Wounds of War

Suzanne Gordon

Description

U.S. military conflicts abroad have left nine million Americans dependent on the Veterans Health Administration (VHA) for medical care. Their "wounds of war" are treated by the largest hospital system in the country-one that has come under fire from critics in the White House, on Capitol Hill, and in the nation's media.In Wounds of War, Suzanne Gordon draws on five years of observational research to describe how the VHA does a better job than private sector institutions offering primary and geriatric care, mental health and home care services, and support for patients nearing the end of life. In the unusual culture of solidarity between patients and providers that the VHA has fostered, Gordon finds a working model for higher-quality health care and a much-needed alternative to the practice of for-profit medicine.

Sujets

• Sociologie, société et politique
• USA
• Veteran
• Health
• États-Unis

Informations

• Publié par: Cornell University Press
• Date de parution: 15 octobre 2018
• Nombre de lectures: 0
• EAN13: 9781501730849
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Wounds of War

Avolumeintheseries TheCultureandPoliticsofHealthCareWork EditedbySuzanneGordonandSiobanNelson

Foralistofbooksintheseries,visitourwebsiteatcornellpress.cornell.edu.

WoundsofWar

HowtheVADeliversHealth,Healing, and Hope to the Nation’s Veterans

SuzanneGordon

ILR Press an imprint of Cornell University Press Ithaca and London

Copyright©2018bySuzanneGordon

Allrightsreserved.Exceptforbriefquotationsinareview,thisbook,or parts thereof, must not be reproduced in any form without permission in writing from the publisher. For information, address Cornell University Press, Sage House, 512 East State Street, Ithaca, New York 14850. Visit our website at cornellpress.cornell.edu.

Firstpublished2018byCornellUniversityPress

PrintedintheUnitedStatesofAmerica

LibraryofCongressCataloginginPublicationData

Names: Gordon, Suzanne, 1945– author. Title: Wounds of war : how the VA delivers health, healing, and hope to  the nation’s veterans / Suzanne Gordon. Description: Ithaca, New York : ILR Press, an imprint of Cornell  University Press, 2018. | Series: The culture and politics of health  care work | Includes bibliographical references and index. Identifiers: LCCN 2018018474 (print) | LCCN 2018018810 (ebook) |  ISBN 9781501730832 (epub/mobi) | ISBN 9781501730849 (pdf) |  ISBN 9781501730825 | ISBN 9781501730825 (cloth : alk. paper) Subjects: LCSH: United States. Veterans Health Administration. |  Veterans—Medical care—United States. Classification: LCC UB369 (ebook) | LCC UB369 .W678 2018 (print) LC record available at https://lccn.loc.gov/2018018474

TomydaughtersAlexandJessicaEarly My most beloved advocates of patients and their caregivers

Acknowledgments

ListofAbbreviations

Contents

Introduction: What Kind of Care for Veterans?

1. Promises Broken and Kept: A Short History of the VHA

2. Those Who Have Borne the Battle: The VHA’s Patient Population

Profile—What It Means to Be a VA Volunteer

3. Primary Care the Way It Should Be

4. Healing Minds and Bodies: Integrated Mental Health Care and Primary Care

5. Dealing with a World of Hurt: VHA Treatment of Chronic Pain

6. When Wounded Warriors Are Women: Caring for Female Veterans

ix

xiii

1

19

39

60

62

87

99

117

vi i i

Contents

7. Mental Health the Way It Should Be

8. Unpacking PTSD: From Diagnosis to Effective Treatment

Profile—Karen Parko: A Special Kind of Professional Development at the VA

 9. Returning to Civilian Life: Veterans on Campus

10.SuicidePrevention:VHAProgramsThatSaveLives

11.OvercomingDisability:VARehabilitationServices

Profile—Mark Smith: No Ordinary Bike Shop

12.TranscendingTrauma:TheMartinezCognitive Rehabilitation Program

13.OfftheStreets:ReducingVeteranHomelessness

14.AlternativestoJail:Veterans’JusticePrograms

Profile—Cops and Vets: The Memphis Crisis Intervention Model

15.SpecializinginElderCare:TheVAandGeriatrics

16.KnockingonHeaven’sDoor:TheVAand EndofLife Care

17.BetterCareWhere?TheVHAComparedtothe Private Sector

Conclusion:ASystemWorthSaving—and Making Even Better

Epilogue: Thank You for Your Service?

Notes

Index

About the Author

130

144

165

172

180

201

235

239

258

281

298

308

331

353

372

396

401

423

447

Acknowledgments

Thisbookhadmanysourcesofinspiration,andIoweitspublicationto an entire battalion of friends, colleagues, VHA caregivers, veterans, and, of course, family members. It’s not possible for me to list here by name everyone I spoke with for this book, so the “shout out” below is for those interviewed not once but multiple times. Many people have helped me better understand the specific nature of veterans’ health care and the dif ficulties involved in delivering it. Others have helped me put current issues into historical context, or navigate the maze of congressional politics and policy making, especially in the chaotic environment of Washington, DC, since January 2017. IwanttoexpressmygratitudetoalltheVAcaregiversandstaff,and veterans and their family members who shared their time and insights with me, or who allowed me to follow them as they worked or went to appoint ments. Some people who have helped me prefer to remain unnamed.