At Walter Reed, a New Approach

The wounded at Walter Reed Army Medical Center now get help from the Army's  Warrior Transition Brigade, which includes battle veterans.
The wounded at Walter Reed Army Medical Center now get help from the Army's Warrior Transition Brigade, which includes battle veterans. (Photos By Michel Du Cille -- The Washington Post)
By Steve Vogel
Washington Post Staff Writer
Tuesday, July 31, 2007

It was the sort of message that sergeants have delivered to soldiers since time immemorial: Formations would be held three days a week at 7:30 a.m., and attendance was mandatory. "NO EXCEPTIONS!" screamed the e-mail, sent this month by a staff sergeant to his squad.

"I am sick and tired of chasing everyone around when it should be simple," the message read. "This [is] the United States Army NOT the Salvation Army."

Normally, no one in the Army would blink. But the e-mail recipients were stationed at Walter Reed Army Medical Center, where many are missing limbs, coping with post-traumatic stress disorder or suffering from brain injuries. The backlash was swift. After fielding a complaint from a soldier's mother, a commanding officer ordered the sergeant to apologize.

After revelations this year of squalid living conditions and bureaucratic nightmares at Walter Reed, the Army took the unusual step of creating the Warrior Transition Brigade. It brings in combat-seasoned officers and sergeants to assist the facility's nearly 700 outpatients -- tracking their recovery, ensuring that their appointments are kept and watching out for their morale.

But the effort to help wounded soldiers navigate the medical bureaucracy has also produced a culture clash, with many battle-hardened noncommissioned officers having difficulty adapting to Walter Reed's civilian atmosphere. As some injured troops and their families publicly voice complaints, the brigade leaders face a dilemma: Should they treat the recovering troops as patients first and foremost, or as soldiers?

Staff Sgt. John Guna, 38, received only three weeks' notice that he was being sent to Washington to oversee wounded soldiers. "When they first told me I was going to Walter Reed, I said, 'Did they put a tank out there at the front gate?' " recalled Guna, a tanker and veteran of three tours in Iraq.

Brig. Gen. Michael S. Tucker, the deputy commanding general at Walter Reed, told reporters yesterday that the brigade proves the Army's commitment to fixing problems at the hospital. "When the Army is serious about something, it puts boots on the ground," he said.

To lead the brigade, senior Army officials tapped Col. Terrence McKenrick, a highly regarded Army Ranger whose previous assignment was at the Joint Operations Center for Multi-National Corps-Iraq. Combat arms officers and noncommissioned officers with proven records were chosen from infantry and armor units -- the core of the Army's fighting machine. Drill sergeants also joined the brigade.

"They understand the dynamics of motivating people under the most demanding of conditions," McKenrick said. "The greatest challenge is how to inspire these warriors and bring them out of their despair."

The brigade has replaced Walter Reed's much-maligned Medical Hold Company, in which platoon sergeants -- many of them former patients or medics and other medical command soldiers -- were each responsible for an average of 55 outpatients, and often more than 100. Platoon sergeants operated with little support and found it impossible to track so many patients with serious physical and emotional wounds.

"How could we expect a platoon sergeant to handle that?" McKenrick asked. "It makes me realize how short we came up as an Army."

In the new brigade, the companies are divided into three platoons, which are in turn broken down into three squads, with each squad leader overseeing about a dozen soldier-patients. Outpatients interviewed said that under this new structure, problems can be detected and responded to more quickly.

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