Silent Witnesses

1.

A couple of weeks after revelations that US Army specialist Alyssa Peterson's 2003 death in Iraq was a suicide, another story of suicide by a woman in the US military broke. Linda Michel's death received much less media attention, though it bears similarities to Alyssa Peterson's.

Linda Michel was a Navy medic in Camp Bucca, the largest US military prison in Iraq, holding over 6000 Iraqi detainees. She was from Clifton Park, NY, about twenty miles north of Albany, and had just returned home in October.

Last month, Jeanne "Linda" Michel came home from Iraq. Back in the suburbs, she tried to feel normal.

She'd been homesick for months. She couldn't wait to see her kids, ages 11, 5 and 4. Between her husband's deployment and her own, the children had been with just one parent for nearly three years.

She was 33, with a bright smile and stubborn determination. Reuniting should be easy. In another month, she'd be discharged from the Navy after five years of service.

"She had come through a lot and she had always risen to challenges," her husband, Frantz Michel, said last week. . . .

Two weeks after she got home to Clifton Park, Linda Michel shot herself to death, stunning her colleagues and family.

According to a special report by the Hartford Courant, suicides among Army personnel, alone, "reached an all-time high in 2005 when 22 soldiers killed themselves---accounting for nearly one in five of all Army non-combat deaths." The number of suicides by military personnel who have completed tours of duty has not been publicly tabulated.

Despite some obvious differences between the two stories, I believe there are some other similarities, beyond the fact that Peterson and Michel's deaths can both be seen as part of a disturbing trend.

Michel's death was probably preventable. She was one of many US personnel who have been prescribed psychotropic medications in combat zones in Iraq.

She saw a Navy doctor and was diagnosed with depression. The doctor prescribed Paxil.

Frantz Michel knew his wife's days were long and grueling. But he didn't know about the Paxil.

Studies have linked Paxil to adverse effects, including suicide, sparking an FDA warning in May.

When Linda came home, the Navy discontinued her medication. Again, Frantz Michel wasn't told.

"I just wish the Navy would have done some more follow-up, instead of just letting her come home," said her husband, Frantz, who is on the division staff of the Army National Guard.. "If somebody needs Paxil in a combat zone, then that's not the place for them to be. You either send them to a hospital or you send them home and then make sure that the family members know and that they get follow-up care."

There are not as yet any indications that Alyssa Peterson was diagnosed or treated for mental illness or that there was any other information that could have helped others prevent her suicide. Michel committed suicide after returning to the States, and she was a medic, not an interrogator.

Yet as a medic Michel was very likely to have had comparable direct experiences of the kinds of abuse that so disturbed Peterson.

2.

Overcrowding, prisoner riots, understaffing, insufficient resources and poor security conditions at Camp Bucca were sure to have confronted Linda Michel with human rights quandaries.

One medic (referred to as "#95") interviewed for the Army Surgeon General's 2005 Assessment of Detainee Medical Operations [PDF, 8MB] reported that

the only medical supplies he was allowed to deploy with were those on the MTOE [Modified Table of Organization and Equipment] and included only his aid bag and no medications (not even Tylenol). #95 felt the packing list for the aid bag was inadequate. #95 reported that he and the other medic in his unit were told by their company that they would always be with a hospital and have medical supplies provided to them in theater. #95 stated that he used all of the resources he had on the detainees and did not have enough for US soldiers at times. Before Dec 2003, #95 had to drive to Kuwait to pick up supplies for US soldiers and detainees.

Basic scarcities of resources meant medical neglect. Master Sergeant Lisa Girman* said that she "saw ... skin actually grow over stiches on a man's head because they weren't taken out in time."

Unmanageable security conditions lead to numerous abuses. For example, Amnesty International found that

Memos obtained by the ACLU in December 2004 under Freedom of Information Act requests, for example, revealed that four members of a US special operations unit in Iraq had been disciplined for excessive force, including improperly using tasers on prisoners. According to the memos, dated June 2004, detainees held in Iraq often arrived at prisons bearing "burn marks" on their backs. An eye-witness told Amnesty International about a more recent incident in November 2005 in which two detainees were shocked with tasers used as stun guns while they were being transferred to a medical facility within Camp Bucca in Iraq (emphasis added).

And then there were the abuses directly associated with the US interrogation regime:

• [I]nternees at Camp Bucca are alleged to have been exposed deliberately to extremes of both heat and cold, by being made to wait for hours in the heat of the sun while their accommodation was searched and forcibly showered with cold water and exposed to cold air conditioners. (Amnesty International)
• Psychotic detainees were being held in Connexes in 130 degree temperatures, lying in own urine and feces. (Army Surgeon General's Assessment of Detainee Medical Operations [PDF])
• [Medical personnel] stated that a detainee reported he was dragged by chains around the compound by a HMMWV. (Ibid.)
• In . . . Camp Bucca, the ICRC found that hooding was "part of standard intimidation techniques used by military intelligence personnel to frighten inmates into cooperating." (Amnesty International)

Some abused deatinees were denied medical treatment. In at least one case (at Abu Ghraib), doctors treated detainees so they could then be tortured more [PDF]:

[T]hey brought young Iraqi prisoners and Grainer tortured them by pouring water on them from the second floor until one of them started crying and screaming and started saying "my heart." They brought the doctors to treat him and they thought he was going to die. After they brought six people and they beat them up until they dropped on the floor. . .

The Army Surgeon General's Assessment records a range of other inappropriate requests made of medical personnel:

• 17 of 436 of interviewees had been asked to delay an initial medical examination until after an interrogation.
• 32 of 495 were asked to be present during interrogations.
• 2 of 793 fluent in Arabic served as translators during interrogations.
• One interviewee fluent in Arabic was asked to gather intelligence for
  interrogator.
• One physician was asked to feign evaluations and treatment on detainees by
• doing a DNA test from a hair sample
• doing a DNA test from a buccal swab
• providing cough syrup but informing the detainee it was truth serum.
• The physician complied with the first two requests, but refused to comply with the third. He thereafter refused any further involvement by himself or any of his medical personnel.
• One medic agreed to gather intelligence upon developing a rapport with
  detainees.

A significant omission in the Army Surgeon General's Assessment is who was doing the asking. Were these requests made by poorly trained Military Intelligence personnel with insufficient oversight? Or were the requests made by Military Intelligence and CIA operatives, authorized by Rumsfeld's Special Access Program (SAP), to operate outside the military command structure, without the knowledge of the officers in charge of Camp Bucca, Abu Ghraib, Camp Cropper and elsewhere?

If any of the documented requests are traces of Rumsfeld's SAP, then we are probably only scratching the surface, since units operating under the SAP are exempt from investigation.**

3.

In her article "A Utilitarian Argument Against Torture Interrogation of Terrorists," psychologist and interrogation ethics expert Jean Maria Arrigo argues that

The use of sophisticated torture techniques by a trained staff entails . . . problematic institutional arrangements . . . : physician assistance; cutting edge, secret biomedical research for torture techniques unknown to the terrorist organization and tailored to the individual captive for swift effect; well trained torturers, quickly accessible at major locations; pre-arranged permission from the courts because of the urgency; rejection of independent monitoring due to security issues; and so on. These institutional arrangements will have to be in place, with all their unintended and accumulating consequences, however rarely terrorist suspects are tortured.

(Science and Engineering Ethics, Volume 10, Issue 3, 2004; available here in slightly different form.)

Rejection of independent monitoring occludes the range and extent of medical personnel's involvement the CIA's use of "enhanced techniques." There is, however, documentation of the assumed involvement of military medics in the interrogation process. The Interrogation Rules of Engagement [PDF]***, which interrogators signed to affirm their understanding of their obligations, include a series of interrogation approaches requiring authorization of the Combined Joint Task Force Seven Commander, Ricardo S. Sanchez:

Change of scenery down - full plan with location and security measures
Dietary manipulation - minimum bread and water, monitored by medics
Environmental manipulation - i.e., reducing AC in Summer, lower heat in winter
Sleep adjustment - reverse schedule - allowing detainee to sleep during day and stay up at night
Isolation - for longer than 30 days (within the approved CPA holding facility)
Presence of working dogs - coordinate with mil working dogs, and time limitations
Sleep management - for 72-hour time period maximum; monitored by medics
Sensory deprivation - for 72-hour time period maximum; monitored by medics
Stress positions - no one position for longer than 45 minutes, within a 4-hour time period.

(Emphasis added.)

Having medics monitor dietary manipulation, sleep management and sensory deprivation would presumably be justified as a measure to ensure the safety of detainees. But as with all other health professional monitoring of interrogations, this amounts to calibrating pain and abuse. How hungry does a detainee have to be before it is abuse? How disoriented by sleep management? How close to psychosis from sensory deprivation?

4.

Linda Michel worked as a Navy medic at Camp Bucca, near Umm Qasr in southern Iraq. She was forced into a land-based combat area because of the general shortage in US Army personnel. She cared for soldiers injured in battle and for detainees held at Camp Bucca, "the coalition's primary facility for enemy prisoners of war."

The camp was named after Ron Bucca, a New York fire marshal and Army Reservist who died in the Sept. 11, 2001 attack on the World Trade Center. Envisioned as a temporary place to hold Iraqi prisoners of war, the camp was emptied and closed by December 2003. However, Iraq's postwar insurgency created the need for a place to house thousands of suspected insurgents, and commanders turned to Camp Bucca to supplement the facilities at Abu Ghraib prison outside Baghdad.

The US Army textbook Military Medical Ethics has a chapter on "Medical Ethics on the Battlefield," written by Thomas E. Beam, Colonel (Retired), Medical Corps, US Army and Medical Ethics Consultant to the Army Surgeon General. In his introduction, Beam writes [PDF]:

[I]t is impossible to imagine a more challenging environment in which to practice medicine than on the battlefield. It is the antithesis of the ideal medical setting. It is violent. It is noisy. It is chaotic. It is in constant flux. And it is unpredictable. Lack of creature comforts is the least of the problems faced. Noise levels prevent normal aspects of patient care. Rapid movement, often on little or no advance notice, requires treatment facilities to be set up and taken down very quickly. Patients can arrive before preparations are completed. Medical personnel, as well as patients, suffer from the fatigue and filth.

At Camp Bucca and other US military prisons in Iraq, Linda Michel and her colleagues treated a largely civilian population of detainees, 70%-90% of whom were arrested by mistake. Most of the injuries she'd have witnessed among the detainees would have been products not of combat on the "battlefield" but of unhealthy prison conditions and abuse inside the military prison.

On top of providing care to a vast population of unjustly imprisoned civilians in a dangerous and volatile environment, there were numerous junctures at which medical personnel might be asked to participate in interrogations, conducted by interrogators who were licensed to torture:

• examinations and treatment prior to interrogation
• presence, examination or treatment during interrogation
• examination or treatment after interrogation
• concealing facts after interrogation

In an online tribute to Linda Michel, her Camp Bucca roommate, Tammy Cartwright, said:

I had a rough time dealing with the Comand [sic] and other issues. Linda knew this and she was there for me. She was the one that helped me get out of bed every morning when all I wanted to do was give up and go home."

Linda Michel was an active Navy veteran due to be discharged November 8, 2006.

Linda Michel was a beloved wife, mother, sister, daughter and aunt.

Linda Michel was a housewife and homemaker and a communicant of St. Mary's Church in Crescent.

Linda Michel loved her country.

[Cross-posted at Never In Our Names.]

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RELATED POST
Alyssa Peterson's Suicide

NOTES
* Lisa Girman was at first convicted and later cleared of prisoner abuse charges at Camp Bucca.

** Physicans for Human Rights [PDF] has said that "The Surgeon General’s inquiry was far too narrow and limited to support definitive conclusions about the full extent of physician and other health personnel involvement in coercive and harmful interrogations."

*** Interrogation Rules of Engagement is pulled from memos collected with the testimony of Col. Thomas Pappas [PDF, 3MB], commander of the 205th Military Intelligence Brigade at Abu Ghraib. This and many other documents from Major General Anthony Taguba's investigation into the abuse of detainees are available at the Center for Public Integrity.