Walter Reed Army Hospital.....?

[Gimpy]

SOLDIERS FACE NEGLECT, FRUSTRATION AND FILTH AT WALTER REED --


Signs of neglect are everywhere: mouse droppings, belly-up cockroaches, filthy, stained carpets, cheap mattresses.

Soldiers Face Neglect, Frustration At Army's Top Medical Facility


By Dana Priest and Anne Hull
Washington Post Staff Writers

Behind the door of Army Spec. Jeremy Duncan's room, part of the wall is torn and hangs in the air, weighted down with black mold. When the wounded combat engineer stands in his shower and looks up, he can see the bathtub on the floor above through a rotted hole. The entire building, constructed between the world wars, often smells like greasy carry-out. Signs of neglect are everywhere: mouse droppings, belly-up cockroaches, stained carpets, cheap mattresses.


This is the world of Building 18, not the kind of place where Duncan expected to recover when he was evacuated to Walter Reed Army Medical Center from Iraq last February with a broken neck and a shredded left ear, nearly dead from blood loss. But the old lodge, just outside the gates of the hospital and five miles up the road from the White House, has housed hundreds of maimed soldiers recuperating from injuries suffered in the wars in Iraq and Afghanistan.


The common perception of Walter Reed is of a surgical hospital that shines as the crown jewel of military medicine. But 4 1/2 years of sustained combat have transformed the venerable 113-acre institution into something else entirely -- a holding ground for physically and psychologically damaged outpatients. Almost 700 of them -- the majority soldiers, with some Marines -- have been released from hospital beds but still need treatment or are awaiting bureaucratic decisions before being discharged or returned to active duty.


They suffer from brain injuries, severed arms and legs, organ and back damage, and various degrees of post-traumatic stress. Their legions have grown so exponentially -- they outnumber hospital patients at Walter Reed 17 to 1 -- that they take up every available bed on post and spill into dozens of nearby hotels and apartments leased by the Army. The average stay is 10 months, but some have been stuck there for as long as two years.


Not all of the quarters are as bleak as Duncan's, but the despair of Building 18 symbolizes a larger problem in Walter Reed's treatment of the wounded, according to dozens of soldiers, family members, veterans aid groups, and current and former Walter Reed staff members interviewed by two Washington Post reporters, who spent more than four months visiting the outpatient world without the knowledge or permission of Walter Reed officials. Many agreed to be quoted by name; others said they feared Army retribution if they complained publicly.


While the hospital is a place of scrubbed-down order and daily miracles, with medical advances saving more soldiers than ever, the outpatients in the Other Walter Reed encounter a messy bureaucratic battlefield nearly as chaotic as the real battlefields they faced overseas.


On the worst days, soldiers say they feel like they are living a chapter of "Catch-22." The wounded manage other wounded. Soldiers dealing with psychological disorders of their own have been put in charge of others at risk of suicide.


Disengaged clerks, unqualified platoon sergeants and overworked case managers fumble with simple needs: feeding soldiers' families who are close to poverty, replacing a uniform ripped off by medics in the desert sand or helping a brain-damaged soldier remember his next appointment.


"We've done our duty. We fought the war. We came home wounded. Fine. But whoever the people are back here who are supposed to give us the easy transition should be doing it," said Marine Sgt. Ryan Groves, 26, an amputee who lived at Walter Reed for 16 months. "We don't know what to do. The people who are supposed to know don't have the answers. It's a nonstop process of stalling."


Soldiers, family members, volunteers and caregivers who have tried to fix the system say each mishap seems trivial by itself, but the cumulative effect wears down the spirits of the wounded and can stall their recovery.


"It creates resentment and disenfranchisement," said Joe Wilson, a clinical social worker at Walter Reed. "These soldiers will withdraw and stay in their rooms. They will actively avoid the very treatment and services that are meant to be helpful."


Danny Soto, a national service officer for Disabled American Veterans who helps dozens of wounded service members each week at Walter Reed, said soldiers "get awesome medical care and their lives are being saved," but, "Then they get into the administrative part of it and they are like, 'You saved me for what?' The soldiers feel like they are not getting proper respect. This leads to anger."

This world is invisible to outsiders. Walter Reed occasionally showcases the heroism of these wounded soldiers and emphasizes that all is well under the circumstances. President Bush, former defense secretary Donald H. Rumsfeld and members of Congress have promised the best care during their regular visits to the hospital's spit-polished amputee unit, Ward 57.


"We owe them all we can give them," Bush said during his last visit, a few days before Christmas. "Not only for when they're in harm's way, but when they come home to help them adjust if they have wounds, or help them adjust after their time in service."


Along with the government promises, the American public, determined not to repeat the divisive Vietnam experience, has embraced the soldiers even as the war grows more controversial at home. Walter Reed is awash in the generosity of volunteers, businesses and celebrities who donate money, plane tickets, telephone cards and steak dinners.


Yet at a deeper level, the soldiers say they feel alone and frustrated. Seventy-five percent of the troops polled by Walter Reed last March said their experience was "stressful." Suicide attempts and unintentional overdoses from prescription drugs and alcohol, which is sold on post, are part of the narrative here.


Vera Heron spent 15 frustrating months living on post to help care for her son. "It just absolutely took forever to get anything done," Heron said. "They do the paperwork, they lose the paperwork. Then they have to redo the paperwork. You are talking about guys and girls whose lives are disrupted for the rest of their lives, and they don't put any priority on it."


Family members who speak only Spanish have had to rely on Salvadoran housekeepers, a Cuban bus driver, the Panamanian bartender and a Mexican floor cleaner for help. Walter Reed maintains a list of bilingual staffers, but they are rarely called on, according to soldiers and families and Walter Reed staff members.


Evis Morales's severely wounded son was transferred to the National Naval Medical Center in Bethesda for surgery shortly after she arrived at Walter Reed. She had checked into her government-paid room on post, but she slept in the lobby of the Bethesda hospital for two weeks because no one told her there is a free shuttle between the two facilities. "They just let me off the bus and said 'Bye-bye,' " recalled Morales, a Puerto Rico resident.


Morales found help after she ran out of money, when she called a hotline number and a Spanish-speaking operator happened to answer.


"If they can have Spanish-speaking recruits to convince my son to go into the Army, why can't they have Spanish-speaking translators when he's injured?" Morales asked. "It's so confusing, so disorienting."


Soldiers, wives, mothers, social workers and the heads of volunteer organizations have complained repeatedly to the military command about what one called "The Handbook No One Gets" that would explain life as an outpatient. Most soldiers polled in the March survey said they got their information from friends. Only 12 percent said any Army literature had been helpful.


"They've been behind from Day One," said Rep. Thomas M. Davis III (R-Va.), who headed the House Government Reform Committee, which investigated problems at Walter Reed and other Army facilities. "Even the stuff they've fixed has only been patched."


Among the public, Davis said, "there's vast appreciation for soldiers, but there's a lack of focus on what happens to them" when they return. "It's awful."


Maj. Gen. George W. Weightman, commander at Walter Reed, said in an interview last week that a major reason outpatients stay so long, a change from the days when injured soldiers were discharged as quickly as possible, is that the Army wants to be able to hang on to as many soldiers as it can, "because this is the first time this country has fought a war for so long with an all-volunteer force since the Revolutionary War."


Acknowledging the problems with outpatient care, Weightman said Walter Reed has taken steps over the past year to improve conditions for the outpatient army, which at its peak in summer 2005 numbered nearly 900, not to mention the hundreds of family members who come to care for them. Each platoon sergeant used to be in charge of 125 patients; now each one manages 30. Platoon sergeants with psychological problems are more carefully screened. And officials have increased the numbers of case managers and patient advocates to help with the complex disability benefit process, which Weightman called "one of the biggest sources of delay."


And to help steer the wounded and their families through the complicated bureaucracy, Weightman said, Walter Reed has recently begun holding twice-weekly informational meetings. "We felt we were pushing information out before, but the reality is, it was overwhelming," he said. "Is it fail-proof? No. But we've put more resources on it."


He said a 21,500-troop increase in Iraq has Walter Reed bracing for "potentially a lot more" casualties.


Bureaucratic Battles


The best known of the Army's medical centers, Walter Reed opened in 1909 with 10 patients. It has treated the wounded from every war since, and nearly one of every four service members injured in Iraq and Afghanistan.


The outpatients are assigned to one of five buildings attached to the post, including Building 18, just across from the front gates on Georgia Avenue. To accommodate the overflow, some are sent to nearby hotels and apartments. Living conditions range from the disrepair of Building 18 to the relative elegance of Mologne House, a hotel that opened on the post in 1998, when the typical guest was a retired officer recovering from hip-replacement surgery.


The Pentagon has announced plans to close Walter Reed by 2011, but that hasn't stopped the flow of casualties. Three times a week, school buses painted white and fitted with stretchers and blackened windows stream down Georgia Avenue. Sirens blaring, they deliver soldiers groggy from a pain-relief cocktail at the end of their long trip from Iraq via Landstuhl Regional Medical Center in Germany and Andrews Air Force Base.


Staff Sgt. John Daniel Shannon, 43, came in on one of those buses in November 2004 and spent several weeks on the fifth floor of Walter Reed's hospital. His eye and skull were shattered by an AK-47 round. His odyssey in the Other Walter Reed has lasted more than two years, but it began when someone handed him a map of the grounds and told him to find his room across post.


A reconnaissance and land-navigation expert, Shannon was so disoriented that he couldn't even find north. Holding the map, he stumbled around outside the hospital, sliding against walls and trying to keep himself upright, he said. He asked anyone he found for directions.


Shannon had led the 2nd Infantry Division's Ghost Recon Platoon until he was felled in a gun battle in Ramadi. He liked the solitary work of a sniper; "Lone Wolf" was his call name. But he did not expect to be left alone by the Army after such serious surgery and a diagnosis of post-traumatic stress disorder. He had appointments during his first two weeks as an outpatient, then nothing.


"I thought, 'Shouldn't they contact me?' " he said. "I didn't understand the paperwork. I'd start calling phone numbers, asking if I had appointments. I finally ran across someone who said: 'I'm your case manager. Where have you been?'


"Well, I've been here! Jeez Louise, people, I'm your hospital patient!"


Like Shannon, many soldiers with impaired memory from brain injuries sat for weeks with no appointments and no help from the staff to arrange them. Many disappeared even longer. Some simply left for home.


One outpatient, a 57-year-old staff sergeant who had a heart attack in Afghanistan, was given 200 rooms to supervise at the end of 2005. He quickly discovered that some outpatients had left the post months earlier and would check in by phone. "We called them 'call-in patients,' " said Staff Sgt. Mike McCauley, whose dormant PTSD from Vietnam was triggered by what he saw on the job: so many young and wounded, and three bodies being carried from the hospital.


Life beyond the hospital bed is a frustrating mountain of paperwork. The typical soldier is required to file 22 documents with eight different commands -- most of them off-post -- to enter and exit the medical processing world, according to government investigators. Sixteen different information systems are used to process the forms, but few of them can communicate with one another. The Army's three personnel databases cannot read each other's files and can't interact with the separate pay system or the medical recordkeeping databases.


The disappearance of necessary forms and records is the most common reason soldiers languish at Walter Reed longer than they should, according to soldiers, family members and staffers. Sometimes the Army has no record that a soldier even served in Iraq. A combat medic who did three tours had to bring in letters and photos of herself in Iraq to show she that had been there, after a clerk couldn't find a record of her service.


Shannon, who wears an eye patch and a visible skull implant, said he had to prove he had served in Iraq when he tried to get a free uniform to replace the bloody one left behind on a medic's stretcher. When he finally tracked down the supply clerk, he discovered the problem: His name was mistakenly left off the "GWOT list" -- the list of "Global War on Terrorism" patients with priority funding from the Defense Department.


He brought his Purple Heart to the clerk to prove he was in Iraq.


Lost paperwork for new uniforms has forced some soldiers to attend their own Purple Heart ceremonies and the official birthday party for the Army in gym clothes, only to be chewed out by superiors.


The Army has tried to re-create the organization of a typical military unit at Walter Reed. Soldiers are assigned to one of two companies while they are outpatients -- the Medical Holding Company (Medhold) for active-duty soldiers and the Medical Holdover Company for Reserve and National Guard soldiers. The companies are broken into platoons that are led by platoon sergeants, the Army equivalent of a parent.


Under normal circumstances, good sergeants know everything about the soldiers under their charge: vices and talents, moods and bad habits, even family stresses.


At Walter Reed, however, outpatients have been drafted to serve as platoon sergeants and have struggled with their responsibilities. Sgt. David Thomas, a 42-year-old amputee with the Tennessee National Guard, said his platoon sergeant couldn't remember his name. "We wondered if he had mental problems," Thomas said. "Sometimes I'd wear my leg, other times I'd take my wheelchair. He would think I was a different person. We thought, 'My God, has this man lost it?' "


Civilian care coordinators and case managers are supposed to track injured soldiers and help them with appointments, but government investigators and soldiers complain that they are poorly trained and often do not understand the system.


One amputee, a senior enlisted man who asked not to be identified because he is back on active duty, said he received orders to report to a base in Germany as he sat drooling in his wheelchair in a haze of medication at Walter Reed. "I went to Medhold many times in my wheelchair to fix it, but no one there could help me," he said.


Finally, his wife met an aide to then-Deputy Defense Secretary Paul D. Wolfowitz, who got the erroneous paperwork corrected with one phone call. When the aide called with the news, he told the soldier, "They don't even know you exist."


"They didn't know who I was or where I was," the soldier said. "And I was in contact with my platoon sergeant every day."


The lack of accountability weighed on Shannon. He hated the isolation of the younger troops. The Army's failure to account for them each day wore on him. When a 19-year-old soldier down the hall died, Shannon knew he had to take action.


The soldier, Jeremy Harper, returned from Iraq with PTSD after seeing three buddies die. He kept his room dark, refused his combat medals and always seemed heavily medicated, said people who knew him. According to his mother, Harper was drunkenly wandering the lobby of the Mologne House on New Year's Eve 2004, looking for a ride home to West Virginia. The next morning he was found dead in his room. An autopsy showed alcohol poisoning, she said.


"I can't understand how they could have let kids under the age of 21 have liquor," said Victoria Harper, crying. "He was supposed to be right there at Walter Reed hospital. . . . I feel that they didn't take care of him or watch him as close as they should have."


The Army posthumously awarded Harper a Bronze Star for his actions in Iraq.


Shannon viewed Harper's death as symptomatic of a larger tragedy -- the Army had broken its covenant with its troops. "Somebody didn't take care of him," he would later say. "It makes me want to cry. "


Shannon and another soldier decided to keep tabs on the brain injury ward. "I'm a staff sergeant in the U.S. Army, and I take care of people," he said. The two soldiers walked the ward every day with a list of names. If a name dropped off the large white board at the nurses' station, Shannon would hound the nurses to check their files and figure out where the soldier had gone.


Sometimes the patients had been transferred to another hospital. If they had been released to one of the residences on post, Shannon and his buddy would pester the front desk managers to make sure the new charges were indeed there. "But two out of 10, when I asked where they were, they'd just say, 'They're gone,' " Shannon said.


Even after Weightman and his commanders instituted new measures to keep better track of soldiers, two young men left post one night in November and died in a high-speed car crash in Virginia. The driver was supposed to be restricted to Walter Reed because he had tested positive for illegal drugs, Weightman said.


Part of the tension at Walter Reed comes from a setting that is both military and medical. Marine Sgt. Ryan Groves, the squad leader who lost one leg and the use of his other in a bomb blast, said his recovery was made more difficult by a Marine liaison officer who had never seen combat but dogged him about having his mother in his room on post. The rules allowed her to be there, but the officer said she was taking up valuable bed space.


"When you join the Marine Corps, they tell you you can forget about your mama. 'You have no mama. We are your mama,' " Groves said. "That training works in combat. It doesn't work when you are wounded."


Frustration at Every Turn


The frustrations of an outpatient's day begin before dawn. On a dark, rain-soaked morning this winter, Sgt. Archie Benware, 53, hobbled over to his National Guard platoon office at Walter Reed. Benware had done two tours in Iraq. His head had been crushed between two 2,100-pound concrete barriers in Ramadi, and now it was dented like a tin can. His legs were stiff from knee surgery. But here he was, trying to take care of business.


At the platoon office, he scanned the white board on the wall. Six soldiers were listed as AWOL. The platoon sergeant was nowhere to be found, leaving several soldiers stranded with their requests.


Benware walked around the corner to arrange a dental appointment -- his teeth were knocked out in the accident. He was told by a case manager that another case worker, not his doctor, would have to approve the procedure.


"Goddamn it, that's unbelievable!" snapped his wife, Barb, who accompanied him because he can no longer remember all of his appointments.


Not as unbelievable as the time he received a manila envelope containing the gynecological report of a young female soldier.


Next came 7 a.m. formation, one way Walter Reed tries to keep track of hundreds of wounded. Formation is also held to maintain some discipline. Soldiers limp to the old Red Cross building in rain, ice and snow. Army regulations say they can't use umbrellas, even here. A triple amputee has mastered the art of putting on his uniform by himself and rolling in just in time. Others are so gorked out on pills that they seem on the verge of nodding off.


"Fall in!" a platoon sergeant shouted at Friday formation. The noisy room of soldiers turned silent.


An Army chaplain opened with a verse from the Bible. "Why are we here?" she asked. She talked about heroes and service to country. "We were injured in many ways."


Someone announced free tickets to hockey games, a Ravens game, a movie screening, a dinner at McCormick and Schmick's, all compliments of local businesses.


Every formation includes a safety briefing. Usually it is a warning about mixing alcohol with meds, or driving too fast, or domestic abuse. "Do not beat your spouse or children. Do not let your spouse or children beat you," a sergeant said, to laughter. This morning's briefing included a warning about black ice, a particular menace to the amputees.


Dress warm, the sergeant said. "I see some guys rolling around in their wheelchairs in 30 degrees in T-shirts."


Soldiers hate formation for its petty condescension. They gutted out a year in the desert, and now they are being treated like children.


"I'm trying to think outside the box here, maybe moving formation to Wagner Gym," the commander said, addressing concerns that formation was too far from soldiers' quarters in the cold weather. "But guess what? Those are nice wood floors. They have to be covered by a tarp. There's a tarp that's got to be rolled out over the wooden floors. Then it has to be cleaned, with 400 soldiers stepping all over it. Then it's got to be rolled up."


"Now, who thinks Wagner Gym is a good idea?"


Explaining this strange world to family members is not easy. At an orientation for new arrivals, a staff sergeant walked them through the idiosyncrasies of Army financing. He said one relative could receive a 15-day advance on the $64 per diem either in cash or as an electronic transfer: "I highly recommend that you take the cash," he said. "There's no guarantee the transfer will get to your bank." The audience yawned.


Actually, he went on, relatives can collect only 80 percent of this advance, which comes to $51.20 a day. "The cashier has no change, so we drop to $50. We give you the rest" -- the $1.20 a day -- "when you leave."


The crowd was anxious, exhausted. A child crawled on the floor. The sergeant plowed on. "You need to figure out how long your loved one is going to be an inpatient," he said, something even the doctors can't accurately predict from day to day. "Because if you sign up for the lodging advance," which is $150 a day, "and they get out the next day, you own the government the advance back of $150 a day."


A case manager took the floor to remind everyone that soldiers are required to be in uniform most of the time, though some of the wounded are amputees or their legs are pinned together by bulky braces. "We have break-away clothing with Velcro!" she announced with a smile. "Welcome to Walter Reed!"


A Bleak Life in Building 18


"Building 18! There is a rodent infestation issue!" bellowed the commander to his troops one morning at formation. "It doesn't help when you live like a rodent! I can't believe people live like that! I was appalled by some of your rooms!"


Life in Building 18 is the bleakest homecoming for men and women whose government promised them good care in return for their sacrifices.


One case manager was so disgusted, she bought roach bombs for the rooms. Mouse traps are handed out. It doesn't help that soldiers there subsist on carry-out food because the hospital cafeteria is such a hike on cold nights. They make do with microwaves and hot plates.


Army officials say they "started an aggressive campaign to deal with the mice infestation" last October and that the problem is now at a "manageable level." They also say they will "review all outstanding work orders in the next 30 days."


Soldiers discharged from the psychiatric ward are often assigned to Building 18. Buses and ambulances blare all night. While injured soldiers pull guard duty in the foyer, a broken garage door allows unmonitored entry from the rear. Struggling with schizophrenia, PTSD, paranoid delusional disorder and traumatic brain injury, soldiers feel especially vulnerable in that setting, just outside the post gates, on a street where drug dealers work the corner at night.


"I've been close to mortars. I've held my own pretty good," said Spec. George Romero, 25, who came back from Iraq with a psychological disorder. "But here . . . I think it has affected my ability to get over it . . . dealing with potential threats every day."


After Spec. Jeremy Duncan got out of the hospital and was assigned to Building 18, he had to navigate across the traffic of Georgia Avenue for appointments. Even after knee surgery, he had to limp back and forth on crutches and in pain. Over time, black mold invaded his room.


But Duncan would rather suffer with the mold than move to another room and share his convalescence in tight quarters with a wounded stranger. "I have mold on the walls, a hole in the shower ceiling, but . . . I don't want someone waking me up coming in."


Wilson, the clinical social worker at Walter Reed, was part of a staff team that recognized Building 18's toll on the wounded. He mapped out a plan and, in September, was given a $30,000 grant from the Commander's Initiative Account for improvements. He ordered some equipment, including a pool table and air hockey table, which have not yet arrived. A Psychiatry Department functionary held up the rest of the money because she feared that buying a lot of recreational equipment close to Christmas would trigger an audit, Wilson said.


In January, Wilson was told that the funds were no longer available and that he would have to submit a new request. "It's absurd," he said. "Seven months of work down the drain. I have nothing to show for this project. It's a great example of what we're up against."


A pool table and two flat-screen TVs were eventually donated from elsewhere.


But Wilson had had enough. Three weeks ago he turned in his resignation. "It's too difficult to get anything done with this broken-down bureaucracy," he said.


At town hall meetings, the soldiers of Building 18 keep pushing commanders to improve conditions. But some things have gotten worse. In December, a contracting dispute held up building repairs.


"I hate it," said Romero, who stays in his room all day. "There are cockroaches. The elevator doesn't work. The garage door doesn't work. Sometimes there's no heat, no water. . . . I told my platoon sergeant I want to leave. I told the town hall meeting. I talked to the doctors and medical staff. They just said you kind of got to get used to the outside world . . . my platoon sergeant said, 'Suck it up!'"


Staff researcher Julie Tate contributed to this report.


-------END--------


Disgusting, to say the least!

[Robert Ryan]

Read about this on another site, it is deplorable what they are doing to these men and women. I guess since Walter Reed is on the closesure list they will not be doing anything to help improve it.

[Packo]

Sounds just like the VA Hospital in DC. Hope they get this placed closed and the men and women over to Bethesda. My buddy runs the ICU there. I'll ask him about the conditions.

Gimpy....this is a disgrace and more sad news. Will we as a nation ever learn.

Pack

[Robert Ryan]

On the news last night there was report about this and since it had been brought to light, the Army says it will do something about the conditions.

[WateringHole]

I'm surprise our President home is just a hop, skip and a jump from Walter Reed Hospital and I don't recall him going visit the Military Service Personells who are patients there. If he would, maybe somebody can point-out all the deplorable conditions at the hospital that exist.

[Packo]

He's been there and Bethesda numerous times. Sometimes people show you only what they want seen. Other times people see things but do nothing about it. Not sure which is what here. I can't imagine any President seeing rodents and crap like that and not saying WTF? but anythings possible. Nobody did a thing about the deplorable conditions at the VA Hospital in DC after the DAV and a Congressman did a surprise visit after I turned that place in after my first hip replacement. Think the Chief of MAS got fired, that's it.

Pack

[WateringHole]

Packy.....I have one of my neighbors who was a patient at Madigan Hospital at FT Lewis, Wash some six years ago and he said from what he was able to see, it was kept pretty clean.
I have a nephew in the Army who went through operating room procedures tech at Ft Sam couple or so years ago who told me by email Brooke Hospital is kept about as clean as a brand new silver dollar 24/7. And here we have Walter Reed Hosp in our nations Capitol that leaves a lot to be desired.

[Packo]

Welcome to our nations Captiol.

Pack

[Gimpy]

The latest update from the authors of the first article about Walter Reed Army Hospital.


###START###


THE HOTEL AFTERMATH -- Inside Mologne House, the survivors of war wrestle with military bureaucracy and personal demons.





By Anne Hull and Dana Priest
Washington Post Staff Writers
Feb. 20, 2007


The guests of Mologne House have been blown up, shot, crushed and shaken, and now their convalescence takes place among the chandeliers and wingback chairs of the 200-room hotel on the grounds of Walter Reed Army Medical Center.


Oil paintings hang in the lobby of this strange outpost in the war on terrorism, where combat's urgency has been replaced by a trickling fountain in the garden courtyard. The maimed and the newly legless sit in wheelchairs next to a pond, watching goldfish turn lazily through the water.


But the wounded of Mologne House are still soldiers -- Hooah! -- so their lives are ruled by platoon sergeants. Each morning they must rise at dawn for formation, though many are half-snowed on pain meds and sleeping pills.


In Room 323 the alarm goes off at 5 a.m., but Cpl. Dell McLeod slumbers on. His wife, Annette, gets up and fixes him a bowl of instant oatmeal before going over to the massive figure curled in the bed. An Army counselor taught her that a soldier back from war can wake up swinging, so she approaches from behind.


"Dell," Annette says, tapping her husband. "Dell, get in the shower."


"Dell!" she shouts.


Finally, the yawning hulk sits up in bed. "Okay, baby," he says. An American flag T-shirt is stretched over his chest. He reaches for his dog tags, still the devoted soldier of 19 years, though his life as a warrior has become a paradox. One day he's led on stage at a Toby Keith concert with dozens of other wounded Operation Iraqi Freedom troops from Mologne House, and the next he's sitting in a cluttered cubbyhole at Walter Reed, fighting the Army for every penny of his disability.


McLeod, 41, has lived at Mologne House for a year while the Army figures out what to do with him. He worked in textile and steel mills in rural South Carolina before deploying. Now he takes 23 pills a day, prescribed by various doctors at Walter Reed. Crowds frighten him. He is too anxious to drive. When panic strikes, a soldier friend named Oscar takes him to Baskin-Robbins for vanilla ice cream.


"They find ways to soothe each other," Annette says.


Mostly what the soldiers do together is wait: for appointments, evaluations, signatures and lost paperwork to be found. It's like another wife told Annette McLeod: "If Iraq don't kill you, Walter Reed will."


After Iraq, a New Struggle


The conflict in Iraq has hatched a virtual town of desperation and dysfunction, clinging to the pilings of Walter Reed. The wounded are socked away for months and years in random buildings and barracks in and around this military post.


The luckiest stay at Mologne House, a four-story hotel on a grassy slope behind the hospital. Mologne House opened 10 years ago as a short-term lodging facility for military personnel, retirees and their family members. Then came Sept. 11 and five years of sustained warfare. Now, the silver walkers of retired generals convalescing from hip surgery have been replaced by prosthetics propped against Xbox games and Jessica Simpson posters smiling down on brain-rattled grunts.


Two Washington Post reporters spent hundreds of hours in Mologne House documenting the intimate struggles of the wounded who live there. The reporting was done without the knowledge or permission of Walter Reed officials, but all those directly quoted in this article agreed to be interviewed.


The hotel is built in the Georgian revival style, and inside it offers the usual amenities: daily maid service, front-desk clerks in formal vests and a bar off the lobby that opens every afternoon.


But at this bar, the soldier who orders a vodka tonic one night says to the bartender, "If I had two hands, I'd order two." The customers sitting around the tables are missing limbs, their ears are melted off, and their faces are tattooed purple by shrapnel patterns.


Most everyone has a story about the day they blew up: the sucking silence before immolation, how the mouth filled with tar, the lungs with gas.


"First thing I said was, '[Expletive], that was my good eye,' " a soldier with an eye patch tells an amputee in the bar.


The amputee peels his beer label. "I was awake through the whole thing," he says. "It was my first patrol. The second [expletive] day in Iraq and I get blown up."


When a smooth-cheeked soldier with no legs orders a fried chicken dinner and two bottles of grape soda to go, a kitchen worker comes out to his wheelchair and gently places the Styrofoam container on his lap.


A scrawny young soldier sits alone in his wheelchair at a nearby table, his eyes closed and his chin dropped to his chest, an empty Corona bottle in front of him.


Those who aren't old enough to buy a drink at the bar huddle outside near a magnolia tree and smoke cigarettes. Wearing hoodies and furry bedroom slippers, they look like kids at summer camp who've crept out of their rooms, except some have empty pants legs or limbs pinned by medieval-looking hardware.



Medication is a favorite topic.


"Dude, [expletive] Paxil saved my life."


"I been on methadone for a year, I'm tryin' to get off it."


"I didn't take my Seroquel last night and I had nightmares of charred bodies, burned crispy like campfire marshmallows."


Mologne House is afloat on a river of painkillers and antipsychotic drugs. One night, a strapping young infantryman loses it with a woman who is high on her son's painkillers. "Quit taking all the soldier medicine!" he screams.


Pill bottles clutter the nightstands: pills for depression or insomnia, to stop nightmares and pain, to calm the nerves.


Here at Hotel Aftermath, a crash of dishes in the cafeteria can induce seizures in the combat-addled. If a taxi arrives and the driver looks Middle Eastern, soldiers refuse to get in. Even among the gazebos and tranquility of the Walter Reed campus in upper Northwest Washington, manhole covers are sidestepped for fear of bombs and rooftops are scanned for snipers.


Bomb blasts are the most common cause of injury in Iraq, and nearly 60 percent of the blast victims also suffer from traumatic brain injury, according to Walter Reed's studies, which explains why some at Mologne House wander the hallways trying to remember their room numbers.


Some soldiers and Marines have been here for 18 months or longer. Doctor's appointments and evaluations are routinely dragged out and difficult to get. A board of physicians must review hundreds of pages of medical records to determine whether a soldier is fit to return to duty. If not, the Physical Evaluation Board must decide whether to assign a rating for disability compensation. For many, this is the start of a new and bitter battle.


Months roll by and life becomes a blue-and-gold hotel room where the bathroom mirror shows the naked disfigurement of war's ravages. There are toys in the lobby of Mologne House because children live here. Domestic disputes occur because wives or girlfriends have moved here. Financial tensions are palpable. After her husband's traumatic injury insurance policy came in, one wife cleared out with the money. Older National Guard members worry about the jobs they can no longer perform back home.


While Mologne House has a full bar, there is not one counselor or psychologist assigned there to assist soldiers and families in crisis -- an idea proposed by Walter Reed social workers but rejected by the military command that runs the post.


After a while, the bizarre becomes routine. On Friday nights, antiwar protesters stand outside the gates of Walter Reed holding signs that say "Love Troops, Hate War, Bring them Home Now." Inside the gates, doctors in white coats wait at the hospital entrance for the incoming bus full of newly wounded soldiers who've just landed at Andrews Air Force Base.


And set back from the gate, up on a hill, Mologne House, with a bowl of red apples on the front desk.


Into the Twilight Zone


Dell McLeod's injury was utterly banal. He was in his 10th month of deployment with the 178th Field Artillery Regiment of the South Carolina National Guard near the Iraqi border when he was smashed in the head by a steel cargo door of an 18-wheeler. The hinges of the door had been tied together with a plastic hamburger-bun bag. Dell was knocked out cold and cracked several vertebrae.


When Annette learned that he was being shipped to Walter Reed, she took a leave from her job on the assembly line at Stanley Tools and packed the car. The Army would pay her $64 a day to help care for her husband and would let her live with him at Mologne House until he recovered.


A year later, they are still camped out in the twilight zone. Dogs are periodically brought in by the Army to search the rooms for contraband or weapons. When the fire alarm goes off, the amputees who live on the upper floors are scooped up and carried down the stairwell, while a brigade of mothers passes down the wheelchairs. One morning Annette opens her door and is told to stay in the room because a soldier down the hall has overdosed.


In between, there are picnics at the home of the chairman of the Joint Chiefs of Staff and a charity-funded dinner cruise on the Potomac for "Today's troops, tomorrow's veterans, always heroes."


Dell and Annette's weekdays are spent making the rounds of medical appointments, physical therapy sessions and evaluations for Dell's discharge from the Army. After 19 years, he is no longer fit for service. He uses a cane to walk. He is unable to count out change in the hospital cafeteria. He takes four Percocets a day for pain and has gained 40 pounds from medication and inactivity. Lumbering and blue-eyed, Dell is a big ox baby.


Annette puts on makeup every morning and does her hair, some semblance of normalcy, but her new job in life is watching Dell.


"I'm worried about how he's gonna fit into society," she says one night, as Dell wanders down the hall to the laundry room.


The more immediate worry concerns his disability rating. Army doctors are disputing that Dell's head injury was the cause of his mental impairment. One report says that he was slow in high school and that his cognitive problems could be linked to his native intelligence rather than to his injury.


"They said, 'Well, he was in Title I math,' like he was retarded," Annette says. "Well, y'all took him, didn't you?"


The same fight is being waged by their friends, who aren't the young warriors in Army posters but middle-age men who left factory jobs to deploy to Iraq with their Guard units. They were fit enough for war, but now they are facing teams of Army doctors scrutinizing their injuries for signs of preexisting conditions, lessening their chance for disability benefits.


Dell and Annette's closest friend at Mologne House is a 47-year-old Guard member who was driving an Army vehicle through the Iraqi night when a flash of light blinded him and he crashed into a ditch with an eight-foot drop. Among his many injuries was a broken foot that didn't heal properly. Army doctors decided that "late life atrophy" was responsible for the foot, not the truck wreck in Iraq.


When Dell sees his medical records, he explodes. "Special ed is for the mentally retarded, and I'm not mentally retarded, right, babe?" he asks Annette. "I graduated from high school. I did some college. I worked in a steel mill."

I
It's after 9 one night and Dell and Annette are both exhausted, but Dell still needs to practice using voice-recognition software. Reluctantly, he mutes "The Ultimate Fighting Challenge" on TV and sits next to Annette in bed with a laptop.


"My name is Wendell," he says. "Wendell Woodward McLeod Jr."


Annette tells him to sit up. "Spell 'dog,' " she says, softly.


"Spell 'dog,' " he repeats.


"Listen to me," she says.


"Listen to me." He slumps on the pillow. His eyes drift toward the wrestlers on TV.


"You are not working hard enough, Dell," Annette says, pleading. "Wake up."


"Wake up," he says.


"Dell, come on now!"



For Some, a Grim Kind of Fame


No one questions Sgt. Bryan Anderson's sacrifice. One floor above Dell and Annette's room at Mologne House, he holds the gruesome honor of being one of the war's five triple amputees. Bryan, 25, lost both legs and his left arm when a roadside bomb exploded next to the Humvee he was driving with the 411th Military Police Company. Modern medicine saved him and now he's the pride of the prosthetics team at Walter Reed. Tenacious and wisecracking, he wrote "[Expletive] Iraq" on his left leg socket.


Amputees are the first to receive celebrity visitors, job offers and extravagant trips, but Bryan is in a league of his own. Johnny Depp's people want to hook up in London or Paris. The actor Gary Sinise, who played an angry Vietnam amputee in "Forrest Gump," sends his regards. And Esquire magazine is setting up a photo shoot.


Bryan's room at Mologne House is stuffed with gifts from corporate America and private citizens: $350 Bose noise-canceling headphones, nearly a thousand DVDs sent by well-wishers and quilts made by church grannies. The door prizes of war. Two flesh-colored legs are stacked on the floor. A computerized hand sprouting blond hair is on the table.


One Saturday afternoon, Bryan is on his bed downloading music. Without his prosthetics, he weighs less than 100 pounds. "Mom, what time is our plane?" he asks his mother, Janet Waswo, who lives in the room with him. A movie company is flying them to Boston for the premiere of a documentary about amputee hand-cyclers in which Bryan appears.


Representing the indomitable spirit of the American warrior sometimes becomes too much, and Bryan turns off his phone.


Perks and stardom do not come to every amputee. Sgt. David Thomas, a gunner with the Tennessee National Guard, spent his first three months at Walter Reed with no decent clothes; medics in Samarra had cut off his uniform. Heavily drugged, missing one leg and suffering from traumatic brain injury, David, 42, was finally told by a physical therapist to go to the Red Cross office, where he was given a T-shirt and sweat pants. He was awarded a Purple Heart but had no underwear.


David tangled with Walter Reed's image machine when he wanted to attend a ceremony for a fellow amputee, a Mexican national who was being granted U.S. citizenship by President Bush. A case worker quizzed him about what he would wear. It was summer, so David said shorts. The case manager said the media would be there and shorts were not advisable because the amputees would be seated in the front row.


" 'Are you telling me that I can't go to the ceremony 'cause I'm an amputee?' " David recalled asking. "She said, 'No, I'm saying you need to wear pants.' "


David told the case worker, "I'm not ashamed of what I did, and y'all shouldn't be neither." When the guest list came out for the ceremony, his name was not on it.


Still, for all its careful choreography of the amputees, Walter Reed offers protection from a staring world. On warm nights at the picnic tables behind Mologne House, someone fires up the barbecue grill and someone else makes a beer run to Georgia Avenue.


Bryan Anderson is out here one Friday. "Hey, Bry, what time should we leave in the morning?" asks his best friend, a female soldier also injured in Iraq. The next day is Veterans Day, and Bryan wants to go to Arlington National Cemetery. His pal Gary Sinise will be there, and Bryan wants to give him a signed photo.


Thousands of spectators are already at Arlington the next morning when Bryan and his friend join the surge toward the ceremony at the Tomb of the Unknowns. The sunshine dazzles. Bryan is in his wheelchair. If loss and sacrifice are theoretical to some on this day, here is living proof -- three stumps and a crooked boyish smile. Even the acres of tombstones can't compete. Spectators cut their eyes toward him and look away.


Suddenly, the thunder of cannons shakes the sky. The last time Bryan heard this sound, his legs were severed and he was nearly bleeding to death in a fiery Humvee.


Boom. Boom. Boom. Bryan pushes his wheelchair harder, trying to get away from the noise. "Damn it," he says, "when are they gonna stop?"


Bryan's friend walks off by herself and holds her head. The cannon thunder has unglued her, too, and she is crying.



Friends From Ward 54


An old friend comes to visit Dell and Annette. Sgt. Oscar Fernandez spent 14 months at Walter Reed after having a heart attack in Afghanistan. Oscar also had post-traumatic stress disorder, PTSD, a condition that worsened at Walter Reed and landed the 45-year-old soldier in the hospital's psychiatric unit, Ward 54.


Oscar belonged to a tight-knit group of soldiers who were dealing with combat stress and other psychological issues. They would hang out in each other's rooms at night, venting their fury at the Army's Cuckoo's Nest. On weekends they escaped Walter Reed to a Chinese buffet or went shopping for bootleg Spanish DVDs in nearby Takoma Park. They once made a road trip to a casino near the New Jersey border.


They abided each other's frailties. Sgt. Steve Justi would get the slightest cut on his skin and drop to his knees, his face full of anguish, apologizing over and over. For what, Oscar did not know. Steve was the college boy who went to Iraq, and Oscar figured something terrible had happened over there.


Sgt. Mike Smith was the insomniac. He'd stay up till 2 or 3 in the morning, smoking on the back porch by himself. Doctors had put steel rods in his neck after a truck accident in Iraq. To turn his head, the 41-year-old Guard member from Iowa had to rotate his entire body. He was fighting with the Army over his disability rating, too, and in frustration had recently called a congressional investigator for help.


"They try in all their power to have you get well, but it reverses itself," Oscar liked to say.


Dell was not a psych patient, but he and Oscar bonded. They were an unlikely pair -- the dark-haired Cuban American with a penchant for polo shirts and salsa, and the molasses earnestness of Dell.


Oscar would say things like "I'm trying to better myself through my own recognizance," and Dell would nod in appreciation.


To celebrate Oscar's return visit to Walter Reed, they decide to have dinner in Silver Spring.


Annette tells Oscar that a soldier was arrested at Walter Reed for waving a gun around.


"A soldier, coming from war?" Oscar asks.


Annette doesn't know. She mentions that another soldier was kicked out of Mologne House for selling his painkillers.


The talk turns to their friend Steve Justi. A few days earlier, Steve was discharged from the Army and given a zero percent disability rating for his mental condition.


Oscar is visibly angry. "They gave him nothing," he says. "They said his bipolar was preexisting."


Annette is quiet. "Poor Steve," she says.


After dinner, they return through the gates of Walter Reed in Annette's car, a John 3:16 decal on the bumper and the Dixie Chicks in the CD player. Annette sees a flier in the lobby of Mologne House announcing a free trip to see Toby Keith in concert.


A week later, it is a wonderful night at the Nissan Pavilion. About 70 wounded soldiers from Walter Reed attend the show. Toby invites them up on stage and brings the house down when he sings his monster wartime hit "American Soldier." Dell stands on stage in his uniform while Annette snaps pictures.


"Give a hand clap for the soldiers," Annette hears Toby tell the audience, "then give a hand for the U.S.A."



A Soldier Snaps


Deep into deer-hunting country and fields of withered corn, past the Pennsylvania Turnpike in the rural town of Ellwood City, Steve Justi sits in his parents' living room, fighting off the afternoon's lethargy.


A photo on a shelf shows a chiseled soldier, but the one in the chair is 35 pounds heavier. Antipsychotic drugs give him tremors and cloud his mind. Still, he is deliberate and thoughtful as he explains his path from soldier to psychiatric patient in the war on terrorism.


After receiving a history degree from Mercyhurst College, Steve was motivated by the attacks of Sept. 11, 2001, to join the National Guard. He landed in Iraq in 2003 with the First Battalion, 107th Field Artillery, helping the Marines in Fallujah.


"It was just the normal stuff," Steve says, describing the violence he witnessed in Iraq. His voice is oddly flat as he recalls the day his friend died in a Humvee accident. The friend was driving with another soldier when they flipped off the road into a swamp. They were trapped upside down and submerged. Steve helped pull them out and gave CPR, but it was too late. The swamp water kept pushing back into his own mouth. He rode in the helicopter with the wet bodies.


After he finished his tour, everything was fine back home in Pennsylvania for about 10 months, and then a strange bout of insomnia started. After four days without sleep, he burst into full-out mania and was hospitalized in restraints.


Did anything trigger the insomnia? "Not really," Steve says calmly, sitting in his chair.


His mother overhears this from the kitchen and comes into the living room. "His sergeant had called saying that the unit was looking for volunteers to go back to Iraq," Cindy Justi says. "This is what triggered his snap."


Steve woke up in the psychiatric unit at Walter Reed and spent the next six months going back and forth between there and a room at Mologne House. He was diagnosed with bipolar disorder. He denied to doctors that he was suffering from PTSD, yet he called home once from Ward 54 and shouted into the phone, "Mom, can't you hear all the shooting in the background?"


He was on the ward for the sixth time when he was notified that he was being discharged from the Army, with only a few days to clear out and a disability rating of zero percent.


On some level, Steve expected the zero rating. During his senior year of college, he suffered a nervous breakdown and for several months was treated with antidepressants. He disclosed this to the National Guard recruiter, who said it was a nonissue. It became an issue when he told doctors at Walter Reed. The Army decided that his condition was not aggravated by his time in Iraq. The only help he would get would come from Veterans Affairs.


"We have no idea if what he endured over there had a worsening effect on him," says his mother.


His father gets home from the office. Ron Justi sits on the couch across from his son. "He was okay to sacrifice his body, but now that it's time he needs some help, they are not here," Ron says.

Outside the Gates


The Army gives Dell McLeod a discharge date. His days at Mologne House are numbered. The cramped hotel room has become home, and now he is afraid to leave it. His anxiety worsens. "Shut up!" he screams at Annette one night, his face red with rage, when she tells him to stop fiddling with his wedding ring.


Later, Annette says: "I am exhausted. He doesn't understand that I've been fighting the Army."


Doctors have concluded that Dell was slow as a child and that his head injury on the Iraqi border did not cause brain damage. "It is possible that pre-morbid emotional difficulties and/or pre-morbid intellectual functioning may be contributing factors to his reported symptoms," a doctor wrote, withholding a diagnosis of traumatic brain injury.


Annette pushes for more brain testing and gets nowhere until someone gives her the name of a staffer for the House Committee on Oversight and Government Reform. A few days later, Annette is called to a meeting with the command at Walter Reed. Dell is given a higher disability rating than expected -- 50 percent, which means he will receive half of his base pay until he is evaluated again in 18 months. He signs the papers.


Dell wears his uniform for the last time, somber and careful as he dresses for formation. Annette packs up the room and loads their Chevy Cavalier to the brim. Finally the gates of Walter Reed are behind them. They are southbound on I-95 just past the Virginia line when Dell begins to cry, Annette would later recall. She pulls over and they both weep.


Not long after, Bryan Anderson also leaves Mologne House. When the triple amputee gets off the plane in Chicago, American Airlines greets him on the tarmac with hoses spraying arches of water, and cheering citizens line the roads that lead to his home town, Rolling Meadows.


Bryan makes the January cover of Esquire. He is wearing his beat-up cargo shorts and an Army T-shirt, legless and holding his Purple Heart in his robot hand. The headline says "The Meaning of Life."


A month after Bryan leaves, Mike Smith, the insomniac soldier, is found dead in his room. Mike had just received the good news that the Army was raising his disability rating after a congressional staff member intervened on his behalf. It was the week before Christmas, and he was set to leave Walter Reed to go home to his wife and kids in Iowa when his body was found. The Army told his wife that he died of an apparent heart attack, according to her father.


Distraught, Oscar Fernandez calls Dell and Annette in South Carolina with the news. "It's the constant assault of the Army," he says.


Life with Dell is worsening. He can't be left alone. The closest VA hospital is two hours away. Doctors say he has liver problems because of all the medications. He is also being examined for PTSD. "I don't even know this man anymore," Annette says.


At Mologne House, the rooms empty and fill, empty and fill. The lobby chandelier glows and the bowl of red apples waits on the front desk. An announcement goes up for Texas Hold 'Em poker in the bar.


One cold night an exhausted mother with two suitcases tied together with rope shows up at the front desk and says, "I am here for my son." And so it begins.


Staff researcher Julie Tate contributed to this report.

--------END-------

[Packo]

Gimpy,

All I can say is....oh, man.

Even if I lived near there....I'm too burned out to help them. It's time for others to step up to the plate, I'm done, stick a fork in me.

Pack