Роберт Гейтс - Duty - Memoirs of a Secretary at War

At West Point the same day, I delivered a lecture to the entire corps of cadets with a similar message about military leadership, knowing that my remarks there would be read throughout the Army. I told the cadets,

In order to succeed in the asymmetric battlefields of the twenty-first century—the dominant combat environment in the decades to come, in my view—our Army will require leaders of uncommon agility, resourcefulness, and imagination; leaders willing and able to think and act creatively and decisively in a different kind of world, in a different kind of conflict than we have prepared for for the last six decades.… One thing will remain the same. We will still need men and women in uniform to call things as they see them and tell their subordinates and superiors alike what they need to hear, not what they want to hear.… If as an officer—listen to me very carefully—if as an officer you don’t tell blunt truths or create an environment where candor is encouraged, then you’ve done yourself and the institution a disservice.

Mindful of an article published earlier by an Army lieutenant colonel that was highly critical of senior officers, I added: “I encourage you to take on the mantle of fearless, thoughtful, but loyal dissent when the situation calls for it.”

Because of the ISR issue and other concerns I had with the Air Force (more later), my speech to them was generally seen as a broadside against its leadership. At a press conference soon afterward, I was asked if that was my intention. I said there had been a lot of praise for the Air Force in my speech and that I had criticized the military bureaucracy across the board, particularly with regard to getting more help to the war fighter now. Everyone recognized that both speeches represented my first public assertion that supporting the wars we were already in and those fighting those wars, as well as preparing for future conflicts, would require cultural change in all the services. It was only the opening salvo.

WOUNDED WARRIORS

I believe that exposure of the scandalous problems in the outpatient treatment of wounded troops at the Walter Reed Army Medical Center mortified the senior military leadership of the services and the whole Department of Defense. I was always convinced they had been unaware of the bureaucratic and administrative nightmare that too often confronted our outpatient wounded, as well as the organizational, financial, and quality-of-life difficulties that faced our wounded troops and their families. The scandal prompted numerous reviews and studies of the entire wounded warrior experience, while the department and the services simultaneously began remedial actions.

During my entire tenure as secretary, I never saw the military services—across the board—bring to a problem as much zeal, passion, and urgency once they realized that these men and women who had sacrificed so much were not being treated properly after they left the hospitals. Senior generals and admirals jumped on the problem. I don’t think that was because I had fired senior people. I was always convinced that once the military leadership knew they had let down these heroes, they were determined to make things right for them. The established bureaucracies, military and civilian, in the Departments of Defense and Veterans Affairs, however, were a different story.

The Army was the service, along with the Marine Corps, that had suffered the overwhelming preponderance of casualties, physical and psychological, in the post-9/11 wars. I met with Army Chief of Staff Casey in early March and told him not to wait on the reviews or studies but to act right away to fix Walter Reed and look at the rest of the Army’s treatment of wounded warriors. With respect to evaluating soldiers for disability, I told him, “When in doubt, err on the side of the soldier.” Casey and Army Vice Chief of Staff Dick Cody leaped on the problem without further urging from me. On March 8, I was briefed on the Army’s action plan. Under Cody’s supervision, other personnel changes had already been made at Walter Reed, a Wounded Warrior Transition Brigade was created (to give wounded soldiers an institutional unit to look after them while in outpatient status), a “one-stop soldier and family assistance center” was established, and all outpatient soldiers were moved into proper quarters. The Army was establishing a wounded warrior and family hotline, organizing teams to examine circumstances at the Army’s twelve key medical centers, and looking into how to improve the Army’s physical disability evaluation system. General Casey took the lead in aggressively tackling the problem of traumatic brain injury and post-traumatic stress. In June, Casey briefed me on a program to train every soldier in the Army on the causes and symptoms of post-traumatic stress in an effort not only to help them cope but also to begin to remove the stigma of mental illness. As he told me, “We’ve got to get rid of the mentality that if there are no holes in you, then you’re ready for duty.” The other services were not far behind the Army’s lead.

On March 9, I had sent a message to every man and woman in the U.S. armed forces on the Walter Reed situation. I described the actions taken so far, including establishment of the two outside review panels. I told them we would not wait on those reports before tackling the problems. I told them I had directed a comprehensive, department-wide review of military medical care programs, facilities, and procedures, and that I had told the senior civilian and military leadership that in dealing with this challenge, “Money will not be an issue.” I went on: “After the war itself, we have no higher priority than caring properly for our wounded.” It was a sentiment and an admonition I would repeat often over the next four years.

Shortly thereafter I created the Wounded Warrior Task Force, charged with reporting to me every two weeks actions that were being taken across the Defense Department to address the needs of wounded warriors and their families. The goals of the task force were ambitious: (1) to completely redesign the disability evaluation system; (2) to focus on traumatic brain injury and post-traumatic stress; (3) to correct the flaws in case management of wounded warriors and their support; (4) to expedite Defense–Veterans Affairs data sharing; (5) to ensure proper facilities for wounded warriors; and (6) to reexamine the entire process for transitioning wounded warriors to Veterans Affairs. These were also the primary issues addressed by the West-Marsh independent review I had appointed and by the presidential Dole-Shalala commission. I was in a hurry and was not concerned about the three efforts stumbling over one another; each had a somewhat different mandate.

I wanted to ensure that good ideas were being shared across the services and around the Defense Department. As with MRAPs and ISR, I intended to make clear from my personal engagement the priority I attached to this endeavor, and that I was going to make sure everyone was moving aggressively to fix any problems we found. Gordon England and I also reenergized a joint Department of Defense–Veterans Affairs oversight group—the Senior Operations Committee—cochaired by each department’s deputy secretary in an effort to make significant improvements in the process of transitioning from active duty to retired or veteran status.

I believe that at the outset of the Afghan and Iraq wars, neither Defense nor VA ever conceived of, much less planned for, the huge number of wounded young men and women (overwhelmingly men) who would come pouring into the system in the years ahead. Many of our troops would not have survived their wounds in previous wars, but extraordinary medical advances and the skills of those treating the wounded meant that a large number with complex injuries—including traumatic brain injuries and multiple amputations—faced prolonged treatment, years of rehabilitation, or a lifetime of disability. The Defense and VA bureaucracies, accustomed to dealing with older vets from Vietnam and earlier wars or retirees with all the ordinary problems of aging, seemed incapable of adjusting to wartime circumstances, just like the rest of Defense and the rest of government. There were three areas where I fought the military and civilian bureaucracy on behalf of the wounded, and all three stemmed from my strong belief that those wounded in combat or training for combat should be dealt with as a group by themselves and be afforded what I referred to as “platinum” treatment in terms of priority for appointments, for housing, for administrative assistance, and for anything else. I wanted them to have administrative staff for whom they were the sole “customers.” The Defense and VA health care bureaucracies just could not or would not differentiate the wounded in combat from all others needing care.