When President Obama named retired Gen. Eric Shinseki as Veterans Affairs secretary in 2009, the announcement took many by surprise. Shinseki, a West Point graduate who was wounded in Vietnam, had retired as Army chief of staff in 2003 after famously clashing with then-Defense Secretary Donald Rumsfeld over the size of the postwar occupation force that Iraq would need. (History would prove Shinseki right and Rumsfeld spectacularly wrong.) At the VA, Shinseki oversees a massive bureaucracy struggling to cope with the demands of wounded veterans returning from the wars in Iraq and Afghanistan. National Journal Senior Correspondent James Kitfield spoke with him on the eve of Veterans Day. Edited excerpts from their discussion follow.
NJ Chief of staff of the Army is generally the pinnacle of a military career. Why did you decide to return to duty in Washington?
SHINSEKI President Obama asked that I do two things: take better care of our veterans and change Veterans Affairs into a 21st-century organization that everyone can be proud of. I also took this job because you don’t often get “do-overs” in life. For me, this job is a big do-over, because I get to take care of people I served within Vietnam as well as people whom I sent to war as Army chief of staff.
NJ Today, more than 400,000 service members suffer from posttraumatic stress disorder by one estimate; 168,000 of the wounded are graded “60 percent disabled” or higher; and the military has historically high rates of substance abuse, divorce, and suicide.
SHINSEKI There is no such thing as a good, long war.… Certainly, today’s conflicts have taken a toll—not only in visible injuries but also in invisible injuries. As we learned after Vietnam, combat veterans
who go untreated can develop PTSD as late as eight or nine years after the conflict. Just short of 3 million service members joined since 9/11, and about 1.25 million of those have already left the services. In the next five years, we expect an additional million service members coming out of Iraq and Afghanistan to separate and join the ranks of veterans.
NJ Is that rapid growth in the veteran population partly responsible for the VA’s backlog of roughly 492,000 cases in benefits claims?
SHINSEKI Veterans of Operation Enduring Freedom and Operation Iraqi Freedom account for about 93,000 claims in that backlog—which is significant, though not a majority. When I made a decision to settle Agent Orange claims from Vietnam, it added 250,000 claims to an already beleaguered system. But I decided it was the right thing to do. We have also made significant investments in automation that are allowing us to push a lot more claims through the system, but the demand continues to grow.
NJ The enemy’s weapon of choice in Iraq and Afghanistan is the improvised explosive device. How has the VA adapted? What have you learned?
SHINSEKI We learned that there’s still quite a lot we don’t understand. We have a program called Emerging Consciousness that treats the most challenging comatose patients. We put together a treatment regimen that includes things as simple as having a family member holding their hand and acting as that quiet voice of reassurance, or music simulation, and [we] combine that with medicinal treatments. The combination differs with the individual cases. But in almost 70 percent of these cases, comatose patients we might have almost given up on in the past have come out of their vegetative state. It’s a slow process that might start with an eye blink, or a thumbs up, or a single stroke on a keyboard.
NJ What have you learned about PTSD?
SHINSEKI We estimate that somewhere between 10 and 18 percent of combat veterans will develop full-blown PTSD. It shouldn’t surprise anyone that if you have early diagnosis and treatment of these mental issues, there is a good chance the condition will improve. Treatment can be challenging, however, because you’re dealing with young 20-something Americans who think they are invincible and who may resist treatment for mental problems because they think it demonstrates vulnerability or carries a stigma. Along with the Department of Defense, we’re working hard to remove that stigma.
NJ What can you do for the veterans who return from war and can’t find jobs?
SHINSEKI Employers and colleges shouldn’t be alarmed by concerns about PTSD. These kids are just the kinds of people you would want in any business enterprise. They are creative people who know how to solve problems and are expert and practiced team-builders.… I’ve also had responsibility for implementing the new GI Bill. Quite frankly, beginning in 2009, we had a rocky start. But that year, I put 178,000 kids in colleges and paid their tuition with a pencil-and-paper system. Today, we have 800,000 veterans in college-level programs with a fully automated system for paying their tuition—and few of the complaints we used to hear all the time.
This article appears in the November 12, 2011, edition of National Journal Magazine.