Thursday, November 19, 2009

2007 Memo Criticizes Hasan - Professionalism and Judgment

The big question regarding Nidal Malik Hasan and the Fort Hood shootings: What did they know and when did they know it?

From CNN:

A memo reportedly written two years ago by Maj. Nidal Hasan's supervisor at Walter Reed Army Medical Center says the accused Fort Hood shooter demonstrated "a pattern of poor judgment and a lack of professionalism" during his residency at the hospital.

National Public Radio obtained what it said is a copy of the memo, posting on NPR.org a retyped version that the network said was a "transcript" of the memo and "not a facsimile or PDF of the actual document."

"The faculty has serious concerns about CPT Hasan's professionalism and work ethic," said the memo, signed by Maj. Scott Moran, the residency program's director. "Clinically he is competent to deliver safe patient care. But he demonstrates a pattern of poor judgment and a lack of professionalism."

Transcript of memo.
Hasan's supervisor at Fort Hood Army Post, Col. Kimberly Kesling, has said that Hasan's evaluations from Walter Reed contained some information that concerned her, but the concerns triggered an approach to integrate Hasan into the staff that she said had been successful.

"The types of things that were reported to me via his evaluation report were things that concerned me, but did not raise red flags toward this [the shootings] in any way, shape or form," she said, adding that Hasan "was doing a really good job for us."

...The memo obtained by National Public Radio said that Hasan, then a captain, was "counseled for inappropriately discussing religious topics" with patients and went through a remediation program for inappropriate documentation of his handling of a homicidal patient during an emergency room encounter.

The document said Hasan's remediation on that problem was successful but added that he was placed on administrative probation at the end of the year for not taking and passing the U.S. Medical Licensing Examination. He later corrected that problem as well, the memo said.

The memo also noted a poor attendance record and lower-than-expected scores on the Psychiatry Resident-In-Training Examination, a yearly exam that Hasan failed to take during one of his residency years.

Based on the information in the memo, it's hard to believe that, according to Hasan's supervisor at Fort Hood Army Post, Col. Kimberly Kesling, Hasan "was doing a really good job for us."

This memo is just one piece of the puzzle.

Of course, Hasan's lack of professionalism and judgment is of concern.

However, it's those contacts with al Qaeda that should have caused great alarm.


Video.


Transcript
CAMPBELL BROWN: Let's take a look at the contents and this memo that you obtained at NPR.

Again, this is from the director of Hasan's military psychiatry training program dated May 17, 2007.

DANIEL ZWERDLING, NATIONAL PUBLIC RADIO: That's right.

BROWN: I just want to read a little of it for people. "The Faculty has serious concerns about captain Hasan's professionalism and work ethic. Clinically, he is competent to deliver safe patient care. But he demonstrates a pattern of poor judgment and a lack of professionalism."

And then the memo goes on to list a series of reasons why.

Walk us through some of those reasons and your take on all this.

ZWERDLING: Essentially, what this memo says, despite that sentence about competent care, it basically says this guy was a lousy and potentially very dangerous psychiatrist to his patients.

He would be on call. He would be the guy the doctors would call in a psychiatric emergency, and he wouldn't answer his telephone. He mishandled a psychotic patient in the emergency room and essentially allowed her to escape from the emergency room.

At a time when psychiatrists and other mental health specialists at Walter Reed and hospitals around the country were overwhelmed with soldiers and other troops coming back from the war with serious mental health problems, this fellow, Nidal Hasan, saw almost no patients for his last year at Walter Reed. He saw about one patient per week.

Most psychiatrists were seeing 10 to 20 times that many. And this was his choice to see so few patients. And his supervisors and others say they kept reprimanding him over and over again. He was proselytizing to patients. He told at least one patient that Islam can save your soul.

But what's so extraordinary about this memo, I think, is that put his Islamic obsession aside. Put aside Hasan's apparently extremist Islamic views. What this memo is saying -- it's right there in the Army's official credentials file -- it is saying this psychiatrist could be reckless for his patients. He could be a danger to them. Yet, he kept getting promoted. And as we all know, he was sent to Fort Hood to treat some of the most vulnerable soldiers in the Army.


BROWN: And, in fact, Daniel, I know you talked to people about that specifically, people who treat PTSD. And there were real concerns about the fact that -- that he was handling soldiers who were in such a delicate frame of mind and the danger that that could have caused to them.

ZWERDLING: Today, I talked to several psychotherapists who have worked with the military or with troops. And I said to them, please forget for a moment that this is Nidal Hasan and that he has allegedly shot dozens of people at Fort Hood.

Suppose you got an application from a psychiatrist to get a job at your medical center, and the chief of Sheppard Pratt -- that's one of the most prestigious psychiatric hospitals in the country, near Baltimore -- he said, even if I were desperate to fill a psychiatry slot, if I got an evaluation on an applicant like Nidal Hasan's, he would never even get in the door for an interview. And another therapist who runs a big project treating soldiers in California -- it's called the Soldiers Project -- I mean, she said this almost borders on malpractice, the fact that they would -- that the Army would send a psychiatrist like Nidal Hasan to treat soldiers in a very vulnerable state.

When you come back from the war and you are falling apart, you are feeling suicidal, you need a therapist who you can trust 150 percent, not somebody who didn't show up on call, not somebody who let a psychotic woman escape from the emergency room. She said it is disgraceful.

Hasan told at least one patient that "Islam can save your soul."

That's more than a red flag. That's a king-size red sheet.

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