but were ignored.
Salon has learned that Gerald Leeling, a majority counsel to the Senate Armed Services Committee, was informed of the tape and its contents. Leeling reports to Sen. Carl Levin, D-Mich., the chairman of the committee. However, there is no evidence that Levin’s committee ever launched an investigation or did anything to check whether the Army’s investigation was thorough and unbiased.
Leeling did not respond to a request for an interview. A committee spokeswoman released a statement, essentially deferring to the official Army line: “The Army conducted an investigation into whether mental health providers at Fort Carson were being pressured by the Command to change diagnoses from PTSD to Anxiety Disorder. The investigation found that that there was no command pressure to influence diagnoses.”
While the Senate was declining to act last July, there was building pressure within the Army to do something about the tape. (Heat would come from the outside as well — though the timing of the contact is unclear, a spokeswoman for Sen. Bond confirms that the senator personally contacted Army Secretary Pete Geren to express alarm about the implications of the recording.)
On July 10, the Army initiated an investigation. In addition, Gen. Cody, the Army’s second-most-powerful officer, contacted the NVLSP to arrange a meeting at the Pentagon.
The Pentagon’s sprawling parking lot shimmered with heat as Bart Stichman, a co-executive director for the NVLSP, arrived for a face-to-face meeting with Cody last July 14, flanked by fellow co-executive director Ron Abrams and investigator Andreas Pogany.
It was already halfway through a year that would mark the highest suicide rate in Army history. And Stichman, Abrams and Pogany were aware of the Army’s apparent pattern of misdiagnosing troops, often leaving them without access to the best care for their war-related mental injuries and possibly no care at all. “We have seen other cases like this, where diagnoses are changing over a short time frame,” Stichman’s investigator, Pogany, said in a recent telephone interview. “We are seeing what is described on the tape.”
The three were hopeful, however. If anybody had the power to recognize the real problems and start fixing things, it would be Cody.
The three entered a conference room deep inside the Pentagon to meet with Cody and an A-list of Army power players: Lt. Gen. David Huntoon, director of the Army staff; Maj. Gen. Bernard Champoux, chief legislative liaison; Brig. Gen. Gary Cheek, director of the Army’s wounded warrior transition program; Cheek’s chief of staff, Col. Jimmie Keenan; Lt. Gen. Scott Black, the Army’s top lawyer; Brig. Gen. Jeffrey Phillips, deputy chief of public affairs; and Col. James Polo, assistant deputy for health policy.
Stichman and his colleagues felt somewhat optimistic simply because Cody was the one who had called the meeting. But in person, Cody set a cold, browbeating tone early. “Are we tape-recording this meeting?” Cody joked icily. “Do you advise your clients to tape-record meetings?” To Stichman, it seemed Cody was trying to imply that Sgt. X and his tape were part of a setup and that the NVLSP was involved.
Stichman started with a discussion of some of the problems identified by his organization. “We were going to go over what the problems we saw were and what could be done about it,” Stichman recalled to Salon. He hoped the tape might spur the Army to launch an independent probe to see whether Army doctors elsewhere also felt pressured to issue misdiagnoses for combat veterans.
But when the discussion came to the subject of the tape, Cody cut Stichman off. The tape should stay private, Cody argued, citing a “moral obligation to protect this soldier.” Cody then suggested that the psychologist, McNinch, might have felt “pressure” to make timely disability payment decisions for soldiers, rather than pressure to misdiagnose soldiers, although on the tape the psychologist clearly stated he was pressured “to not diagnose PTSD and diagnose anxiety disorder.”
Stichman was stunned. “Look, we can understand English,” Stichman said to Cody. “I don’t know if you heard the same thing we heard, but the guy clearly says he’s pressured not to give diagnoses of PTSD.”
Cody seemed unconcerned, Stichman recalled. “To our surprise, when we came into that meeting, he no longer seemed to be disturbed by that tape. He said there was going to be an investigation, but that he didn’t see anything wrong and felt that the Army is doing well by soldiers. It was clear that they weren’t taking it seriously. It was very disheartening. I was in disbelief.”
Stichman’s NVLSP counterpart, Abrams, recalled that Cody avoided talking about the specifics of the tape or discussing how a thorough investigation of the tape might ultimately improve Army mental health care. Instead, Abrams remembered Cody describing Army initiatives to improve mental health care, including efforts to deal proactively with suicide risk through “chain teaching” — commanders supporting commanders to get soldiers help. In other words, Abrams said, Cody seemed reluctant to explore whether the tape was a representation of specific abuse and possibly wider problems. Instead, Cody merely spoke in broad terms about how the Army’s existing healthcare system operates. Cody’s tone, Abrams said, was “insulting.”
Cody told Stichman and his associates that an internal investigation of the tape would be conducted. To Stichman’s surprise, Cody then suggested what the not-yet-completed investigation would reveal.
Cody denied that the Army was pressuring doctors not to diagnose PTSD in soldiers. “There is no one in leadership telling doctors to do this,” stated Cody. “This is not Army policy.” Cody called the evidence on the tape “anecdotal.”
After the meeting was concluded, Stichman never heard from Cody again. None of the other officers in the room contacted Stichman, either. Just three weeks after the meeting, Cody retired from the Army. Last September, the former general joined L-3 Communications, a defense contractor, as corporate vice president. Salon described this article to an L-3 spokeswoman and requested an interview with Cody, but was told Cody was “not interested” in talking. “He has retired and moved on,” the spokeswoman said.
On July 28, a week before Cody’s retirement, the Army completed its internal investigation, an informal review known as an “AR 15-6.”
Salon requested a copy of the investigation in November through the Freedom of Information Act. The Army finally produced a copy in March, after it became apparent that Salon had obtained the recording and planned to write about it. Large portions of the report are blacked out, including several entire pages of the “analysis of evidence” and the explanation of the conclusions. The Army even blacked out some references to “PTSD.”
What is not blacked out is that the Army Medical Command, which investigated itself, determined that none of the medical workers under its watch did anything wrong. “This investigation,” it states, “does not find that any level of [the Army Medical Command] staff and leadership have attempted to coerce or otherwise influence the outcome of clinical evaluations.”
What also escaped the black pen was the name of the man who presided over the review: Brig. Gen. James Gilman, who commands Great Plains Regional Medical Command, which oversees several Army hospitals, including the one under scrutiny at Fort Carson. Gilman assigned Col. Bruce Crow, the clinical psychology consultant to the Army surgeon general, to supervise the actual investigation.
Almost the entire investigation consists of questionnaires handed out to a handful of healthcare providers. There is no interview of Sgt. X, the soldier who made the tape, or any review of his case.
The copy of the investigation ultimately obtained by Salon shows that the Army reached almost exactly those conclusions that Cody had predicted it would reach: “This investigation does not find that any level of [the Army Medical Command] staff and leadership have attempted to coerce or otherwise influence the outcome of clinical evaluations.”
Yet the investigation found “potential systemic pressures” that could cause a misdiagnosis. Those pressures “may lead providers to avoid making a diagnosis of PTSD … contrary to their clinical judgment.” The Army says it fixed those problems last December by removing a requirement that soldiers produce “credible supporting evidence” that they faced trauma in war in order to receive benefits.
In addition to relying almost exclusively on questionnaires to a handful of Army healthcare officials and failing to interview Sgt. X or scrutinize his medical records, the Army also did not interview the NVLSP’s Pogany, who has documented several cases that support what was said on Sgt. X’s tape. And there is no evidence the Army went back to see how many soldiers might have been refused benefits to which they were entitled during the years since the nation began its wars in Iraq and Afghanistan.
Gilman, the general who ordered the Army’s investigation, defended the Army’s response to the tape. “We were very, very concerned about what we heard on the tape,” he said in an interview. “We felt that an investigation was warranted and we moved out on that as expeditiously as we could.” He also supported the idea of limiting the investigation mostly to questionnaires sent to healthcare providers. “The thing that concerned me was that internal to the hospital … somehow people were getting the word that people should use something other than good clinical practice and clinical judgment to assign diagnoses,” Gilman said. To investigate that, he added, “you go talk to the people who are involved in those processes.”
It appears, however, that investigators did not question the Army officer who Douglas McNinch said had pressured him not to diagnose PTSD. In an interview with Salon, McNinch said the pressure to misdiagnose soldiers came from the psychiatrist who used to head the Department of Behavioral Health at Fort Carson. “His name was Steve Knorr,” McNinch said. When asked if he told Army investigators this information, McNinch responded, “Yes, I did.” Though the extensive redaction makes it difficult to say for certain, there is no sign in the report that Knorr was contacted or interviewed by Army investigators.
McNinch also said he was afraid to talk. He himself suffers from medical issues and, as a civilian employee of the Army, is going through the process of getting government benefits. “I am going through a disability process right now,” he said, “and quite frankly, I would not put it past the Army to, you know, fuck me over, to be blunt.”
McNinch’s naming of Knorr is particularly intriguing, given that Knorr’s name has come up before in connection with internal investigations of possibly questionable Army medical care. In a 2007 article for the Nation, journalist Joshua Kors documented a shocking coverup of Army misdiagnoses. The Army was apparently diagnosing soldiers as having “personality disorders” instead of combat-related stress. Since “personality disorders” supposedly preexist military service, they cannot be attributed to combat, meaning veterans are potentially ineligible for proper benefits. Kors reported that Knorr conducted a review of cases on behalf of the Army’s acting surgeon general and determined that no one in the Army had done anything wrong. Within a year, in response to the Nation article, the Government Accountability Office, the investigative arm of Congress, released a report questioning why 2,800 war veterans had been diagnosed as having “personality disorders.”
Contacted by Salon, Knorr said, “I don’t talk with media. Good day,” and hung up.
Salon has learned that one of the officers conducting the investigation of the tape is a junior officer to Knorr at their shared Army post. Lt. Col. Kris Peterson, chief psychiatrist at Madigan Army Medical Center at Fort Lewis, Wash., assisted Col. Bruce Crow in the investigation of the tape. Knorr is now a health consultant at Madigan.
Crow, meanwhile, was also implicated in the “personality disorder” scandal. As Knorr was writing up his review back in 2007, the Army dispatched Crow to Congress to “set the record straight,” as he told the House Committee on Veterans’ Affairs on July 25, 2007. Crow said the Army would study soldiers dismissed with personality disorders but suggested the Army was doing nothing wrong. He said soldiers with a diagnosis of personality disorder only “feel” they have been wrongly separated from the Army. “I want to assure the Congress that the Army Medical Department’s highest priority is caring for our warriors and their families,” he told the panel.
In a statement to Salon, Col. Catherine Abbott, an Army spokeswoman, reiterated Gilman’s defense of the Army’s internal investigation of Sgt. X’s tape. “They did do an investigation into it,” said Abbott in a phone interview. “There was indeed no pressure and no coercion to make any diagnosis other than the correct ones,.”
“This story,” Abbott said, “is over and done with.”
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Tomorrow: Salon explores the possible motivations for the Army to avoid recognizing the size and scope of psychiatric injuries among American ground troops, and examines the case of one soldier the Army seems to have misdiagnosed.
Michael de Yoanna first met John Needham when the troubled soldier stepped off a plane near Fort Carson, Colo., in November 2007. De Yoanna didn’t know it at the time, but a year later Needham would be part of a lengthy Salon series about soldiers involved in murders or suicides as the Army neglected their psychological war wounds. Reporters de Yoanna and Mark Benjamin documented Needham’s tale as part of the “Coming Home” series, after Needham was arrested for allegedly beating his girlfriend to death in late 2008.
Now Needham is gone too. He died on Feb. 19, about 10 days after back surgery at a Veteran’s Affairs hospital in Tucson, Ariz. The circumstances surrounding Needham’s death are unclear. According to his father, Mike Needham, an older brother discovered John Needham slumped over his bed at his mother’s house in Arizona, his face blue. Efforts by his brother, and then rescuers, to revive him were unsuccessful.
Needham, a tall, blond, sturdy California surfer and house painter, was deployed to Iraq in 2006. Not long after arriving, his life turned into a blur of roadside bombs, bloodshed and confusion. He was knocked unconscious by a grenade, suffering a brain injury. Shrapnel ripped into his legs. His back eventually gave him problems. He got a Purple Heart.
The damage to Needham wasn’t just physical. He also suffered from mental wounds. In Iraq in September 2007, when the carnage he had witnessed and participated in became too much, Needham pointed a pistol at his head and pulled the trigger. It would have ended there if a friend had not leaped forward to push the gun aside. The bullet hit a wall. Needham, who had a clean bill of health when he entered the Army, was shipped home.
When de Yoanna met him briefly in the airport in Colorado, Needham seemed nervous. He’d spent several weeks receiving care at Walter Reed Army Medical Center. Back at Fort Carson in Colorado Springs, Needham complained about punishment instead of treatment for his mental issues. His commanders threatened him with charges for discharging his weapon in his suicide attempt. Superiors also harassed him for falling asleep while heavily medicated. He was called a pussy. Though he had been diagnosed with post-traumatic stress disorder, Needham was punished for showing symptoms: failing to appear in formation, insubordination to superiors, and other problems.
With the advocacy of his father and others fighting behind the scenes, the charges against Needham disappeared and in July of 2008, the Army had washed its hands of him. He received an honorable discharge and a partial disability — but his benefits didn’t provide full access to mental health treatment, a critical gap in his care.
Had he received such care, things might have been different just weeks later. In September 2008, Needham made headlines across the country after allegedly beating his girlfriend, 19-year-old aspiring model Jacqwelyn Villagomez, to death in his San Clemente, Calif., condo.
After 10 months in a maximum-security jail cell awaiting trial, Mike Needham raised the $1 million needed to bail his son out to prepare for the murder trial.
Based in Colorado, de Yoanna traveled to California last summer and spent several days with Needham — part of Salon’s ongoing effort to understand veterans struggling with the hidden wounds of war.
Needham told de Yoanna during that visit that he couldn’t provide specifics about his case, fearing any statements he made to the press might become ammunition for prosecutors. He emphasized, however, that he was “not the murderer” authorities and the press had made him out to be. Looking over the crashing waves he loved to surf, the war veteran also said he had become an outcast and wanted to leave his home and live somewhere on the California coast where nobody would know him.
So he lived in the present, often on the beach. He surfed some, hoping the ocean would restore his body, but the pain in his lower back persisted.
After a first V.A. surgery on his back in Los Angeles that did not go as planned in late November, Needham struggled with severe pain. He developed an addiction to painkillers and was hospitalized in Long Beach in the following weeks to deal with it. Then his family brought him to Tucson, hoping the V.A. hospital near his mother’s home would do better. There was another surgery a few weeks later and one more — Needham’s third – earlier this month. Each was an effort to repair Needham’s deteriorating lower back.
Though Needham had a serious infection after his last surgery and a “tumor the size of a grapefruit” on his back, according to his father, he was only cared for by a visiting nurse while staying at his mother’s home at the time he died.
Autopsy and toxicology reports are being completed; medical investigators did not return a call to Salon by deadline.
Needham’s father feels the Army and perhaps the V.A. let his son down. “He never got correct care in the Army and, in my opinion, never got correct care from the V.A. either,” Mike Needham said. “What if they helped him when he first struggled after the explosions in Iraq? Instead, they sent him into battle day after day and harassed him when he struggled. As for the V.A., I think they’re the medical authority and responsible. I question why he was on outpatient status with a tumor the size of a grapefruit on his back.”
Mike Needham plans to join with family and friends in a small private ceremony to scatter the ashes of his son at the beach where he loved to surf. “That’s our spiritual altar — the ocean.”
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Last April, two Marines at Camp Lejeune predicted to a psychiatrist that some Marine back from war was going to “lose it.” Concerned, the psychiatrist asked what that meant. One of the Marines responded, “One of these guys is liable to come back with a loaded weapon and open fire.”
They weren’t talking about Marines suffering from a tangle of mental and religious angst, like news reports suggest haunted the alleged Fort Hood shooter, Maj. Nidal Malik Hasan. The risk they reported at Camp Lejeune was broader and systemic. Upon returning home, troops suffering mental health problems were getting dumped into an overwhelmed healthcare system that responded ineptly to their crises, the men reported, and they also faced harassment from Marine Corps superiors ignorant of the severity of their problems and disdainful of those who sought psychiatric help.
As Dr. Kernan Manion investigated the two Marines’ claims about conditions at the North Carolina military base, the largest Marine base on the East Coast, he found they were true. Manion, a psychiatrist hired last January to treat Marines coming home from war with acute mental problems, warned his superiors of looming trouble at Camp Lejeune in a series of increasingly urgent memos.
But instead of being praised for preventing what might have been another Fort Hood massacre, Manion was fired by the contractor that hired him, NiteLines Kuhana LLC. A spokeswoman for the firm says it let Manion go at the Navy’s behest. The Navy declined to comment on this story.
While military officials and the media examine whether the Army missed warning signs that might have indicated an unhinged Nidal Hasan was capable of killing 13 people at Fort Hood, Manion’s Camp Lejeune story is a cautionary tale of what happens to those who blow the whistle on conditions for military personnel with mental problems.
Manion says the April incident with the two Marines was just one of a series of disturbing events and serious problems with mental healthcare he saw at Camp Lejeune, a base that may be best known for a water contamination scandal that led to high rates of cancer and birth defects among Marines and their families who lived there. He was particularly concerned to see that troubled Marines were stricken with the overwhelming impulse to commit suicide or murder, telltale signs of severe combat stress.
In a telephone interview from his Surf City, N.C., home, Manion talked of overburdened staff and inadequate resources at the Naval hospital at Camp Lejeune. The psychiatrist charged that medical officials failed to study and discuss violent events among returning Marines in an effort to prevent further, similar events, and did little planning to improve handling distraught Marines who were killing themselves and others in shocking numbers. In 2008, for example, 42 Marines committed suicide and 146 attempted to do so, according to the Marine Corps.
Coincidentally or not, within 12 hours of Hasan’s shooting spree, Camp Lejeune officials discovered the body of one Marine and took into custody another Marine, Pvt. Jonathan Law, who is accused of killing his colleague. Law, who had served a seven-month tour in Iraq, was suffering from self-inflicted wounds when arrested.
Mirroring reports from military installations across the country, Manion also reported harassment of Marines seeking mental help. The psychiatrist began to worry about the possibility of a major outburst of violence on the base.
“A significant number of Navy medical officials and Marine commanders do not get it,” a frustrated Manion said about the situation at Camp Lejeune. “They do not understand the implications of what happens if somebody loses it,” explained Manion, who has 25 years of experience as a psychiatrist and who also specializes in traumatic brain injury — exactly the kinds of skills needed so desperately at military hospitals, because mental problems and brain injuries are the signature wounds of the ongoing wars. “People either commit suicide, commit homicide, get drunk, beat up the wife, all these things. I’ve seen it,” he added. “That is how serious this is and they just don’t get it.”
Manion believes he likely prevented a “Columbine-style attack” late last April after the two Marines who warned that someone might “lose it” directed him to a third Marine who seemed on the verge of violence. Manion also provided his superiors with documentation showing troubling incidents and neglect for the needs of returning Marines that could easily precipitate violence. Maybe not on the scale of the massacre at Fort Hood, but more like the rampage by a frustrated Sgt. John Russell, who gunned down five fellow soldiers at a military mental health facility in Baghdad last May.
Manion provided to Salon a stack of correspondence with superiors, a virtual crystal ball predicting dire consequences if mental healthcare at Camp Lejeune isn’t immediately improved.
In an April 24 memo to his superiors, including Cmdr. Robert O’Byrne, head of mental health for the Camp Lejeune Naval Hospital, Manion describes a frustrated Marine punching a telephone pole with his bare fists outside a treatment clinic, then storming around, cursing, with a piece of lumber with a nail in it, though nothing was done to ensure he didn’t hurt himself, again, or others. In another case, a severely homicidal and suicidal Marine pounded his fists into a table and stormed out of treatment. Yet the hospital, Manion complained to his superiors, made no efforts to discuss these cases or how to better handle similar events in the future.
“There was — and continues to be — no means of discussion of high-intensity/dangerous cases such as this,” a desperate Manion wrote on April 24. He warned of “immediate concerns of physical safety” at the base’s mental health facilities. Manion wanted to set up special protocols for handling intense situations, such as having specially trained MPs ready to intercede if things got bad, and a plan to hospitalize potentially violent patients quickly. “They dragged their feet on that,” he told me.
Within days that April, Manion intervened with the two Marines who’d warned of colleagues potentially losing it. They directed him to a third Marine who they believed was going to go on a shooting rampage. Manion worked hard to get that Marine into treatment, possibly averting bloodshed. The two Marines involved also reported harassment for working limited duty while seeking mental healthcare for themselves. They heatedly claimed that two noncommissioned officers had recently told them, “I don’t care why you are on [limited duty]. You are nothing but worthless pieces of shit,” according to an April 29 e-mail Manion sent to O’Byrne and others, complaining about such attitudes.
Like many healthcare providers at military bases across the country, Manion technically worked for a military contractor, Spectrum Healthcare Resources, a subcontractor for NiteLines Kuhana LLC.
On June 24, a supervisor for the contractor warned Manion to stop making trouble. “Kernan Manion, it is requested that you cease and desist all further correspondence with the government,” the supervisor with NiteLines, Pamela Friend, wrote to Manion.
But Manion was still frustrated that Camp Lejeune did not seem to be taking these risks seriously. On Aug. 30, he appealed to a series of military inspectors general in a written complaint. He warned of an “immediate threat of loss of life and/or harm to service members’ selves or others” if conditions did not improve. He complained of a “complete disregard for … implications for patient safety and well-being.” He decried that officials at Lejeune had ignored “repeated overt and emphatically stated concerns about the very safety and overall welfare of the affected patients.” And he warned that “many patients’ lives are imminently at risk.”
Four days later, the contractor fired Manion “effective immediately,” according to his termination e-mail. The note provides no reason for the firing. Manion was directed to clean out his office the next day, under the watchful eye of a chief petty officer, and have no further contact with his patients.
In a statement to Salon, NiteLines said the Navy wanted Manion fired, but did not explain why. “The treatment facility at Camp Lejeune notified (Nitelines) that Dr. Manion did not meet the Government’s requirements in accordance with the contract, and they directed he be removed from the schedule,” it reads.
Salon e-mailed the spokesman for the Naval Hospital Camp Lejeune, Raymond Applewhite, with details of this story and then described some of these facts with him in a follow-up telephone call, requesting an interview with O’Byrne. The Navy did not respond further.
Manion left Camp Lejeune after he got fired, but he did not stop worrying about the potential for violence there. In mid-September, Manion filed a 14-page complaint with the Department of Defense inspector general. On Sept. 29, he warned the Navy’s Bureau of Medicine and Surgery inspector general in writing of “serious mismanagement of post-deployment mental health services that was both endangering patient, staff and community safety as well as severely compromising the quality of care” for returning Marines. Manion noted that the poor care at Camp Lejeune continued despite “the ever present threat of life-threatening violence by distraught service members towards themselves or others.”
Finally, Manion wrote President Obama that same day. “Frankly, in my more than 25 years of clinical practice, I’ve never seen such immense emotional suffering and psychological brokenness — literally a relentless stream of courageous, well-trained and formerly strong Marines deeply wounded psychologically by the immensity of their combat experience,” he wrote to the president. Manion added, however, that at Camp Lejeune, that immense problem was being met with “inadequate treatment” and “callous indifference.”
He still worries. “I don’t like seeing these guys mistreated,” Manion said. “This is akin to somebody dying on the battlefield and not being attended to,” he added. “These guys are saying they are broken and need help, and the system is saying, ‘next, next, next.’”
Woody Harrelson began our interview by climbing barefoot onto the interior windowsill of his hotel room overlooking New York’s Union Square to point out an apartment across the square where he lived briefly, 15 or 20 years ago. (It’s in the building that houses the Heartland Brewery, if you know the neighborhood. On the second or third floor, he couldn’t remember.) Then he got into bed.
There wasn’t an ounce of pretense about any of this, I swear. He was curious to get a look at that old apartment, and felt like telling me about it. He was tired, so he got into bed. When you meet Harrelson, you get a momentary glimpse of what a strange and exhausting job it must be to be famous. The job involves meeting an endless ocean of people you don’t know and most likely will never see again. The obvious solution would be to retreat behind a well-rehearsed performance of your persona, to recycle a handful of gestures and mannerisms.
Harrelson, on the other hand, seems like a guy totally determined not to let the artificiality of these interactions impinge on his sense of who he is. Perversely, the fact that he is frank and thoughtful, and known to hold unorthodox political opinions he doesn’t keep to himself, has only augmented his fame. You can’t throw an empty Chardonnay bottle out your car window in west L.A. without hitting a Hollywood liberal, but Harrelson is something much rarer: a vegan, raw-foodist, antiwar, anti-capitalist, pro-marijuana, eco-funky, genuine radical who happens to be a beloved character actor with a good-ol’-boy demeanor.
Like the other journalists who showed up to talk to him about his role in “The Messenger,” writer-director Oren Moverman’s film about the United States Army’s Combat Notification Unit (i.e., the dreaded door-knockers who show up with really bad news), I was asked by the publicists to restrict my questions to the film and Harrelson’s acting career. It’s a laughable request anyway, but in fact I would have needed to tie Harrelson up and gag him if I didn’t want to hear his opinions about the wars in Iraq and Afghanistan, the dangers of capitalism and the looming possibility that Barack Obama could become a second LBJ.
For the first half of this decade, Harrelson was mostly absent from the movie screen; he did some theater and TV, a fair amount of environmental and pro-cannabis activism — his illegal banner-drop from the Golden Gate Bridge goes back to 1996 — and a lot of time with his family. (He lives most of the year on Maui with his wife and three daughters.) It seemed entirely plausible that the one-time “Cheers” star and Oscar nominee (for “The People vs. Larry Flynt”) had burned up his 15 minutes, and then some.
It doesn’t look that way now. Harrelson has appeared in more than two dozen films over the past three years, with more in the pipeline, and three of them are piling up on top of each other this fall. He co-stars in the action-comedy “Zombieland” and the apocalypse-thriller “2012,” both of them likely to gross more in a single weekend than “The Messenger” will in its entire history. But Moverman’s low-budget, high-intensity drama about the social and psychological costs of war is clearly “a labor of love” for all concerned, as Harrelson puts it.
In “The Messenger,” Harrelson plays Capt. Tony Stone, a damaged, middle-aged hardass assigned to mentor the younger Sgt. Will Montgomery (Ben Foster), a decorated and wounded Iraq vet, as they take on the uniquely difficult task of informing civilians that their loved ones serving overseas won’t be coming home. If that sounds wrenching, well, it is. But the acting is superlative — Harrelson’s right when he says that Foster’s starring role has echoes of James Dean or the young De Niro — and the half-improvised quality of the filmmaking feels dangerous and intimate but never showoffy.
When Stone and Montgomery are assigned to notify an NOK — that’s “next of kin,” in Army parlance — Foster and Harrelson literally went into the scene not knowing what would happen. They hadn’t even met the actors playing the bereaved-civilian roles, and weren’t sure whether they would break down in tears or respond with physical violence. (Moverman and co-writer Alessandro Camon partly based his screenplay on stories they heard from casualty-notification soldiers.) The story of what Stone and Montgomery have to do, and how it affects them, offers an intimate, human-scale portrait of the real costs of warfare.
Once Harrelson was safely tucked under the covers, wearing an Army T-shirt and a pair of blue jeans, I put my tape recorder on top of the duvet and we got talking. It was a nice big bed, and looked extra-comfy. Woody probably wouldn’t have taken it the wrong way. I can’t say I wasn’t tempted.
This movie isn’t connected to the Fort Hood shooting in any way, but still. It’s kind of intense to be talking about this subject, about death and the military, right after that.
It’s related in the sense that it’s another sad story connected to this war. There’s a lot of those, and that one’s pretty devastating. I feel really terrible for those families.
And then I just happened to notice, on the same page of today’s New York Times as that story, two more of those names in bold-face type. Two more soldiers whose families are going to be getting visits from guys like the one you play in the movie. [Just to put names to them, they were Spc. Tony Carrasco Jr., of Berino, N.M., and Staff Sgt. Amy C. Tirador of Albany, N.Y.]
It really is a devastating thing. I’ve had an evolution of sorts in terms of my attitude toward the war. Not in the sense of the war itself, which I do continue to think is wrong — and I think it’s pretty obvious what the war is about, both of them. During the course of making this, I had the opportunity to spend time with a bunch of soldiers and hear a bunch of stories, and you know, just start to feel a great deal of empathy and compassion toward the men and women who are over there working their asses off every day, not getting paid much and just putting their lives on the line for love of country. I do think that a big part of supporting the troops would be the concept of not sending them into battle in a war for resources.
So you think both Iraq and Afghanistan are wars over resources?
Iraq’s about the oil and Afghanistan’s about a pipeline. It always has been. They started building a pipeline as soon as there was a moment to do so. They started building a pipeline to the Caspian Sea, that’s always been their directive. The guys from Chevron went in and met with the Taliban and realized those guys just weren’t in control enough. That’s why they wanted to oust them. Otherwise it’s an absurd concept: You’re going to war because a guy from some other country, a Saudi, is living somewhere in the mountains? So we’re going to bomb Kabul, bomb the cities? That’s absurd. It’s a foreign policy gone way wrong. But that’s how it always is. American foreign policy has always been, not about spreading democracy, but about spreading capitalism.
It does feel sometimes like our government suffers from some kind of amnesia or OCD. It’s like they keep making the same foreign policy mistakes and just hoping it won’t turn out quite as badly the next time.
I’m hoping that other countries look at us and say, “OK, there’s the government and then there’s the people.” Granted, you’d like the will of the government to be conjoined with the will of the people. But it’s the same way I’ve made the evolutionary step of looking at the war as separate from the soldiers. When I look at Russia, I don’t look at Putin as representing the Russian people. I’m sure they’d love to get him out of there. Regardless, the Bushes and their various oligarchies have gotten us into a situation that’s just very unfortunate.
At least at this point, it appears that Obama is pushing onward with the war in Afghanistan. Is he just constrained by geopolitics? Is he simply not free to say, “Look, we’re not going to do this anymore”?
I think there’s a lot of persuasive and powerful people around Obama. For a president to make his own decisions, I think that’s a rarity. Even someone who we think of as our guy — this is a guy with integrity, a guy who cares, for the first time in a long time — in the Oval Office, even with him we don’t really know who’s pulling the strings. I think of every president as being a marionette. Whether he’s any different, I don’t know. Certainly his military advisors all want him to prosecute this war to the end, just as they did in Vietnam with LBJ.
It’s just too depressing, I think we’re going to have to hit the streets. Obama has the chance of becoming JFK or LBJ. I think JFK was one of our last great presidents, although I thought Carter was pretty great too. LBJ could have been a great president if he hadn’t gotten bogged down in war, but that was quite a war to get bogged down in. Notwithstanding the fact that the war was wrong and they were talking about the Red Scare and the domino effect, if you go and read the Pentagon Papers they were also talking about rubber, tin and oil. They killed 2 and a half million people. What was it all for? In Korea they killed 4 and a half million. Like, we’re liberating these people?
Well, one of the things this movie engages, in a way, is the fact that the combined U.S. fatalities in Iraq and Afghanistan are still below 4,500. Not that that’s not terrible for those families, but it’s not a number that has affected every town and every neighborhood, the way other wars did.
Yeah, but it’s got to be more than 10 times that in terms of people with injuries, people strongly affected by it. I’m not sure what’s going to make people hit the street, and, you know, I’m one of those people who’s not on the street. I recognize that I’m just a guy bitching about it, not a guy who’s doing anything.
The thing I love about this movie is that it really takes into account the consequences of going to war. It’s been gratifying to me to hear from people who say, “Before it was just a thing in the news, a statistic.” You’re not really seeing a blown-up body, or seeing the coffins at Dover. I think it’s a good thing that it puts a human face on it.
On one level I really dreaded those scenes where you and Ben went to knock on people’s doors, do the notifications. They were hard to sit through. But on the other hand, I kind of needed that emotional catharsis. And they’re very intense. In the first scene we see, the woman completely goes nuts and attacks you.
That was cool because of the way Oren shot it. We really didn’t know what was going to happen. I didn’t know she was going to hit me. You don’t know what level the people are going to, the way they’ll manage their grief. I think it made those scenes much more realistic. We never rehearsed, and never even met the people ahead of time. We shot those in one shot. All of that was really good.
They weren’t all done in one shot, were they?
No, there’s only two notification scenes that are actually one shot as you see them in the movie. One is Steve Buscemi’s and then there’s another one. But they were all shot as a one-camera, single-shot thing, with one camera following the action. Later on, if Oren did three takes or whatever, he’d join the different takes together, find whatever worked better. But they were designed to be one-shot takes, and it felt very real. It kept us right on our toes, and on edge.
That guy that you’re playing felt very real to me. He’s this hardass military lifer, an Army guy, and he’s really messed up in ways he doesn’t even recognize. I mean, this guy badly needs a hug.
[Laughter.] That’s the best description yet. He badly needs a hug. That’s true.
I thought there was terrific chemistry between you and Ben Foster, who plays your younger tag-team partner. Obviously you guys are pros so it can be hard to tell, but it felt like there was something real happening there.
Oh, it was incredible. I feel like he’s my brother, I really love him. And as an actor, he’s one of the best I’ve ever worked with, if not the best. Total immersion in the mind-set of the character, and constantly reminding himself of the significance of what we’re doing. Just before a scene, maybe I’m not completely grounded, and he hands me these pictures of soldiers smiling or hanging with their kids, and they’re marked with the dates they died, 2003, 2004, whatever. You can’t help but be full of the emotion, with what this movie’s connected to. It’s one of the few times that I’ve felt emotional pretense really skirting on emotional reality. I don’t think I said that right. It’s just, you know, we’re pretending, but the reality of it is big.
I’ve seen him in other movies, but people are really going to notice him this time, if they haven’t already.
I think he’s one of the most amazing actors. It’s like I’m working with James Dean before people know that he’s James Dean. I feel like I just did “East of Eden” with James Dean. His talent is so expansive, he’s got a huge career ahead of him.
You took several years off, and for a while there it didn’t seem clear whether you wanted to make Hollywood movies anymore. I guess you’re at peace with them now! I’m not ranking on you for making movies. You’re an actor. But does it help you somehow to do a smaller project like this one alongside a big movie like “2012,” which can pay a lot of bills?
You know, I don’t feel like a movie has to have a message, necessarily. If a movie’s fun and funny and just great entertainment, that’s enough. But it’s nice to do a movie like “The Messenger” where you feel like people watch it and it’s initiating conversations that are important. What more could you hope for?
I did take a long time off. I wasn’t planning on taking that long, it just kind of happened. Five years. I did keep my hand in, in terms of doing some plays. I wasn’t entirely out of the loop. But it was a good thing. I needed to spend some time with my kids. I needed to get away from it. I wasn’t liking the whole, I guess you would say, business-y side of it. I came into acting initially because I loved theater, I wanted to be on Broadway. You know, I would have been on Broadway, but I ended up doing this show.
I’ve heard about that! Apparently you were on TV for a few years.
Yeah. Otherwise I just would have been here in New York. I love theater, that is where my passion is. There was a lot about “The Messenger” that felt very theatrical. Just really being in a scene with a fucking serious actor, like a young De Niro type of actor. It was just a great experience all the way around. I feel super lucky to be a part of this movie.
“The Messenger” opens Nov. 13 at the Angelika Film Center and Lincoln Plaza Cinemas in New York, with wider release to follow.
The harsh combat in Iraq, including potential war crimes that were witnessed by soldiers, contributed to a series of brutal murders by soldiers based at this Army post near Colorado Springs after they returned home, according to a hard-hitting Army study released Wednesday. Many of the findings in the study, which was announced by senior Army brass at a press conference on the post, mirror those in Salon’s Coming Home series, which identified a pattern of preventable homicides and suicides at Fort Carson among soldiers who served in Iraq with combat stress and failed to receive proper medical treatment.
According to the report, “Survey data from this investigation suggest a possible association between increasing levels of combat exposure and risk for negative behavioral outcomes.” The study also says that “combat intensity/exposure . . . may have increased the risk for violent behaviors” and that its “findings are consistent with recent research on combat exposure and subsequent behavior outcomes among Soldiers.”
Salon’s Coming Home series showed that soldiers who returned from combat duty with symptoms of stress were often ridiculed or otherwise discouraged from seeking help, were overmedicated or misdiagnosed, or chose to self-medicate with drugs and alcohol. Many had been deployed even though they were already displaying signs of combat stress. Additionally, some of the soldiers involved in violence against themselves or others had preexisting conditions that should have disqualified them from service, but were allowed into a military hard-pressed for new recruits via waivers.
The 126-page report issued by the Army Wednesday — an epidemiological study, or EPICON in military lingo — focused largely on 14 of the Army post’s soldiers allegedly involved in murders since 2005. Ordered by Fort Carson commander Maj. Gen. Mark Graham in the wake of the slayings, it is studded with statistical evidence that buttresses Salon’s investigation. The numbers point to a link between violent behavior and substance abuse, repeated deployments, exposure to combat and enlistment waivers. In addition, many of the 14 soldiers allegedly involved in murders witnessed incidents described in the report as War Crimes. Five either heard of or witnessed the “murdering/killing” of non-combatants; three, “detainee abuse;” and, two, “fabricating evidence to justify attacks or criminal acts.”
Yet the Army officials presenting the report denied that it established any cause-and-effect relationships. Eric Schoomaker, the Army’s surgeon general, waved his hands across his chest under clear blue skies during the outdoor press conference, dismissing the notion that the report proved a tie between soldier-involved killings and the horrors those soldiers experienced in the war.
“While this is probably the most intensive and in-depth investigation on the clustering of violent-on-violent crimes in the Army that we’ve ever seen or are aware of,” said Schoomaker, “it is still in many respects preliminary.”
Without causation, there is no way to establish how the murders could’ve been prevented. “We would all like to look back at the cluster of misconduct and criminal activities,” said Schoomaker, “that resulted in devastating human tragedies here in Colorado and be able to say, ‘This is the reason they happened and we know exactly what could have been done to prevent them,’ but that’s rarely the way things work when dealing with human behavior.”
Without causation, there is also limited accountability. While commanders were blamed for standing in the way of soldiers receiving mental health and substance-abuse care, Lt. Gen. Michael Rochelle, the Army’s director of personnel, said the report “was not a tool that was intended to be used to either fix accountability or to be used for any sort of disciplinary action that may follow.”
Schoomaker, Rochelle and Maj. Gen. Graham, who was also on the podium Wednesday, were able to deny cause-and-effect because of caveats in the study. The authors of the report, a 24-member team assembled the Army’s Center for Health Promotion and Preventive Medicine, issued recommendations to stop the belittling of soldiers who seek mental health care and to identify units with high exposure to combat. They stopped short, however, of positing causation, saying that “”the cross-sectional nature of the study does not allow for making causal inferences.”
Thus Schoomaker could say, truthfully, “It’s pointing the finger to levels of causation, but we don’t know direct causation yet. … I’m very reluctant to put cause and effect there. In fact, the authors [of the report] are very careful to say these are correlations … not necessarily one causing the other.”
Yet Schoomaker also seemed to place some blame on the soldiers themselves for failing to seek help. He suggested that units where the soldiers were more willing to get help were less likely to be plagued with violence. The study, he noted, analyzed two brigades at Fort Carson, the 4th and the 3rd. “What did seem to differ between the two was the willingness and ability of those soldiers within the unit where crimes were committed to seek and get effective care for emerging behavioral health problems — alcohol and drug problems — and prompt attention to misconduct.”
But Schoomaker also claimed that the experiences of the 4th and 3rd Brigades in combat were “similar.” That’s not what’s indicated in the report — the 4th Brigade, where the murder suspects were clustered, had eight times more combat deaths than the 3rd. Moreover, the report indicated that the Army itself played a role in denying care to the soldiers — half, some with suicide issues, were sent back to Iraq “early,” according to the report.
U.S. Senator Mark Udall, a Colorado Democrat, who met on Tuesday with Schoomaker, issued a statement following the release of the report, noting it raises “serious questions about whether the military is doing enough to help service members transition from battle back into civilian life.”
“This is a matter of life and death, for our service members – and civilians,” Udall stated. “We must do everything in our power to ensure that the military is providing all necessary treatment and support to protect our service members, their families, and our communities.”
That could be a long road. The report indicated that “overall staffing” for behavioral health at Fort Carson’s Evans Army Community Hospital between 2006 and 2008 was just 65 percent of authorized positions.
Woody Harrelson in "The Messenger" 
Maj. Gen. Mark Graham (right), Fort Carson's commander, speaks to members of the press on Wednesday. Behind him are the Army's chief of personnel, Lt. Gen. Michael Rochelle (left), and, Army Surgeon General Eric Schoomaker. 
