It’s very au courant to criticize the Veterans Administration, particularly its medical wing. Waiting lists have apparently been manipulated. Opiates have apparently been overprescribed for pain management. According to a report on Page One of the Union-Leader, at the Manchester VA Medical Center, the former head of its spinal clinic is accused of cutting and pasting patient notes and leading a clinic where 59 percent of patients suffered myelopathy, a loss of spinal-cord function.
These are terrible truths, but they haven’t been my experience with the VA. I know the dangers of argument by anecdote, and have protested against it in other circumstances, whether used positively or negatively. For example, Mother Theresa may have been short-tempered and cranky with her underlings – that doesn’t take away from the good work she did. Contrariwise, Bill Cosby was an incredibly funny role model for Americans – until it came out he was a chemically-enabled rapist. Anecdotes are just pieces of information, and they don’t compose an argument by themselves.
Still, my experience is all I have, and the three stories I’m about to tell are my experience with the Veterans Administration, even though they don’t fit into a larger critical narrative.
Ten-and-a-half years ago, I walked into the VA Medical Center in Manchester and told the nurse behind the Urgent Care Desk, “My name’s Keith Howard. I’m a veteran, but I’ve never used VA services before. I don’t want to be alive anymore.” That nurse, whose name is lost to history, helped save my life. She didn’t send me to see a Primary Care Provider. She didn’t tell me to go to the psychiatric clinic on the fourth floor. She didn’t tell me I needed to demonstrate eligibility. She treated me like a human being who wanted to kill himself – or at least let his life go like a bread wrapper in the wind. She sat down with me, talked about what was going on inside me, and arranged for me to be transported to White River Junction, where I would be treated for depression and introduced to a program of recovery that remains central to my existence. She helped protect me from myself, and made it possible for me to go on doing that for other people.
After I’d been sober and relatively sane for a few years, I developed a hairless spot, but not on the top of my head as a sign of incipient baldness. My spot was on the right-hand side of my skull and started off the size of a quarter, growing slowly to silver-dollar size. Oddly, the hairless flesh on my scalp was as smooth as a baby’s bottom. Having other things to occupy my energy, I didn’t give it much thought until I went to see my VA doc, who called it alopecia, ordered some tests and referred me to dermatology. The skin doctors gave me a topical ointment which grew my hair back, but the tests showed I had Hepatitis C, a potentially deadly disease, especially given the hard roads I’d led my liver down through years of drinking.
The Hep C diagnosis introduced me to a true secular saint – Linda DeOrio, a VA provider. Linda talked with me about the possible routes of my infection – IV drug use, unprotected sex with a positive partner, other blood-to-blood contact – ways to prevent my infecting others, and possible treatment. At the time of my diagnosis, the only approved treatment for Hep C was Interferon, which carried with it side effects ranging from suicidal depression (YIKES to a man who’d wandered back from the abyss) to severe weight loss (I’d finally gotten up to my target weight after drinking most of my caloric intake for a long time) to exhaustion (making it difficult for me to go on working). Linda also told me my liver tests showed my years of abuse hadn’t done significant damage to the organ’s function, my viral count was manageable and, biggest of all, there were new drugs in the pipeline that seemed not to have Interferon’s complications. In consultation with Linda, we waited to begin treatment; instead, I would meet with her every quarter, as I recall, to monitor the disease’s progress.
During these meetings, Linda was informative, delightful and optimistic, keeping me updated on my health and the progress of the medication approval process. Just as important as the information, though, was her presence, her kindness , her spirit – she kept me believing we were going to beat this disease. Eventually, a newer new drug was released, with none of Interferon’s side effects, Linda put me on a regimen of it and, ta-da, I was cured. Today, other than an inability to ever donate blood again (because, I believe, the antibody still shows up in my bloodstream), I am completely free of Hepatitis C. The medicine killed the virus, but it was Linda that kept it from killing me.
I’ve had a lot of primary doctors in my life, beginning with Dr. Jesse Galt in Dover, my pediatrician and family doctor until I went into the Army. Doctor Galt was a good man and a good doctor, I’m sure, although I’m biased against him based on his change of heart regarding circumcision, a rethinking that took place when I was eight. When I was adopted, I hadn’t been circumcised, and Dr. Galt saw no reason to recommend the procedure to my parents. Fine. Unfortunately for me, he read an article when I was in third grade that changed his opinion – he forced me under the knife and I’ll never forget how mortified I was to have to explain my absence from school.
The best doctor I’ve ever had, hands down, was my provider at the Manchester VA, Dr. Muhammed Huq. He was the doc who started my alopecia treatment, oversaw me during my hep treatment and acted as a cheerleader throughout my recovery. Each time I saw Dr. Huq, he remembered me well, inquiring after my daughters and their activities, encouraging me to take on new responsibilities in sobriety and was very proud when I was named director of Liberty House. No matter what life brought me, Dr. Huq was there, cheering me on and treating me like a fellow human being, an equal. A year or so ago, he was transferred to, I believe, Annapolis, and while my new doctor is great, she’ll never have shared the experiences I had with Dr. Huq.
I began this column talking about criticism of the Veterans Administration, all valid, I’m sure. I mentioned the Manchester VA Medical Center’s spinal clinic and the doctor who oversaw its 59 percent complication rate, the doc who reportedly cut-and-pasted patient notes, which may or may not have been a factor in that statistic. That doctor was Dr. Muhammed Huq, the best doctor I’ve ever had. I feel horrible for anyone who suffered myelopathy; I want the VA to investigate the reasons for this occurrence; I want the government to hold accountable any provider who did a shoddy job.
But I also want you to know the worst thing you know about a man isn’t necessarily the truest.
Keith Howard used to be a homeless drunk veteran. Then he got sober and, eventually, became director of Liberty House in Manchester, a housing program for formerly homeless veterans. There, he had a number of well-publicized experiences – walking away from federal funds in order to keep Liberty House clean and sober, a contretemps with a presidential candidate and a $100,000 donation, a year spent living in a converted cargo trailer in Raymond. Today, he lives in a six-by 12-foot trailer in Pittsburg, NH, a few miles from the Canadian border with his dog, Sam. There, Howard maintains tinywhitebox.com, his website, works on a memoir, and a couple of novels while plotting the next phase of his improbable life.