“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.

Monk and Mental Health

Tony Shalhoub played the defective detective in the police drama “Monk” from 2002 to 2009.  Monk is obsessive-compulsive and has a list of 312 prioritized fears and phobias.  But, as the main character, everyone is expected to see and find his mental health challenges somewhat humorous.  However, I like the show Monk for another reason, all the other mental health issues swimming around Monk that nobody understands or even recognizes due to Monk’s fears and phobias being so over the top.monk tv show cast - Google Search | Monk tv show, Mr monk

Monk started a mental health conversation in America, reflecting that even those with mental health issues can be productive members of society if given a chance.  For example, Captain Stottlemeyer, for the majority of the show’s run, has anger issues, and yet he is considered capable and competent as a Police Captain.  Lieutenant Disher struggles with his identity as a person and his value to the organization.  The supporting character’s mental health problems create the drama.  Monk provides comedy and allows the supporting characters to be accepted for their mental health issues, which is essential in this discussion.

TV Reviews - TV Liveblogging: Some Episode Of Monk - KittysneezesSharona struggled with being a mother, her boss was driving her crazy, and her mental health issues stemmed from both her boss and her nursing responsibility.  Sharona plays a problematic role; does she provide nursing care for Monk or provide living assistance as a counselor?  Concluding that stress can be a mental health issue when taken to extremes.  Natalie Teager struggled with loneliness and a desire to be her own person outside of her family.  Both mental health challenges that many people struggle with silently.  Other supporting characters had substance abuse issues stemming from mental health concerns and personal choices, thus Monk’s subtlety and genius.

When Sharona, his nurse, leaves the show, Natalie Teager provides a lesson on mental health, the difference between coddling and helping a person with mental health problems.  Sharona, for all her care and concern, never saw Monk as capable without assistance.  Natalie Teager saw Monk as competent but needing some assistance.  The difference is subtle but very real.  Monk’s behaviors and mental health problems lessen when Natalie Teager enters the show, and the story becomes richer.

Perception vs. Reality in Care Support

Image result for monk tv show cast | Monk tv show, Mr monk, Adrian monkAre you weak to admit you have a mental health problem?  Per society, not as much anymore.  Per yourself, who knows.  Perception versus reality is critical in the person with mental health concerns and in the care-providing staff surrounding that person.  Now, I suffer from PTSD, Anxiety, and Depression, as mental health concerns; but, I thank God for my support (spouse) and those characters in my life that provide the drama, while my mental health provides the comedy.  Not a single person who knows of my mental health struggles has ever treated me capable without assistance, and this makes all the difference in how I approach the world.

The pattern of admitting the mental health challenges, coping with those challenges, and the consequences of those challenges have been made bearable because my supporters never waiver from the foundation that I am capable but occasionally need assistance.  Monk taught me that it was okay to have mental health issues, to see those issues in others, and a pattern of living and approaching others with mental health issues.  The perceptions of the supporting people become a reality in the mental health challenges of the person suffering.

Monk (S1/F12) im TV Programm: 22:35 - 08.11. - Universal ChannelIt is not easy supporting someone with mental health issues, and while mental health sufferers get the attention, Monk taught the world that the mental health of the family and friends is as important to the cure as well as the problem in mental health patients.  Consider the two different approaches of the psychiatrists on Monk, but never forget two other principles in mental health, change is hard, and change is beneficial.

Change and Mental Health

Monk was stuck in a rut, and a change in the insurance policies spurs Monk to change.  As the show develops, change is witnessed as beneficial and challenging.  When Sharona left, Monk experienced quite a shock; the different care styles provided by nurses spurred complex and healthy changes in Monk. Differences in approaches by the psychiatrists produced more changes and spurred growth in Monk and the other supporting characters.  Hence, as a mental health patient and as a care provider, another pattern is produced: am I looking for changes?  Am I open to helping others engage in change?  Do I embrace both the light and dark of change?

Pin by Smeesmii R on MONK | Monk tv show, Mr monk, Detective monkAdaptation is the only constant in life.  We adapt to the people around us, the social environments, the emotions, and the influences of peers, employers, family, and so much more.  Yet, we often try to control everything to prevent change, even though every new day brings change.  Monk showed he could not handle change, mainly because he and his brother had never been taught to handle change.

Patterns in Family Rearing – Mental Health Challenges

As a kid, I was told that I would never amount to anything since I was raised in poverty and abuse.  I had teachers who made this comment often enough that I got mad!  Nobody was going to curtail my abilities and shoehorn my potential.  Their reasoning was the research that showed those in poverty as children stay in poverty as adults.  That abuse is generational, and that abuse will always influence those raised in abuse to perpetuate abuse to the next generation.

Monk (TV Series 2002-2009) - Posters — The Movie Database (TMDb)Monk showed me differently, proved that individual choices could change preset patterns, and end captivity.  Sure, Jack Junior and Ambrose are typical examples of the generational nature of abuse, leading to mental health issues.  But, Monk overcame, chose, and in choosing and sticking with his choices, he endured and conquered.  Monk overcame even with his mental health challenges, not because of, or as an excuse, but with his mental health challenges as a companion.

While it is true how a child is reared, does dictate how that child will approach the world as an adult.   Individual agency, moral choice, and the choice and consequence cycles also play fundamental roles in that person’s life.  Thus, one cannot, and should not, place blame upon how one was raised for the failures in one’s life; this position negates the agency inherent in each person, and shifting the responsibility of choices is not healthy mental health practices.  More lessons learned from Monk about how to face the world, even if you might not have had the best family environment as a child.

Did you notice that when Jack Junior makes his appearance, Adrian (Monk) has changed enough to know not to gratify and indulge his step-brother in his poor decisions?  Despite the differences in mental health problems, Ambrose, Monk’s other brother, was also not pampered, although he was given special care.  Cementing the theme that people with mental health problems are capable, have potential, and need only the opportunity to show who they are and what they can become, just like everyone else.

I am not my handicap

I have disabilities; disabilities do not have me.  I am not my handicap!  Monk taught me this lesson in spades.  When Monk gets his badge back, he realizes he has learned this lesson as well as learning what his abilities as a disabled person are.  Another subtle theme in Monk worthy of exploration.  Adrian Monk was not “Obsessive-Compulsive, Mentally health challenged, Adrian Monk.”  Adrian Monk was Adrian Monk who lived with obsessive compulsion, fears, and phobias.  The distinction is subtle but essential to living with mental health challenges as a companion, not a ruler!

I am forever grateful for the lessons learned and still being learned from Monk!  I encourage you who read this to ponder the themes herein; change is beneficial and hard, but critical; family and family life is not your life; you are not your handicap or illness.  These themes and more can help open your eyes and mind to new possibilities, freeing you from your captivity of mental health challenges, but only if you choose to open your eyes and mind.

Finally, remember your support staff.  Have you thanked them lately for their support, care, and kindness?  If not, start there, express gratitude to and for the care received from those who live with you, work with you and desire your success.  Never forget, on your bad days, your support staff is still there trying to help, and they need support too.

© 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.