TAKING CARE OF SOLDIERS

Specialist Town Takes His Case to Washington,” by Joshua Kors [Oct. 15], contained numerous inaccuracies, despite our providing written response.

(a) The Army medical family has a strong commitment to taking care of soldiers. If a soldier believes he or she was discharged incorrectly, the formal mechanism is an appeal to the Army Board for the Correction of Military Records. However, due to my concern over these issues, they may provide their information directly to me, and I will ensure review of their records.

(b) A personality disorder diagnosis does not necessarily mean that a medical evaluation board is needed. It indicates that a soldier has personality traits that are not compatible with military service. A personality disorder diagnosis does not negate a medical evaluation board if that is warranted by other illnesses or injury.

(c) It is unacceptable for any provider to be pressured to falsely diagnose a patient. I ask any individual who may have information about such allegations to come forward to my office or to the Inspector General so that the allegations can be fully investigated.

(d) The behavioral health officers at the Army hospital at Fort Carson reviewed the Chapter 5-13 cases in soldiers who were diagnosed with PTSD. The data demonstrated that there were no soldiers separated under Chapter 5-13 in the last four years who should have undergone a medical evaluation board.

(e) Some specific cases were brought to my attention, and they were reviewed by the chief of the psychiatry department at the Fort Carson hospital. A second level of review was done by behavioral health staff in my office. In all of these cases, the documents reflected appropriate medical care.

(f) Mental health records contain a great deal of information about the soldiers’ prior history, family of origin, substance use, previous patterns of behavior, as well as their current behavioral issues. A review of the chart normally reveals a wealth of diagnostic information, to include psychological testing. Routinely, there is evidence in the record to substantiate the diagnosis. The soldiers are also screened for posttraumatic stress disorder, head trauma and other medical diagnoses, and those symptoms, or lack thereof, are recorded in the charts.

The bottom line is that we care about soldiers and are committed to providing them the best care possible. Again, due to my concerns, soldiers may provide their information to me, and I will have their records reviewed.

MAJ. GEN. GALE S. POLLOCK
Acting Surgeon General, US Army


Mt. Vernon, N.Y.

The diagnosis of personality disorder attributed to veterans of combat operations is not applicable to returning soldiers. In order to have pre-existing conditions, veterans would have to have had a diagnosis of conduct disorder prior to their eighteenth birthday.

As a veteran myself, I remember that the ability to kill an enemy combatant without feeling guilt or remorse was prized. The Diagnostic and Statistical Manual of Mental Disorders describes a personality disorder as “an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.” I remember a drill sergeant drumming into our heads during basic training that we were going to be broken down and rebuilt into “mean green killing machines.” The louder we screamed as we jammed our bayonets into mock-up enemy soldiers the more verbal reinforcement we received.

When are we going to come to terms with the fact that violence and aggression are at the core of our existence, and when it is displayed appropriately in battle we are respected and envied for it. Soldiers are trained to have “personality disorders” and should not be punished for it.

ROBERT M. LICHTMAN, PhD


KORS REPLIES

New York City

My thanks to Dr. Lichtman for his thoughtful letter.

For five months I asked Surgeon General Pollock to speak with me about the personality disorder scandal. Each interview request was denied. ABC’s Bob Woodruff asked Pollock to join him on camera. She refused. Congressman Bob Filner called her to testify before Congress. She declined. Now comes her letter to the editor.

No doubt readers will find it strange that she promises to reveal “numerous inaccuracies,” then ends her letter without having pointed out one.

Pollock is right that the Army Board has the power to overturn personality disorder cases. It’s a power they rarely employ. Of the dozens of cases I examined, only one had his discharge overturned: William Wooldridge, who battled the military for twenty-four months and benefited from extensive behind-the-scenes work by his high-ranking Washington contacts.

Anyone familiar with Army discharges will recognize the specious logic of Pollock’s point (b): soldiers who merely have personality disorder traits–say, nervousness or depression–aren’t discharged from the Army. They see a counselor and are returned to their unit. An army in need of soldiers to wage two simultaneous wars does not dismiss troops who can still perform their duties. Only when a soldier grows so ill that he can no longer do his job is he dismissed–and then a medical board discharge is required by Army regulations.

In point (d) Pollock confirms that the four-year review of Fort Carson’s personality disorder discharges, trumpeted in her Tallman memo, never occurred. As she reminds us, Army officials did say that they examined fifty-two personality disorder cases (the soldiers who had also been diagnosed with PTSD and whose records had not been lost by Fort Carson officials). But the Army eventually admitted that the other 220 cases were not examined. Those included soldiers who returned from Iraq with brain damage and those who could not persuade their doctors to diagnose PTSD.

The Army’s contention that a “thoughtful and thorough” review can be performed without examining or even speaking to soldiers–point (f)–I discussed twice in my Nation articles. Readers will recall Col. Steven Knorr, the man Pollock selected to lead the personality disorder review, stating that soldiers are not trained to recognize personality disorder, so speaking to them would be of limited value. Cynthia Vaughan, Pollock’s official spokeswoman, explained that Pollock didn’t talk to soldiers because soldiers’ input on their own cases does not hold “medical validity.”

Soldiers will be happy to hear Pollock’s assertion that her office also reviewed the personality disorder cases examined by Cololnel Knorr, though most, I imagine, won’t be too satisfied to learn of another anonymous reviewer who examined paperwork without speaking to soldiers and, like Knorr, concluded that Purple Heart-earning Specialist Town was not wounded in combat.

JOSHUA KORS


EAST IS EAST & WEST IS WEST

In “Rudy’s Bird of Prey” [Oct. 29] we characterized Paul Singer as an Upper East Side billionaire. He resides on the Upper West Side.