Hope in Vets Administration, despite turnover

Recent events concerning a possible fourth Secretary of the Veterans Administration in as many years should be a cause for concern. After all, this is a sprawling federal health care system with more than 360,000 employees, caring for more than eight million veterans across our vast nation. But as one of these employees, I’ve followed this story with little consternation. This, despite myriad colorful texts, urgent calls, and widespread virtual hand-wringing on social media. With nearly 20 years of experience as a primary care physician in the VA and 10 years as an administrator, I’d been through this before.

I wondered if my lack of feeling was actually something more ominous, like learned helplessness. The ennui of a federal worker, perhaps, an inevitable form of detachment bred by long-term exposure to bureaucracy? Or worse yet, strong signs that I was burned out like so many of my fellow primary care physicians?

I couldn’t help but think about a Marine Corps veteran I’d seen earlier in the day, Mr. P, a lanky, 89-year-old who served in WWII and then went on to become an Emmy-winning political writer and documentarian. He didn’t mention any of his successes, in fact, he barely mentioned the severe right shoulder pain he’d endured in the week since he’d fallen. Instead, he spent more time asking me about my daughters, my wife’s well-being, and catching me up on current events. This had been his decadeslong pattern during our relationship, regardless of whether his arm might be broken or he was having angina. As he left my office that day, I knew that he’d given both me and our country more than we would ever given him.

Much of what has recently been written would indeed have you believe that I am disengaged, that I am merely one of 360,000 “typical” VA employees. The number itself, 360,000, is now used more often to garner headlines about the breadth of brokenness and the scale of a shambling federal agency, rather than who we actually are.

VA employees are a diverse group of men and women. A third of us are veterans. We sweep floors, paint walls, put up new buildings, and patrol our facilities. We lose our lives in the line of duty. We transport patients, perform operations, counsel and console. We treat high blood pressure, PTSD and depression. We teach, innovate and sometimes give hugs. We do this every day, many of us, for decades.

I thought back to the Marine I’d seen earlier in the day, his misshapen shoulder, his cool, pale skin, the layer upon layer of clothing he wore to keep his thin, aging frame from the cold. In those moments, holding his arm, I could not have been more attached to the importance of my work. I was not broken or burned out. I cared.

Instead, like 359,999 of my fellow workers, I have developed an indefatigable tolerance for bureaucratic whims. I fill the chasm between Washington and my VA exam room with a commitment to serve veterans. I do this even in times of change and uncertainty. I navigate the policy du jour.

I relish the times our health care system functions smoothly, and I fight when it does not. And while I may hope for strong, stable leadership, my vocation and my institution are inured to this chaos.

So next year, I think I’ll turn off my phone and miss the annual uprooting of my VA Secretary. Either way, I’ll always have Mr. P. to fill me in on current events.