Togus Revisited

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I’ve written here and in the print edition of Down East about the VA medical center at Togus. My take, drawn largely from my own observations, has been strongly positive.

That has drawn a couple of responses from readers — a couple as in two, so far — which are striking in that they represent almost polar ends of the spectrum.

One gentleman named Lee, an acquaintance from years back when I was active in the Maine Writers and Publishers Alliance [2], called me at home to say he shared my high regard for Togus and the people who work there. “From the very beginning, I always got the sense that it was a warm, caring, welcoming place.” Lee now volunteers at Togus a few hours every week, helping out in the eye-care clinic. He’s got nothing but praise for the staff.

The other response came by e-mail from a gentleman who reports: “The truth about Togus is not as it seems.” Speaking from long personal experience, he recounts a series of problems including botched surgery, stonewalling by physicians, over-prescription of pain killers, refusal by staffers to release medical records, mistreatment of younger vets, and a relative who was forced to spend his savings on outside care because his treatment at Togus was woefully inadequate.

“I am not asking anyone to take my word,” this gentleman concludes, requesting that his name not appear in print, “because my treatment would ...drastically worsen.”

Now I am no expert in statistics, but even I realize that two opinions don’t constitute a meaningful sample out of a population of some 50,000 Mainers enrolled in the VA health system, roughly three-quarters of whom visit Togus regularly. Yet I would say this much: though they may represent extreme cases, neither of these personal stories strikes me as implausible.

One thing that stands out —  the biggest thing, perhaps — when you examine the history of the place is the jarring inconsistency of care and attention given to its patients over the years. These ups and towns have come mostly from budgets being alternately slashed, patched-up, and re-inflated. There was a time, shortly after its founding as a home for disabled Civil War vets, when Togus did not even have a full-time staff physician. There was another time, during the 1930s, when an ambitious building-and-hiring program turned the place into a “model federal city,” complete with post office, theater, chapel, recreation facilities, and weekend concerts on the grounds.

My friend Lee once had a waiting-room chat with an old fellow who’d served in the Civilian Conservation Corps during that area, and was part of the crew that planted the grand allée of pine trees lining the entrance drive.

From then to now, the cycle of boom and bust has continued — it’s really a cycle of remembering and forgetting, I think — as the nation’s attention has fixed upon, then wandered away from, its military vets. We’re on an upswing now, as “Support Our Troops” evolves into “Stand By Our Vets.” But not many years ago, from the 90s into the early years of this century, the local news media reported problems not at all unlike those reported by my e-mail correspondent.

I’d love to know more about this, because it seems to me increasingly significant. One lesson I draw personally, thus far, is that it’s possible for the government to do wonderful things in the field of health care (as in the field of planting rows of stately pines, or putting up buildings that still are handsome and functional after many decades). It’s also possible to royally screw the whole thing up. Which way it goes seems to depend on the extent to which we, the broader society, are willing first to take the matter seriously and give it our best shot, and then to pay the bills as they continue to arrive.