I have a book somewhere in my library written in the late 70s that details how Vietnam vets got the same treatment as those complaining now at a New York Va. The problem was identical. That facility, however, had a huge number of injured and sick vets referred them from all over the area. They simply rationed so that no population of vets got more than others. They all got the same and there wasn’t enough for anyone.

I prefer not to think that these people are intentionally stiffing vets, although the woman head of the Phoenix VA is now showing signs that she did all this to “look efficient” to her bosses so she could climb the career ladder faster. I think they figured out ways to ration care and hide it from the media (for a while).

I “think” the problem is an overwhelming mass of returning vets with a ton of medical problems and a limited amount of resource to deal with them. There are more doctors than Carters has Liver Pills all over Iraq and certainly Afghanistan. None of these doctors can do much definitive care there but they can “patch up” and send them back to the USA alive but with disastrous issues they would have ordinarily died from. Then they require a ton of expensive care that isn’t available in the system.

This is especially true for neurosurgical injury. If a soldier got a serious neurosurgical injury in Vietnam they died. In fact, if s soldier got an injury that a paramedic couldn’t fix at the scene he still had a pretty good chance of dying. Now they get patched up by doctors at up-front field facilities and sent back to the USA for a lifetime of expensive care and many remain non-functional, requiring some form of welfare support. All this is incredibly expensive and the funds were never available.

Most of the Vietnam vets were sent back with relatively inexpensive health care issues and there was enough resources in the VA system to cover them. When I was a resident in both Indianapolis and New York City, I trained at the VA hospitals in both those cities and I was never impressed that their resources were stretched. I thought patients there got pretty good care and very good training of doctors. Now they’re coming back requiring a LOT of chronic care for injuries that should have killed them and the system is dramatically overloaded.  So what do you do when you have resources for 100 soldiers a week and you have 1000 pushing at the gate to get in?

The answer in a perfect world is you prioritize in some way so those requiring the more acute care get it first and the rest stand in line till their number comes up. But watch the “Wounded Warrior” commercials on TV. They’re all acute and they all need more expensive technical care, ICUs, neuro care, extensive rehab for blown off limbs.

In this country, allowing one group to cut in line on the basis of anything will get vociferous complaints of favoritism and discrimination. So I have little doubt that the VA simply found ways to thin out the demand for services by backing them all up into a barrel and turning the spigot open to allow a defined number of them into the system that could deal as effectively as possible. The rest just backed up waiting their turn. There are lots of ways to do that. What they did in Phoenix is one. Then the media got hold of it and the resulting feeding frenzy didn’t point out the fundamental problem of too many injured soldiers trying to get too few resources. It pointed out incompetence and stupidity which is much better copy.

So how to fix the fundamental problem.

As long as we’re resuscitating otherwise mortal injury in Afghanistan, we will continue to deal with them inadequately in the overheated VA system. Now that the toothpaste is out of the tube in the media, it won’t go away. We have several choices.

1.  Pour a ton of money into the VA system creating a “separate but equal” care system for acute injury and rehab.

2.  Close the VA system for acute injury and spread these patients out through the nearly overheated public health care system and pay for that care via a separate reimbursement provision that the military has in place anyway for veterans who for some reason cannot access a veterans facility.

I “think” that #2 is the logical way to deal with these patients most effectively. The VA system clearly cannot deal with them at all, much less effectively. It would cost a lot more to bring the VA system up to speed than to adjust the “private” system. At any rate, we better do something soon because there are a lot of soldiers out there who deserve better.

It was the year 1959 AD. My dad was the only general surgeon in a town of about 10,000 souls located in northwestern Wisconsin studiously picked for his hunting and fishing passions.

He was a very conservative Republican as most if not all doctors were at that era. The “up by your bootstraps” age selected for them. The best government was no government, and in the escalating post war, post-Eisenhower age of prosperity, that seemed attractive.

Credit cards were virtually unknown. Gas was 29.9 cents a gallon, a mortgage on a nice house was a hundred bucks a month, a nice car cost US$2000 and virtually all health care was affordable out of pocket. There was no Medicare or Medicaid.

But the Eisenhower era was closing and a new era of cold war paranoia was emerging with the Presidential election of 1960. The world was becoming a dangerous. I was a sophomore in high school and my only interest was girls and cars, pretty much in that order. My interest in politics was yet to emerge so I was pretty much a disinterested observer.

The two candidates that emerged for 1960 were polar opposites, Richard M. Nixon, a crusading anti-communist from California and Kennedy, a relatively new senator from Massachusetts.

In the first ever TV debates in living black and white, he looked sneaky, dark and foreboding as opposed to the other guy, Kennedy, who brightened up the screen with an articulate vernacular. Even to my naïve eye, Nixon looked positively sinister.

Seemed like a pretty easy choice to me, but there was a problem. Kennedy happened to be a Catholic, a big problem in 1959 American culture. Catholics were very much discriminated against in mainstream America, thought by many to be as much a cult as “Christian Scientists” or “Scientology”.

Catholic. That’s all my bible thumping conservative Baptist mother needed to hear. So I could hear from my bedroom the fervent pleas that Richard Nixon would save us from being ruled by the Pope. But it wasn’t to be. Kennedy was elected by the thinnest of margins and my dad had to pull my mothers head out of the oven.

But in the end, Kennedy went on to become possibly the more revered President in American history, maybe rivaled by Bill Clinton. Interesting that they shared the same vices, but with different media access saturation.

But no matter. Kennedy was perhaps the most intelligent, articulate, funny President our country ever had. If he had shortcomings, all downplayed them. He and his family formed a veritable dynasty that was almost immediately equated with the Camelot legends of King Arthur. It is impossible to overestimate the love this man accumulated by the American public, (never my mother).

It was an idyllic scene unsullied by the eventual cultural revolution of the late 60s and the war in Vietnam. A relatively brief period of quietude and prosperity that was destined to collapse under it’s own weight, but it was extraordinary while it lasted. My only worries were girls and cars.

Cut to November, 1963. I had flunked out of the University of Wisconsin the first time (long story) and had eased into a job as an “orderly” at the local hospital where my dad practiced general surgery as I plotted my next move. The then Director of Nursing was the venerable and formidable Miss Myrtle Worth who watched me closely. After she died the hospital was re-named after “Myrtle Worth Memorial Hospital”. But that’s another story.

Sometime in the early afternoon of 22 November I was perambulating down the hall of one of the hospital floors on my way to some chore, probably carrying a bedpan, when one of the TV sets in the rooms I was passing by suddenly proclaimed a “We interrupt this program”.

This was a little unusual as these kinds of interruptions rarely justified breaking into regular programming. So I stopped and backed up in time to see Chet Huntley (NBC News) solemnly announce that President Kennedy had been shot in Dallas and no details were available.

Everything in the entire hospital instantly stopped cold. Every nurse, every administrator, every doctor all stopped what they were doing and congregated around the nearest available TV. Shortly thereafter came the famous spectacle of American’s most trusted TV commentator, Walter Cronkite, sadly proclaim with tears in his eyes that the President was dead.

There are no words even in my formidable vocabulary to express to you the emotional and cultural disaster that followed. This was absolutely unprecedented on every level. Camelot by its nature was impenetrable. No one ever thought in their wildest dreams that Camelot was vulnerable. To have it come crashing down was a cultural train wreck of immeasurable consequences. Like an out of control LSD trip, there was n way to process it.

What was to follow was unbroken ground, chronicled minute to minute by the unblinking eye of network TV in living black and white. Everything in the country stopped dead in its tracks, and I mean EVERYTHING. Every radio station carried only continuous funeral dirge music. There was no traffic anywhere. All businesses were closed including gas stations.

Everyone in the country sat ensconced before a TV set watching the funereal progression, the caisson, the riderless horse with boots reversed in the stirrups, the lying-in-state under the Rotunda, the unimaginable grief and horror of his wife preserved on.

It was like a nuclear winter until after the funeral when things slowly came back to at least baseline, but never actually back to normal. Even my mother was in tears. We then went on to the further culture shock of Bobby Kennedy and Martin Luther King, further illustrating the danger society never dreamed of on November 21, 1963.

I send this remembrance out every year at this time. This and Timothy Leary and “Alice’s Restaurant”, the theme song of a generation that my Fellows know nothing about threaten to be forgotten, like Vietnam.

Let me bring back the vibrant remembrance because it’s important.

August 28, 1963 is the date of one of the most important and profound communications ever uttered by a human.

I have been a student of the 60s for most of my life, having lived and participated in much of 60s culture. I’ll spare you the details this time of my own experiences standing twenty feet from Dr. King during a speech in Atlanta in 1965, but if you have an interest, you can check out my first book on the subject:

http://store.blurb.com/ebooks/404827-the-60s-70s-confessions-of-an-attentive-observer

The eBook version is free.

I lived in Georgia for a huge chunk of the civil rights years and I experienced and participated in much of it. Someday I’ll write the full book on it, but for the moment, just walk along with me.  I’ll paint you the color commentary as we maneuver through the throngs toward he stage. I’ll interpret what’s going on from the vantage of a participant.

This day, August 28, 1963, produced the “I have a dream” speech by Dr. Martin Luther King, a communication rivaled only by Lincoln’s Gettysburg Address at Gettysburg, PA, November, 19,1863, 100 years earlier. There are similarities and differences between the two speeches.

Like King, Lincoln explored the principles of human equality, but proclaimed the Civil War as a struggle for the preservation of the Union necessary to frame principles thereof.  But unlike the King speech, Lincoln’s mood is described by Ken Burns as a quiet, almost whispering matter-of-fact tone directed at no one in particular within the relatively small group present.  At the time, it was virtually ignored. There is only one photograph from the Matthew Brady collection of Lincoln delivering the speech and it was from a distance.

The enormity of Lincoln’s speech is contained in the words, not the enunciation. Conversely, Dr. King’s speech occurred at the largest and most important civil rights demonstration in history and it was loud, covered by all three major TV networks. At the time of the demonstration, two thirds of the nations persons of color were not allowed to vote, attend integrated schools or use public facilities. 250,000 participants jamming the National Mall demanding civil rights legislation that was only to come two years later.

King took the stage just before noon with a prepared speech and began reading from it word for word. The text decried the fact that “fivescore years ago” Lincoln’s Emancipation Proclamation on July 1, 1863 freed the slaves in the ten states that were still members of the Confederate States of America, applying to a relatively small number, around 4 million slaves at the time.

But King goes on to lament: “100 years later the negro is still not free!”  “Lincoln’s promises were a bad check and “we’re here to cash it!” Then about halfway through the text something important changes. King looks up at the crowd sensing an opportunity to pontificate extemporaneously, as he did frequently in other speeches. The text did not match the emotion required at the moment and King simply went with the flow as he felt it, acting more like a Baptist preacher on a roll than an interpreter of a prepared text.

King was the undisputed master of grabbing audiences and holding them spellbound. On this day, he found his theme and worked it mercilessly, alternately chastising the crowd then raring back smugly, basking in himself. His words did not exist in any text. They were created in his soul for the occasion and they flowed freely, some of the most important words ever uttered by a human, relegating King to every history book.

 “I have a dream that one day on the red hills of Georgia the sons of former slaves and the sons of former slave owners will be able to sit down together at the table of brotherhood”

“I have a dream that my four little children will one day live in a nation where they will not be judged by the color of their skin but by the content of their character”.

“I have a dream that one day every valley shall be exalted, every hill and mountain shall be made low, the rough places will be made plain, and the crooked places will be made straight, and the glory of the Lord shall be revealed, and all flesh shall see it together”.

At this point, King is totally consumed by unrelenting passion and running completely on maniac fervor.  A shoddy analogy might be watching Neil Young play “The needle and the damage done” on The Johnny Cash variety show in 1971. Young doesn’t know where he is or who’s in the room. He doesn’t know where the chords come from. He’s completely consumed with the story he wants to tell and everything accompanying it flows like a wild river.

“I hit the city and

I lost my band.

I watched the needle

Take another man….

Gone, gone, the damage done……”

But I digress.

Dr. King continues:

 “From every mountainside, let freedom ring. And when this happens, when we allow freedom to ring, when we let it ring from every village and every hamlet, from every state and every city, we will be able to speed up that day when all of God’s children, black men and white men, Jews and Gentiles, Protestants and Catholics, will be able to join hands and sing in the words of the old Negro spiritual………”

At this point King is close to emotional collapse. Those around him stare with slack jaws.

(Rising tonal cadence)  “Free at last! Free at last! Thank God Almighty, we’re free at last!”

King collapses into a chair, staring blankly at Ralph Abernathy. For a moment, the audience was shocked silent. John Kennedy allegedly turned to an aide and muttered: “Damn, this guy’s good”.

The “I have a dream” speech was he high point of his career, changing his public persona dramatically from a commonly perceived rabble-rousing jailbird to a fisher of men.  King biographer David J. Garrow wrote that King had created a masterpiece on the fly like some kind of jazz musician.

King was assassinated on April 4, 1968.  I was finishing Jungle School in preparation for Vietnam on that day and I witnessed the pain and frustration.

Here is a youtube rendition of the speech. It MUST be watched and absorbed by anyone claiming to be an educated person. Take the time to watch the entire eleven minutes of this one of the most important speeches ever made by a human. Watch for the transition to extemporaneous passion.