Physician heal thyself

What happened at Walter Reed? An article in USA Today suggests that events which have still to become public knowledge led to Maj. Nidal Malik Hasan’s departure from the Walter Reed Army medical center.


At issue, S. Ward Casscells told USA TODAY, “is whether the Army missed a warning signal. It’s a legitimate question.” … Casscells, who retired in April as the Pentagon’s assistant secretary for health affairs, said he had been speaking to many who worked with Hasan at the Walter Reed Army Medical Center near Washington, D.C.

Some at Walter Reed, Casscells said, was that Hasan was sent to Fort Hood for “a fresh start” after a difficult time at Walter Reed.

Hasan received a poor performance evaluation there, the Associated Press reported, quoting an official who spoke on condition of anonymity. While he was an intern, Hasan had some “difficulties” that required counseling and extra supervision, according to Dr. Thomas Grieger, who was the training director at the time. …

“Talking to people who knew him,” Casscells said, “no one thinks that this was (post traumatic stress), and they are skeptical that he was subject to religious harassment.”

“That is not tolerated in the military. The military will look at all this closely and decide if there is any mental or physical illness, whether this is just a lonely guy with a remote personality who got a bad officer evaluation report and lost the confidence of his peers, maybe withdrew into religion as solace. What could we have missed? How could we do better?”

“These are the types of questions that will be rigorously asked.”


If Hasan was in the doghouse, then it would be interesting to ask why a “lonely guy with a remote personality” badly regarded by his evaluators was selected to represent the Uniformed Services University School of Medicine at a Homeland Security series of workshops held between April 2008 and January 2009. (Hasan’s name is on page 32). Those workshops were attended by a wide variety of personalities, including foreign diplomats, think tank analysts and academics. It would have been difficult to imagine why Hasan should be chosen to front for an institution if his views were controversial.

The US News report says “Hasan came to the attention of law enforcement officials six months ago because of Internet postings about suicide bombings and other threats, including posts that equated suicide bombers to soldiers who throw themselves on a grenade to save the lives of their comrades. Investigators had not determined for certain whether Hasan was the author of the posting, and a formal investigation had not been opened before the shooting, law enforcement officials who spoke on condition of anonymity told the Associated Press.” The Army refused to rule out the possibility that Hasan was not acting alone.

What happened at Walter Reed? Did Hasan have an influential patron? If Hasan had exhibited certain disturbing tendencies, and if he was in fact being scrutinized by law enforcement, then what was achieved by moving him to Fort Hood, except putting distance between Hasan and whatever was in Washington DC?  What hypothesis could cover so many disparate facts? Many questions remain unanswered. There’s not enough data yet to conclude anything.


President Obama ordered the flags at the White House and other federal buildings be at half-staff and urged people not to draw conclusions while authorities investigate. “We don’t know all the answers yet. And I would caution against jumping to conclusions until we have all the facts,” Obama said in a statement.

This investigation can go anywhere. There’s a great incentive to make sure that whatever the truth happens to be that those in officialdom who have the most to lose should not be the last to know.

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