Surviving war, only to die suffering

Woeful staffing at facility dedicated to veterans results in virus’s unchecked spread.

HOLYOKE, MASS. — In 1945, James Leach Miller returned from the war and said nothing.

He said nothing about it to his wife, not for 64 years of marriage. He folded up his Army uniform, with the medals still pinned to it, and put it in the basement, where his older boy would sometimes take it out to play soldiers.

He joined the fire department. He went to church on Sundays. He never complained.

“That generation, they didn’t air their problems,” said his younger son, Michael Miller. “He would say, ‘It was not a good time. I’ve had better times.’ He would not embellish.”

James Miller was already in his 70s when he began to tell Michael Miller, an Air Force flight engineer, little bits about landing on Omaha Beach on D-Day.

“Fragments would come out,” his son said.

Michael Miller once offered to take him back to Normandy — World War II veterans were making the journey — but his father shook his head and said, “I’ve been there once.”

This story comes up for a reason. James Miller, 96, who survived what was for Americans the bloodiest battle of World War II, died of complications from the

coronavirus March 30 inside the Holyoke Soldiers’ Home. The virus has spread in more than 40 veterans’ homes in more than 20 states, leading to the deaths of at least 300 people.

The conditions inside the 247-bed, state-run home, where Miller had lived for five years, were so chaotic that his children cannot recount them without breaking down.

When Miller lay weak and gasping that weekend, his two daughters, in a car in the parking lot, pleaded with a nurse on duty over an iPhone to give him morphine or atropine to relieve his suffering.

“She said, ‘We can’t do it,’ and she started to cry,” said his daughter Linda McKee. “There was no one there giving orders.”

Michael Miller, at his father’s bedside, did the only thing he could do: moistened his lips with a sponge on a wooden stick.

“At that point, he was choking,” McKee said. “He died with no care whatsoever.”

The question of what went wrong at the Holyoke Soldiers’ Home will be with Massachusetts for a long time.

With scarce protective gear and a shortage of staff, the facility’s administrators combined wards of infected and uninfected men, and the virus quickly spread through a fragile population.

Of the 210 veterans who were living in the facility in late March, 89 are now dead, 74 having tested positive for the virus. Almost three-quarters of the veterans inside were infected. It is one of the highest death tolls of any end-of-life facility in the country.

Multiple investigations have been opened, several of which seek to determine whether state officials should be charged with negligence under civil or criminal law. The facility’s superintendent, Bennett Walsh, a retired Marine Corps lieutenant colonel with no nursing home experience, was placed on administrative leave March 30.

But many in the state are revisiting decisions made since 2015, when a moderate, technocratic Republican governor, Charlie Baker, was elected on a promise to rein in spending.

The facility’s budget increased by 14% through the past five years, according to a spokesman for the state’s health department. Even so, there were persistent shortfalls in staffing, and the local unions complained that workers were frequently pressured to stay for unplanned double shifts. The facility’s previous superintendent stepped down in 2015, declaring that the home could not safely care for the population on the existing budget.

All this was well-known before the coronavirus arrived in the state this spring, said Erin O’Brien, an associate professor of political science at the University of Massachusetts, Boston.

“All these regular Massachusetts folks that are now outraged — I don’t disagree, but veterans programs require funding,” she said. “When you vote to shrink government, it has ramifications.”

Soldiers’ Home had passed three successive yearly inspections, meeting or provisionally meeting the standards set by the U.S. Department of Veterans Affairs. But the union representing most of the staff warned persistently that the facility was operating at 80% staffing levels.

“They were trying to do their jobs,” McKee said of the staff. “They just didn’t have the means.”

By March 14, the home was closed to most visitors, like most nursing facilities in the state. By the third week of March, one-quarter of the staff was not reporting to work, Walsh has said. To accommodate the low staffing, medical staff decided to consolidate two units. Walsh has said his superiors approved that decision and were routinely updated on the distress the facility was in.

Baker has said little about these assertions, citing an ongoing investigation.

Miller died March 30, on the day when a cascade of scrutiny began to fall on the facility. From his father’s bedside, Michael Miller could see a group of public health officials making their way through the units. But his attention was with his father, who was breathing but no longer responding, and the strangeness of surviving Omaha Beach, only to die that way.

“That’s the irony: He landed on Normandy beach, and your chances of survival weren’t great,” he said. “And he made it.”