From the VA Hospital: Maybe there’s no free lunch. But breakfast?

By admin on May 15, 2013

Today was a long day at the DeBakey Veterans Affairs Medical Center in Houston. I had a five-hour wait to see the doctor. There was nothing that could have been done with that for various personal circumstances.

My 45-minute or so visit with the neurologist went probably better than any visit in a great while. The doctor has agreed to take me off the side-effect-ridden Cymbalta and put me back on another drug I once took for the same conditions. What was even better was I got the neurologist to put me in a consultation with a neurosurgeon because of my back pain. This would be after undergoing another MRI on my back and an EMG. Now I had an EMG earlier this year or later last year. I can’t remember. That was to determine problems with my hands and fingers, which was then diagnosed as carpal tunnel. I was given two gigantic black braces for each hand, both bearing the U.S. Flag. When I don them both, I look like someone gearing up for bomb disposal, such as in the movie, “The Hurt Locker.” The braces aren’t very practical for my work as I disarm or detonate very few, if any, bombs in my daily comings and goings.

However long it takes after all the tests I will consult with the neurosurgeon as to whether I need back surgery and, if so, whether I will ask for it. I see that as a long way down the line. I have decided that I need to try and access a better physical shape and improve my health. Along with that, I also should start thinking long and hard about how to medically retire from my paying job and determine how to live on however meager the pittance might be. Time to be a vagabond, perhaps?

As ridiculously long as the day has left me, I did come away with one of those head-spinning acts of humanity.

I got some bacon and eggs, a sausage, and a biscuit along with a cup of coffee this morning at the Patriot Cafe. The cafe is the dining hall inside the huge DeBakey hospital. They have about four cashiers who have customers paying on either side of them. I went to one of those tellers and only a single customer was on the other side.

I hardly noticed the other customer on the other side except to note that she looked as if she was a VA employee and that she had a small item, a coffee perhaps. I thought I heard the cashier ask the young woman if she was paying for mine too. I was somewhat stunned but figured what I heard must have been in error. The other customer paid and walked off.

The cashier turned to me as I held my plastic in my hand. “She paid for yours,” she said. I was then truly dumb-founded. I quickly turned around and saw the generous woman as she was walking out the door. “Thank you very much,” I told her, though not very loudly as I was still wondering took place.

“Did you know her?” the cashier asked me, about the woman. “No,” I told her.

Thus ended a long day that left me wearisome and tired. The mysterious VA worker’s generosity might have been misplaced or mistaken. Or maybe she saw the tiredness in my eyes. Or maybe she was just messing with my head. Be it far from me to look good fortune in the mouth. Or anywhere else. Including in my local VA hospital

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A visit to the clinic with an art showing on the side

By admin on May 1, 2013

“Lo and behold!” That is what I said this afternoon while awaiting my meds from the pharmacy at our local Veterans Affairs outpatient clinic. No epiphanies usually jump up and slap the heart-worm medicine out of the dog that is my soul. I have been accused of being a sick puppy. If that is so, I would figure the illness which would be dogging me (sorry) might run toward some psychiatric affliction.

I don’t know what the hell I am talking about, in reality. I am not a dog. I don’t have heart-worm. And I don’t have canine psychosis. I have enough on the health end of the spectrum to keep me too busy to sit around making up imaginary dog diseases. Poor sick puppy.

Back to hold and below or whatever. Parked out under the clinic portico was about the coolest car I have seen since my friend Blake drove his father’s Rolls Royce through the bumpy and manure-littered cow pasture road leading to the farmhouse I rented in the East Texas countryside. And that was a while ago.

Watch out! Art on wheels!

Watch out! Art on wheels!

I don’t know what one would call it. Well, “Honda Accord” for a start. But the toil and trouble put into this plastered and painted auto made it some kind of keen collage of rolling steel. From the “Hot-rod Era” to the 50s sex-kittens such as Monroe, for this “Hollywood Daddy-O” (Sorry, I haven’t mastered my iPhone camera and plus it was a day in which my essential tremors were shakin’ harder than Ol’ Pop down at the corner malt shop.) Even local sights from our fair city’s American Graffiti past were represented, as below.

Rolling history of Southeast Texas.

Rolling history of Southeast Texas.

I have to mention here that the photos (from top to bottom) of the Calder Avenue Pig Stand in Beaumont (Texas), now closed, and the sights from Vidor and Beaumont’s, may be copyrighted. I am sharing these pictures here under the Fair Use Doctrine. Look it up if you so desire. You really should read it if you are going to post pictures online. Oh, sorry for the headlight or whatever that is at the Pig Stand. That’s the photo though.

Studying the exhibition, I linked up with the artist. He turned out to be a 64-year-old Air Force veteran although he looked somewhat younger, even with whitish shoulder-length hair and beard to match. I believe his name was Dave. Sorry, I could just say I have problem remembering names. But I was so taken with his work that the car art overtook any profundity the artist might have exclaimed. It wasn’t a boring conversation, I really enjoyed the talk. But art is where you find it.

I happened to have found it at the VA. And it was free and close up and cool.

 

 

 

 

 

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Are today’s veterans being “dissed” on campus?

By admin on January 9, 2013

An article on the online version of Stars and Stripes brought back some memories recently. The staff-written story on the “independent” Department of Defense-run newspaper told of veterans incurring anti-military attitudes on college campuses. Such a piece sparks an interest in me because I have long followed veterans issues and the fact that I am a veteran who is a college graduate in part due to the GI Bill.

First though, a little about the quotation marks surrounding the word “independent.” Stars and Stripes first published in 1861 when a Union regiment found an abandoned newspaper office in Missouri and gave today’s paper its name.

Stripes became well-known during the first and second world wars among soldiers overseas, featuring journalists who are now considered among the greatest talents of the 20th century. Among them, the great sports writer Grantland Rice and noted drama critic Alexander Woollcott from the WWI era. The World War II staff included Andy Rooney and cartoonist Bill Mauldin of “Willie and Joe” fame.

For all the restrictions on journalists through wars during the last 90 years Stars and Stripes has published, I have to say it is a very good newspaper. The civilian writers certainly have unique office politics as well.

A reporter I knew who covered military issues for a metro-sized Texas paper went to work for Stripes. She called it the “world’s largest PR firm,” or words to that effect. Nonetheless, she could for the most part experience and write about what any other battlefield journalist could. Combat news coverage has never been perfect even though the best practitioners of journalism have given it hell over time.

Okay, perhaps a little more than you might want to know about Stars and Stripes, but I am just trying to give the story a little context. This isn’t The New York Times, but Stripes also isn’t MSNBC or Fox News. The writer in the linked story gives only limited anecdotal evidence that today’s veterans are being “dissed” on campus and that professors are overtly antagonistic toward ex-military. That isn’t to say that such feelings do not get displayed on college campuses today, especially given the divided religious and political viewpoints in our society which are egged on by talking-heads in media.

Given, 1980 — when I matriculated — on an East Texas college campus with a large portion of its student body hailing from Houston and Dallas suburbs is different from 2013 at a school such as UC-Berkeley. But one factor we had in common is age. We were young then. These vets, who may have experiences that have made the grow up way too fast, nevertheless are for the most part also young men and women.

Now I believed what many told me about former military folks who attended college. That was, they were more serious about studies and generally more responsible. That is true. I worked full time as a firefighter during most of that time as well. As I have said before, the monthly GI Bill payment was mostly gravy. But looking back, I mistook a quasi-cosmopolitan attitude from my service and world travels for wisdom. And though I started school at 25, I quickly felt at ease with the majority of those 18-to-21-year-olds who made up most of the student body.

I remembering engaging with certain professors with whom I disagreed. I found for the most part that they dug it. I actually ended up more liberal when I left the military than when I enlisted. Thus, the “left-leaning” professors, which absolutely were in a minority where I went to college, were all right by me. I also enjoyed being engaged and made to think as well as learning so very much that I didn’t know, not that it has always stuck!

Members of the military are treated better nowadays by the public than anytime I can remember. Though the extent of hostility toward military personnel during the Vietnam War has been questioned, those in uniform during that entire Vietnam Era could easily encounter prejudice. Such hostility wasn’t just from long-haired “peaceniks” either. I once talked to several Vietnam vets who avoided service organizations such as the VFW or American Legion toward the end of the war because the majority World War II membership saw that day’s serviceman as a “loser.”

Former Army Chief of Staff Gen. George Casey Jr., said in the Stars and Stripes article that veterans attending college should be open to others and walk away from scholars whose minds you will not change. I certainly agree with the first part of that. But I think the vets need to engage those they do not agree with as well, whether professor or student. It contributes to a richer learning atmosphere which is just as much a major portion of college as books and lectures. All of this also doesn’t have to happen in a classroom. Who knows how many theories I discussed around a keg or in the bar.

I can’t help but have kind of mixed feelings on the case made by the news article. Yes, there are a great number of people against the war in Afghanistan and our adventure into Iraq. But the outward show of support military people get today makes it difficult to believe, minus greater evidence, that campus animosity toward veterans is as rampant as the story suggests.

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Beaumont, other VA clinics, in need of volunteer drivers. Why doesn’t anyone answer the call?

By admin on December 19, 2012

At the moment I am sitting here in Beaumont rather than awaiting my appointment at the Houston VA hospital. I cancelled the appointment I had with the Sleep Clinic yesterday. I haven’t had a follow-up since I was first diagnosed with sleep apnea in 2000. Everything is okay in the sleep department. I just need a follow-up so I have had to reschedule — to a June appointment. My reason for rescheduling is a lack of transportation.

I have a pick-up truck and a work car, the latter is for “Official Use Only” if you get my drift, the truck is a 1998 Toyota Tacoma. It gets me around town but it also needs some work. I am just not sure about taking it on a 80-mile trip,  most of which is interstate highway and Houston traffic. I took a Greyhound last time. The trip wasn’t bad at all. I took a Metro light rail train and switched to a bus, all in all 30 minutes to the hospital. The same on the way back. I left about 8 a.m. that day and got back around 6 p.m. And, I didn’t have to drive in that ridiculous Houston rush hour traffic. The cost was $36 round trip. When I looked last week, the price was up to about $45. Still, not a lot but higher than I could cough up at the time. I even put an ad on craigslist.org and got no reply.

So why didn’t I take the van that takes patients from the VA clinic in Beaumont to the Houston VA hospital? Well, the lady who is firmly in charge of the program at the clinic, a volunteer, told me the month of December was all booked up. What are the rest of us supposed to do? Cancel, I guess.

The reason, I was later told, is that the volunteer driver program through the service organization Disabled American Veterans, is down to only one driver. There is another van sitting in the parking lot of the Beaumont VA clinic but it doesn’t go bye-bye because there is no volunteer driver to make it go bye-bye. It has been that way for awhile. That makes me wonder why? There is a flyer posted on the Houston VA Web site with the following information:

 Voluntary Service Van Drivers


Help pick-up outpatients receiving treatments or therapy and other outpatient appointments. To fill this role, you must have a current, valid Texas driver’s license, must be 18 years or older, have automobile insurance and pass a physical exam. Hours vary.
We are looking for volunteer drivers for the following locations:


Beaumont, TX               Willis, TX
Woodville, TX                Conroe, TX
Lake Jackson, TX           Texas City, TX
Galveston, TX                Bay City, TX
Brazoria County, TX       Cleveland, TX
Waller County, TX

If you would like to become a volunteer van driver please contact the volunteer office at 713-794-7135.

I am at a loss as to why, that in a metropolitan area of almost 390,000 people, one volunteer cannot be found to drive the other van. It doesn’t look all that demanding although most drivers I have seen in the past were a little older veterans. Whether it is more demanding on them, I can’t say. I don’t know whether the VA really finds that veterans getting to their appointments in Houston is a priority. Surely this Web page isn’t the only site where this call for volunteers can be found? If I didn’t have the physical problems I have, I would volunteer. Or so I think.

In the end, I don’t suppose I would find out the answer to what the problem is unless I ask. Even then, I am not so sure I would get the full explanation. Whether there are ulterior motives at the Beaumont Clinic, the Houston VA hospital or both, I can’t say. I just hope the problem gets solved in time for my next appointment.

 

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Lufkin VA back open and bed bug-less, delivered here in a wave of HST nostalgia

By admin on December 7, 2012

Some good news for veterans who use the Lufkin (Texas) VA clinic just appeared on my mojo wire. Actually, it came by e-mail which sometimes seems to bring mojo of one sort of another. Hunter S. Thompson actually used the term “mojo wire” in his classic “Fear and Loathing on the Campaign Trail ’72.” My estimation of who knows Hunter S. and who is reading this blog is not imaginable. So Thompson, whose style of work as a writer was called “gonzo journalism,” was probably the first gonzo journalist. All of those young writers — Me? Guilty — whose instinct was to fight the “system” emulated Thompson. In the end, only Hunter S. was Hunter S. His ashes shot from a cannon on a 153-foot tower shaped in a double-thumbed fist holding a peyote button, and all. Forgive me, I was cast adrift on a wave of nostalgia.

Perhaps it isn’t appropriate to make a blog post about a VA clinic reopening with references to a drug-addled maniac. But Hunter was an Air Force veteran, where he began his writing career as a sports reporter. I think that means something or other here.

My point is that a news release from the Department of Veterans Affairs came to me this afternoon announcing the Charles Wilson – of “Charlie Wilson’s War” or “Good Time Charlie Wilson” fame – VA Clinic in Lufkin is reopening after a good debugging.

 ” … a veteran came in to the clinic seeking medical assistance for a rash, the press release said. Clinic staff found bed bugs on his clothing and wheelchair. While the patient refused help and left, the staff immediately took action.”

The clinic reopened today after exterminators “extensively fumigated the building” and found no more bed bugs.

This dispatch raises several questions. One is, why did the patient refuse help? Was it because they planned to fumigate him? A Wikipedia article on bed bugs said the insects were a big problem on U.S. military bases during World War II.

Initially, the problem was solved by fumigation, using Zyklon Discoids that released hydrogen cyanide gas, a rather dangerous procedure. Eventually, DDT was found as a “safe” alternative, said the Wikipedia article.

I am not insinuating that the VA would use the WWII method on the bed bug-ridden vet who sought treatment and touched off warning bells. Some vets just don’t have the patience one needs at times to travel the road to VA assistance. “It’s socialized medicine,” said a VA employee awhile back. And so it is. But it is all many of us veterans have.

A VA microbiologist/control specialist noted that bed bugs have become a problem again due to increased travel and reduced usage in pesticides, said the press release. DDT? Remember running behind the mosquito trucks in the smoke as a kid?

Bed bugs were pretty commonplace when I was a kid and gradually they were gone and now they are back and they are pissed!

Oh well, if you are a veteran and have been bitten by bed bugs or think you have, here is a good article from a reputable source (The Mayo Clinic.) Make mine with mayo on the side … I’m sorry I don’t know what gets into me. And after reading the Mayo article, if you need help, then get it!

 

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An open letter to the rest of America on the Texas secession issue

By admin on November 14, 2012

Dear Fellow Americans,

By now you may have heard of a petition addressed to the White House “We the People” Web site that seeks a peaceful withdrawal of Texas from the United States of America. The site allows petitions that upon reaching the threshold of 25,000 names may be reviewed and given an official response. As of this afternoon almost 82,000 names have been posted.

As a Texan and one who supported President Obama and his re-election I wanted to say publicly and in the best manner a lifelong Texas boy can convey that this whole petition business is a total, 100 percent crock of bullshit.

Those who push the petition, as if it would ever receive any official presidential consideration, have missed the exit for Make-Believe World and are headed for a rapid trip to Delusional City. Why would people who are ticked off due to the election sign a petition to the President? It is his election to begin with that has wound up tightly these people who fancy themselves Texas nationalists. If many thousands of those who put their names on the petition were honest with the rest of us and themselves, their main reason for such a notion is the fact that the President is an African-American. To be exact, he is half black African and half white American, that equals ta-da! an African-American.

The petition “cites blatant abuses” of rights such as the “NDAA, the TSA, etc.” No specific abuses are cited for the condemnation of what I suppose is the National Defense Authorization Act or the Transportation Security Agency. Many of the worries are based on what is heard from the right-wing propaganda machine such as Fox News. Nevertheless, plenty of fanciful rhetoric is spouted on the Texas Nationalist Movement Web site which sees the United States government handing over the keys to the kingdom of Texas and saying “here you go!”

All of this is beyond ludicrous. We will not secede. Even our hare-brained Gov. Good Hair Perry doesn’t advocate such malarkey. He likely only brought it up as a means of snaring some of our nuttier voters for his god-awful presidential campaign. You see where such talk got him.

Face reality, those of you who think breaking off from the United States is a good idea. Any treasonous move to split our country would be met with sharp resistance. As it gradually sinks in that the election is over and Barack Obama won, I imagine such fanciful talking will be much more subdued. I hope so at least.

We Texans are a proud bunch. Yes, I know we can be obnoxious braggarts. But I suspect probably the majority of us also feel equally proud and protective of our country. Yesterday I saw that pride and that love of country reflected in those of us veterans who were graciously served a free meal for Veterans Day by Golden Corral. Vets from Vietnam and World War II as well as peacetime veterans sat by me at my table and not a one, not even the elderly gent from the second World War, failed to stand and salute during the National Anthem.

I also would be willing to bet that most Texans love their state and all of its beauty: From the mountains to the Pineywoods, to the Gulf; to the prairies and to the brush country. But we likewise love the surf of San Diego County, the majestic Rocky Mountains of Colorado, the Gateway Arch of St. Louis, the brass of New Orleans, the multicolored splendor of New England falls and on and on.

I won’t apologize for being a Texan. I will not even apologize for the idiots who believe this great state should break away from this wonderful nation. But I stress that most of us are not like those who are so deluded they probably need some drugs. Come see us in Texas. We’ll have a good time. We’re all Americans here.

Yours truly,

Dick of EFD

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Irresolution 2012 plus Veterans Day freebies

By admin on November 6, 2012

It’s time to elect a president. What can be said that hasn’t already been said a million, billions of times?

I make no bones or joints or ligaments about it, I support another term for President Barack (Yes, Hussein) Obama. No one elected to the most powerful position on Earth will be perfect. The President is not perfect. He has never indicated he is. But Mitt Romney deals in lies. He may be a very nice man. In fact, I would expect him to be as I have found most people of the Latter Day Saints faith to be exceedingly nice and polite. Oh but how that man can spout untruths.

Mitt wants voters to buy a pig in a poke, even those folks who don’t eat pork! He says he has plans although he “cannot” tell us the details until he is elected. I could go on and on. But it has all been said before as I said before and has been said by the Department of Redundancy Department and the Natural Guard. Thanks to Firesign Theater for that final phrase.

On another note, B♭ major I believe, Veterans Day is Monday. Not only is it a paid seven hours for me, there is an abundance of freebies for active duty and veterans. In fact, I might have a choice in where to eat relative free for lunch and dinner that day.

Here is a list.

I’m off to work after a routine trip to the Veterans Affairs Clinic. I will most likely be back here this evening for election returns. Heigh ho!

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Here’s to getting lost

By admin on October 22, 2012

A good morning or afternoon or evening, depending on where it is this may find you. Actually, if it finds you, wouldn’t that technically mean you are lost? I hope you aren’t lost. It’s no fun being lost. It is funny being lost sometimes, though not fun. Well, I suppose it can be fun.

I remember one day in my “ute” — meaning youth — getting lost whilst riding around on South Mississippi country roads with my friend Buffalo Bob. We left the Seabee base in Gulfport early one afternoon and stopped off to pick up a cold six-pack of something or other. I’m not trying to be cute. I mean, it was beer, hell yeah, it was! I just can’t remember what we were drinking back then, maybe it was Miller High Life. Interestingly enough I had a cold can of Miller in my fridge that I used to cook some chicken last night. Coincidence? I think so.

It seems we drove and drove and drove some more that beautiful day discussing all the major matters of the world as we knew it. Sometimes I wish I could have recorded some of those conversations although, on the other hand, maybe not. We eventually came to a crossroads where lo and behold there sat a VFW hall. Now neither Bob nor I were members though we were in the Navy. Bob was a veteran of a foreign war, one of the most foreign at the time, a place called Vietnam. It didn’t matter in the grand scheme of things though.

We walked in that VFW hall as if Bob was Sgt. Alvin York and I was Audie Murphy. Up to the bar we lumbered and asked for a cold beer. Since no one else was in the bar but the tender, whether or not to serve us because we weren’t members didn’t seem like a major decision to the beer tender. Actually, I think we still had beer in the car. We had stopped to ask for directions because it seemed as if we had been driving all afternoon. We had been, actually.

“So how do you get to Gulfport from here?” I asked the noble bartender.

He gave us instructions that didn’t require copying down, thankfully, because I doubt there was a writing pen closer than 40 miles from us.

“Where you boys from?” the barkeep asked as we paid up and headed toward the door.

“Oh, we’re from Gulfport,” said Buffalo Bob.

In reality, we were both from Texas but sometimes one has to use a little poetic license, which would be helpful if this was a poem, but it isn’t.

Off into the sunset we rode. Actually, it was in the opposite direction of the sunset. But that’s neither here nor there. I always thought that exchange we had in the VFW hall was kind of funny.Maybe you had to be there. And maybe you didn’t.

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A one-day to and from riding the ‘dog’

By admin on September 26, 2012

Top o’ the morning to you! That’s right, morning. Well, speaking of blowing it, I blew it in that I wrote my post on the bus from Beaumont to Houston this morning and forgot to publish it. My memory is shot. Speaking of shot, I am passing by Minute Maid Park in Houston as I write this. Shot being the word because the Houston Astros are about to play its last game as a National League team. Let’s hope the Lastros get a little better next year in its debut season as an American League product, like losses only in the double digits.

Incredible how I made it to this bus. I finished my appointment at the VA in time to take a jam-packed bus to a stop near the Houston Metro Rail line. Then I rode to the Downtown Transit Center, just a couple of blocks from Greyhound. My ticket was for a 6:05 p.m. bus that supposedly gets back to “Beaumont-Vidor” around 8 o’clock. More on Vidor in a moment. But I made it just as the gate locked on the 4 o’clock bus that allegedly arrives at 5:30 p.m. That’s not going to happen with all the stop-n-go with the bus heading toward I-10 at the beginning of rush hour. Hopefully, I will be back a bit earlier than I had planned.

My truck is parked in Rose City. That is a freeway truck stop spot on I-10 just across the Orange County line headed toward Louisiana. That is where the Beaumont Greyhound station is now located, having moved several months ago from its long-time stretch downtown on Magnolia Street. It is considered by Greyhound as the “Beaumont-Vidor” bus station now although its closer to downtown Beaumont than Vidor. I guess downtown “revitalization” is like the weather. People do a lot of talking about it but do nothing. The bus station is but one piece of downtown moved out into the nether lands. First Baptist Church, which takes up a whole city block between Calder and Broadway avenues, is being moved out to the West End. It makes me wonder if the great work the church does for our less fortunate brothers and sisters will be continued once it moves out into the land of milk and honey. I hope so, one never knows when one is going to need that help one day.

Traveling by bus isn’t quite the adventure it was during the days of my youth. I guess that’s a good thing, for me. Why the bus even has electrical outlets and WiFi. And the WiFi works.

Bus stations are certainly fewer and farther in between nowadays. Why I can remember in the old days — time to roll your eyes boys and girls — when every little mud hole and town that was big enough for a city limit sign had a bus station. Of course, there were more bus companies than just Greyhound back then as well. Let’s consider my trip today to the VA hospital in Houston.

The bus route from Beaumont to Houston — a straight shot west on Interstate 10 — now travels to Port Arthur on U.S. 69/96/287 where it stops at some Latino bodega on Gulfway Drive a.k.a. State Highway 87. The bus then picks up Texas 73 to Winnie, which is not named after Winnie the Pooh, or at least I don’t believe that is the case. The route jumps back on I-10 and makes another stop at a convenience store on the north side of the interstate in Baytown before heading downtown to the Houston bus station.

On the bus I’m now riding it is “an express” to Rose City as this puppy’s major destination is New Orleans and, perhaps even Miami, or Cuba.

We just now passed a traffic SNAFU that held us up for awhile. It looks as if three Army trucks were somehow involved. It looked more like a breakdown than an accident. One certainly hopes so. It is already 5:30 and we are at least 30 or so miles from Beaumont. If I make it back by the time I intended to depart Houston I will feel lucky indeed. I really better quit while I’m ahead now. Or as one of my old hippie friends used to say: “Better quit while I’m a head.”

 

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Veterans health care: Question authority!

By admin on August 10, 2012

Look online at various Department of Veterans Affairs patient initiatives and prepare to be dazzled.

Recent years have seen the VA expand its footprint over community after community with programs festooned with the typical government alphabet soup such as PCMH and PACT. These stand for “patient-centered medical home” and “patient aligned care teams.” While these collaborations appear to border on something a 21st century Marcus Welby M.D. might tout the programs also face the immediate danger of being quarantined to the bureaucracy ward.

Like most VA programs these initiatives are well-intentioned but also destined to constant undermining by forces beyond control of hands-on patient caregivers.

The PACTs seem to be working well at the Beaumont (Texas) VA Outpatient Center where I see my primary care team, or “Teamlet” in PACT jargonese. I now can send my blood glucose readings by secure e-mail each week to my nurse who, in turn,  enters them in her computer where she can keep a close watch on my Type 2 diabetes. This monitoring along with my medication and diet has brought my A1C reading, which measures your average blood glucose control for the past 2 to 3 months, from the verge of my requiring insulin shots to something much more manageable. Still, diabetes control requires more than simply eating right and taking your metformin.

Foot care is also another component of diabetic care especially if the patient has foot infections or abnormalities. Mine has had both including a wound that hasn’t fully healed in several months. My large toenails also require a special trimming that is beyond my ability. I have asked my primary care folks for a couple of years now if I could get a referral to a podiatrist. I was once told by a doctor that a patient had to have an infection before a consult could be given. I later found that out to be false. When I finally had an infected toe, I asked my primary caregiver to get me a podiatrist referral. She said that she would do that. I eventually forgot about that and finally asked my nurse if a consult had been ordered. She looked on her computer and apparently found a note indicating consults to podiatrist care in Houston could only be given to those with foot emergencies. Since I had previously found erroneous information on that subject, I decided to “question authority.”

Since I am a free-lance journalist and blogger, sometimes even a serious one such as now, I sometimes contact Bobbi Gruner, the VA spokesperson for the Houston VA, with questions. Ms. Gruner replied that she did not believe the podiatry policy I was quoted to be correct. She referred me to someone whose department is over that podiatry branch.

The answer I was given was that ” … there is no policy we are aware of that states the podiatrists now only see emergency patients.” This was according to Sangita Shah, who is the administrative officer of the Houston VAMC surgery department. Ms. Shah also asked for the “last four” numbers of my Social Security Number, which hopefully means she will look into my case.

I have no answer why I have twice received incorrect policies or policy interpretations in response to my request to see a foot doctor. I have my suspicions, but do not know for sure. What such problems show is how far the VA strays from their own goals of consistency. The Veterans Health Care Administration, VHA, is one of three administrations within the VA. It covers health while the remaining two administers benefits and cemeteries. They got you coming and going might be a good motto. But the VHA acknowledges collaboration and integration within the preamble to its vision statement:

 ”This care will be delivered by engaged, collaborative teams in an integrated environment that supports learning, discovery and continuous improvement.”

Integration is a key word to examine. In the manner it is used in the vision statement the word “integration” implies cooperation, harmony and an interrelatedness.  It isn’t just the so-called “home-centered” care that the VA exclaims will move boldy forth. I came across a temporary worker program for medical professionals in the VA. It has joined the private medical world in developing a “Locum Tenens” program. The Latin phrase loosely means to “hold a place.”  The VA describes a locum tenens physician as one who temporarily fills in for another while they are out on vacation, maternity leave, professional development or so forth, A flyer for the program touts: “A Consistent Practice: Coast-to-Coast.

 ”Here, you’ll find consistent patient care delivery methods and a single Computerized Patient Record System that’s networked nationwide. Learn it once, and it’s smooth sailing after that.”

 Such a promise is, well, not exactly accurate at least from this patient’s point of view. But if it is inconsistencies you are looking for one can certainly find a home in the VA health care system. Travel from one hospital to the other and don’t expect to find the same medicine you have been taking. If you are looking for a new drug and especially one that is expensive, you will not likely get it from VA pharmacies. As I have also found recently don’t expect hospitals and outpatient clinics to be on the same page when it comes to billing. Don’t even the expect the toll-free call center one phones to ask billing questions to be on the same page with the hospitals. Inconsistencies found such as this one regarding PTSD care for recent war veterans have begun to attract public and congressional attention. But many other dissimilarities remain.

VA health care can be among the best to be found in the country. That has not always been the case. That isn’t always the case now. That isn’t for the vast majority of its employees’ lack of trying. The best way to ensure that one receives the care they deserve is to stay attuned to their treatment, ask questions, and when something does not seem fair or right, it just might not be.

It may go against the grain of those who spent many years of their lives taking orders, especially the older veterans, to ask probing questions of your medical providers. But it is your life we are talking about here. If some VA medical policy seems inconsistent or unjust it might be time to do, as old Ben Franklin supposedly admonished was a citizen’s responsibility: question authority.

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