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Nieman Reports: Covering the Iraq war

SHOWCASE | July 01, 2008

In more than a dozen articles, investigative reporters and photo-journalists offer sharp, sometimes wrenching coverage of the Iraq war in the Summer 2008 issue of Nieman Reports. Their work is part of a year-long focus by the magazine on investigative reporting. In this article, Mark Benjamin, now of Salon and previously of UPI, describes his reporting on conditions at Walter Reed and other military hospitals two years before Dana Priest and Anne Hull of the Washington Post. Priest and Hull won a well-deserved Pulitzer. But when Benjamin wrote, few if any paid attention.

By Mark Benjamin

They started asking me questions about my mom and my dad getting divorced. That was the last thing on my mind when I’m thinking about people getting fragged and burned bodies being pulled out of vehicles …. That is not the fucking problem here. Did you ever put your foot through a 5-year-old’s skull? … Nobody hears about what really happens when you are there getting the “premier” medical treatment.
—Spc. Josh Sanders, who served in Iraq, describing mental health treatment at Walter Reed Army Medical Center.

I met Josh Sanders in the spring of 2004, when things were going badly for him at Walter Reed. Evacuated from Iraq to Walter Reed because of combat stress, Sanders was first held in the lock-down psychiatric ward, like other soldiers I knew.

Ward 54.

It’s not a nice place. I’d been there. Heavily medicated patients padded around the linoleum floors in Army-issued slippers and robes. Soldiers ranging from alert to catatonic sat around a television in a communal room, some with what looked like evidence of self-inflicted wounds. The doors to the patients’ rooms were kept open 24-hours a day, for constant observation of sometimes unstable patients. And the ward is quite literally “locked down”—heavy, mechanized twin doors opened remotely with a buzzer activated at the nurses’ station.

But it wasn’t being locked in that bothered the soldiers. It was the care—or lack thereof—they received there and in the outpatient psychiatric ward they were sent to next for months of follow-up treatment, Ward 53.

I spent a year there as a reporter tracking 14 patients at Walter Reed suffering mental problems from the war. And my February 18, 2005 article in Salon, “Behind the Walls of Ward 54,” explored the world of overmedicated soldiers receiving outmoded, ineffective treatment and battling a harsh, Byzantine and confrontational bureaucracy.

It was, in a word, neglect.

Yes, this reporting—and publication of what my investigation revealed—happened two years before The Washington Post chronicled the same things happening at Walter Reed in their excellent, Pulitzer Prize-winning series on the hospital. But no, nobody seemed to pay much attention to what I’d found happening to Iraq War soldiers, which Salon had published back in 2005. Nor was much attention paid to any of the series of stories I continued to write about problems at Walter Reed through 2006. It was as though until headlines blared from newsstands in the nation’s capital, the trees in this forest weren’t really falling.

The neglect at Walter Reed had serious consequences. All of the 14 soldiers said their symptoms either stayed the same or got worse while they were there. Two made suicide attempts. And one afternoon while wandering the hospital hallways, one of my sources there walked up to me and thrust a folder into my hands.

The folder contained the medical records of 43-year-old Spc. Alexis Soto-Ramirez, who had been in Ward 54 in January 2004 for what doctors thought were war-related mental problems. But there was hope. Just before being sent to Walter Reed, a doctor had written in his records, “Outcome will depend on adequacy and appropriateness of treatment.”

On January 12, 2004 Soto-Ramirez hanged himself with his bathrobe sash inside Ward 54.

I was able to track down one of his Army buddies at Walter Reed, René Negron, who had visited Soto-Ramirez just before he killed himself. “He was real upset with the treatment he was getting,” Negron said. “He said: ‘These people are giving me the run-around …. These people think I’m crazy, and I’m not crazy, Negron. I’m getting more crazy being up here.’”

Unfortunately, the plight of Soto-Ramirez didn’t shock me too much because I’d heard a lot of tough tales already. I actually had started reporting on the plight of veterans for United Press International in late 2003, with a byline from Fort Stewart, Georgia, and a headline that read, “Sick, Wounded U.S. Troops held in squalor.” In the first two paragraphs, the dimensions of this scandal were described:

Hundreds of sick and wounded U.S. soldiers including many who served in the Iraq war are languishing in hot cement barracks here while they wait—sometimes for months—to see doctors.

The National Guard and Army Reserve soldiers’ living conditions are so substandard, and the medical care so poor, that many of them believe the Army is trying to push them out with reduced benefits for their ailments. One document shown to UPI states that no more doctor appointments are available from October 14 through November 11—Veterans Day …. A half dozen calls by UPI seeking comment from Fort Stewart public affairs officials and the U.S. Forces Command in Atlanta were not returned.

Though this story caught the Army’s attention—and calls from them, laced with expletives, occurred the day after its publication—for several years these dire circumstances were all but ignored by the press. Neither did an article about this reporting, published in Nieman Reports in the Summer of 2004, spark any noticeable coverage of these soldiers’ medical issues or their abysmal treatment by the military.

In early 2004, I started my visits to Walter Reed that would continue on and off for over two years. I mostly went at night, when the soldiers weren’t busy with doctor visits or chasing their paperwork from administrative appointment to administrative appointment. In a January 5, 2006 Salon article, I explored the haunting world of veterans at Walter Reed struggling for treatment of another invisible, soon-to-become signature injury from Iraq called traumatic brain injury. It included soldiers like Spc. Wendell McLeod, Jr., who because of a head blow in Iraq would get lost in a supermarket aisle, unable to recall that his wife had just dispatched him to grab a carton of milk.

Yes, these are the same McLeods who appeared in The Washington Post series a year later. No, nobody had seemed to notice what was happening to this same family when I wrote about them.

Why the Story Didn’t Get Told

When the Post series did run in early 2007, I was headed to Ft. Benning, Georgia to write about the collision of medical care and the so-called “surge” of troops into Iraq. I was working alone on the Fort Benning story, which wasn’t unusual for me. In fact, for the two-plus years I spent on and off at Walter Reed, I never bumped into another reporter. For years most of the news media missed the story about suffering among troops returning from Iraq, not just at Walter Reed but everywhere. I’m often asked why I think that is.

There are number of reasons. But in part, the story was invisible to some reporters for some of the same reasons many Americans can’t pick out Iraq on a map: The smallest percentage of Americans is serving under arms in the history of the country. There is just a huge disconnect between those in uniform and the rest of us—the press included. How many reporters personally know someone who has fought in Iraq, much less have a family member who has served?

Ask any soldier what is the most difficult thing about returning from a third combat tour. Chances are good he’ll say how weird it is that we are all going on with our lives, running to Target or Wal-Mart, like there is no war at all. Well, that is weird. And it didn’t help matters that the Army insisted that there was no story, that everything was perfect right up until—and even for some time after—all hell broke loose with the front page Washington Post series in early 2007. Up until then, the Army invited reporters to the hospital for the “good news” story, say on the treatment of amputees, when the real news was just down the hall.

But also, to do it well, this kind of work does require a relatively novel, sometimes unorthodox set of journalistic tools. Soldiers are not used to dealing with the press. To report stories like the ones I’ve done means they are sharing medical records and other very private information with me. And they are putting their careers—and because health care is involved, arguably their lives—on the line by agreeing to have their information published. In return, a reporter has to surrender some control of what gets into the story over to those sources. In some cases, this means giving them veto power. I’d tell some of the soldiers with whom I worked that “nothing is ever going to go into print until you know the complete context and I have read the quotes back to you over the phone and you say it is okay.”

Some reporters are uncomfortable working like that. This is not their kind of story.

I didn’t get into doing this story for altruistic reasons. There was a war going on, and my wife didn’t want me to go there as a reporter. So I decided to cover what I could from here. Especially back in 2003—when I did the first of these medical care stories and subsequently discovered that reporting on all of this would virtually turn into a beat assignment—everything seemed so scripted by the Bush administration, which along with the military seemed as though they were capable of dictating a largely unquestioned narrative. They had so much control.

I asked myself then the same question I always ask about that kind of situation. “What part of the narrative can’t they control?” With this war, the answer was injured soldiers like Josh Sanders at Walter Reed. What all of this has reminded me is there will always be something—and it’s our job to find it.

Mark Benjamin is an investigative reporter with Salon.com’s Washington bureau. Along with his award-winning work on national security issues, he also obtained for Salon the Army’s entire Abu Ghraib investigative files.

Posted by Don Capps
07/08/2008, 03:44 PM

The problems with Walter Reed began before the BRAC/A-76 process made the situation even more challenging. The basic, unavoidable fact is that the Department of Defense and the Army in particular, dropped the ball.

And it was dropped big time.

Although the Army has finally started to encourage open discussion on the issue of mental health issues brought about from the stresses, strains, and trauma resulting from repeated deployments, extended periods of family separation, and now the recruitment of increasing numbers of marginal soldiers, the Army Culture still operates. That culture continues to place the onus of any mental health problems squarely on the soldier. Efforts are being made to change this perception, but it will be slow going. I would not hold my breath while awaiting any sudden cracks in the long-standing attitudes that permeate the Army.

The problems at Walter Reed struck a chord that hit hard and deep within the Army. We in the Army failed to keep faith and do what was right for soldiers wounded in combat, whether those wounds were physical or mental. This is inexcusable, but the latter problem has long been a challenge for the Army and continues to be so.

Combat affects each and every individual differently, but it does affect them in some way. Too often we soldiers suck it up and drive on. This is how we are. Whether it is experiencing IEDs in Iraq or running Ranger missions in the Mekong Delta, and everything in between, we deal with it on our own terms, that being how we are. Of course, this often means that others involved, such as spouse and family, get left out of the loop.

Make no mistake, it will take a lot of time and more than a few senior officers to 'fess up to the fact that they have dealt with depression or other problems related to military before others in the ranks will finally begi to do so. The concept of "Lead by Example" makes this a Catch 22 in many ways.

At any rate, it is difficult to buy into the concept of "balanced coverage" when the problem is so blatently a failure of not only leadership, but a violation of the code of honor that soldiers buy into when they wear a uniform. That the mess at Walter Reed was being pointed to long before the Washington Post articles finally caused major action to be taken does not reflect well on us.

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