Monday, September 20, 2021

At The VA, Critical Care and Critical Race

The scope of my involvement with the Veterans Administration was helping my father, a WWII vet, and my father-in-law, a Korean Conflict vet, deal with the bureaucracy. And that was mostly waiting on hold on the phone, which would be a full-time job in some cultures. When a human finally answered, they tended to be helpful and pleasant provided you could dedicate your life to waiting for them. I suspect the hold was no longer or shorter based on a lack of equity.

Yet, the VA, like the rest of government, is under orders to seek and destroy inequity, and so its resources have been diverted from reducing the wait on the phone to listening. Not to vets, per se, but to vets of a certain stripe.

The Department of Veterans Affairs wants to hear from its customers, so to speak, but check your skin color before raising your hand. The VA is holding dozens of “listening sessions” for patients at its medical facilities. Eight cities are being virtually canvassed, with hearings for “racial/ethnic minorities,” “LGBTQ+ veterans,” and so forth. By all means, hear out veterans and improve their care, but is this how the government should do it?

To be fair, the first question is whether there’s a need for it, and there’s no way to find out other than to ask. Are there problems with the treatment of gay, black and women vets that are distinct from others? Are there needs going unmet that straight white men fail to realize? Should they be given the chance to say so? Sure. And more to the point, the opportunity to talk about it should be offered without the overlay of white guys talking about their problems, or trivializing the problems of minorities they don’t have.

It doesn’t hurt to listen to people whose life was at much at peril as anyone else’s, and who might well have issues that the majority does not. So the VA did.

At a session on race last week in Augusta, Ga., a woman who described herself as white spoke in favor of inclusive language and safe spaces. “I appreciate your being upfront about the fact that you’re not a person of color yourself,” the VA’s facilitator chided, “because this listening session is for those from racial and ethnic minorities, to give them that kind of safe space.” The woman took the hint and shut up.

The ally conundrum, believing in the duty to speak out on behalf of others when your speech does two unproductive things: it uses the opportunity for people to speak for themselves and, more importantly, it reflects what this white woman believes black vets want rather than what black vets want. Do black vets want “inclusive language” or shorter waiting times?

Yet in reality, slicing people into narrow identity groups has reduced opportunities for public comment. A hearing in Augusta was canceled when not enough veterans joined. The needed quorum, as the VA’s facilitator explained, was “at least three participants.” Apologies to the one woman who showed up. Of six breakout groups in Louisville, Ky., last week, four were scotched, sorry again to the guy on the line. Broader open hearings might have at least let him speak.

This may reflect a lack of concern about unmet needs by the people whose needs are potentially unmet, or just a lack of interest in these “listening sessions,” a concept adored by people with a lot of time on their hands and the inherent need to let words emit from their mouth. It may also have something to do with vets having problems keeping a roof over their head and a computer with wifi at the ready.

Another Augusta call had a quorum but was ended after 10 minutes of dead air. That one was reserved for “religious minorities and persons otherwise adversely affected by persistent inequality.” The VA’s hosts prodded, but nobody came off mute. Ditto at Louisville’s LGBTQ+ session.

But even when people showed up, little came of it. Does that mean there weren’t any need of gay, black and women vets unmet? Not necessarily.

Some of the substantive points came from women veterans. One said she thought physicians sometimes spoke to her condescendingly and blew off her concerns. Who among us hasn’t ever felt that way? Yet the VA has a special reason to be on guard: Only about 10% of veterans are female, so women’s health issues in particular might come across, if unintentionally, as an afterthought. Good for the VA to know.

It is good for the VA to know that women, although only 10% of the military, are still every bit as entitled to care for their concerns as men. Perhaps her complaint was just about docs being  condescending jerks, as they were taught in med school, or perhaps the physicians at the VA have spent so long focused on the medical needs of men that they don’t take women’s medical needs as seriously. If the latter, tough nuggies, doc. Women are in the army now, so treat them with the same respect as every other service member.

Was it weird and wrong to hold these listening sessions that came to naught? Weird, maybe, in the same sense that all of these pseudo-group therapy sessions are presumed to be everybody’s comfort zone. Maybe soldiers don’t want to whine in front of their brothers and sisters about their personal gripes, knowing that they all shared the possibility to have their head blown off as did their comrades, after which their gripes come off as petty.

But it wasn’t wrong for the VA to give people who aren’t part of the mass of the military the opportunity to raise issues that affect them differently, that they have needs distinct from those of straight white men that are left unnoticed and unmet. And if the opportunity was provided and nobody came, or nobody spoke up, maybe the VA got its answer, that their needs are pretty much the same as every other soldier’s needs, and the VA needs to do better serving all veterans.

No comments:

Post a Comment