Saturday, November 21, 2009

Fired therapist: Stressed Marines got bad care

Fired therapist: Stressed Marines got bad care
Camp Lejeune patients had to use trailers near live-fire training exercises

Jim R. Bounds / AP
Dr. Kernan Manion was fired after he complained about conditions for his patients at Marine Corps Base Camp Lejeune, N.C.
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updated 1:22 p.m. ET, Sat., Nov . 21, 2009
CAMP LEJEUNE, N.C. - Marines treated at Camp Lejeune for post-traumatic stress had to undergo therapy for months in temporary trailers where they could hear bomb blasts, machine-gun fire and war cries through the thin walls, according to servicemen and their former psychiatrist.

The eight trailers were used for nearly two years, until a permanent clinic was completed in September in another location on the base, said a Camp Lejeune medical spokesman, Navy Lt. Mark Jean-Pierre.

The noise from training exercises "shook me up real bad. I couldn't take it. I almost ran out of there a couple of times," said a Marine patient who spoke on condition of anonymity because he is not authorized to talk to the media. "My mind couldn't focus on the treatment. I couldn't tell the difference between the combat zone and the non-combat zone."

The allegations became public after the dismissal of Dr. Kernan Manion, a civilian psychiatrist who says he was fired for writing memos to his military superiors complaining of shoddy care of Marines returning from Iraq and Afghanistan with post-traumatic stress disorder, or PTSD, a condition that can make patients jumpy, fearful of loud noises and prone to flashbacks.

"These guys are saying, 'I'm fried and I can't get out,'" Manion said in an interview. Referring to the Fort Hood shooting rampage in which an Army psychiatrist who counseled PTSD victims allegedly killed 13 people earlier this month, he said: "Is there potential for another blowup? Yes, indeed."

In e-mails shown to The Associated Press, Manion complained, among other things, that the military was not dealing with PTSD properly and that the trailers were infested with bugs and noisy.

"Given that PTSD is the most frequent diagnostic group we see, one would question the sense of locating a clinic in such close proximity to the booming of bombs that shake the trailer, the ratta-tat-tat of machine gun fire and the almost daily occurrence of grunts yelling war cries," Manion wrote.

In an interview with AP, Manion said the military should have rented a building off base.

Manion was fired in September after working for eight months for a company that has a contract with the military to provide mental health care on the North Carolina base. He said that when he asked the contractor why he was being fired, he was told it was ordered by the Navy.

Tom Greene, a regional manager with the contractor, Spectrum Healthcare Resources, said in an e-mail statement to the doctor that Manion "did not meet the government's requirements in accordance with the contract." Greene offered no specifics and did not respond to e-mails seeking further comment.

Review said to be in works
The inspector general for the Navy's Bureau of Medicine is reviewing the allegations of inadequate care, a military official said Friday on condition of anonymity because he was not authorized to speak about it.

Jean-Pierre said artillery fire can be heard nearly everywhere on the 240-square-mile (620-square-kilometer) base, which has 80 live-fire ranges.

In an e-mail, the spokesman said: "We are confident that our medical services are of the highest quality." He would not comment directly on why Manion was fired, but said that civilian doctors have to adapt to the "rapid evaluation and short-term treatment" that the military offers.

Three of Manion's patients told the AP that being so close to the sounds of gunfire made it hard to concentrate and made them jumpy and nervous. The patients, who spoke on condition of anonymity because they are not authorized to speak to media, said they were making progress and were shocked when Manion was fired. All three patients said they trusted Manion after months of treatment and now found it hard to get help from other doctors.

Manion, 59, has 25 years of experience as a psychiatrist with a specialty in traumatic brain injury, or TBI.

He told the AP his Marine patients told him they were ostracized and sometimes punished by superiors for seeking treatment. He said one unit at the base made all of its soldiers suffering from PTSD sit in a room and read infantry manuals.

"How do we help a guy make sense of all that and heal from that when the Marine Corps is saying to get treatment means you're weak?" Manion said.

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