“That’s Crazy!!!” – More Chronicles From the VA Chapter 3

Bobblehead DollIt is no secret I am on several prescription medications.  I take these under strict medical advice, and three of these prescriptions regard mental health improvements.  However, my prescription reasons were subtly shifted because Phoenix’s last two primary care providers did not listen to the patient.  Since the El Paso primary care physicians appear to be utterly incapable of even attempting to listen, I have now been without a mental health prescription for an entire week.  This is called bureaucratic cold-turkey prescription stoppage!

Not the first time this has happened, especially for this particular medication, a serotonin blocker.  Here’s the rub, the physical and mental withdrawal symptoms of cold turkeying the drug; includes, but is not limited to, the following symptoms, of which I have ALL of the problems!

      • Nightmares
      • Suicidal Ideation/Thoughts/Visions
      • Headaches
      • Heart Palpitations, radiating chest pain
      • Anxiety
      • Depressions
      • Mood Swings
      • Irritability
      • Tinglings and Prickling sensations of the skin
      • “Brain Saps”/”Brain Shivers”/Spaced-Out Zombie Spells
      • Fatigue
      • Dry Mouth
      • Insomnia and Sleepiness – Which is a major whiplash feeling!
      • Pain and neurological events in every part of my body!
      • … and more… Much…  Much… More!

I have been without this medication due to bureaucratic stupidity for several days in the past due to pharmacy issues.  But, this is now the longest I have been without this medication since getting prescribed this medication.  I wish, like anything, I had known some of these withdrawal symptoms before I went to the ER earlier this week for pain and neurological problems; I would have raised the refill issues as part of the ER visit.  I went online looking for other people’s experiences; I want some medical advice before continuing this medication!!!

PACT_modelI am a root cause kind of person; why do I bring this up?  I have had three primary care providers since arriving in the El Paso VAHCS in May 2021.  None of them have gotten any of the medications correct due to a blatant refusal to LISTEN to the patient with the INTENT to understand!  Nurses with VA-provided primary care providers are expected to communicate with patients between 24 and 72 hours post any ER visit.  Since moving to Las Cruces, I have visited the ER twice and have not spoken to the nurse yet!

I have initiated the conversation with the nurse through phone and secure messaging, and the nurse has refused to engage.  Through secure messaging, I am advised, “Secure messaging is not the place to triage a patient, and no question can be answered as this requires triage of a patient.”  No direct phone contact is possible with the clinic.  One must call, get routed to a call center, leave a message, and then hope the clinic calls you back sometime before you die!  Don’t forget; I am the same patient told, “The clinic will not see you in person because you “WILL NOT” wear a mask.”  Completely refusing to understand, accept, and believe that I cannot wear a mask due to medically documented (by the VA medical providers, which medical records they possess) reasons.  Best of all, the veteran is then sent letters and marketing materials urging the veteran to use secure messaging through “MyHealtheVet as a safe and secure way to access your medical team and get your questions and concerns addressed by your PACT team!”  If the VA were a mental health patient, they would have schizophrenia and at least a dual-personality.

PACT 1Snide, rude, and disrespectful staff, all made possible by, supported through, and legally accepted under federal government fiat.  Do you realize that the nurse not doing their job will have any number of valid and acceptable excuses, and these excuses are accepted because of designed intentional incompetence allowed under federal employment laws, regulations, and directives, established by and supported through Congressional oversight?  In Disney’s “Princess Diaries 2: Royal Engagement,” Viscount Mayberry has a line,

Your staff is incompetent and unreliable!”

The VA is incompetent and unreliable, and the victims are the veterans and their families.  We are talking about dangerous drugs, forced addictions, and then the ineptitude of incompetent and irresponsible bureaucrats who refuse to do their jobs in a timely and responsible manner.  But do not take my word for it.  Let’s review what a watchdog organization, the Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG), has to say on this matter.

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  • Tracy McNeil, of Raeford, North Carolina, was sentenced to one year and one day in prison and ordered to pay $90,003 in restitution for committing wire fraud involving an elderly veteran in her care. From February 2015 to February 2017, McNeil fraudulently obtained benefits from the VA and the Office of Personnel Management by executing a power of attorney over a disabled veteran who served in the Army and worked for the US Postal Service. The investigation revealed that McNeill arranged for the victim, who had dementia, to move into her home in February 2015 and then directed the VA and OPM to deposit the veteran’s benefits into her bank account. Between April 2015 and December 2016, the VA deposited $11,151, and OPM deposited $61,318 into McNeil’s account. Further, OPM disbursed the veteran’s life insurance for $17,533 to McNeil. Financial analysis showed that most of the funds were spent on McNeill’s expenses, including rent, utilities, credit card payments, and personal purchases.

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  • Strock Contracting, Inc., of Cheektowaga, New York, has agreed to enter into a consent judgment with the United States for $4.7 million to resolve claims that Strock violated the False Claims Act. The United States filed an action in federal court alleging that Strock Contracting profited financially after fraudulently obtaining federal contracts intended to benefit service-disabled veterans. The United States alleged the company, which was not owned or controlled by a veteran, recruited a service-disabled veteran to create a pass-through company, known as Veterans Enterprises Company, Inc. (VECO), which the Strock Contracting its owner, Lee Strock, controlled. The company allegedly directed VECO to submit false eligibility certifications to the government, obtaining substantial profits on numerous federal contracts.
        • Where are the VA Employees who should know what “fake eligibility certificates” look like?
        • Where are the supervisors who should have been providing training?
        • Where are the Congressional oversight teams in holding the VA accountable?

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    • William Rich, of Windsor Mill, Maryland, was arrested for allegedly obtaining more than $1 million in veterans and Social Security Administration disability benefits by falsely claiming that he had paraplegia. Allegedly, Rich misrepresented his physical condition in VA disability compensation claims, in communications with the VA, and during medical examinations in pursuit of VA disability benefits. While serving in Iraq in 2005, Rich sustained injuries that resulted in the loss of use of both lower extremities. However, approximately six weeks after his injuries, he made substantial progress toward recovery and was no longer paralyzed. Later records show the VA rated him one hundred percent disabled following an examination in 2007. The examining physician noted that he did not have access to Rich’s complete claims file, so he did not review Rich’s medical history or observe the earlier report. In 2018, the VA OIG conducted an audit of specific claims and learned of conduct by Rich inconsistent with his purported condition. Over the next two years, VA OIG special agents conducted surveillance. They observed Rich walking, going up and downstairs, entering and exiting vehicles, lifting, bending, and carrying items—all without visible limitation or assistance of a medical device, including a wheelchair [emphasis mine].
        • OK, let me be clear, I am glad this veteran got better; I do not in any way condone theft. But, where is the VA in being culpable for FAILURE to do their job correctly?
        • Will the doctor who failed to do their job be held liable for the malpractice performed?

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    • William H. Precht, of Kent, Ohio, was sentenced to 37 months imprisonment and ordered to pay $1.25 million in restitution after pleading guilty to theft of government property and participating in a bribery and kickback scheme. In October 2010, Precht registered a purported vendor, a company he controlled, as a small disadvantaged business and veteran-owned small business in the VA vendor system. He then used his VA purchase card and other employee cards to purchase over $1 million in alleged medical supplies from the vendor. In addition, from May 2015 through January 2019, he conspired with Robert A. Vitale, a medical sales representative for multiple companies that conducted business with the medical center, to devise a scheme in which Precht would receive kickbacks and other items of value in exchange for steering VA business and other monetary awards to Vitale.VA 3

Speaking of staff being “incompetent and unreliable,” did you know that the VBA is using “COVID-19” as an excuse for being backlogged in cases, AGAIN?  Did you know that COVID-19 was so powerful that it caused the VA to fall 200,000+ cases behind, in an inventory of 600,000+ cases requiring decisioning, with 70,000+ needing additional review for entitlement, and needs to hire 2,000+ new employees to help correct the problem?  Since the VBA continues to fail in staff training, exactly how will hiring new employees help?  Honest question!  With the current staff rated as incompetent and unreliable, not by me only, but by the VA-OIG who has regularly taken these issues and more to Congress asking for additional scrutiny and assistance in improving the VBA, VHA, and National Cemetery specifically and the VA collectively; what exactly can new employees do?VA 3

The VHA cannot plan construction projects and put planned maintenance into proper categories to execute maintenance tasks correctly.  Congress refuses to scrutinize budgets and fiscal compliance for just maintenance of facilities.  How in the world can anyone expect more when the VA cannot even hit the basics of planned maintenance tasks?  I can; I do!

I-CareWhen the VA publishes marketing materials claiming they set standards for excellence and lead the industry, I want them to prove their competence and abilities!  Right now, their failures scream louder than the voices in their own ears, and they refuse to listen to anyone, and I am not happy!  You, the taxpayer, should not accept the performance of ANY government agency, including the entire legislative, judicial, and executive branches of government at the local, county, state, and federal levels, until they correct their behaviors!  It is time to end the charade and put paid to this contemptible behavior and abuse!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

“I Hate the Living!” – Our Brains are Wired to Connect

Men in Black | Movie fanart | fanart.tvThe title for today originates as a quote from the movie “Men In Black” and is an opening line from the mortician as she signs for a body from an NYPD officer.  “I hate the living;” I love this line.  My second time in fourth grade, I was forced to take a personality test.  I was told to pursue a career that did not involve interacting with other people, specifically as a mortician; a bully heard this and claimed I should be the mortician’s dummy.  I guess you could say this was the beginning of my dislike for standardized tests in general and personality tests in particular.  While I do not “specifically” hate the living, I have extensive experience in and with people in a dynamic range of environments.Bait & Switch 2

Having been on the front lines of mental health emergencies, physical emergencies, religious crises, and family issues, I have met some great and some truly horrible people.  More to the point, I have been reading an interesting book, “Social: Why our brains are wired to connect,” written by Dr. Matthew D. Lieberman.  The book has me thinking, and I would like to discuss some of the high points the book raises.

Social Pain and Physical Pain

Several years ago, I learned a lesson about the word “paradox.”  A paradox occurs when people think some things are opposites when they are much closer than they are apart.  Physical pain and social pain are a paradox, most people believe that physical pain and social pain are opposites, but science indicates that the pains are much closer in the brain than they are apart.  The author asks a question that has me thinking, “Given the fact that our brains treat social and physical pain similarly, should we as a society treat social pain differently than we do?”

Non Sequitur - DecisionsMy paternal grandfather died when my grandmother was relatively young, she was forced to raise her two children as a single parent, and several times I could not help wonder that she was sad that she did not have a companion to grow old with.  My mother-in-law spent more than 20 years alive after her long-time spouse passed.  I know for a fact she was lonely and longing for her spouse.  While my mother-in-law had family and friends, they were not a spouse, and the lack of a spouse was very difficult for her to survive.

As discussed in the Old Testament, the social connections in a married relationship make two people one, making the social pain of a spouse passing physical and mental.  Now, I have limited experience with death.  My aunt passed when I was around eight, my grandparents passed while I was deployed in the US Navy, and my family never even informed me.  I called my grandmother and got chewed out by my uncle for missing the funeral I was never told about.  Yet, I am still enthralled with the implications of the scientific discussion revolving around physical and social pain to the brain.  More the point, as a person who struggles with socially connecting, does this mean I am missing something mentally?Scared Eyes!

Thinking Socially

One of the most significant trends in recent years in business has been the rise of emotional intelligence.  Except, emotional intelligence is a misnomer, a fallacy, and a fascinating social experiment, all based on the premise that I can control someone else’s emotional response by increasing my intelligence regarding emotional connections.  Why are humans the dominant mammalian species on Earth; non-religious people claim opposable thumbs, imagination, and other unique aspects made humans dominant.  Religionists claim it was inherited from the creator as an assignment, as discussed in the book of Genesis in the Old Testament.  Dr. Lieberman proposes it was because of the unique aspect of human mammals’ ability to think and connect socially.  Believe as you choose; I am not here to dictate a single belief structure.  However, I would like to discuss the unique aspect of connecting and thinking socially.Mediocre Joke

A correlational aspect of the brain is important to note, “In many situations, the more you turn on the brain network for non-social reasoning, the more you turn off the brain network for social reasoning.”  This relationship creates a dichotomy and an antagonism between social and non-social thinking, especially apparent in problem-solving.  I can attest to this phenomenon, even though I could not describe what was occurring and being observed before reading this book.  Long have I been hailed as an incredible problem-solver but a lousy social integrator.  In emergencies, people want me around to help fix the problems, but I am not a desirable person to associate with when there are no emergencies.

Too Many Synaptic Connections in Cerebellum Creates Problems | Psychology TodayLong have I wondered what other people realized that I could not, and the answer lies in the fact that my brain is hard-wired for non-social reasoning or problem solving without the human element.  It is also why a friend of mine is always wanted around when there are no emergencies.  His brain is hard-wired towards social reasoning, and he is constantly having problems disconnecting from group-think situations.  Our brains work 180-degrees separately, which is not a bad thing, in and of itself, but not knowing how we approach problem-solving was the problem.

New Light Shed on Brain-Behavior LinkMy friend harmonizes easily with social situations, social cues, and social environments.  On the other hand, I am lousy at picking up social signals, am horrible at understanding social-emotional displays, and have never cared about the social aspect of problem-solving.  I hate funerals and weddings; I never know what to say, how to act, where to stand, how to dress, etc.  I am a full-blown social dunce!  I rely upon my spouse and others to tell me what I am expected to do, trying not to insult someone who doesn’t know me, by not being sensitive to social situations others naturally understand and adapt to.  The more I read this book and others, the more I think my experiences changed my brains wiring where socially connecting is concerned, leading to additional questions and self-reflection.

A Socially Malleable Sense of Self

Leadership CartoonDr. Lieberman makes the following point, “The self is more of a superhighway for social influence than it is an impenetrable private fortress.”  My brain is not very malleable in social situations; I have learned to recognize social cues, usually through failure and poor social experiences.  But, my sister appears to have mastered socially connecting and hiding her beliefs behind a socially acceptable mask of cheerfulness and a cherub-like demeanor.  I have no idea how she does this, for my emotional state is as recognizable on my face as a red nose on a clown.

I have often been in trouble for not being able to bend in social situations on principles to meet the demands of a crowd.  To find a balance between points of view and promote calm instead of contention.  My self is not very socially malleable; in fact, it is quite rigid, much to my chagrin and dismay!  However, I must ask, is this a bad thing?  Is being socially rigid undesirable?  Dr. Lieberman claims that social malleability promotes survival and reproduction, intensifying bonds felt while increasing our capacity to predict what is happening in the minds of those around us – which sounds very much like emotional intelligence.

Bobblehead DollLet us consider these topics on a grander and larger scale.  Is it possible for society to change how we consider social pain and award the same degree of medical attention to it as we do to physical pain relief?  One aspect of social pain relief that is not as emphasized in physical pain relief is the attitudes and choices of the pain sufferer.  For example, a broken leg is not dependent on the patient’s beliefs and behaviors to mend.  Whereas in contrast, social pain is more dependent upon the choices and behaviors of the patient.  Would this focus improve physical pain relief?

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.