by: NBC News and news services
President-elect Barack Obama has selected retired Gen. Eric K. Shinseki to be the next Veterans Affairs secretary, telling NBC News in an exclusive interview that "he and I share a reverence for those who serve."
Obama will announce the selection of Shinseki, the first Army four-star general of Japanese-American ancestry, at a news conference Sunday in Chicago. He will be the first Asian-American to hold the post of Veterans Affairs secretary, adding to the growing diversity of Obama’s Cabinet.
“I think that General Shinseki is exactly the right person who is going to be able to make sure that we honor our troops when they come home,” Obama said in an interview with NBC’s Tom Brokaw on “Meet the Press” to be broadcast Sunday.
Sunday also marks the 67th anniversary of the Japanese attack on Pearl Harbor.
NBC released a transcript of the interview after The Associated Press reported that Shinseki was Obama’s pick.
Shinseki’s tenure as Army chief of staff from 1999 to 2003 was marked by constant tensions with Defense Secretary Donald Rumsfeld, which boiled over in 2003 when Shinseki testified to Congress that it might take several hundred thousand U.S. troops to control Iraq after the invasion.
Rumsfeld and his deputy, Paul Wolfowitz, belittled the estimate as “wildly off the mark,” and the army general was forced out within months. But Shinseki’s words proved prophetic after President George W. Bush in early 2007 announced a “surge” of additional troops to Iraq after miscalculating the numbers needed to stem sectarian violence.
Obama said he selected Shinseki for the VA post because he “was right” in predicting that the U.S. will need more troops in Iraq than Rumsfeld believed at the time.
“When I reflect on the sacrifices that have been made by our veterans and, I think about how so many veterans around the country are struggling even more than those who have not served — higher unemployment rates, higher homeless rates, higher substance abuse rates, medical care that is inadequate — it breaks my heart,” Obama told NBC.
Shinseki, 66, will take the helm of the government’s second largest agency, which has been roundly criticized during the Bush administration for underestimating the amount of funding needed to treat thousands of injured veterans returning from Iraq and Afghanistan.
Thousands of veterans currently endure six-month waits for receiving disability benefits, despite promises by current VA Secretary James Peake and his predecessor, Jim Nicholson, to reduce delays. The department also is scrambling to upgrade government technology systems before new legislation providing for millions of dollars in new GI benefits takes effect next August.
Sen. Daniel Akaka, D-Hawaii, and chairman of the Senate Veterans Affairs Committee, praised Shinseki as a "great choice" who will make an excellent VA secretary.
"I have great respect for General Shinseki's judgment and abilities," Akaka said in a statement. "I am confident that he will use his wisdom and experience to ensure that our veterans receive the respect and care they have earned in defense of our nation. President-elect Obama is selecting a team that reflects our nation's greatest strength, its diversity, and I applaud him."
Veterans groups also cheered the decision.
"General Shinseki has a record of courage and honesty, and is a bold choice to lead the VA into the future," said Paul Rieckhoff, executive director of the Iraq and Afghanistan Veterans of America. "He is a man that has always put patriotism ahead of politics, and is held in high regard by veterans of Iraq and Afghanistan."
Obama’s choice of Shinseki, who grew up in Hawaii, is the latest indication that the president-elect is making good on his pledge to have a diverse Cabinet.
In Obama’s eight Cabinet announcements so far, white men are the minority with two nominations — Timothy Geithner at Treasury and Robert Gates at Defense. Three are women — Janet Napolitano at Homeland Security, Susan Rice as United Nations ambassador and Hillary Rodham Clinton at State. Eric Holder at the Justice Department is African American, while Bill Richardson at Commerce is Latino.
Shinseki is a recipient of two Purple Hearts for life-threatening injuries in Vietnam.
Upon leaving his post in June 2003, Shinseki in his farewell speech sternly warned against arrogance in leadership.
“You must love those you lead before you can be an effective leader,” he said. “You can certainly command without that sense of commitment, but you cannot lead without it. And without leadership, command is a hollow experience, a vacuum often filled with mistrust and arrogance.”
Shinseki also left with the warning: “Beware a 12-division strategy for a 10-division army.”
Sunday, December 7, 2008
Thursday, December 4, 2008
Brain-injured Troops Face Long Term Health Risks
22 percent of Iraq vets affected by traumatic head wounds, report finds
by: the Associated Press
Many of the thousands of troops who suffered traumatic brain injuries in Iraq and Afghanistan are at risk of long-term health problems including depression and Alzheimer's-like symptoms, but it's impossible to predict how high those risks are, researchers say.
About 22 percent of wounded troops have a brain injury, concluded the prestigious Institute of Medicine — and it urged precise steps for studying how these patients fare years later so that chances to help aren't missed.
The Veterans Affairs Department, which requested the report, and the Pentagon already are taking some of the recommended steps. But a report out Thursday highlights the urgency.
"I don't think we really knew how big a hole in scientific knowledge there is about blast-induced brain injuries," said Dr. George Rutherford of the University of California, San Francisco, the report's lead researcher.
Traumatic brain injury, or TBI, is a signature injury of the Iraq war. Most aren't penetrating head wounds but damage hidden inside the skull caused by an explosion's pressure wave. It can range from a mild concussion to severe injury. And because symptoms may not be immediately apparent, troops may not seek care.
"If you have a gunshot wound to some specific part of your brain, I can tell you the consequences," Rutherford said. But with blast concussions, it's not even possible to say "if you have six of these, are you six times more likely to have something bad happen to you than if you've had one?"
Returning soldiers have reported headaches, dizziness, memory loss, confusion, irritability, insomnia and depression. The military has said most recover with treatment.
"There's clearly a whole bunch of people who have mild TBI who have no negative outcomes," Rutherford agreed.
But his committee examined decades of studies into mostly civilian injuries and found:
Also, it urges the Defense Department to conduct rigorous studies and a VA-run registry of TBI patients to identify long-term risks and factors that improve or worsen outcomes, in comparison to deployed troops with non-brain injuries.
The veterans agency said it would consider the recommendations, and has 60 days to decide whether those long-term disorders will be presumed linked to brain-injured veterans' military service.
by: the Associated Press
Many of the thousands of troops who suffered traumatic brain injuries in Iraq and Afghanistan are at risk of long-term health problems including depression and Alzheimer's-like symptoms, but it's impossible to predict how high those risks are, researchers say.
About 22 percent of wounded troops have a brain injury, concluded the prestigious Institute of Medicine — and it urged precise steps for studying how these patients fare years later so that chances to help aren't missed.
The Veterans Affairs Department, which requested the report, and the Pentagon already are taking some of the recommended steps. But a report out Thursday highlights the urgency.
"I don't think we really knew how big a hole in scientific knowledge there is about blast-induced brain injuries," said Dr. George Rutherford of the University of California, San Francisco, the report's lead researcher.
Traumatic brain injury, or TBI, is a signature injury of the Iraq war. Most aren't penetrating head wounds but damage hidden inside the skull caused by an explosion's pressure wave. It can range from a mild concussion to severe injury. And because symptoms may not be immediately apparent, troops may not seek care.
"If you have a gunshot wound to some specific part of your brain, I can tell you the consequences," Rutherford said. But with blast concussions, it's not even possible to say "if you have six of these, are you six times more likely to have something bad happen to you than if you've had one?"
Returning soldiers have reported headaches, dizziness, memory loss, confusion, irritability, insomnia and depression. The military has said most recover with treatment.
"There's clearly a whole bunch of people who have mild TBI who have no negative outcomes," Rutherford agreed.
But his committee examined decades of studies into mostly civilian injuries and found:
- Moderate-to-severe TBI is linked with later-in-life risks including Alzheimer's-like dementia, Parkinson's-like symptoms, seizures, problems with social functioning and unemployment.
- TBI in general is linked to depression, aggressive behavior and post-concussion symptoms such dizziness and amnesia.
- If mild TBI caused loss of consciousness, a risk of later memory, movement and seizure problems cannot be ruled out.
Also, it urges the Defense Department to conduct rigorous studies and a VA-run registry of TBI patients to identify long-term risks and factors that improve or worsen outcomes, in comparison to deployed troops with non-brain injuries.
The veterans agency said it would consider the recommendations, and has 60 days to decide whether those long-term disorders will be presumed linked to brain-injured veterans' military service.
Monday, December 1, 2008
Bases Brace for Surge in Stress-related Disorders
Associated Press
Some 15,000 soldiers are heading home to this sprawling base after spending more than a year at war in Iraq and Afghanistan, and military health officials are bracing for a surge in brain injuries and psychological problems among those troops.
Facing prospects that one in five of the 101st Airborne Division soldiers will suffer from stress-related disorders, the base has nearly doubled its psychological health staff. Army leaders are hoping to use the base's experiences to assess the long-term impact of repeated deployments.
The three 101st Airborne combat brigades, which have begun arriving home, have gone through at least three tours in Iraq. The 3rd Brigade also served seven months in Afghanistan, early in the war. Next spring, the 4th Brigade will return from a 15-month tour in Afghanistan. So far, roughly 10,000 soldiers have come back; the remainder are expected by the end of January.
Army leaders say they will closely watch Fort Campbell to determine the proper medical staffing levels needed to aid soldiers who have endured repeated rotations in the two war zones.
"I don't know what to expect. I don't think anybody knows," said Gen. Peter Chiarelli, vice chief of staff of the Army, as he flew back to Washington from a recent tour of the base's medical facilities. "That's why I want to see numbers from the 101st's third deployment."
What happens with the 101st Airborne, he said, will let the Army help other bases ready for similar homecomings in the next year or two, when multiple brigades from the 4th Infantry Division and the 1st Cavalry Division return.
Noting that some soldiers in the 101st Airborne units have been to war four or five times, Chiarelli said he is most worried the military will not be able to find enough health care providers to deal effectively with the troops needing assistance.
Many of the military bases are near small or remote communities that do not have access to the number of health professionals who might be needed as a great many soldiers return home.
More than 63,600 active duty Army soldiers have done three or more tours in Iraq or Afghanistan. That is a nearly 12 percent of the total number of soldiers who have deployed at least once. Roughly four in 10 soldiers who have gone to war have served more than one deployment — and that number is growing steadily.
One solution under discussion is the formation of mobile medical and psychological teams that can go to Army bases when they are expecting a surge in activity from returning units.
At Fort Campbell, the director of health services, Col. Richard Thomas, has roughly doubled his authorized staff of psychologists and behavioral specialists to 55 and is trying to hire a few more.
"I think we have enough staff to meet the demands of the soldiers here, but I could use more, and I'll hire more if I can," said Thomas. "I'll hire them until they tell me to stop."
He said he expects the increased staffing levels to last at least through next year.
'They're not bipolar'For the first time, Thomas said, every soldier returning home will have an individual meeting with a behavioral health specialist and then go through a second such session 90 days to 120 days later.
The second one is generally the time when indications of stress surface, after the initial euphoria of the homecoming wears off and sleeplessness, nightmares, and other symptoms show up.
"We're seeing a lot of soldiers with stress related issues," he said. "They're not bipolar or schizophrenic. But they're deploying three and four times and the stress is tremendous. They're having relationship issues, financial issues, marital problems — all stress related."
According to Dr. Bret Logan, deputy commander for managed care at the base, extended war zone stints that have lasted as long as 38 months over the course of the wars in Afghanistan and Iraq have taken a severe toll.
More than 3,000 of the 15,000 troops returning home, Logan estimated, probably will experience headaches, sleep disorders, irritability, memory loss, relationship strains or other symptoms linked to stress disorder.
Medical staff at Fort Campbell say they also worry that there will be a new surge of suicides — an escalating problem in recent years, largely related to the stresses of war.
Jon Soltz, an Iraq war veteran and chairman of VoteVets.org, said more soldiers will have stress-related problems, and the military must be vigilant in diagnosing and treating post-traumatic stress disorder to head off more serious issues. "The longer you are there (at war), the more PTSD you're going to see. You wonder when it's going to be your time," he said.
Each returning soldier is evaluated through a seven-day reintegration program. It includes medical checkups, tests, lectures on suicide prevention and relationships, and other sessions to help them transition back into life at the base and with their families.
During his visit to Campbell, Chiarelli took a spin on one of the base's simulators, which are used for soldiers having neurological or stress problems. The simulator can be used to test soldiers' reflexes or as a way to work someone back into everyday situations.
With occupational therapist Eileen Hayes watching over his shoulder, Chiarelli adeptly negotiated the city streets, sudden turns and other obstacles moving at him on the small screen.
The simulators said Logan, put patients in high stress scenarios to test their decision-making ability while under duress.
While soldiers have been routinely deploying for 15-month tours, most Marines serve about seven months and airmen deploy for about four months, although some may serve for tours of six months or longer.
Late this past summer, Pentagon leaders ordered a change, saying any soldier who deployed in August or after would serve 12-month tours. Army leaders say they want to reduce that to nine months, but doing so will be difficult considering the strains of fighting two wars at once.
Logan said that some 85 percent of those soldiers with stress disorder symptoms will recover with the help of some treatment or medication. But the other 15 percent will require more intensive help.
Some 15,000 soldiers are heading home to this sprawling base after spending more than a year at war in Iraq and Afghanistan, and military health officials are bracing for a surge in brain injuries and psychological problems among those troops.
Facing prospects that one in five of the 101st Airborne Division soldiers will suffer from stress-related disorders, the base has nearly doubled its psychological health staff. Army leaders are hoping to use the base's experiences to assess the long-term impact of repeated deployments.
The three 101st Airborne combat brigades, which have begun arriving home, have gone through at least three tours in Iraq. The 3rd Brigade also served seven months in Afghanistan, early in the war. Next spring, the 4th Brigade will return from a 15-month tour in Afghanistan. So far, roughly 10,000 soldiers have come back; the remainder are expected by the end of January.
Army leaders say they will closely watch Fort Campbell to determine the proper medical staffing levels needed to aid soldiers who have endured repeated rotations in the two war zones.
"I don't know what to expect. I don't think anybody knows," said Gen. Peter Chiarelli, vice chief of staff of the Army, as he flew back to Washington from a recent tour of the base's medical facilities. "That's why I want to see numbers from the 101st's third deployment."
What happens with the 101st Airborne, he said, will let the Army help other bases ready for similar homecomings in the next year or two, when multiple brigades from the 4th Infantry Division and the 1st Cavalry Division return.
Noting that some soldiers in the 101st Airborne units have been to war four or five times, Chiarelli said he is most worried the military will not be able to find enough health care providers to deal effectively with the troops needing assistance.
Many of the military bases are near small or remote communities that do not have access to the number of health professionals who might be needed as a great many soldiers return home.
More than 63,600 active duty Army soldiers have done three or more tours in Iraq or Afghanistan. That is a nearly 12 percent of the total number of soldiers who have deployed at least once. Roughly four in 10 soldiers who have gone to war have served more than one deployment — and that number is growing steadily.
One solution under discussion is the formation of mobile medical and psychological teams that can go to Army bases when they are expecting a surge in activity from returning units.
At Fort Campbell, the director of health services, Col. Richard Thomas, has roughly doubled his authorized staff of psychologists and behavioral specialists to 55 and is trying to hire a few more.
"I think we have enough staff to meet the demands of the soldiers here, but I could use more, and I'll hire more if I can," said Thomas. "I'll hire them until they tell me to stop."
He said he expects the increased staffing levels to last at least through next year.
'They're not bipolar'For the first time, Thomas said, every soldier returning home will have an individual meeting with a behavioral health specialist and then go through a second such session 90 days to 120 days later.
The second one is generally the time when indications of stress surface, after the initial euphoria of the homecoming wears off and sleeplessness, nightmares, and other symptoms show up.
"We're seeing a lot of soldiers with stress related issues," he said. "They're not bipolar or schizophrenic. But they're deploying three and four times and the stress is tremendous. They're having relationship issues, financial issues, marital problems — all stress related."
According to Dr. Bret Logan, deputy commander for managed care at the base, extended war zone stints that have lasted as long as 38 months over the course of the wars in Afghanistan and Iraq have taken a severe toll.
More than 3,000 of the 15,000 troops returning home, Logan estimated, probably will experience headaches, sleep disorders, irritability, memory loss, relationship strains or other symptoms linked to stress disorder.
Medical staff at Fort Campbell say they also worry that there will be a new surge of suicides — an escalating problem in recent years, largely related to the stresses of war.
Jon Soltz, an Iraq war veteran and chairman of VoteVets.org, said more soldiers will have stress-related problems, and the military must be vigilant in diagnosing and treating post-traumatic stress disorder to head off more serious issues. "The longer you are there (at war), the more PTSD you're going to see. You wonder when it's going to be your time," he said.
Each returning soldier is evaluated through a seven-day reintegration program. It includes medical checkups, tests, lectures on suicide prevention and relationships, and other sessions to help them transition back into life at the base and with their families.
During his visit to Campbell, Chiarelli took a spin on one of the base's simulators, which are used for soldiers having neurological or stress problems. The simulator can be used to test soldiers' reflexes or as a way to work someone back into everyday situations.
With occupational therapist Eileen Hayes watching over his shoulder, Chiarelli adeptly negotiated the city streets, sudden turns and other obstacles moving at him on the small screen.
The simulators said Logan, put patients in high stress scenarios to test their decision-making ability while under duress.
While soldiers have been routinely deploying for 15-month tours, most Marines serve about seven months and airmen deploy for about four months, although some may serve for tours of six months or longer.
Late this past summer, Pentagon leaders ordered a change, saying any soldier who deployed in August or after would serve 12-month tours. Army leaders say they want to reduce that to nine months, but doing so will be difficult considering the strains of fighting two wars at once.
Logan said that some 85 percent of those soldiers with stress disorder symptoms will recover with the help of some treatment or medication. But the other 15 percent will require more intensive help.
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