The Washington Post published the first in a series of exposés on the medical neglect and deplorable living conditions of wounded soldiers at Walter Reed Army Medical Center, the Army’s major hospital. The exposé led to a national scandal and public condemnation, the resignations of top government and military officials, the formation of a presidential commission to investigate the matter, and new, focused programs for soldier-patients systemwide.
On February 18, 2007, The Washington Post (The Post) published the first in a series of articles that chronicled inadequate medical care and neglect at Walter Reed Army Medical Center for troops returning from the wars in
Walter Reed was once among the military’s premier medical facilities. Located only five miles from the White House in Washington, D.C., the hospital has served more than 150,000 active duty, National Guard, reserve, and retired military personnel. With fifty-five hundred rooms and more than twenty-eight acres of floor space, it is one of the world’s largest medical facilities. U.S. presidents, members of Congress, and foreign dignitaries also have received treatment at the facility.
Allegations of poor care and bureaucracy had been raised in Web-based features in 2004 and 2005 (on Salon.com). Furthermore, two members of Congress, both Republicans, were briefed about the problems as early as 2004 but failed to investigate for fear of embarrassing the Army. Also, an internal Walter Reed memorandum in September, 2006, had warned of possible “mission failure” because of the privatization and outsourcing of many of its services. However, it was the coverage by The Post that launched a national, public scandal.
The scandal led to the firing of several medical center and military officials. Countless investigations followed, all causing significant embarrassment to George W. Bush and his administration. Moreover, a House of Representatives panel investigating the Walter Reed allegations concluded that the hospital’s problems were likely emblematic of the military’s health care system in general.
Among the scandal’s casualties was the medical center’s commander, Major General George W. Weightman, who had claimed to be unaware of the center’s shoddy conditions and overwhelming red tape. Weightman was relieved of his command on March 1. Others were forced to resign, including on March 2 Secretary of the Army Francis J. Harvey. Lieutenant General Kevin C. Kiley, the Army’s surgeon general and the center’s commander from 2002 to 2004, retired on March 12.
Although The Post hailed the inpatient area of the medical center as “a place of scrubbed-down order and daily miracles, with medical advances saving more soldiers than ever,” much of the controversy was centered on outpatient treatment. Outpatients at Walter Reed traditionally have been active-duty personnel assigned to special outpatient military units at the center. At the height of the scandal, these patients were housed in base facilities and dozens of nearby hotels and apartments contracted by the military. Such facilities were described as a “holding ground” for hundreds of outpatients—mostly soldiers and Marines—and Walter Reed’s staff and facilities became overwhelmed by the legions of injured personnel from years of war in the Middle East.
Although the average stay following inpatient treatment was about ten months, many outpatients were assigned to Walter Reed’s outpatient units for two years or more. According The Post, outpatients quickly outnumbered inpatients by a ratio of 17-1. Many were amputees or had suffered head and brain injuries; still others had severe psychological problems. According to an interview with General Weightman, problems at the center stemmed from the Army’s intense scrutiny of medical discharges during two concurrent, long-term wars using an all-volunteer force.
Among the biggest complaints waged by those interviewed by The Post was the amount of paperwork and bureaucracy soldiers and their families had to surmount to receive basic services. Investigators reported that the typical soldier filled out twenty-two forms—filed with eight different commands, many of them off post—to enter or exit the military medical system. Furthermore, to process the forms, the Army relied on sixteen incompatible data systems and three incompatible personnel systems. Separate and incompatible pay and medical records systems were used as well. Because of these bureaucratic hurdles, records were frequently lost, forcing injured soldiers to bring in medals, photographs, and personal documents to prove they were injured in war. Soldiers and their families apparently received little guidance in navigating this arcane system.
While paperwork may have frustrated soldiers and their families, public outcry came after The Post described life at Walter Reed’s inferior outpatient facilities, particularly a former hotel just outside the gates of the post identified as Building 18. This outpatient building had everything from vermin to mold and stained carpeting. Worse, injured and disfigured soldiers—many of whom also were suffering from post-traumatic stress disorder, paranoid delusional disorders, and schizophrenia—reportedly spent their days wandering aimlessly through the facility. Most were waiting for a bureaucrat’s decision on whether they would be discharged from the service or returned to active duty.
Reporters Priest and Hull noted that the alarming conditions were exacerbated because many patients housed in Building 18 subsisted on carry-out food and used hotplates for warming up food because the medical center’s mess hall was located far from their barracks. Building 18 lacked adequate security and was located in an area of the city known for drug dealing and other crimes. In addition, noncommissioned officers, themselves with serious psychological disorders, frequently supervised other patients, some at risk of suicide.
Building 18 originally had been slated for renovation, but that project was put on hold because the medical center was scheduled for closure. In addition, a thirty-thousand-dollar grant for upgrades and recreational equipment for the residents was canceled in December, 2006, just before the Christmas holidays, because an official was concerned that such expenditures could trigger an audit. By January, the funds were no longer available. Army vice chief of staff Richard Cody, along with Harvey, walked through the facility and insisted that changes were in order.
Ultimately, medical center leaders were accused of having unqualified military personnel and overworked and undertrained case managers help injured soldiers and their families. In addition to assisting patients with housing and pay, these medical center personnel were tasked with helping soldiers with such apparently simple, but almost insurmountable, issues such as replacing their destroyed uniforms, ruined when the soldiers were injured. The task seemed simple enough. In one case, however, a soldier receiving a medal for his war service was disciplined for showing up for the ceremony in sweat pants and shirt; he had not received replacement uniforms. The Army requires outpatient soldiers, even amputees and personnel using wheelchairs, to wear uniforms during treatment.
Beyond the firings and forced resignations, investigators began to examine the medical care of not only Walter Reed but also the military health care system in general. An independent review panel appointed by Defense Secretary Robert Gates confirmed in April, 2007, that many of the allegations made in The Washington Post and elsewhere were indeed true. The panel’s report cited neglect and “virtually incomprehensible” inattention to maintenance at Walter Reed.
On March 6, shortly after the story broke in The Washington Post, President Bush appointed the Task Force on Returning Global War on Terror Heroes and convened the Commission on Care for America’s Returning Wounded Warriors
Although many of the commission’s recommendations were mired in bureaucratic red tape, one suggestion made news headlines: assigning so-called recovery coordinators from outside the military to each seriously wounded soldier to help shepherd him or her through the system. Also, as a result of the recommendations, several pieces of so-called wounded-warrior legislation were proposed in Congress.
The Government Accountability Office reported in September that the Pentagon’s promised fixes at Walter Reed and elsewhere in the military health care system remained threatened by staff shortages and a lack of clarity on how best to care for wounded troops. Adding to concerns of staff shortages and stalled improvements in medical care was the slated closure of Walter Reed by the
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Priest, Dana, and Anne Hull. “Soldiers Face Neglect, Frustration at Army’s Top Medical Facility.” The Washington Post, February 18, 2007. The first article in the special investigative report on Walter Reed Army Medical Center. This is the story that broke the scandal. -
United States Congress. Senate Armed Services Committee. Care, Living Conditions, and Administration of Outpatients at Walter Reed Army Medical Center. Washington, D.C.: Government Printing Office, 2007. The Senate report of its hearings on the Walter Reed Hospital medical neglect scandal. The hearings began on March 6, 2007. -
Vogel, Steve. “Report Says Fixes Slow to Come to Walter Reed.” The Washington Post, September 27, 2007. Reporter Vogel follows up on the initial February, 2007, exposé and investigates the progress of promised changes at Walter Reed Hospital.
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