
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: MONDAY, March 6, 1992                   TAG: 9204060186
SECTION: EDITORIAL                    PAGE: A-9   EDITION: METRO 
SOURCE: DAN DEWEY
DATELINE:                                 LENGTH: Medium

APPLAUSE

I AM seeking treatment at the Veterans Administration Medical Center in Salem, and over the weeks have interacted with their "front-line" staff. The staff has been courteous, professional and, above all, concerned for me.

This concern I believe to be sincere, and I appreciate the significance considering the high degree of burn-out evident in health-care providers treating demanding patients in even the best of settings.

That a large portion of vets present personality disorders demanding treatment shouldn't surprise anyone. The elemental stress of the military cauldron is enough to seed neurosis, if not developmentally derail, many young vets.

For those veterans who would do so, making something positive of participation in the death and mutilation of human beings, and the destruction of their possessions and their country, requires many years. Many don't do so, and continue in life with neurotic manifestations of acting out, anger, dissociation, reaction formation, depression . . . I prefer alienation. To me, then, admissions staff should be continually applauded for daily treating, with limited resources, a difficult population.

Why are resources scarce? The VA is legally, ethically and morally bound to provide medical care to veterans. Couple this mandate with polls indicating that 90 percent of the social order "support the troops," and one would think medical care would be readily available.

It is and it isn't. Catch-22? A truth stood on its head to attract attention? Is this why admissions staff are concerned for me, because medlcal care isn't readily available? People die on waiting lists? Why? Because government policy and implementation are not sincerely concerned with veterans, but rather with bean counting?

I went to the VA not as a charity case, but because I've earned my eligibility. Yet it seems that what treatment I'll receive won't be due to a vigorous application of policy, but rather to individual staff exending favors in my behalf. (Why do I feel uncomfortable?)

I'm lucky. Lucky that the VA staff show concern and can provide care - albeit in disregard of internal policy and at their own expense. More applause for those VA staff who can manage what's "right," with compassion and professionalism in spite of deceitful policies, bean-counting administrators and justifiably demanding and sometimes disordered patients. I myself am disturbed.

Dan Dewey, of Indian Valley, is a Vietnam veteran with two years' work experience in the 1970s in psychiatric admissions at the Albany, N.Y., VA Medical Center.

by CNB