Home-grown Terror -- CNN report, Andrew Kehoe and Others

By John Ballard

Speaking of denial, the tragedy at Ft. Hood (strategically scheduled exactly between Election Day and Veteran Day)  prompts little in the way of soul-searching as many patriotic Americans close ranks for a stoning.

As a population we are quick to be in denial about the violent extremism which was the subject of Mark Lynch's probing questions. We need not look outside the country to find violence and terrorism of American origin. 

CNN should be commended for quick reporting on a timely topic just hours after the event. I caught the story while on assignment and expected them to run with it. But for some reason this excellent piece of reportage has evaporated, likely because some pusillanimous, PC-crippled editorial self-censorship elected not to run it again. (I'm not an avid TV watcher, so I may have missed it. But I have already seen half a dozen repeats of talking heads with less to say.)

Fortunately someone captured it and uploaded it to You Tube. Unless it gets pulled, here it is.

==>Also, the Wall Street Journal has an on-line interactive map of the US showing fifteen locations over the last two decades accounting for the deaths of more than a hundred people in more than a dozen mass shooting incidents.

Go to the link and take a look.

Following the Virginia Tech killings I became aware of Andrew Kehoe and the Bath School disaster which still holds the record for the greatest number of students killed in one event.
The date was May 18, 1927.
The place was Bath Township, Michigan. 

Kehoe was born in Tecumseh, Michigan into a family of 13 children. His mother died when he was five, and his father remarried; reportedly, Kehoe often fought with his stepmother. When Kehoe was 14, the family's stove exploded as she was attempting to light it. The oil fueling the stove soaked her, and she caught on fire. He watched his stepmother burn for a few moments before dumping a bucket of water on her. She later died from the injuries.

Kehoe was regarded by his neighbors as a highly intelligent man who grew impatient and angry with those who disagreed with him. Neighbors recalled that Kehoe was always neat, dressed meticulously, and was known to change his shirt at midday or whenever it became even slightly dirty. Neighbors also recounted how Kehoe was cruel to his farm animals, having once beaten a horse to death.

This is a story worthy of a movie, but no one would buy a ticket. This is lifted from Wikipedia.

On the morning of May 18, Kehoe first killed his wife and then set his farm buildings on fire. As fire fighters arrived at the farm, an explosion devastated the north wing of the school building, killing many of the people inside. Kehoe used a detonator to ignite dynamite and hundreds of pounds of pyrotol which he had secretly planted inside the school over the course of many months. As rescuers started gathering at the school, Kehoe drove up, stopped, and detonated a bomb inside his shrapnel-filled vehicle, killing himself and the school superintendent, and killing and injuring several others. During the rescue efforts, searchers discovered an additional 500 pounds (230 kg) of unexploded dynamite and pyrotol planted throughout the basement of the school's south wing.

There is no clear indication as to when Kehoe conceived and planned the steps leading to the ultimate events. A subsequent investigation concluded that, based upon the activity at the school and the purchases of explosives, his plan had probably been under way for at least a year.

In early 1926, the board asked Kehoe to perform maintenance inside the school building. Regarded by most as a talented handyman, he was known to be familiar with electrical equipment. As a board member appointed to conduct repairs, he had free access to the building and his presence was never questioned.

There were a few warning signs prior to the events. Kehoe passed out employee paychecks the prior week and told bus driver Warden Keyes, "My boy, you want to take good care of that check as it is probably the last check you will ever get." Teacher Bernice Sterling telephoned Kehoe two days before the blast and asked to use his grove for a class picnic. Kehoe told her that if she "wanted a picnic she would better have it at once."

Prior to May 18, Kehoe had loaded the back seat of his car with metal debris. He threw in old tools, nails, pieces of rusted farm machinery, digging shovels, and anything else capable of producing shrapnel during an explosion. After the back seat was filled, Kehoe placed a large cache of dynamite behind the front seat and a loaded rifle on the passenger's seat.

In the same way that local officials sometimes wait for a few traffic fatalities before they get around to installing better traffic signals at dangerous intersections, we as a country often wait until the bodies pile up before investigating the causes.

Major Hasan happens to have been a Muslim, but he was also an American military officer. It would be careless and foolish to examine one of those identities for the roots of his behavior and remain in denial about the other.

Here are more links connecting a few more dots.

Christine Pelosi  (Yes, Nancy's daughter, b 1966) writing at Huffpo, comments.

Fort Hood Killings: No Safe Place from Invisible Wounds of War In the wake of the massacre there will be a tendency to say one man snapped. That would be wrong. The truth is anyone could have snapped -- and this one sent out warning flares before he did -- so we need to de-stigmatize PTSD and mental health before someone else snaps and more American families suffer. 

While it is unfair to expect an after action report on such a sensitive subject in the instantaneous news cycle, some immediate questions deserve attention, such as how does a negative performance review (as alleged here) yield a deployment to a war zone? At what point does PTSD render a soldier unfit for deployment? Do we have the mental health regimes we need? Who is screening the screeners?

Others will say that after the Walter Reed investigations and needs assessment, we are doing all we can to help our troops and veterans get the resources they need. That too would be wrong - we currently have a Senate "hold" blocking passage of S. 1963, �The Caregivers and Veterans Omnibus Health Services Act of 2009� which could be helping troops and veterans cope with disability and trauma -what the American Legion calls "the invisible wounds of war."

Also, we can work faster and smarter to implement the ideas expressed at last week's first-ever DOD-VA Mental Health Summit.

Tragedy will strike again: there is no safe place from the invisible wounds of war. We can't say we weren't warned; but, for the sake of the grieving families, the dead and the wounded, we must be able to say we did all we knew how to stop it.

Nearly a year ago Maggie Mahar wrote the following.

[...]
In recent months, VFA reports, it has been contacted by a number of soldiers based at Fort Drum who are concerned about their own mental health and the health of other members of their units. In response, VFA launched an investigation of conditions at Fort Drum, and what it found was shocking.

Soldiers told the VFA that �the leader of the mental health treatment clinic at Fort Drum asked soldiers not to discuss their mental health problems with people outside the base.� The report observed that �Attempts to keep matters �in house� foster an atmosphere of secrecy and shame,� and that such a directive �is not conducive to proper treatment for combat-related mental health injuries.�

The investigators also discovered that �some military mental health providers have argued that a number of soldiers fake mental health injuries to increase the likelihood that they will be deemed unfit for combat and/or for further military service.�

The report notes that a �conversation with a leading expert in treating combat psychological wounds� confirmed �that some military commanders at Fort Drum doubt the validity of mental health wounds in some soldiers, thereby undermining treatment prescribed by civilian psychiatrists� at the nearby Samaritan Medical Center in Watertown, New York.

�In the estimation of this expert, military commanders have undue influence in the treatment of soldiers with psychological wounds,� the report noted. �Another point of general concern for VFA is that Samaritan also has a strong financial incentive to maintain business ties with Fort Drum�a dynamic [that] deserves greater scrutiny.�

Because some soldiers do not trust Samaritan, the report reveals that a number of �soldiers have sought treatment after normal base business hours at a hospital in Syracuse, more than an hour�s drive from Watertown, . . . because they feared that Samaritan would side with base leadership, which had, in some cases, cast doubt on the legitimacy of combat-related mental health wounds.�

�In one case,� the report continued, �after a suicidal soldier was taken to a Syracuse hospital, he was treated there for a week, indicating that his mental health concerns were legitimate. Unfortunately, mental health officials at Fort Drum had stated that they did not believe this soldier�s problems were bona fide.�

According to the VFA, the problem of military doctors refusing to back soldiers with mental health problems is widespread: �VFA�s work across the country has confirmed that soldiers often need their doctors to be stronger advocates for improved treatment by their commanders and comrades. For instance, soldiers need doctors who are willing to push back against commanders who doubt the legitimacy of combat-related mental health injuries.�

While talking to soldiers at Fort Drum, VFA also discovered �considerable stigma against mental health treatment within the military and pressure within some units to deny mental health problems as a result of combat.

Some soldiers who had been in the military for more than a decade stated that they lied on mental health questionnaires for fear that if they disclosed problems, it would reduce their likelihood of being promoted.

Soldiers at Fort Drum are not alone. In an earlier report titled �Trends in Treatment of America�s Wounded Warriors� (pdf)  VFA disclosed that leaders of the military mental health treatment system have been warning Department of Defense leadership of the magnitude of the mental health crisis that is brewing.

A report by the Army�s Mental Health Advisory Team (MHAT) that was released last May found that the percentage of soldiers suffering �severe stress, emotional, alcohol or family problem[s]� had risen more than 85 percent since the beginning of Operation Iraqi Freedom. MHAT also found that 28 percent of soldiers who had experienced high-intensity combat were screening positive for acute stress (that is, Post-Traumatic Stress Disorder, PTSD). =

Finally, MHAT disclosed that soldiers who had been deployed more than once were 60 percent more likely to screen positive for acute stress (that is, PTSD) when compared to soldiers on their first deployment.

VFA�s most recent report notes points out that, despite these warnings, soldiers at Fort Drum do not have access to the care they need: �More than six years after large-scale military operations began in Afghanistan and, later, in Iraq, a casual observer might assume that programs would have been implemented to ensure access for Soldiers from the 10th Mountain Division to mental health services on base. Unfortunately, an investigation by VFA has revealed that [soldiers] who recently returned from Iraq must wait for up to two months before a single appointment can be scheduled�

The report continues, saying that �Given the great amount of public attention that has been focused on the psychological needs of returning service members, a casual observer might also assume that these needs would have been given a higher priority by Army leaders and the National Command Authority�the two entities with the greatest responsibility for ensuring the strength of our Armed Forces. These needs have long been acknowledged but,� the report concludes �there has been insufficient action.�

Last month the army tried putting a band-aid on the problems at Fort Drum by sending three Army psychiatrists from Walter Reed Army Medical Center (WRAMC) to Fort Drum on a temporary basis to treat the large influx of returning soldiers requiring mental health care. But, as the VFA points out, �this is only a temporary fix, as the Walter Reed-based psychiatrists will likely return to Washington, D.C., within a few weeks.

Fort Drum will again be left with the task of treating thousands of soldiers with far too few mental health specialists. In addition, for those service members who were initially treated by psychiatrists from Walter Reed, their care will suffer from discontinuity, as their cases will be assigned a new mental health professional on subsequent visits.�

And the war drags on. Earlier this month, the U.K. Times reported that �the conservative Washington think tank [the American Enterprise Institute] that devised the �surge� of US forces in Iraq now has come up with a plan to send 12,000 more American troops into southern Afghanistan.�

The article continues, saying that �A panel of more than 20 experts convened by the (AEI) has also urged the administration to get tough with Pakistan,� and that �The US should threaten to attack Taliban and Al-Qaeda fighters in lawless areas on the border with Afghanistan if the Pakistan military did not deal with them itself, the panel concluded.�

Where do conservatives expect to find those troops?

More soldiers are likely to suffer the fate of the soldiers at Fort Drum. They will be sent back to combat, again and again�until finally, they break. Soldiers suffering from post-traumatic stress syndrome, depression, or a host of other mental problems are not in a good position to protect themselves. Sending them back only guarantees that fatalities will rise.

This is not "breaking news."

This by Phillip Carter appeared in March, 2007, sub-titled "How the US Army broke in Iraq"
===> You get that? This was written TWO AND A HALF YEARS AGO...<===

Of all the signs of breakage, perhaps the most acute is the decision to redeploy Army brigades to Iraq sooner and for longer tours in combat. The entire active-duty force is either deployed, set to deploy soon, or within one year of coming home from Iraq or Afghanistan. Short of conscripting millions of Americans to rapidly build a larger military, contracting out for a larger force, or mobilizing the entire reserves at once, military leaders say they have no other choice�to surge in Iraq, they must reduce the time soldiers spend at home between deployments and lengthen their combat tours from 12 to 16 or 18 months. But sending troops to Iraq after such a short time to reorganize, refit, and retrain is a recipe for disaster.

The combat-stress literature [link in original to a training resource is no longer active] suggests there's a finite limit to the amount of time that men and women can withstand combat. British historian Richard Holmes pegged this figure at approximately 60 days of sustained combat. In Iraq, we often wondered what our finite limit was, given the stresses of our advisory mission and the frequent attacks on our compound in downtown Baqubah. You can drink only so much chai with Iraqi leaders, and hit so many improvised explosive devices, before you burn out and need to go home. The soldiers and Marines fighting high-intensity operations in Ramadi probably had a different limit than my team, as did the troops assigned to staff duty in the International Zone or on major forward-operating bases.

• [Recommended link reading by Thomas Ricks: "Like most towns, Balad has distinct neighborhoods. The southwest part, home to thousands of civilian contractors, is "KBR-land," a reference to the construction company. "CJSOTF," for Combined Joint Special Operations Task Force, is home to a special operations unit and is hidden by especially high walls. Visitors aren't welcome there, and the Army public affairs chief on the base said he'd never been inside.�Next door to CJSOTF is the junkyard, one of the places where war comes closest -- it contains dozens of Army Humvees wrecked by bombs or rollovers. The other place where the war intrudes is the busy base hospital, where doctors perform 400 surgeries a month on the wounded.�The base boasts its own airline, "Catfish Air," that shuttles soldiers among the U.S. bases in Iraq. It also has its own customs post, run by a relaxed but savvy group of Navy reservists.�Searching for drugs, pornography and souvenir weapons, they have learned the favorite places that departing Army troops use to hide contraband -- Bibles, picture frames, soap dishes and the sleeves in body armor vests that hold the bulletproof plates. Army engineers undergo especially close inspections because "they think they know where to hide everything," sometimes building false bottoms in toolboxes and containers, said Petty Officer 1st Class Steven Honer."]

To a senior Pentagon official studying a set of PowerPoint slides in the Pentagon, the question may seem academic. But to men under fire, it is anything but. Keeping units in combat for longer than a 12-month tour may push many troops past their breaking point, endangering both their lives and the mission.

Today's Army and Marine Corps is more family-oriented than other forces fielded recently by the United States. My deployment affected my family far more than me. I knew when I was safe and when I was in harm's way; families can only guess, piecing together what they get from CNN and sporadic e-mails from their loved ones. Extending soldiers' tours crushes the hopes of their families, who pin so much on a fixed return date. Soldiers have always received "Dear John" letters, but it's different now, because so many troops have spouses and children�and because today's troops are getting "Dear John" e-mails and phone calls in real time. Extending these tours creates enormous strain for military families. And shortening these families' time together between deployments all but guarantees family issues on the next rotation. Problems at home quickly become problems in Iraq or Afghanistan, forcing combat leaders to take time away from their mission to advise soldiers about family matters.

These extensions create enormous strain for reservists, 80,373 of whom are now on active duty. Unlike regular Army troops, who currently serve about a year in Iraq, reservists typically serve between 16 and 18 months away from their families�12 months in Iraq and then four to six months for training and processing before and after their tours. Extending the combat-tour length for reservists will create tours close to two years.

The Pentagon's plans also call for many reservists to be called up for a second or third time in as many years. This effectively rewrites the social contract of the reserves. During the 1980s and '90s, soldiers joined the reserves on the understanding that they would train one weekend per month and deploy for either discrete missions or "the big one." Over the last three years, the Pentagon has gradually transformed (27 pg pdf) these part-time forces from a "strategic" into an "operational" reserve, meaning they can now expect to deploy one out of every five to six years, or more, depending on the situation.

Many reservists have chosen to get out of the military, creating a manpower crisis. Reserve units now frequently deploy to Iraq as composite units, victims of so many personnel exits and transfers that their soldiers often don't even meet until they are called up to active duty. Consequently, the reserve units deploying to Iraq today are not as good as the units that went in 2003-04, and there are few reservists left to fight elsewhere should the need arise.

Am I alone imagining that Major Hasan was unaware of realities such as this?
Is it possible that a trained psychiatrist in the military was able to matriculate the required academic hurdles as well as the military requirements and still not know what lay in his future?

I think not. As I said, this is not breaking news.

And if he had any doubts, according to his job description he would have living, first-hand evidence that orders to deploy were not very different from a doctor delivering news of an inoperable terminal diagnosis. Looking at the situation from a distance, it would appear that his military environment orchestrated all the right variables to precipitate his irrational behavior. 

The mission of the military is to take impressionable young men and women whose risk-aversion instincts are still somewhere between primitive and non-existent and convert them into warriors.
It is the human equivalent to making an IED from easily procured everyday components. (It's no wonder that live weapons are not allowed in training situations. Too dangerous.)
IED's, both mechanical and human, can be detonated by something as simple as an ordinary cell phone. As can be seen in the case of Major Hasan, they can be quite dangerous. 

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Yesterday on Weekend Edition Saturday, Scott Simon and Daniel Zwerdling discussed a large and growing problem with returning injured veterans, not the ones who are damaged but recovering, but a more tragic number who are damaged for life and must be cared for as long as they live.

This five minute piece is worth a little part of your day.

ZWERDLING: ...the government gives the most help if the vet is totally incapacitated. For instance, I met a young man a couple of weeks ago near Tampa, Florida. Part of his head was blown off by a grenade. He can't walk, he can't talk. His mother has to change his diapers, do everything for him. If your son is like that, then the VA will pay you roughly $100,000 a year. And if the vet or the guardian says it's okay, your family can use that money to hire help to take care of them.

SIMON: Does that cover everything?

ZWERDLING: Well, no. I called a home healthcare agency the other day. They said this would cover basically just care during the day, okay? So let's say you're the vet's father. Here's your choice: do you want to keep working at your usual job while some home healthcare aides take care of your son during the day? Okay, that's fine. But then you come home at night and you have to then become the overnight nurse - you'll be totally exhausted. Or do you want to take the $100,000 and use that to pay your family's bills, but then you will take care of your son yourself 24 hours a day?

SIMON: Which obviously doesn't sound like a very encouraging choice. You said that that's the most help the government gives?

ZWERDLING: Yeah, because I've talked to mothers and fathers and sisters and others whose family members came home from the war in one piece. They look normal, but they have severe PTSD or traumatic brain injury, or both, and their families say we cannot leave these people alone, even for a few minutes. SIMON: Because it gets dangerous if they do?

ZWERDLING: You know, if you have TBI, [traumatic brain injury] you can be very forgetful. I mean, literally TBI victims turn on the stove and walk away and forget it's there. They could burn down the entire house. Now, veterans do not like to use this phrase in public, but they call these people walkie-talkies - they walk, they talk, but these vets can't function normally. But because they're not totally incapacitated, the VA gives them way less money. Indeed, these families are really, really hurting.

SIMON: Veterans' advocates, is what they suggest as simple as telling the government we need more money?

ZWERDLING: That's a start. They want Congress to pass a law that some people call the Family Caregivers Act. And under this law, the VA would actually pay family members to take care of wounded vets. It's sort of like a salary.

SIMON: Are there other features they'd like to see changed?

ZWERDLING: In addition, the law would pay for you to get training so that you would have, you know, you wouldn't be a nurse but you would know better how to take care of somebody who's seriously wounded. You could get counseling. They would actually pay for nursing aides to relieve you so you could go on a long vacation so you would not burn out.

SIMON: Congress has a lot on its plate already. What are the chances of legislation like this coming about in the next few months?

ZWERDLING: There's a big push for it and members on both sides say they support it, but there are some influential members of Congress who say, wait a minute, this is going to cost billions of dollars. You know, we're trying to cut the budget, not add to it. On the other hand, the supporters of the bill say, wait a minute, if we avoid putting a single vet in a nursing home, this could save the government money, 'cause, you know, it could cost, you know, $250,000 a year easily.

SIMON: Do we know how many families would be affected by this, are affected right now?

ZWERDLING: You want to hear the astonishing answer?

SIMON: Yeah.

ZWERDLING: The government does not know. Now, the VA says there are roughly seven or eight hundreds vets who are so incapacitated they need round-the-clock care by their families, but they have not counted the number of so-called walkie-talkies out there. So it could be in the thousands. They do not know.

How many?
The government Does. Not. Know.
Unbelievable.

And unless I miss my guess, many of the same people agitating to send more troops into the Afghanistan theatre are the same ones prating about "fiscal restraint," "budget considerations" and the growing federal deficit.
We just witnessed them last night all this week and especially last night using the budget and money-shortage arguments in their multi-dimensional attempts to block the progress of universal health care and insurance reform.

I'm looking at the problem through the lens of a caregiver. Not only were my wife and I my mother's caregiver for two years before she went to live elsewhere -- first in assisted living, then a nursing home -- but my post-retirement full-time employment includes five years in an independent living facility for seniors and I am now a non-medical caregiver working part-time through an agency.

I have seen first hand the challenges of caregiving. I know how hard it is for adult men and women whose bodily functions are compromised to allow other people, often not the same gender, to assist them with their most intimate problems. It's not easy for anyone, especially family members, to cope with someone whose cognitive challenges cause them to be incoherent, angry, depressed, unresponsive and often combative.

Some situations, even the most traumatic, can be better endured when there is a light at the end of the tunnel. I cared for an elderly bachelor who had a broken ankle AND cerebral palsy. But it turned out to be a rewarding assignment because he had a large and loving support network of family, church and community contacts whose constant attention made the days something for which to look forward. 

On the other hand, when a man in his eighties was the sole caregiver for his incontinent wife with advancing Alzheimer's the situation was not as bright. She had already been twice in nursing homes up to the 100-day maximum covered by Medicare, but each time he brought her home for personal caregiving. (After one hundred days of "rehabilitation" Medicare categorizes the beneficiary as "custodial" and covers only strictly medical needs. Food, shelter and personal care are not considered "medical needs" because ordinary citizens do not have the resources of large, well-organized business and professional groups.)

The national conversation about health care, foreign policy, military protocols, veterans benefits and national politics all intersect with this most recent dramatic event in which Major Hasan may have been the main figure, but was by no means the main problem.