V.A.'s 'social minimalism' problems need doctors who’ll ‘stay aboard’

EL PASO--Trendy critics have the U.S. Veterans Administration health care system on the ropes again because of long wait times in getting mental health services to returning war veterans from Afghanistan. My suggestion? Talk to the MH director at the local V.A. here. Give her more “doctors who stay aboard ship” rather than fly off at the first peek of a pay increase.

Should Caring come before Sharing?

“Stick with me on this treatment program,” a strained but firmly positive Dr. Eliza San Roman, D.O., told me back in March when I complained about the long waiting period in just getting a medication review. “Remember, I’m the one who stayed aboard ship. Trust me!”

Within a six-month period, mas or meno, most if not all of Dr. San Roman’s staff psychologists had abandoned ship, so to speak, left for fame and fortune in the private health care world or beyond. It’s the way we are today, aren’t we? Fixed to anything is a rat hole in a dead-end alley!

“They don’t make any money here, not when compared to outside [the system]” she’d admitted. A quick internet check showed average V.A. annual salary in Detroit at $176,000, for instance. And that’s not El Paso.

Too, the bigger issue for society is where do we want to cap these spiraling costs? Are we near entering serious political maximum/minimum wage debates yet?

The V.A. assigns all patients to primary team physicians, M.D.s. Since I was a recent transplant to El Paso from Presidio (where for 15-16 years I’d taken V.A. medications for anxiety and depression), last summer my primary physician had asked me to get my mh dosages reevaluated. Maybe they needed to be changed.

But mental health at the El Paso V.A. has problems keeping doctors now, yes. With no more salary than Congress allows it to offer, recent medical grads sorely needing to repay school loans, for instance, (the young bunch) just about fills the recruiting crop. (Hee, hee. Reminded me of 40 years ago in newspaper reporting, only even then newspapers already were showing signs of being true dead-end jobs! Who’d go into ‘em?!)

And since, too, these new staff psychologists are scouting for a better paying position almost from the first moment they arrive, if they come, they’re not the keenest on individual case details either, you could argue.

The one who’d seen me on three different interviews, for instance, twice had mistaken bad days with my chronic breathing problems for a sky was falling overall health condition; and worriedly escorted me personally to an ER visit. And hence was able to skip out on the MH evaluation. Delay tactic? Whatever, it worked. Until he was out of here!

Dr. San Roman, left in a lurch by it all, quickly leaned on Texas Tech University, and developed a plan. Give me psychology post-graduate students willing to do an emergency temporary residency program, as fill-in’s. It’ll give me time to find good veteran psychologists who want to be in El Paso – not just because it’s a nice place to live but it’s El Paso and full of meaningful challenges.

She personally saw me in March--going thru her long waiting list, I guess—to explain her temporary situation. But as busy as she was, she’d spent time in my files, too. It helped. She was aware that, as a Vietnam era veteran, for instance, I’d once spent two years as a radar IFF technician aboard a “bird farm”-- the 5,000-crew aircraft carrier U.S. Independence.

So, first, she could talk my lingo – ships company personnel are those permanently attached to a ship; airedales are aviation crew members who fly aboard once the ship sets sail on a mission; stays with it until the assignment is finished; and then just as mysteriously fly off somewhere else a day or so before the ship returns to her home port.

There’s not much time in frequent moving for developing friendships with many ships company personnel. If, like me, you make friends only after some observation, the rapport between these two work classes—although professionally cooperative at sea, of course – can be dicey.

Dr. San Roman, with determination and by repeatedly emphasizing she stayed aboard in the staff crisis when other doctors left for money and fame, left me feeling both welcome and confident of future treatment. A good V.A. health ambassador, she is.

Treating this country’s social minimalism disease (disease is my word) then, in my opinion, begins similarly with people spending less time obsessively chasing both flashy insignias and large amounts of wealth in the high skies of their profession or avocation, and more time on the home front in what’s typically referred to as basic relationship housekeeping chores.

Getting to know each other as fellow shipmates, from laconic behavior patterns to a person’s special interests or problems (regardless of wealth, job or social connection gained/lost in the process), metabolizes stronger social bonding--whether you’re building a family and a home, or a community of dedicated, selfless workers.

Such bonding is excellent medicine to ward off icy, contemptuous stares of a social minimalist, too, in order to personally keep your own life’s fishing buoy afloat; and to be able to adapt in choppy economic waters.

The V.A.’s most recent criticism (a report citing an average evaluation ‘waiting period’ for new mental health applicants of more than 50 days), comes amidst proposals by the V.A. to increase staff sizes -- to not only reduce waiting periods but also to help increase programs for homeless veterans. The New York Times, citing the obstinacy of Republican ‘House budget-cutters’ in Congress, didn’t want to take that bait as a simple answer.

“The Department of Veterans Affairs says it plans to hire 1,900 psychiatrists, psychologists, social workers, clinicians and clerical employees, a 10 percent increase in its mental health staff,” it reported. (Again, the story link's here.) “…But a lot more needs to be done.”

Ok, you’ve got a cyclical windstorm spiraling into eternity. The problem clearly is social minimalism, e.g., being rejected by status seekers--an economic condition with which the GOP has blood all over its hands in the past 40 years for helping to create. What do you do?

For starters, talk to Dr. San Roman. First, admit what got us into this. Too much emphasis on wealth at the cost of service.

Then, reduce the obsessive wealth-and-glory-seeking values with ones where people get greater inner peace and contentment rewards from simply doing their job well. (Hell, award ‘em fishing trips to The Keys on dead weekends!) Competently helping people, if we're a true Christian nation, is one’s Gold Star. (Figuring exactly how to do this could bring holy hell, yes. Don’t look for it soon. Hee, hee.)

I don’t know what Dr. San Roman did. Is it critically important that we know? When I went in to MH last week for a scheduled appointment at the V.A., she had a new staff person though — a Ph.D. psychologist, an older woman with a daughter here – that somehow she’d recruited (along with the Texas Tech residency students, of course) to assist her in treating the backlog of veterans.

My evaluation interview with this woman was friendly and professional. She assured me same dosages of the medication I’d been taking all these years should continue. She also was attentive enough though to notice I wasn’t being treated for memory loss nor low energy levels caused by my lung disease problems, e.g., insufficient oxygen. Imagine? I get this out of left field!

Prescriptions Dr. San Roman then signed which have added thiamin, folic acid and modafinil to my daily medications have made me feel simply wonderful—compared to the way I was dragging myself around for months before last week.

How’d that happen? Finding a professional who cared?

Could our problem as a nation in arresting runaway social minimalism be that simple?

Duh…An aspirin, dammit! I need an aspirin, Jethro!

“Rol-l-l out the barrels, and we’ll have a barrel of …”

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