More than medicine
By
Joseph J. Frank
Until the land mine went off, it was a pretty routine
assignment. I was directing a truck loaded with sandbags to a bridge site at
Tam Ky, in what was then South Vietnam. The road from base camp to the river
had been swept for mines, but the truck swerved left, off the main path. There
was an explosion, but I didn’t hear it. The next thing I remember is lying flat
on the ground, sensing my legs were still in the air. A medic was immediately
upon me, pushing painkillers through my skin, to go along with numbing shock.
Strange thoughts entered my mind. Someone was giving me last rites. Was I dead?
No, I did not think I was dead. Then I heard the beat of Huey blades in the
tropical air.
I will never forget the date. It was Jan. 14, 1968, 48 years ago
– the height of the Vietnam War. I had begun that day as a strapping young
soldier in the Army’s 39th Engineer Battalion (Combat). It was the last morning
I would rise and feel my feet hit the ground beneath me.
I came back to the United States paralyzed from the chest down,
a T4-5 paraplegic. The hardest part of a spinal injury, for many of us, is
psychologically accepting the reality that no matter how hard we try, we’re
never going to get up and walk again. The human brain is not easily convinced
of this and continues, almost involuntarily, to attempt to solve a problem for
which there are not yet any medical answers.
For me, this new and different life began at the Hines VA Spinal
Cord Center in Chicago. There, I had doctors and counselors who understood not
only my condition but my context. Healthy soldier one day and paralyzed veteran
the next, I had suddenly returned to the United States to begin the yearlong
rehabilitation from an injury in a war that most Americans misunderstood or
hated. Some would look at me and see an illustration of political viewpoints I
did not necessarily share with them.
In a ward with 32 other paralyzed veterans I learned to get
dressed in the morning, take care of myself, operate my wheelchair, keep my
upper-body muscles strong and drive a vehicle without the use of lower limbs. I
also learned what it means to have health-care services specific to my status as
a veteran, delivered in the company of others who have served in uniform. As a
young veteran in need, I realized that VA care is a cherished benefit reserved
only for those of us who pledged our lives to defend our nation. It’s something
we get in return for what we have given.
As the VA privatization movement rattles through Washington
heading into the fall elections, I think back to that year I spent at Hines.
After I got used to my wheelchair, I started helping other paralyzed veterans
in the ward as some had done for me when I arrived. I made several discoveries
that first year of major adjustment, and those discoveries have guided my
career as a champion for veterans and people with disabilities alike.
I discovered, for instance, that veterans need caregivers who
understand the post-military journey, whether we are looking for relief from
post-traumatic stress disorder, trying to figure out a new prosthesis, hunting
for a job, filing a claim, buying a house or getting checked for hepatitis C.
As an American Legion member, and later as a counselor and service officer in
the St. Louis VA system, I also discovered why it’s important to be both a
constructive critic and a tireless advocate of VA health care. We address the
system honestly and demand improvements when needed because VA health care
belongs to us, the veterans who use it. Too often today, I find that the
biggest supporters of VA privatization are not VA patients at all. Many are not
even veterans.
Too often, veterans’ criticism of VA has been misinterpreted as
condemnation. And our calls for change and reform within the system have been
erroneously translated into a perceived demand for its transfer to the private
sector. The American Legion has supported the 2014 Choice Act and its provisions
only as a temporary measure for veterans whose VA facilities are unreasonably
distant or overbooked. The Legion opposes permanent use of non-VA providers, as
well as expansion of vouchered care to the private sector, for a number of
relevant economic reasons, including lower average cost per patient – but
there’s much more to it than that.
More importantly, VA consistently outperforms other providers in
terms of patient satisfaction and quality. That was certainly the case for me
in VA’s spinal cord program, which is superior. A VA health-care provider is
far more likely to know where to turn for answers on claims applications,
disability ratings adjustments, or college and career help. VA health care is
more than medicine. It’s a network of people – providers and patients alike –
who care about veterans in ways non-VA medical practitioners can’t be expected
to understand, let alone provide. Why would we ever want to take this benefit –
a health-care system that understands the context of our lives as veterans and
can help us in multiple ways – and hand it off to private providers whose
quality probably ranks lower and cannot fully understand our needs and the
services available to meet them? Outsourcing is only preferable when veterans
have no other choice, such as those who live in rural areas distant from VA
facilities.
I was honored to serve on the presidential committee of people
with disabilities that brought into existence the Americans with Disabilities
Act (ADA), which improved the lives of millions and continues to do so. Not
only did the ADA open doors and make upper floors accessible to people who use
wheelchairs, it changed perceptions. I remember vividly that, in 1968, children
were often frightened by wheelchairs. Today my grandkids want to ride on mine.
My work on the ADA, and its success, proved that revolutionary positive changes
can be accomplished even when dealing with the federal government, and greater
understanding can be achieved on a bigger scale about people outside the
average U.S. demographic, like those of us who use wheelchairs and military
veterans.
The year I was elected national commander of The American
Legion, Congress passed the Veterans Health Care Eligibility Reform Act of
1996, which opened up VA to all who honorably served our nation. Priority
groups were established to ensure that those with the greatest needs and
service-connected conditions would move to the front of the line should demand
exceed capacity. As demand grew and capacity did not, today’s access problem
understandably arose. The movement to expand privatization because we haven’t
solved the access-demand problem seems to suggest that veterans don’t deserve
the quality care we fought to achieve in our VA system. Now that quality is
great, we will need to go someplace else. That’s pretty hard to accept,
regardless of your service-connected disability rating.
A couple of years ago, I went back to the Hines VA center, where
this journey began. This time, I was on a completely different mission,
conducting an American Legion System Worth Saving site visit. The chief of the
center met our group there, and he brought with him a yellowed file from 1968.
It was mine. In it was a written chronicle from my arrival as a frightened,
young and newly discharged soldier whose future was irreversibly changed,
through my wheelchair training, weightlifting, psychological counseling and
driving lessons. I was carried into that VA facility and I drove away from it,
back to my family in Missouri where I would start a new life. I have been
independent, happy and productive ever since, with the benefit of great family
support. I knew then, from my experience at Hines, that what lay ahead for me
wasn’t always going to be easy, but there are ways to solve almost any problem.
Joseph J. Frank served as national commander of The American
Legion from 1996 to 1997. He also worked as a benefits officer for Paralyzed
Veterans of America and as a peer counselor in the Robert Woolsey Spinal Cord
Center, attached to the St. Louis VA Health Care System. He often speaks at
schools and veterans events about his career in advocacy.
