Healing the mind, body, heart, spirit

COLUMBIA — Every morning, hundreds of soldiers at the U.S. Army's Fort Jackson scramble out of their barracks and file into formation for another day of boot camp. It's a predawn ritual that has played out here since World War I.

Nearby, in the shadow of Moncrief Army Community Hospital, a smaller group of soldiers assembles near a row of temporary buildings. Some hobble on crutches or canes. Some cradle wounded hands. Others struggle with wounds you can't see. None of these soldiers shoot rifles, dig foxholes or train for war. For now, their mission is singular: Heal.

They are members of a new Army outfit, one of about three dozen "Warrior Transition Units" formed recently at military installations around the country and overseas as part of the Army's attempts to transform its embattled health care system.

The unprecedented shift began a year ago after a series of articles in The Washington Post exposed shocking lapses in the Army's medical system at Walter Reed Army Medical Center in Washington. The stories highlighted decrepit outpatient buildings and wounded soldiers slipping through the cracks of a system bound in bureaucratic red tape. The revelations led to the dismissal of some top military leaders, prompted congressional hearings and sparked a revolution in the way the Army cares for its sick and wounded.

Col. James Mundy, commander at Moncrief Hospital, said the findings were embarrassing and sobering for the Army. A year later, he cites the day the first Post story was published, Feb. 18, 2007, the way others recall the dates of Pearl Harbor or 9/11. "It's a famous date because so much has happened since then," he said. "I've been in 27 years, and I've never seen anything like this. It became very apparent that the Army was not just going to sugar-coat this in some way."

Cultural shift?

Army officials acknowledge that the problems extended beyond

Walter Reed and that the Army faced a broader cultural problem that enabled cavalier attitudes toward sick and wounded troops.

Maj. Ricky Smith, an Army Reservist from James Island, deployed to Kuwait in 2004 with the 175th Maintenance Co. based at Fort Jackson. He has seen how some soldiers are reluctant to speak up about injuries for fear of letting their comrades down or being labeled as malingerers. "It's hard to change the mind-set that you are weak when you admit you have a problem, whether it's post-traumatic stress disorder or a back problem. You don't want to be seen as a sissy."

After the problems at Walter Reed came to light, Smith was assigned to the team that investigated maintenance problems there. He later helped craft parts of the Army-wide plan that called for the creation of the transition units. He says he thinks the change is occurring rapidly because top Army brass championed it. "This change is coming from the big dogs at the top and the little dogs are listening."

The pervasiveness of the turnaround is evidenced by the fact that the Army established one of the new units at Fort Jackson. Although it is one of the military's premier basic training installations, the sprawling facility is not considered a major supplier of frontline troops compared with some other combat-oriented posts.

The transition unit at Fort Jackson is one of 35 in the Army that serve some 10,000 soldiers. The units are spread out geographically so that no matter where soldiers live, they can be assigned to a transition unit within a reasonable distance from their families.

Spc. Paul Watkins said being near his family in Greenville keeps his spirits up while he recovers at Fort Jackson from a combat wound. His unit was searching for insurgents and weapons caches in Iraq on Oct. 10 when a bomb exploded underneath him. The blast mangled his pinky toe and sprayed shrapnel up to his waist. He's endured seven surgeries and was recently awarded the Purple Heart, the same honor bestowed on his grandfather in World War II.

Families aid recovery

Before the formation of transition units, injured soldiers like Watkins, 20, could wind up at any number of military installations depending on their unit's location and their medical needs.

1st Lt. Roderick Merritt Jr., 35, of James Island is assigned to the unit to recover from a back injury he suffered jumping out of airplanes for the Army. His wife and children are with him while doctors try to figure out how to fix his back. "It's huge having them nearby," he said.

Fort Jackson initially was not slated to receive one of the transition units. But post leaders lobbied to get it. "We needed to do our part," Mundy said. "We needed to bring this capability to South Carolina."

Fort Jackson's company-sized transition unit was activated in June and has grown to about 75 soldiers. It can handle up to 120. With the South Carolina National Guard's 218th Brigade due back from Afghanistan this spring, some say it won't be long before the unit reaches that limit.

Holistic care

The transition unit's soldiers represent a cross-section of the Army. Men and women. Active duty, Reserve and National Guard. Officers and enlisted. Combat veterans and baby-faced privates. Each soldier is assigned a squad leader, a primary care manager and a nurse case manager, all helping soldiers and their families navigate the health care system, schedule appointments and tend to family issues such as child care, housing and transportation. Soldiers can work in military jobs while they are assigned to the unit as long as it doesn't compromise their care.

The goal of the program is to return soldiers to regular duty or ease them back into civilian life. So far, about 30 soldiers have left the unit on one of these paths. The transition units also work closely with Veterans Affairs and civilian hospitals to hand off soldiers requiring long-term care after leaving the service.

Retired Army Col. Joseph C. Hightower is the unit's administrative director. A serious, fast-walking man, Hightower doesn't display a hint of irony when he talks about the hard-charging branch he served for 30 years now taking a holistic approach to medical care. The program involves the "total healing of the person in mind, body, heart and spirit," he said.

Still, the units are not an automatic fix for all of the emotional and physical problems soldiers might face. Army officials announced earlier this month the deaths of 11 soldiers who were assigned to transition units across the country. Four of the deaths were suicides, three resulted from accidental overdoses of prescribed medications, one was linked to a car accident and three remain under investigation.

"By no means is everything fixed," Hightower said. "But we are aggressively acting on what we can fix now."

Transition unit 1st Sgt. John Nichols says he thinks the program is working because the Army is cutting away the layers that used to hinder a soldier's recovery. He said it's empowering to be given carte blanche from his chain of command to help his soldiers heal.

"The thinking is, if it's not illegal or immoral and it helps the soldier, let's do it," Nichols said.

Reach Ron Menchaca at rmenchaca@postandcourier.com or 937-5724.