Ian Fishback’s American Nightmare
February 28, 2023 1:02 PM Subscribe
He was a decorated soldier, a whistle-blower against torture. Then he was undone by his own mind — and a health care system that utterly failed him. [The New York Times Magazine]
As an athlete with high grades, he was accepted to West Point, securing a place as a cadet in return for five years of active service after graduation. Newberry, population about 2,000, was proud. Placing a student at the academy was grounds to celebrate. His mother could not raise a glass. “It wasn’t that I wasn’t proud,” she said. “I was just devastated because I knew it would destroy him.”
(previously)
As an athlete with high grades, he was accepted to West Point, securing a place as a cadet in return for five years of active service after graduation. Newberry, population about 2,000, was proud. Placing a student at the academy was grounds to celebrate. His mother could not raise a glass. “It wasn’t that I wasn’t proud,” she said. “I was just devastated because I knew it would destroy him.”
(previously)
What a tragedy. There are so many sad and disturbing elements to this story, but one that leaps out at me is how this person has served his country so well, had access to a system that was designed to help him, had a supportive family and lots of social connections, plus all kinds of other advantages and still ended up this way.
What hope is there for so many others who need help?
posted by rpfields at 2:02 PM on February 28, 2023 [5 favorites]
What hope is there for so many others who need help?
posted by rpfields at 2:02 PM on February 28, 2023 [5 favorites]
My thoughts on the first half of this article: He did what he set out to do. Example:
posted by aniola at 2:59 PM on February 28, 2023 [3 favorites]
Acacia Mei Larson, another cadet, found Fishback’s instruction life-changing. “The questions I asked myself in that class, the baby-killer question and all the difficult questions about killing generally,” Larson said, “led me to decide to leave the academy and pursue another career.” Larson departed West Point weeks after completing his course and has felt gratitude since.The second half of the article seems like it would support an investigative journalism article tying this back into the widespread mental healthcare abuse of pharmaceutical drugs as a substitute for adequate care.
posted by aniola at 2:59 PM on February 28, 2023 [3 favorites]
The second half of the article seems like it would support an investigative journalism article tying this back into the widespread mental healthcare abuse of pharmaceutical drugs as a substitute for adequate care.
Did Fishback abuse pharmaceutical drugs? I may have missed that as I'm reading he refused treatment even when ordered by a court that drugs could be administered. Is there a correlation about abuse of drugs and those who refuse or defer treatment within the article. No doubt, self medicating is a thing but is this true in Fishbacks case?
posted by clavdivs at 4:38 PM on February 28, 2023
Did Fishback abuse pharmaceutical drugs? I may have missed that as I'm reading he refused treatment even when ordered by a court that drugs could be administered. Is there a correlation about abuse of drugs and those who refuse or defer treatment within the article. No doubt, self medicating is a thing but is this true in Fishbacks case?
posted by clavdivs at 4:38 PM on February 28, 2023
"widespread mental healthcare (systems) abuse..."
Ah, I see that know. carry on.
posted by clavdivs at 5:25 PM on February 28, 2023
Ah, I see that know. carry on.
posted by clavdivs at 5:25 PM on February 28, 2023
I wasn’t aware of the just-war philosophy and it’s an interesting idea. I can see how hard it could be to maintain that line of reasoning though, especially for someone like Ian who was so into being in the military but raised by anti-war parents. His brain was definitely broken (the verb). I was raised a military brat and spent a year in ROTC in college and my main impression of the military is that if you don’t conform to the rituals, the hierarchy, the customs, you simply won’t succeed.
Also, I have a serious grudge against the VA medical system and Ian’s story of negligence doesn’t surprise me at all. When my dad was in the last week of his life and in hospice after 26 years of service in the Air Force, the VA told us that they were going to stop paying for his room and care at the hospital he’d been treated at for months. They said that on Thursday they would transport him by ambulance to the VA hospital even though his doctors told us that he wouldn’t survive the trip. I don’t know if you believe that people can “let themselves leave,” or decide when they’re ready to die, but he passed away Wednesday evening.
posted by bendy at 7:03 PM on February 28, 2023 [2 favorites]
Also, I have a serious grudge against the VA medical system and Ian’s story of negligence doesn’t surprise me at all. When my dad was in the last week of his life and in hospice after 26 years of service in the Air Force, the VA told us that they were going to stop paying for his room and care at the hospital he’d been treated at for months. They said that on Thursday they would transport him by ambulance to the VA hospital even though his doctors told us that he wouldn’t survive the trip. I don’t know if you believe that people can “let themselves leave,” or decide when they’re ready to die, but he passed away Wednesday evening.
posted by bendy at 7:03 PM on February 28, 2023 [2 favorites]
I have a serious grudge against the VA medical system and Ian’s story of negligence doesn’t surprise me at all.
I'm going to talk about the VA system, because even though the VA system is on blast here, the VA system is not on blast to the extent that it should be, and the overall American system is not on blast to the extent that it should be.
The VA is designed to take care of all of America's veterans who are injured by their military service. In fact, it's not just designed, it's statutorily required to. For those who are considered as - as this gentleman was eventually designated - "100% disabled", they are required to be paid a stipend check for the remainder of their life and all of their healthcare is required to be covered.
Let me tell you, for those of you who are not aware, that a terrifyingly shocking number of America's veterans meet that standard, and that it is only getting worse as they age.
And let me remind you that we were at war for twenty years.
Conservative estimates suggest 2.5 million members served in Iraq and Afghanistan. 1.8 million veterans have some level of disability as a result.
The Department of Veteran Affairs currently accounts for 5% of all federal spending.
And if you've guessed what I'm here to tell you - it's not enough. The true appropriate cost of these wars is fucking *astronomical*. The VA can't bear it. The country could bear it, but it would have to buckle its belt and own its sins in a way that it is not prepared to do.
Most veterans with PTSD that I know prefer weekly sessions. The average therapist is encouraged to see not more than 30 patients a week, so that would be a caseload of 30 patients for each therapist. Assuming the extremely conservative estimate of 500,000 Iraq and Afghanistan vets with PTSD, that means VA would have to hire 16,666 therapists just to see the relatively healthy clients. Assuming an average salary of 60K a year, you're at a billion dollars in outpatient therapists alone. The VA has budgeted only 11 billion dollars nationwide for mental health treatment. That doesn't leave a lot of room for inpatient treatment at the level that it needs to.
posted by corb at 8:37 PM on February 28, 2023 [23 favorites]
I'm going to talk about the VA system, because even though the VA system is on blast here, the VA system is not on blast to the extent that it should be, and the overall American system is not on blast to the extent that it should be.
The VA is designed to take care of all of America's veterans who are injured by their military service. In fact, it's not just designed, it's statutorily required to. For those who are considered as - as this gentleman was eventually designated - "100% disabled", they are required to be paid a stipend check for the remainder of their life and all of their healthcare is required to be covered.
Let me tell you, for those of you who are not aware, that a terrifyingly shocking number of America's veterans meet that standard, and that it is only getting worse as they age.
And let me remind you that we were at war for twenty years.
Conservative estimates suggest 2.5 million members served in Iraq and Afghanistan. 1.8 million veterans have some level of disability as a result.
The Department of Veteran Affairs currently accounts for 5% of all federal spending.
And if you've guessed what I'm here to tell you - it's not enough. The true appropriate cost of these wars is fucking *astronomical*. The VA can't bear it. The country could bear it, but it would have to buckle its belt and own its sins in a way that it is not prepared to do.
Most veterans with PTSD that I know prefer weekly sessions. The average therapist is encouraged to see not more than 30 patients a week, so that would be a caseload of 30 patients for each therapist. Assuming the extremely conservative estimate of 500,000 Iraq and Afghanistan vets with PTSD, that means VA would have to hire 16,666 therapists just to see the relatively healthy clients. Assuming an average salary of 60K a year, you're at a billion dollars in outpatient therapists alone. The VA has budgeted only 11 billion dollars nationwide for mental health treatment. That doesn't leave a lot of room for inpatient treatment at the level that it needs to.
posted by corb at 8:37 PM on February 28, 2023 [23 favorites]
When Nobel-winning economist Joseph Stiglitz estimated the true costs of the wars in Iraq and Afghanistan, he came up with a price tag of $1Trillion for the care and benefits due to soldiers who served — out of an overall coat of $3 Trillion.
posted by jamjam at 9:56 PM on February 28, 2023 [5 favorites]
posted by jamjam at 9:56 PM on February 28, 2023 [5 favorites]
Yeah this article also read to me as more of a condemnation of modern mental health treatment modalities and our inability to understand and properly treat refractory, extreme mental health issues. Even if they have perfect care conditions, the prognosis for for people experiencing what Ian Fishback was dealing with under the current care system is generally not good.
posted by Res0ndf7 at 12:39 PM on March 1, 2023 [2 favorites]
posted by Res0ndf7 at 12:39 PM on March 1, 2023 [2 favorites]
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I feel incredibly badly for whistleblowers because I can't think of a single whistleblower story I've ever heard where it didn't end extremely poorly for the whistleblower.
posted by jenfullmoon at 1:46 PM on February 28, 2023 [11 favorites]