WOUNDED MEN, BROKEN PROMISES

How the Veterans Administration treats and mistreats their ill, with a special focus on the Vietnam-era vet. Klein himself is not a veteran (he was, in fact, an anti-war demonstrator), but as a psychologist-in-training he had some contact with the system; pursuing his interest, he conducted interviews which, with his data, will deal some further blows to the rapidly sinking images of physicians and government. The bottom line is simple: from 1974-80, Vietnam vets generally have been dying at twice the rate of death in actual combat; what the interviews bring out is the outstanding lack of support from the V.A. There are, Klein notes, several problem-areas. The problem with physicians is both individual and institutional: young physicians tend to be unsympathetic or even abusive toward Vietnam-era vets, because of differences in background and experience; most V.A. hospitals are affiliated with medical schools--desirable in theory, but resulting in a lack of on-site supervision and in putting the needs of medical students over the needs of patients. Klein found medical research to be abundant-but not carried out within the norms of informed consent; and one large, logical area for research--care of the elderly--has not in fact received much attention. The system's care for the elderly, indeed, may be no better than that familiar to us through exposÉs of private nursing homes. Especially disturbing is Klein's report on possible victims of Agent Orange: rather than notifying vets of the symptoms, and offering treatment, the V.A. is close-mouthed about the problem, and unable or unwilling to help those who think they or their children may be affected. In general, Klein has supported his findings well, but the individual accounts are the strongest evidence of the shame of the V.A. system.