Shimkus, Albert - Interview master file / Witness to Guantanamo / Duke Digital Repository

Interviewer

Okay, good morning.

0:05

-

Good morning.

0:07

Interviewer

We are very grateful to you

0:08

for participating in the Witness to Guantanamo project.

0:09

We invite you to speak

0:13

of your experiences and involvement at Guantanamo Bay, Cuba.

0:14

We are hoping to provide you

0:20

with an opportunity to tell your story in your own words.

0:21

We are creating an archive of stories

0:25

so that people in America and around the world

0:27

will have a better understanding of what you and others

0:30

have observed and experienced.

0:34

Future generations must know what happened at Guantanamo.

0:37

And by telling your story,

0:41

you're contributing to history.

0:42

We appreciate your courage and willingness speak with us.

0:44

If at any time during the interview you'd to take a break,

0:48

just let us know,

0:50

and if there's anything you say you'd like

0:51

to have removed,

0:53

just let us know and we can remove it.

0:54

-

Sure.

0:55

Interviewer

I'd like to begin

0:56

by asking your name and hometown

0:57

and date of birth and age.

1:00

-

Sure.

1:03

Al Shimkus, born in Washington, DC.

1:04

Hometown is Hopedale, Massachusetts

1:06

Born in April 1945.

1:09

Interviewer

And do you mind my asking

1:13

your marital status

1:15

-

Married.

1:16

-

and your children?

-

Three children, seven grandchildren.

1:18

-

Congratulations.

1:22

-

It's nice.

Interviewer

And a little bit about your education

1:23

and background work.

1:26

-

Sure.

1:30

I was, as many are in our age group,

1:31

we're in the Vietnam era,

1:36

and so I avoided the draft by joining the Air Force.

1:37

And by being drafted into the Army.

1:40

I thought the Air Force was a good deal,

1:43

but I was immediately sent to Vietnam,

1:44

1967 to 68 as a medic.

1:46

I was in Benoit.

1:50

And during the Tet Offensive,

1:51

and saw the, even though an Air Force medic,

1:53

I saw the carnage of conflict and war

1:57

in that brief time in my life.

2:01

And I left Vietnam thinking

2:03

I wouldn't want to ever be

2:07

in that kind of environment again and left the Air Force,

2:09

not ever wanting to return to the uniform service

2:13

of the country.

2:16

Interviewer

Were you trained as a medic

2:17

before you went to Vietnam?

2:18

-

Oh, yes.

2:19

I was trained as a 9205 or 7,

2:20

the Air Force code for medic.

2:24

Interviewer

So what kind of education did you have

2:27

in terms of your medical background?

2:30

-

Simply Corps School or medic training, you know

2:33

six to eight months then

2:36

-

in civilian life?

-

No, in the Air Force.

2:39

Interviewer

I know but,

2:40

you never got any civilian training?

2:41

You're a nurse, right?

2:44

-

I'm a nurse anesthetist.

2:45

Oh, that's afterwards.

2:46

Interviewer

Oh, okay.

2:47

-

Okay, so I left, I left the Air Force

2:48

and met and married my wife

2:51

in 1967, in 68,

2:54

and then went back to finish school,

3:00

in which I didn't do very well,

3:02

not being mature,

3:05

I didn't do very well in school.

3:06

So I went back and completed my associate degree

3:08

at a community college and then was thinking

3:10

about stability for my family.

3:12

At that point, we had one son.

3:15

And so I took the courageous leap of being one

3:17

of the first men in a nursing program at

3:22

Memorial Hospital School of Nursing

3:24

in Western Massachusetts.

3:26

My wife is an RN and I saw what she did and how she felt

3:27

about her profession and decided I would try to do that.

3:32

So a Vietnam acquaintance and I decided

3:35

that we weren't going to do it by ourselves.

3:40

So he and I went to nursing school together,

3:41

a three-year program in Worcester,

3:45

graduated, passed my boards,

3:48

and immediately went to Salem Hospital School of Nursing,

3:50

got my baccalaureate degree in nursing,

3:52

and then for the next couple of years,

3:55

taught in a school of nursing in Salem, Massachusetts.

3:58

Based on my experience and maturity,

4:01

I guess they felt that would be a good faculty member.

4:04

And I enjoyed it completely except

4:05

that the nursing school closed based on fiscal constraints.

4:07

And so we were thinking about what to do,

4:11

and so I obviously wanted to go back

4:13

into a stable environment for my family.

4:16

At that point, we had two children

4:19

and I didn't really enjoy

4:21

being a clinical bedside nurse,

4:25

but I did enjoy teaching,

4:26

but it wasn't paying very well.

4:28

So I thought about going back in the Air Force

4:29

and they said, "Great.

4:31

We would love to have you come back in the Air Force

4:33

except that you're going to go

4:35

to Maida, North Dakota for your first assignment.

4:37

And I said, "Well, maybe not.

4:39

I'll go over and see what the Navy has to offer."

4:40

So I went over to the Navy and they offered me

4:43

at the Naval Academy Hospital down in Annapolis, Maryland.

4:45

And there was a much better opportunity for me.

4:47

So I became a JG.

4:50

Interviewer

Which is?

4:51

-

Lieutenant JG in the Nurse Corps.

4:53

Interviewer

What is a JG?

4:55

-

Lieutenant junior grade in the Nurse Corps.

4:56

Interviewer

Okay.

4:58

-

It's like a first lieutenant.

4:59

And so our first assignment was great.

5:00

I was picked up almost immediately

5:03

for the Navy Nurse Anesthesia program,

5:05

after two years of service

5:09

and went to George Washington University

5:11

and studied nurse anesthesia

5:13

and became a nurse anesthetist

5:15

in 1980

5:18

and practiced anesthesia until I retired in 2007.

5:22

Interviewer

So you don't,

5:29

you don't need a medical degree to practice anesthesia.

5:30

-

No, there are two separate professions

5:32

who provide anesthesia to patients.

5:36

One is the physician anesthesiologist

5:38

and one is the nurse anesthetist.

5:41

In my personal view, the nurse anesthetist is

5:43

a better deal,

5:45

better for the dollar.

5:46

We do exactly the same practice,

5:50

but I'm a certified registered nurse,

5:51

passed the state board exams and so forth.

5:53

And I practice the range of anesthesia as a physician does.

5:55

And in the Navy at that point early

5:59

we were independent practitioners.

6:01

So we practiced without physician,

6:02

an anesthesiologist.

6:06

So over my career,

6:08

I've been deployed on aircraft carriers

6:09

and amphibious ships with the Marines,

6:11

practicing anesthesia in a solo capacity.

6:15

And that was the majority of my practice.

6:19

Interviewer

And why is the word surgeon attached

6:21

to your name or bio,

6:24

where is that coming from?

6:27

-

It's simply a term.

6:28

It's a billet.

6:29

So a nurse, a physician, a medical service Corps officer,

6:32

or a dentist could be a Joint Task Force Surgeon.

6:36

It's simply a title.

6:40

It's not a skill.

6:41

It's a leadership skill but not a medical skill.

6:43

-

Well, that explains

6:46

-

so

-

To capsulate how I got to Guantanamo,

6:50

I decided that I would like to do something

6:54

outside of medicine,

6:58

so I was selected to go to the Naval War College

6:58

as a student in 1992.

7:01

And that's where I met General Leonard,

7:05

as a classmate in 1992

7:07

at the Naval War College in Newport.

7:09

Got my master's degree in National Security Studies

7:11

and I was then sent after graduation

7:14

to the Naval hospital at Guam

7:16

to be the Director of Nursing.

7:19

Once I did that tour, I was invited back

7:21

to the War College to be a faculty member

7:24

based on what they had seen as a student.

7:27

So I was a faculty member for two years

7:28

at Naval War College from 1995 to 97.

7:31

And then I was selected for Navy Captain,

7:35

like a Colonel,

7:38

and was also selected to be the Executive Officer

7:39

of Naval Hospital, Naples Italy.

7:42

And I taught two years

7:44

at the Naval War College,

7:48

screened for XO

7:50

and became Executive Officer Naval Hospital Naples

7:53

from 1997 to 2000.

7:55

And then was screened and was selected to

7:59

be Commanding Officer

8:00

of Naval Hospital at Guantanamo 2000-2003.

8:01

Interviewer

I want to get into that,

8:07

just curiously,

8:08

what were you teaching at the Navel Academy?

8:09

-

National security strategy.

8:11

Nothing to do with medicine,

8:13

but they found that I had a ability

8:14

to talk about issues

8:19

from a staff corps perspective and, you know, medicine

8:19

and nursing and engineers and lawyers

8:21

are staff corps officers.

8:24

And they felt that, the War College felt that

8:25

it would be good to have a staff corps officer

8:28

teaching national security

8:30

because we look at things differently

8:31

than the line officer does,

8:33

whose profession is prosecution of violence.

8:35

And from a staff court perspective,

8:38

they felt that we didn't soften things,

8:39

but certainly looked at the same situation differently

8:42

than a line officer would.

8:44

And so there was value for the student listening

8:46

to what we were teaching.

8:49

In addition to what they're receiving

8:52

from the line officer faculty.

8:54

Interviewer

Was that one of the reasons

8:55

that you were selected

8:57

to be the Chief Medical Officer

8:58

in Guantanamo at that early time?

9:02

-

No, probably not.

9:04

You would think that would be the case,

9:05

but it was simply a matter of being there at the time.

9:06

It had nothing to do with my background most likely.

9:09

I was there, available, the other guy.

9:11

Interviewer

Well, okay.

9:15

So when were you selected for Guantanamo?

9:15

What's the date?

9:19

-

I was selected to be the Commanding Officer

9:20

of the Naval Hospital at Guantanamo

9:24

in probably mid 1999

9:26

when I was Executive Officer of Naval Hospital, Naples,

9:31

like the COO of Naples.

9:34

And then,

9:37

so we were in Guantanamo about 18 months prior

9:38

to the mission, the JTF coming on board.

9:41

So I was simply the Commanding Officer of Naval Hospital,

9:44

Guantanamo from August of 2000

9:47

to August of 2003.

9:51

And the detaining mission began about December 2001.

9:55

Interviewer

So when were you informed

9:59

that detainees were going to be coming to Guantanamo?

10:01

And how did you react to that?

10:04

Maybe you could just tell a story about it.

10:08

-

Sure.

10:10

The base commander and I,

10:13

whom I'll give you his address and phone number

10:15

and email address became very close during our time

10:17

in Guantanamo together.

10:21

He got there a little bit before I did.

10:22

As base commander,

10:24

he was responsible for the entire base

10:25

on Guantanamo.

10:30

And he and I became very close and we ran together

10:31

almost every day.

10:34

And so 9/11 happened and we had no idea

10:36

that anything would be related to Guantanamo from 9/11.

10:40

In fact, we trained for a marathon

10:45

and we ran the Marine Corps Marathon in October of 2011

10:47

and ran around the Pentagon and see all the destruction

10:51

and the things that have occurred there.

10:55

It was very moving for us to have run the marathon

10:56

and then being part of the uniform military

10:59

also running past the Pentagon where the casualties were

11:02

from the airplane.

11:05

And so we finished the marathon,

11:07

went back to Guantanamo

11:10

in late October,

11:11

and then the press started to speculate about detainees

11:13

and where they would be if captured,

11:18

where would they be brought

11:20

into a US controlled environment.

11:21

And we knew detainees are being detained

11:25

in Afghanistan

11:28

and then the press began to speculate about where

11:31

and it became obvious that Guantanamo was one

11:33

of the places that was being considered

11:36

by the administration.

11:37

And then a least worst place started

11:38

to become more talked about.

11:40

And so I guess we learned in the neighborhood

11:44

of probably late November, early December

11:46

that Guantanamo was going to be the place that.

11:49

Interviewer

How did you learn that?

11:52

-

I think it was through message traffic and the press.

11:54

Each reinforcing the other.

11:59

Interviewer

And no one then came

12:03

to you and said be prepared.

12:04

-

Oh, certainly.

12:07

In the medical chain of command, I was responsible

12:09

to the Bureau of Navy, Bureau of Medicine and Surgery

12:14

in Washington DC from the medical chain of command.

12:19

I was responsible to the base commander

12:22

and the Navy chain of command in a line environment.

12:25

And we're also under the auspices

12:29

of SOUTHCOM, Southern Command, which was responsible

12:31

for Guantanamo and areas south of Guantanamo.

12:35

And so I think we got a call,

12:38

Bob Yuen and I got a call from SOUTHCOM

12:40

that Guantanamo was being selected

12:43

for the detention facility.

12:46

And teams began coming down to Guantanamo

12:50

to evaluate the physical ability

12:54

of Guantanamo to to accept the detainee population.

12:59

Now, Guantanamo has a long history

13:02

of receiving human beings

13:03

in need from Haitian and Cuban migration situations.

13:07

So the infrastructure that existed on Guantanamo

13:10

was certainly,

13:14

the sewer and water facilities,

13:17

we made our own water, made own electricity.

13:18

So we're independent from any other outside source.

13:20

So physically

13:23

we could manage the detainee population,

13:26

no matter what numbers would come in.

13:28

And so finally, the physical idea

13:32

of the detention facility was established.

13:37

X-ray being the first place

13:40

that detainees were being brought

13:43

from the air strip

13:47

because that's where the most secure place

13:51

was on the base

13:54

as the detention facility was being built.

13:54

X-ray was the most secure place

13:58

where the worst of the Haitian migrants

13:59

were being housed.

14:04

Those who had a criminal record were in x-ray

14:05

during that period of time.

14:08

And so it was a reasonably secure place,

14:10

away from the main population of the base,

14:12

which began the process,

14:15

the incoming detainee population.

14:17

Interviewer

But from your side,

14:20

what were you doing while the x-ray

14:21

was being refurbished so that it could house the detainees?

14:24

What were your responsibilities?

14:28

-

It was an interesting dynamic

14:32

in that Bob Yuen and I

14:35

were in an environment

14:40

in which was a Caribbean paradise, essentially.

14:43

It was a wonderful place to be.

14:47

Our families enjoyed being there.

14:49

As Bob will tell you,

14:51

it was a Mayberry kind of community

14:52

in which we had the lifestyle

14:55

that one would want in a Caribbean environment.

14:58

Beautiful day every day,

15:03

we had a great school system.

15:04

We had a great opportunity to be with our families.

15:05

It was just a very laid back kind of place.

15:10

With the advent of the mission,

15:13

the things that I thought about

15:19

from a medical perspective was

15:20

I had a community hospital essentially,

15:21

prior to the detainee population coming on board.

15:24

And we had single specialists

15:28

in surgery, anesthesia, pediatrics, obstetrics,

15:30

but a very small community hospital

15:37

as you would have in rural America.

15:38

And so anybody that even suggested

15:40

that there were going to be ill,

15:43

or medically ill, surgically ill,

15:45

we arranged for AirVac

15:48

into Miami to treat them

15:50

because we simply couldn't sustain a significantly injured

15:54

or ill patient in Guantanamo

15:57

and be certain of the outcome.

16:00

In the standard of care

16:03

that military medicine practices,

16:04

we think it's equivalent to

16:07

and sometimes better than what would be offered

16:08

in an equivalent civilian hospital.

16:11

So our base population knew that

16:13

if they become seriously ill,

16:15

I had the ability to call on an airplane

16:19

and get them off the island within hours.

16:21

So my concern was,

16:24

and I was being directed by SOUTHCOM,

16:25

who was in turn being directed

16:30

by the Department of Defense

16:31

that as the detainees came on board,

16:33

there would be no safety valve, if you will,

16:36

for detainees who were either medically

16:40

or surgically ill,

16:43

and that all treatments must take place

16:46

on Guantanamo.

16:48

No one was going to leave Guantanamo.

16:48

So in the matrix of my decision,

16:50

I had to create,

16:54

we were probably level three hospital,

16:56

which means community hospital.

16:58

And I had to create essentially a level four,

16:59

level five hospital,

17:01

which would require me to have an ICU,

17:02

which would require me to have

17:04

a significant professional physician-base

17:07

that would be able to treat essentially

17:12

the wide variety of illnesses or injuries

17:14

that would be received from Afghanistan.

17:17

And initially,

17:21

we did not know the kind of history

17:23

people were bringing in,

17:27

the detainees would bring,

17:29

severely injured and ill patients into Guantanamo.

17:31

We didn't know how ill or injured they were

17:35

until we saw them essentially at the airplane.

17:37

And so I had to create a whole system

17:40

of quality medical care

17:43

for the detainee population,

17:46

which didn't exist before.

17:48

Interviewer

How do you go about doing that?

17:50

-

Well, I was,

17:53

it was a significantly challenging task,

17:54

but I received direct and immediate support from SOUTHCOM.

17:59

And I had guidance from Bureau of Medicine and Surgery,

18:03

and essentially whatever I needed as far

18:07

as equipment or specialty physicians,

18:10

I received.

18:14

And I enumerated those

18:15

in numerous message messages back and forth

18:17

between SOUTHCOM and Bu Med

18:21

and military medicine in whole.

18:22

And essentially whatever I asked for,

18:25

I received,

18:27

based on the importance of the national security mission.

18:28

Interviewer

Were you prepared on January 11, 2002,

18:30

when the first plane load came?

18:36

Did you have all facilities in place?

18:38

-

No.

18:39

It took a while, but I wanted,

18:40

and what was approved by SOUTHCOM,

18:42

was a separate hospital from the hospital

18:44

which we treated the routine base population.

18:48

So as the hospital was being built,

18:53

we used an area of our Naval Hospital

18:56

to treat the seriously ill detainees.

19:00

And we used a clinic at Camp X-ray

19:02

to treat the detainees

19:04

who were coming on board

19:06

and needed routine medical care

19:07

and/or an establishment of a medical record,

19:09

that would be part of their records

19:12

as they remained in Guantanamo.

19:16

So it just so happened,

19:19

I was repiping and rewiring a dental suite

19:22

or a dental operatory

19:27

during that period of time in 2001.

19:29

And I diverted the contractors

19:32

from that to make a 10 bed ICU at the Naval Hospital,

19:34

never thinking I would ever use it,

19:39

but in fact after a couple of months

19:41

was using it significantly

19:43

because of the injuries that we were receiving

19:46

and the illnesses that were being presented

19:48

by the detainee population.

19:50

But initially,

19:53

as the fleet hospital was being brought

19:56

to Guantanamo on a ship,

19:58

and the fleet hospital is a routine hospital setting

20:01

that is used primarily in support

20:05

of American forces when we're in harm's way.

20:08

It's self-contained,

20:11

it has significant surgical and medical capabilities,

20:13

and assigned to the fleet hospitals,

20:16

also a fleet hospital professional staff,

20:18

doctors, nurses, administrators, and corpsman.

20:20

And so we asked for a fleet hospital

20:23

and the decisions that were made

20:27

up the chain of command supported that request.

20:30

Interviewer

What were you told

20:35

about the detainees before they arrived?

20:36

-

Not much.

20:37

Interviewer

Not much?

20:38

Were you concerned at all about who was coming?

20:40

-

Well, concerned is probably a good word.

20:43

I was concerned about our capability to deal

20:48

with the environment and deal with Gitmo

20:50

not being able to get them off the island

20:53

if they needed sophisticated medical care.

20:55

I was concerned that we wanted to do the right thing

20:58

for these human beings who may be injured,

21:01

who may have been medically unstable

21:04

as they travel X number of hours

21:08

across the Atlantic.

21:10

And I wanted to be sure

21:11

I had the right staff to deal

21:13

with the situations

21:14

that we would be going to be encountering.

21:15

One of the things I had never,

21:18

in my professional life,

21:21

ever thought about being in an environment

21:22

of detention, in prisons.

21:25

Just wasn't within my context of understanding

21:28

what that was all about.

21:31

So as we were preparing to receive the detainee population,

21:32

I sent people from my hospital to federal prison

21:35

to see what happens in federal prisons

21:39

because we had no other context

21:41

in which to make decisions about prison care.

21:44

And so they were studying what that happens there.

21:48

And also I needed

21:50

to have specialty physicians

21:53

which were not in Guantanamo,

21:56

which would be infectious disease physicians.

21:57

We knew that there were certain indigenous diseases

22:01

in Afghanistan

22:03

that we had never had any reason to think about

22:05

because they were never in Guantanamo.

22:08

And so I brought in teams of infectious disease physicians

22:11

and also surgeons, and orthopedic surgeons

22:15

who may have to deal with extremity injuries

22:19

and so forth

22:22

because we did get a little bit of information

22:23

from people coming over,

22:24

but didn't actually see the people

22:26

until they actually arrived on Guantanamo

22:27

about the severity of their illnesses.

22:29

I need to blow my nose here.

22:32

I need a Kleenex.

22:34

(interviewer talking off mike)

22:35

Interviewer

Okay.

22:39

-

So we went from a small community hospital

22:40

to a hospital that was able to deal

22:43

in most every kind

22:45

of medical or surgical situation

22:48

in which the detainees would bring to us.

22:50

And it was my philosophical belief

22:53

that we had to give these men care

22:58

which would be equivalent to the care received

23:03

by an American service member

23:07

in a similar environment

23:08

-

Why?

-

under the Geneva convention.

23:09

Because I think we, well, my view was

23:11

and I received some information

23:14

and some guidance from our attorneys

23:17

at Bureau Medicine and Surgery.

23:19

And I said, you know,

23:21

we have a situation here

23:22

that these are not prisoners of war.

23:24

These are enemy combatants,

23:27

as defined by our administration.

23:28

And so under the Geneva Conventions and the definitions

23:31

of a prisoner of war is clearly defined the level

23:36

of medical care that they would receive in confinement.

23:39

The enemy combatant, on the other hand,

23:43

was an undefined, in my view,

23:45

detainee.

23:50

And I needed to be clear,

23:51

to my staff as well

23:53

as to the general public,

23:54

that these detainees,

23:59

although enemies of the state,

24:00

would be given the same quality of care

24:02

as an American service member held

24:04

in a Geneva Convention-like environment,

24:06

a prisoner of war environment.

24:10

Interviewer

Why did you feel that

24:11

if they weren't prisoners of war?

24:12

-

It didn't matter to me.

24:16

What mattered to me deeply

24:18

that these people deserve the same quality of care

24:20

because they were human beings, number one.

24:23

And I didn't want to be responsible

24:25

for care that would be substandard

24:28

and be viewed as substandard in any measure.

24:32

And so using that basic philosophy,

24:35

I articulated that position

24:37

to our staff and specifically indicated

24:39

that anything that the detainee needed

24:43

from the medical context,

24:46

I could get for the physician to treat

24:48

at the level of care

24:51

that it would be for an American service member.

24:52

-

Were you told that these were really bad people,

24:54

the worst of the worst,

24:58

anything that could have made you wonder

24:59

whether they really deserve the kind of care

25:03

that you're describing?

25:05

-

Well, I think there was some adjectives applied

25:07

to the people coming to Guantanamo from Afghanistan.

25:12

And I think we were either told,

25:16

or it was intimated

25:21

that they were picked up on the battlefield.

25:23

They wanted to kill Americans.

25:26

They wanted to take away our democracy,

25:27

they wanted to take away our standard of living.

25:31

And they demonstrated that by flying three airplanes

25:33

and essentially taking many thousands

25:38

of American lives on 9/11.

25:41

And so within that context

25:43

we knew that they were members of an organization

25:45

that wanted to destroy essentially America.

25:48

And so they would probably want to hurt us as well.

25:52

And so I think that underlying tension, if you will,

25:56

or concern was always with our medical staff,

26:00

but based on who we were as Americans

26:03

and based on who we were with the philosophy

26:06

of doing no harm

26:09

and for the philosophy of doing what's best

26:10

for the human being,

26:12

even though it was an enemy of the state,

26:13

I think was inculcated through the different levels

26:15

of command that at least medically,

26:18

we were dealing with the individual detainee.

26:20

Interviewer

Did you have to educate your staff

26:23

to believe what you were believing?

26:27

That we, you have to do the right thing?

26:29

-

Well, I think as members of our professions

26:32

that are in their profession

26:36

because they love to do what they do,

26:38

taking care of people,

26:40

I think simply reinforcing the facts

26:41

that they were doctors and nurses and corpsman

26:44

treating individuals

26:48

who were enemies of the state had no relevance

26:48

in relationship to the quality of care

26:50

we would be giving.

26:52

That's true, they were enemies of the state

26:53

but they were human beings who were suffering.

26:56

And if they were suffering,

26:59

we needed to do everything we could

27:00

to alleviate that suffering.

27:03

Interviewer

So were you there

27:05

when the first plane arrived?

27:06

-

I was indeed.

27:08

Interviewer

Did you see them,

27:09

the men being unloaded

27:11

from the plane and onto the lifts?

27:13

-

I was.

27:15

And they were,

27:16

I think for aircraft security

27:18

they were blindfolded and shackled,

27:20

I believe.

27:21

And once they got off the plane

27:23

at some point along the way

27:26

they got the orange jumpsuits

27:27

and one of the first things that I recognized

27:30

as something that would be necessary for us

27:33

as well as for review of people

27:37

that would be reviewing what we did over time

27:41

was to initiate a medical record.

27:45

A hundred percent of the detainees coming in,

27:47

at least in the first couple of months

27:49

had no medical record at all.

27:51

So treatments may have been given

27:53

in the field prior to coming to Guantanamo,

27:56

but it wasn't well-documented.

27:59

They may have had a tag

28:01

or something that indicated a very rough idea

28:03

of what was being done for them.

28:07

But I was certain

28:10

that we would be reviewed by higher authority later.

28:11

But the real reason was

28:15

that we wanted to,

28:18

for those people who followed us

28:19

into this medical environment in Guantanamo,

28:20

to have a clear record

28:23

of what occurred once we received the patient.

28:25

So we established the first, I think,

28:27

written and then electronic medical record

28:30

for each detainee as they came on board.

28:31

And as I mentioned

28:34

I didn't know any detainees by name.

28:36

I knew them by number.

28:38

And I think that was a decision made

28:40

at some higher authority

28:43

that the detainee would not be known by name.

28:44

So each of the detainees had a medical record by number

28:47

but with a very substantive medical record

28:50

that indicated the physician's first encounter

28:53

with the patient

28:56

and we were

28:57

giving the detainee

29:00

a thorough physical as they arrived,

29:03

so that we understood

29:06

from a baseline where they were

29:07

as they arrived in that particular day.

29:09

Interviewer

Was it your idea to give them a physical

29:10

or was directed from above?

29:12

-

I don't know the answer to that question.

29:17

Other than when you receive a patient,

29:19

you do a routine physical.

29:21

I mean it's just good medical practice.

29:24

And I was certain that

29:26

because that the detainee did not have a medical record,

29:27

and in good medical practice,

29:30

the physician or a nurse practitioner,

29:33

whoever it is,

29:35

wants to see a history

29:36

before they engage further with the patient.

29:37

So I don't recall specifically

29:39

if we were directed to do the physical exam or not

29:41

but I knew that in the context of good medicine,

29:44

you needed the place to begin,

29:47

and the place to begin

29:49

was a very thorough physical examination of the detainee.

29:50

Interviewer

And what were your thoughts

29:53

when you first saw these detainees coming off the bus

29:54

and when you take them to get their examination?

29:58

-

They were physically and emotionally exhausted.

30:00

Interviewer

From the plane ride?

30:03

Or

30:04

-

I'm not sure.

I knew they were exhausted from a plane ride,

30:05

17 hours being in whatever position they were in,

30:07

and that they were certainly

30:11

in an environment

30:14

which was stressful for them as individuals

30:15

coming from a battlefield and flying across,

30:19

they didn't know where to,

30:22

to where they were going.

30:23

Interviewer

Did you think you need a psychologist

30:26

at that moment as well?

30:28

-

No, actually we had,

30:30

I didn't actually.

30:32

I think in 2000 we began to understand,

30:33

and being a Vietnam veteran,

30:39

I understood the consequences of conflict,

30:40

Post Traumatic Stress Disorder,

30:43

but it wasn't at the top of my agenda

30:44

as a Joint Task Force Surgeon,

30:47

initially.

30:51

We can go there maybe later,

30:53

but as any human being who's exposed

30:56

to this kind of an environment,

30:58

certainly there was a psychological-psychiatric overlay

30:59

of what had happened to them.

31:02

But I only had one psychiatrist

31:05

on staff at that time.

31:07

And I engaged him

31:09

in the initial assessment of the detainees in a global way,

31:13

he didn't examine every detainee,

31:17

but there were certain detainees

31:20

who exhibited signs of psychiatric illness.

31:21

And so he was engaged with those people

31:24

and the context

31:28

of the psychiatric and psychological overlay,

31:29

essentially at that point in early

31:33

in the mission was not a primary concern of mine.

31:38

Mine was focused

31:40

on the medical and physical

31:41

situations which each detainee found themselves.

31:45

Interviewer

Were you worried about tuberculosis

31:48

or malaria

31:50

or other tropical diseases?

31:52

-

There is no malaria in Southern Cuba right now.

31:57

And so each detainee,

32:02

as they were examined

32:07

in the Camp X-ray environment,

32:14

received a chest x-ray

32:15

to rule out active tuberculosis,

32:17

because if we had active tuberculosis

32:19

coming in from Afghanistan,

32:21

that would have created

32:25

in an enclosed environment, more tuberculosis.

32:26

So we had radiologists do a wet read

32:29

for any active tuberculosis.

32:33

And if we had active tuberculosis present,

32:34

we then separated the detainee

32:37

from the rest of the population

32:39

and isolated them medically,

32:40

and then began immediate treatment.

32:41

Malaria, on the other hand is another similar situation,

32:44

in which I received information

32:47

from Navy Environmental Health people,

32:50

NEHC,

32:55

and the Center for Disease, CDC,

32:56

in relationship to the treatments for malaria.

32:59

And based on the fact that malaria didn't exist in Cuba.

33:04

And based on the fact that we didn't know

33:08

where these people were coming from,

33:10

we prophylactically treated for malaria.

33:11

Interviewer

Meaning everyone was given,

33:16

which drug were they given?

33:21

-

Well, I know where you're going with this.

33:22

They were given a drug which would have ameliorated

33:26

the chance of spreading malaria into Cuba.

33:30

And I've been criticized for making that decision,

33:33

but it was based on recommendations

33:36

from infectious disease physicians

33:39

and recommendations

33:41

in any kind of literature

33:43

that would have prevented,

33:46

I mean would have ameliorated

33:48

the bringing in of malaria to Cuba.

33:50

And so at that point in time,

33:54

although there are side effects to the drugs we gave,

33:56

to make the call that it would enhance interrogation

34:01

is a stretch.

34:05

And so.

34:06

Interviewer

Did the detainees know

34:08

that they were given this drug because of

34:10

-

Okay, another overlying medical concern

34:14

is that we never ever

34:17

in our American medical system do anything

34:19

to a patient without their consent.

34:23

And so we thought about that

34:26

and we knew that this was an important factor

34:28

in the context of our quality of care environment.

34:30

And so when the first detainee started coming in,

34:34

we didn't have any idea about their language,

34:38

where they're coming from

34:40

and their language skills.

34:42

And so we had some interpreters available to us.

34:43

but probably there were,

34:46

I remember the number 20 or 25

34:50

different languages represented

34:53

within the Afghani population.

34:54

And we simply,

34:56

at that point in time,

34:59

did not have the interpreters there

34:59

to allow interpretation to take place

35:02

within the medical context.

35:04

So when we talk about informed consent,

35:08

for example,

35:11

I think within the context of the medical record,

35:13

I think there was a record kept

35:17

of the medications each detainee received.

35:21

And there may have been a statement there,

35:24

which I don't recall specifically,

35:26

but the main statement there

35:27

that the detainee was informed

35:28

that they would be giving this medication

35:30

for this reason,

35:31

but it is unlikely

35:32

that any detainee would have understood

35:34

what being said because of the language deficiency

35:36

on our side.

35:39

And so as the mission matured,

35:41

we were then able to get the interpreters

35:44

in which would have allowed the detainee

35:49

to understand what was occurring.

35:52

But I can tell you that as the mission matured,

35:54

no detainee in the time

35:58

that I was in Guantanamo received anything

35:59

that was not, we weren't given permission for,

36:01

as far as surgical permission,

36:05

to do the surgery.

36:07

We did orthopedic surgery.

36:09

we did amputations.

36:11

We did enucleations.

36:12

We took an eye out or two.

36:13

And the detainees always signed an informed consent

36:16

given by the physician who was doing the surgery

36:22

or the medical treatment,

36:24

prior to us doing the treatment.

36:25

Interviewer

Were there any other inoculations

36:28

that were given to detainees

36:32

or any other prescription drugs that were given

36:35

besides those for malaria?

36:39

-

Not routinely.

36:41

I think if a patient received

36:43

or was identified as say being a diabetic,

36:44

or some other chronic illness,

36:47

like leishmaniasis and cutaneous leishmaniasis,

36:50

which would be significant

36:54

if not treated,

36:57

there was no routine medication given

37:00

to all detainees,

37:02

other than what I've mentioned

37:03

which would have been the antimalarials

37:04

and if necessary,

37:07

removing the pain of detainee

37:08

from the general population,

37:10

if we suspected tuberculosis.

37:11

Interviewer

How did detainees react

37:17

to the medical profession from the beginning?

37:18

And maybe if it changed over time,

37:21

what, how did, did they?

37:23

-

Well, one of the things

37:27

that I think I was concerned about is that within,

37:27

as we began to understand

37:31

who the detainee was

37:32

and the context

37:37

of their faith,

37:37

religion there

37:38

and the beliefs

37:40

in the context of Islam,

37:44

we became more sophisticated

37:50

in understanding what

37:52

their basic corps values were.

37:53

Initially we did not.

37:56

And so in our American military medical system,

37:58

we have military physicians who are women.

38:01

And I think a third

38:05

of my staff on Guantanamo were women physicians.

38:07

And we understood that being examined

38:11

by a woman physician would not be acceptable

38:15

to a man coming in from Afghanistan

38:19

or with a certain belief

38:23

that other than his wife

38:24

he shouldn't be touched by a woman.

38:26

And so we recognized that,

38:28

but I was constrained

38:29

by the number of personnel

38:30

who were with me at the time.

38:32

And I'm certain there was some detainees who were offended

38:34

by being examined by a woman physician,

38:36

but based on my belief that we needed a thorough

38:39

and complete physical,

38:42

we simply didn't ascribe

38:45

to that cultural significance,

38:47

to that particular detainee.

38:51

But no detainee in my recollection

38:53

resisted either the examination

38:58

or anything else that we decided

39:00

we would need to do

39:02

to understand the detainee better,

39:04

like a chest x-ray or an examination of the eyes or ears,

39:05

or listening to the lungs.

39:10

I don't recall ever having an aggressive act

39:13

being directed toward

39:16

a doctor, nurse, or corpsman

39:19

during my time.

39:21

Interviewer

Did you ever see a detainee say no,

39:22

he wouldn't allow a female to examine him?

39:24

-

If that occurred,

39:32

I don't remember it occurring.

39:33

And if he said, no,

39:35

I'm not sure we would have

39:39

we would have

39:40

-

honored that

honored that,

39:42

but I'm not sure.

39:43

I don't remember that specifically.

39:44

Interviewer

What was the feeling

39:46

of the people you work with

39:49

as they started treating the detainees?

39:51

Did they express?

39:54

-

I think one of the things

39:58

to put this period of time into context

40:00

is that September 11th

40:02

was only four months before.

40:04

And some people certainly had acquaintances,

40:08

two or three times removed,

40:12

that either were killed or injured.

40:13

And so there was significant,

40:16

I would say concern, attribution,

40:20

maybe if you would,

40:25

in relationship to these particular people

40:27

but we're first and primarily healthcare providers.

40:29

And we are there to preserve life.

40:34

And so certainly if people had feelings like that,

40:38

they put them aside and treated the individual

40:41

as a human being needing medical care.

40:44

Interviewer

There was a prison guard who told us

40:48

that the very first person off the first plane or the bus

40:50

was someone they called a stump.

40:56

He was missing a leg.

40:59

He had a prosthetic leg.

41:00

Did you see that person?

41:02

-

Probably.

41:03

Interviewer

You don't remember him?

41:04

-

Well, a number of people came off

41:05

with different elements of injury.

41:07

And I think one of the things

41:11

that I began to recognize reasonably early is

41:13

that we needed to begin a rehabilitation process as well.

41:17

And so the prosthetics,

41:21

if they did arrive with the detainee

41:22

were very rudimentary.

41:25

And there's a type of physician

41:27

called a physiatrist

41:30

and a physiatrist deals with amputees.

41:32

And so within a couple of months,

41:35

I called in our Navy physiatrists

41:37

who basically were working with the VA

41:39

with older veterans,

41:42

because remember we hadn't gone to Desert Storm 1 yet,

41:43

I mean we haven't gone to Desert Storm 2 yet

41:45

and not the war in Afghanistan.

41:48

So the number of amputees

41:49

in the US uniform service were not that many.

41:51

So, but we did have a couple of physiatrists

41:53

in Navy uniforms.

41:55

And so I brought them to Guantanamo

41:57

to begin to evaluate stumps,

41:58

begin to evaluate rehabilitation processes.

42:01

And so we began to rehabilitation process.

42:03

So to answer your question,

42:05

a number of detainees came with old injuries,

42:07

like the enucleation I spoke about,

42:11

removing an eye,

42:13

was an old injury,

42:14

but the eye was dead in the patient's eye socket.

42:15

And so we had an ophthalmologist remove the eye.

42:20

And one of the stories

42:23

that I'm very pleased to tell is

42:25

that once the eye was removed,

42:28

the patient and the ophthalmologist had tea afterwards.

42:30

And because this was a element

42:34

that the detainee wanted to have done,

42:36

but could never have had done

42:39

in the environment which he existed before.

42:41

But the number of stories like that,

42:44

that were heartwarming in the context of,

42:46

you know physicians and nurses doing the right thing

42:49

and physicians being respected

42:52

for their skills by the detainee population

42:55

and then thanking the physician in their own way

42:59

about what had been done for them.

43:01

Interviewer

Why would the medical profession

43:05

take care of old injuries that weren't really present?

43:07

-

Well, they needed,

43:10

because like this dead eye

43:12

would have set up a neurological infection maybe

43:15

in the brain

43:18

and essentially would have gone.

43:20

In a first world country,

43:22

that eye would have been removed much earlier.

43:25

So a number of old injuries,

43:28

we had a number of cases in which there were a number

43:31

of other medical conditions that were either untreated

43:34

or less,

43:38

treated not well

43:39

and we continued their treatment.

43:40

Like old TB, there was lung x-rays

43:42

that would demonstrate TB had occurred

43:46

at some point,

43:48

but maybe it was untreated.

43:49

So we initiated treatments for them.

43:50

Interviewer

And if they were diabetic,

43:52

you would

43:53

-

If they were diabetic,

43:54

we would begin a diabetic regime

43:55

Interviewer

Since you only knew them by number,

43:59

did anyone ever tell you,

44:01

"Look this person's really bad guy"

44:02

when you, when you?

44:05

-

They're their value to the intel community was irrelevant

44:08

to their value to us as patients.

44:11

Interviewer

Could you just describe your day to day

44:17

experience that you had,

44:21

and doctors had,

44:23

just how it worked day to day with the medical team?

44:24

-

My experience was different than the experiences

44:30

of those people taking care of the detainees.

44:33

I was responsible for the detainee population,

44:35

the active duty Joint Task Force population,

44:38

and the base population.

44:42

So I was overseeing all three elements.

44:44

And so what I did is, you know,

44:48

as a hospital commander,

44:51

took care of my business at the hospital

44:52

through my executive officer,

44:55

went to the detainee hospital

44:57

and got a report from the that hospital commander

45:01

about what was happening there,

45:06

and also in the ICU at the Naval Hospital,

45:08

went up to see how they were doing up

45:11

at the ICU,

45:14

and also looked at the different aid stations

45:15

that the Joint Task Force soldiers were visiting

45:19

as far as their illnesses and so forth.

45:22

So my day was very different than those people.

45:25

Interviewer

Could you describe a normal doctor

45:29

or nurse's day?

45:31

-

Very busy.

45:33

Probably 12 hours up

45:33

doing routine care for sick call.

45:35

We had corpsmen going around to detainees

45:40

in the Camp Delta

45:42

and doing routine sick call

45:44

and nurses would do the same thing.

45:47

And physicians would see the detainee population,

45:51

if the corpsman could not have treated the detainee,

45:56

they would bring them back

46:00

into the medical area

46:01

to be seen by a doc or a nurse.

46:04

Interviewer

Were any of the corpsmen or nurses

46:07

or any of your staff afraid

46:09

to interact one on one with detainees?

46:11

-

You were never afraid,

46:15

I don't think.

46:15

There was always that caution

46:17

that there could be an outburst of violence

46:18

against a nurse or corpsman,

46:21

but as the detainee were being seen and treated

46:23

in the medical facility,

46:27

there would be a guard,

46:28

they were never alone with the detainee.

46:31

Interviewer

In a cell were they alone with the detainee?

46:34

-

No.

46:37

Interviewer

And were there any incidents that occurred?

46:39

-

I think there was incidents in relationship to,

46:43

you know, throwing of feces,

46:47

throwing of urine,

46:48

but not directed toward medical,

46:51

they were directed toward the guard force.

46:52

Another element that,

46:55

let's go back to the Camp X-ray a minute,

46:57

another element that was concerning to me

46:58

is that Camp X-ray had rudimentary facilities

47:01

for use of human waste,

47:05

both feces and urine,

47:11

and our Marines

47:13

had to carry human excrement

47:17

from the cell and into a central honeypot,

47:19

I guess you'd call it,

47:23

both urine and feces.

47:24

And that was distasteful for the Marines certainly,

47:26

but also based on what Camp X-ray was,

47:30

necessary as far as public health issues were concerned.

47:33

And I was very concerned

47:36

about the spread of any kind of disease

47:39

that would have occurred in that environment,

47:41

but we didn't have any disease

47:43

that occurred related to that

47:45

because we had very aggressive

47:47

public health people looking at what we were doing

47:49

and being certain that neither the detainee

47:54

or the JTF personnel were being affected

47:56

by this open source of potential vermin

48:01

in the X-ray.

48:05

But once the detainee got into Camp Delta,

48:07

they had a toilet on the floor

48:10

and flushing facilities and so forth.

48:12

So it became much better public health wise.

48:14

Interviewer

You were there until when?

48:18

-

August of 2003.

48:20

Interviewer

So you saw some hunger strikes I assume.

48:23

-

We did.

48:25

Interviewer

Could you describe?

48:26

Were you involved in counseling

48:28

on the hunger strikes

48:30

and how to respond to those?

48:31

-

We were.

48:33

Interviewer

How did?

48:34

-

I think one of the things

48:35

that General Leonard was very concerned about

48:36

is the hunger strike

48:39

and the the damage

48:43

that a hunger striker could do to themselves

48:47

in relationship to their wellbeing.

48:49

And so,

48:52

we instituted a very aggressive physiological assessment

48:53

of the detainee.

48:57

Interviewer

Who was on a hunger strike at the time

48:59

you mean?

49:00

-

Generally,

49:01

as we received the detainee,

49:02

remember we did a complete physical

49:04

which included height and weight.

49:05

So height, weight ratio was one of the ways

49:07

that you look at the physiological wellbeing

49:09

of an individual on a hunger strike.

49:11

So we had a baseline

49:13

when hunger strikes began.

49:15

And so as the hunger strikes,

49:16

were part of the environment,

49:19

we used that baseline to determine

49:23

whether this patient was an extremist.

49:25

And hunger strike is different than a water strike.

49:34

So you can survive without food for a period of time.

49:36

Surviving without water is very different.

49:39

And so General Leonard, rightly so,

49:41

was very concerned about the physiological wellbeing

49:44

of the hunger strikers.

49:47

So when we found an individual

49:48

who would exhibit symptoms

49:51

of being very, very

49:53

significantly dehydrated, for example,

49:57

we would take him out of the environment

50:01

in which he was striking,

50:03

and bring him into the detention hospital.

50:05

And, and we found that,

50:09

at least initially in the hunger striking environment,

50:12

they would willingly take oral fluids.

50:15

Once they are out of their hunger striking environment,

50:19

they would willingly take oral fluids.

50:21

Interviewer

In the clinic or?

50:24

-

In the clinic,

50:25

outside of the purview of their peers.

50:26

-

And on the other hand,

50:30

if we found someone really an extremist,

50:31

they would also accept IV rehydration

50:35

outside of their peers.

50:39

And so we would bring them in,

50:41

rehydrate them,

50:43

and then they would go back

50:44

to the prison population.

50:45

In the context of what we were doing,

50:47

within the U S prison system,

50:51

interventions like that are acceptable.

50:55

Interviewer

How long would you keep them

50:57

before you returned them to their

50:58

-

Until their vital signs became reasonably normal.

51:00

Interviewer

How, is that like a day or two?

51:03

-

It could be a day or two.

51:05

It could be hours.

51:06

Interviewer

Were you worried

51:07

that they would then go on a hunger strike again

51:08

or water strike?

51:10

-

You know, in a medical context,

51:12

we were just consequence managers.

51:15

Certainly we wouldn't keep a person

51:18

out of their confinement environment thinking

51:20

that they would be striking again.

51:26

It was not in our purview.

51:27

So we were, you know,

51:29

managing the consequences

51:30

of what they were doing to themselves.

51:31

Interviewer

Did you have anybody

51:33

that refused to have you do anything,

51:34

even outside of the context of the?

51:37

-

Now, you recall

51:40

that my time ended in August 2nd of 2003.

51:41

So we did not have a detainee ever refuse

51:47

to be either rehydrated by oral hydration

51:52

or IV rehydration.

51:55

Interviewer

So force-feeding was never on your

51:57

-

We thought about that.

52:00

Interviewer

You did?

52:00

-

We did.

52:02

And, you know,

52:02

as you go through the algorithm

52:04

in treating severe hunger strikes,

52:07

and we learn from the situation in Ireland,

52:10

in, you know, the country of Ireland,

52:13

that after a certain point,

52:16

you fall off a precipice

52:19

and whatever you do is not good enough

52:21

and you'll have a death.

52:22

And so we had an algorithm

52:24

which came to the forefront

52:26

in the context of

52:30

what do you do in a hunger strike?

52:31

And the algorithm eventually went down the path

52:33

of putting a nasal gastric tube

52:37

in the nose and into the stomach.

52:39

And then you would do,

52:42

what's this substance called?

52:47

Sustacal.

52:49

It's a formula that babies receive

52:49

when they're very young.

52:54

And it would replenish some

52:56

of the basic nutrients

52:57

that a detainee would require

52:58

if they were on a hunger strike.

53:00

Interviewer

And when, how did you know

53:03

that that was the way to treat people

53:05

on hunger strikes?

53:08

From Ireland, or are you?

53:09

-

And then there are,

53:11

you know,

53:12

studies in US prison medicine

53:12

that allowed us to see

53:16

what the consequences of hunger strikes would be.

53:18

Interviewer

So you prepared for that if necessary?

53:20

-

We were.

53:22

Interviewer

Did people in isolation,

53:28

did they need different kind of treatment?

53:31

-

What do you mean isolation?

53:33

Interviewer

People who were put in isolation

53:34

where they had no access

53:36

to any other detainee

53:38

where they were just kept in.

53:42

Detainees have told us

53:44

that they were sometimes kept

53:45

in what they called isolation

53:47

-

Sure.

53:48

Interviewer

where the air conditioning

53:49

was either turned up very high

53:51

and they were cold all the time

53:52

or turn down to not exist

53:54

and so they were hot all the time.

53:57

-

Now I need to,

53:58

timing is important.

54:00

Interviewer

Right.

54:01

-

I don't believe

54:02

during my time there that we had these areas

54:04

of isolation that were then reported later

54:07

in the mission.

54:12

I think there were being thought about.

54:13

But I think the mission commanders

54:15

isolated me specifically

54:18

from that kind of discussion and environment,

54:20

but essentially what my direction was

54:24

to the JTF medical staff

54:26

was that every detainees should be seen

54:28

at least daily.

54:30

To have eyes on,

54:33

look at me,

54:35

and are you okay today?

54:36

So almost,

54:38

and we had up until,

54:39

I think we had 630 or 40,

54:40

but we had corpsmen going into the,

54:43

you know later in the mission,

54:45

like in April, May of 2003.

54:47

So every detainees should be visually sighted

54:49

that everything's okay.

54:52

So things happened later,

54:53

at least from what the press reports.

54:56

And those kinds of things could have occurred

54:58

toward the end of my time in Guantanamo,

55:02

in a very isolated environment.

55:05

But each detainee was eyes-on

55:07

at least every day, once a day.

55:11

Interviewer

Would detainees had been ERFed

55:13

while you were there?

55:15

-

ERFed?

55:16

(Albert laughs)

55:17

Interviewer

ERFed, yeah.

55:18

So did you ever see the consequences of that?

55:19

Did you ever have to be involved?

55:20

-

Well, if the detainee you were acting up,

55:22

Interviewer

Right.

55:25

-

We were certainly part of the,

55:25

no we were not part of the response team,

55:27

but we were part of the consequence management

55:29

of the detainee.

55:31

And I'm certain that

55:33

if these things were occurring routinely,

55:34

it came to my attention

55:36

and the reports would have been

55:37

in the situation report

55:40

and the injuries,

55:43

if any occurred,

55:45

would have been recorded in the medical record.

55:46

-

So did you find

55:50

that some detainees had been injured as a result

55:51

of the ERF procedure

55:54

and you had to care for them?

55:57

-

That's a pretty specific question.

56:03

And I can't remember specifically.

56:05

I'm sure there was some that were certainly brought

56:07

into the clinic and looked at for bruising

56:09

or other things and treated accordingly.

56:12

But I don't remember any specific situation

56:15

in which like they required surgery for broken bone

56:18

or anything like that,

56:21

that I don't remember anything like that.

56:22

But I'm certain that a corpsmen

56:23

would evaluate the detainee

56:26

after the situation had calmed down

56:28

to see if they needed to be brought back

56:31

to medical for examination by a physician

56:33

Interviewer

One detainee told us how a guy

56:36

jumped on this.

56:38

He was thrown onto the ground

56:39

and a guy jumped onto the side of

56:41

-

Right.

56:42

Interviewer

his face.

56:43

And he became paralyzed for 10 days.

56:44

-

Paralyzed?

56:48

Interviewer

Not likely.

56:49

-

Well, I'm not saying it didn't occur.

56:50

I don't recall that.

56:52

If a detainee became paralyzed

56:54

Interviewer

For a short period of time,

56:56

on one side of his face.

56:58

He couldn't drink fluid

56:59

or it would drip out of his mouth.

57:00

-

I don't

57:03

-

Recall it?

-

Well, I'm not denying

57:05

-

It might have been

after your time.

57:07

I'm just

57:08

-

It could have been.

But we had one suicide attempt

57:09

during my watch

57:13

which was almost successful.

57:15

Interviewer

Can you describe that?

57:19

-

Sure.

57:20

It was, I think, early in 2003

57:21

and a detainee tried to hang himself

57:23

and he was cut down and resuscitated

57:25

by one of our

57:29

very skilled physicians,

57:31

intubated, brought to the ICU,

57:36

and he was intubated and ventilated

57:38

for a period of days

57:42

and continued to have residual,

57:46

residual effects based

57:53

on his hanging attempt.

57:54

And he was partially paralyzed,

58:03

but I don't think we're talking

58:05

about the same guy.

58:06

Interviewer

Do you remember

58:07

how he did try to kill himself?

58:08

-

Hanging in a cell somehow.

58:10

Interviewer

Using what?

58:11

-

I think,

58:12

I forget specifically,

58:13

but something

58:14

you know,

58:15

something that had been available for him

58:16

like pants, maybe.

58:18

I'm not sure.

58:20

Interviewer

And you were called in,

58:21

or your staff was called in to take him down?

58:22

-

He was taken down, given resuscitation.

58:25

I know he's intubated in our medical clinic

58:29

at Camp Delta and then transported

58:32

to the ICU at the hospital and ventilated.

58:34

Interviewer

You know you said something interesting

58:37

and I'm just wondering

58:38

would the medical staff call to take them down

58:39

or was he taken down by

58:41

-

Oh, I'm sure he was taken down by guard staff.

58:42

Interviewer

Okay.

58:45

-

Medics would then go and respond to this situation.

58:46

They would take over medically,

58:48

bring him to the Camp Clinic and then

58:50

stabilize him and then be brought to the hospital.

58:54

Interviewer

Was that the only suicide that you

58:57

-

That was the only one that didn't,

58:59

I mean, it wasn't a suicide.

59:01

It was an attempt.

59:02

Interviewer

Had you ever heard

59:03

of a prison guard named Sean Baker

59:04

who apparently agreed to be ERFed

59:07

in order for the military to try out that procedure

59:11

and he was injured by it?

59:15

You never saw him.

59:16

-

I don't remember if he did.

59:17

I mean, did it occur in Guantanamo or someplace else?

59:19

Interviewer

Is it, oh.

59:21

My understanding is that it occurred in Guantanamo.

59:23

-

It could have been.

59:24

I think from my view,

59:25

the guard staff was very professional,

59:28

and that a guard

59:32

-

He volunteered for this.

-

would have a greater understanding

59:35

of what the ERF was all

59:38

if they in fact were the detainee.

59:40

And so that,

59:42

that could have been occurring on my watch.

59:44

But I don't recall that specifically.

59:47

Interviewer

Could you talk a little

59:53

about the interrogators?

59:54

Cause I know you told me off camera

59:56

that it didn't happen on your watch,

59:58

but I'd just like to have you say it on camera.

1:00:00

-

Sure.

1:00:01

Interviewer

The detainees told us

1:00:02

that the interrogators control the access

1:00:03

to the medical profession

1:00:06

and that detainees wouldn't be able to see a doctor

1:00:07

or a dentist without the approval of the interrogator.

1:00:10

-

No, that was not the case.

1:00:14

In my view, that was not the case.

1:00:16

During my time there,

1:00:18

if a detainee had a medical issue,

1:00:20

there was no intermediary

1:00:22

between the detainee and the physician.

1:00:23

Interviewer

If a detainee went to see a doctor,

1:00:26

how did that work?

1:00:29

-

Remember I said that we had a corpsman see

1:00:30

at least eyes on each detainee.

1:00:33

So the detainee would request

1:00:35

coming into the clinic

1:00:37

to be seen by whatever reason

1:00:40

that the detainee indicated he needed to be seen.

1:00:41

Interviewer

And then you would call for him

1:00:45

and they would come over to you.

1:00:47

-

Correct.

1:00:49

Interviewer

And there's never any interference

1:00:50

by anyone that you knew of.

1:00:52

-

You know,

1:00:55

the top of the pyramid,

1:00:56

there may have been situations

1:00:58

between the corpsman and the guard staff,

1:01:00

but I was not aware of any detainee

1:01:03

not being able to be seen if necessary.

1:01:04

Interviewer

Did you have a dental staff early on too?

1:01:07

Was it from the beginning?

1:01:10

-

We did.

1:01:11

Interviewer

Detainees tell us that often,

1:01:12

if they had problems with their teeth,

1:01:16

instead of having cavities filled,

1:01:18

the dental staff would just pull the tooth.

1:01:21

Have you ever heard stories like that?

1:01:23

-

That's not true.

1:01:25

I think now again,

1:01:27

it could be a language,

1:01:29

an understanding,

1:01:31

even in an American environment,

1:01:33

if you let the tooth go along enough,

1:01:34

it can't be restored.

1:01:36

And so the tooth necessarily needs to be pulled.

1:01:38

Now we had detainees there

1:01:41

who had very sophisticated

1:01:44

Western style dental care.

1:01:46

We had other detainees who obviously had never

1:01:48

seen a dentist.

1:01:50

So I'm certain

1:01:52

that we've had detainees who have had teeth pulled,

1:01:53

but based on the fact

1:01:57

that the tooth could not be saved or restored.

1:02:00

And so you just take a tooth out

1:02:04

because if you didn't,

1:02:06

you set up a situation

1:02:07

in which there significant jaw, face infection and so forth.

1:02:08

So I'm certain that we did pull,

1:02:12

but we also had dental do restorative care.

1:02:14

Interviewer

And can you talk a little bit

1:02:19

about psychologists?

1:02:20

You said you only had one at the initial.

1:02:21

-

We had a psychiatrist,

1:02:23

which is,

1:02:24

psychologist is a PhD,

1:02:26

-

Right.

-

a psychiatrist is a physician.

1:02:28

Interviewer

Right.

1:02:29

You had one psychiatrist and no psychologists.

1:02:30

-

Correct.

1:02:32

But we,

1:02:34

I know where you're going with this too,

1:02:35

I think.

1:02:36

And so there was something called a BSCT,

1:02:37

Behavioral Science Control Team.

1:02:40

And so, I forget exactly when they came on the scene,

1:02:42

but it was probably March or April,

1:02:45

something like that, of 2002

1:02:49

and Behavioral Science Control Team came to see me based

1:02:55

on the fact that they were medical professionals.

1:02:59

And they knew I was the JTF surgeon

1:03:01

and they wanted access

1:03:04

to the detainee

1:03:05

and to work

1:03:10

with the medical staff

1:03:10

with the detainee population.

1:03:13

And so we had a discussion

1:03:16

about what their purpose was.

1:03:17

And so it was my decision,

1:03:19

as soon as I understood what their purpose was,

1:03:22

in which they decided,

1:03:24

what they told me was they were there

1:03:25

to assist the interrogators

1:03:27

with the interrogation process.

1:03:31

And I said, in my view,

1:03:33

you can't be both a caregiver

1:03:36

and be assisting the interrogators.

1:03:38

So I partitioned them very specifically away

1:03:41

from the caregiving

1:03:44

of the detainee population.

1:03:48

And in fact,

1:03:50

our discussions became very limited

1:03:52

because I had no bearing,

1:03:55

no situation

1:04:00

in which I could foresee them being credentialed

1:04:00

by me to give care.

1:04:04

And I was the credentialing authority

1:04:05

for all the physicians in the JTF.

1:04:07

And so anybody treating a detainee

1:04:10

needed to be credentialed

1:04:12

by me as a JTF surgeon and hospital commander.

1:04:13

So I did not credential them to treat patients.

1:04:16

And so it was my decision early in the mission

1:04:19

that they be partitioned away from the caregivers.

1:04:23

And so there were psychologists and psychiatrists

1:04:25

who were advising the interrogators

1:04:28

on interrogation techniques

1:04:33

but they were not part of my medical team.

1:04:34

Interviewer

Did you ask for,

1:04:38

did you go up the chain of command

1:04:39

to make the decision to partition?

1:04:41

-

No.

1:04:43

-

Or did you just do that?

-

Well, I didn't know what I couldn't do

1:04:44

because this was first time

1:04:45

we've ever been in this situation,

1:04:48

at least in the current era.

1:04:50

And so I was,

1:04:54

I was challenged

1:04:59

by these people who were working

1:05:00

on the interrogator side

1:05:03

of the mission,

1:05:05

wanting, you know

1:05:06

to be part of the medical side of the mission.

1:05:08

And I didn't see that as ethical,

1:05:10

so I partitioned them away from the medical side.

1:05:12

Interviewer

So do you think what you did lasted,

1:05:16

or do you think after you left,

1:05:20

they could have crossed boundaries?

1:05:21

-

I thought about that.

1:05:26

and you know the press,

1:05:27

and all the other things that try to sensationalize

1:05:28

this kind of situation

1:05:30

which needs to be and thought and read about

1:05:31

because we don't want

1:05:35

this kind of situation to occur again.

1:05:37

It could be that

1:05:42

the partition became permeable,

1:05:45

but I felt it to be unethical,

1:05:48

to be on both sides.

1:05:50

You either do one or the other,

1:05:51

but not both.

1:05:53

Interviewer

Did interrogators ever come to talk to you

1:05:54

to try to persuade you otherwise or to become involved?

1:05:55

-

I don't ever recall a meeting

1:05:59

with an interrogator.

1:06:01

That was not part

1:06:02

of the mission that I was responsible for.

1:06:03

Interviewer

So your chain of command,

1:06:09

I think you started by saying you had two chains of command,

1:06:12

if you will.

1:06:14

One was medical and one was civilian.

1:06:15

-

Okay.

1:06:18

The chain of command, it's rather complicated.

1:06:19

So my Naval Hospital, Guantanamo

1:06:23

chain of command was Bureau of Medicine & Surgery, Navy.

1:06:26

Interviewer

Right.

1:06:29

-

My chain of command for the Joint Task Force

1:06:30

was through the JTF commander,

1:06:33

General Leonard and his people relieving him,

1:06:36

and SOUTHCOM.

1:06:40

So I had to have a surgeon at SOUTHCOM,

1:06:42

who I probably wrote

1:06:44

that many messages to in relationship to each

1:06:46

situation in a which detainee had a medical issue

1:06:49

and they were well-informed

1:06:53

and as sort of a courtesy,

1:06:55

I informed BMUED as well.

1:06:56

So I had a SOUTHCOM chain of command

1:06:59

for the detainee population

1:07:01

and the Joint Task Force soldiers,

1:07:03

but the medical chain of command

1:07:06

for Navy Medicine.

1:07:07

Interviewer

I'm going back to the psychologist

1:07:11

for a moment,

1:07:12

if a detainee had a psychological problem

1:07:13

as you or somebody diagnosed,

1:07:17

-

Right, sure.

-

did you have services

1:07:19

-

Absolutely.

-

Available?

1:07:23

-

Well, not initially.

And I think this is part of the story

1:07:24

that I think is important

1:07:27

for us to reflect upon.

1:07:29

As we began to understand more concisely

1:07:33

post-traumatic stress disorder,

1:07:36

and post-traumatic stress disorder occurs both

1:07:38

in the enemy combatant

1:07:41

as well as our combatants.

1:07:42

And so I was quoted,

1:07:44

I think on CNN,

1:07:46

if you go back and Google my name,

1:07:47

you'll probably see me quoted in CNN.

1:07:49

And you will, you will hear that.

1:07:52

I felt that there was significant post-traumatic stress

1:07:55

in the detaining population.

1:07:59

When the detainee has no hope of,

1:08:01

no hope, no future,

1:08:03

you can't help but believe

1:08:05

that that affects you

1:08:07

psychologically and psychiatrically.

1:08:08

So based on what I believe to be

1:08:10

a significant level of mental illness

1:08:14

in the detainee population,

1:08:17

I created Delta Block.

1:08:19

And Delta Block was a psychiatric facility,

1:08:22

inpatient treatment of psychiatric illness.

1:08:25

And so we created a Delta Block

1:08:29

I think in late 2002, 2003,

1:08:30

which was I think an 18 bed psychiatric ward

1:08:35

essentially staffed by psychologists and psychiatrists

1:08:37

and psych techs

1:08:40

to include a room that is

1:08:42

like any other room in a psychiatric hospital

1:08:46

that would be there for a violent detainee.

1:08:48

And they treated with counseling and medication.

1:08:52

So any one time we had a number

1:08:59

of people being treated for psychiatric illness

1:09:02

outside of the fact

1:09:04

of that post-traumatic stress.

1:09:05

There are people

1:09:07

in the detainee population

1:09:08

that were psychiatrically ill.

1:09:09

There's no question about it.

1:09:10

And so in addition to being psychiatrically ill,

1:09:11

they had an overlay of post-traumatic stress disorder.

1:09:16

And that's why we create Delta Block.

1:09:18

Interviewer

How long would someone stay

1:09:20

in Delta Block?

1:09:22

-

Days to weeks.

1:09:24

Interviewer

And when they left,

1:09:26

were they still medicated?

1:09:27

-

Probably. If necessary.

1:09:28

Yeah.

1:09:31

Interviewer

And if they refuse their medication?

1:09:32

-

Well,

1:09:35

as we understood the mission more,

1:09:36

you know a patient has a right

1:09:38

to refuse their medication and

1:09:39

and then their symptoms would return

1:09:41

and they would come back to Delta Block.

1:09:43

You know, we did not force medications on people

1:09:46

based on the fact

1:09:49

that if you refuse your medication

1:09:50

and then you understand the consequences of refusal

1:09:53

they're still have the ability to refuse the medication.

1:09:56

Interviewer

And in Delta Block,

1:09:59

were beds close together or were they individual rooms?

1:10:01

-

They were individual, yes.

1:10:05

Individual rooms.

1:10:09

They were not together as patients.

1:10:10

Interviewer

So people were alone in their cell?

1:10:12

-

Not alone in the context,

1:10:15

you know, you could see through

1:10:16

you can see the whole block.

1:10:18

-

Okay.

-

And I think as patients recovered further,

1:10:20

they were then put in rooms of two or four.

1:10:21

Interviewer

Do you think,

1:10:26

You wouldn't have to deal with this,

1:10:27

but I'm wondering, listening to you,

1:10:30

do you think some people were put

1:10:31

in Delta Block as punishment?

1:10:33

-

No.

1:10:35

I, again, in my time there,

1:10:36

in order to be admitted to Delta Block,

1:10:40

you needed the psychiatrist on the staff

1:10:41

recognizing that there was a psychiatric illness

1:10:44

that needed inpatient care.

1:10:47

That's different than your or I

1:10:49

who are a little bit, you know,

1:10:51

off,

1:10:54

being treated in our routine environment.

1:10:55

In our own detention area,

1:10:58

but the patients exhibiting symptoms

1:11:02

that would be either self-harm

1:11:04

or our our harm to others

1:11:05

would be admitted, medicated, stabilized.

1:11:08

In my opinion, no one was ever admitted

1:11:15

to Delta Block for punishment.

1:11:19

Interviewer

I'm listening to you,

1:11:23

I'm also thinking were any prison guards ever

1:11:23

needing medical?

1:11:28

I mean or psychological?

1:11:30

-

Oh yeah, you bet.

1:11:31

And I think one of the first things I did

1:11:32

when I knew the mission was coming

1:11:36

was to bring in the Sprint Team.

1:11:38

The Sprint Team is a Navy term

1:11:39

that is used to support Marines primarily

1:11:42

but used to support people

1:11:46

in combat stress.

1:11:50

And the Sprint Team,

1:11:54

I brought in initially

1:11:55

I think a week after the mission started

1:11:56

and they were there to treat the,

1:11:59

not to the treat,

1:12:01

they were there

1:12:02

to support the JTF population.

1:12:04

And then as the mission became Army,

1:12:07

we brought in the Army Sprint Team

1:12:10

which was there to deal

1:12:11

with the prison guards

1:12:13

who obviously never signed up

1:12:17

for this kind of work

1:12:19

and were affected by what they were doing.

1:12:20

And so we had, I think,

1:12:22

five to seven Army personnel,

1:12:24

first Navy personnel,

1:12:29

but then Amy personnel

1:12:30

consisting of a psychologist

1:12:32

and probably three or four psych techs

1:12:34

who dealt with the soldier

1:12:37

who was having difficulty

1:12:39

in the environment of Gitmo.

1:12:40

Interviewer

How'd you deal with that?

1:12:42

And what kinds of symptoms would you see?

1:12:43

-

Well, again,

1:12:46

I was on the top of the pyramid

1:12:48

and I knew they were treating people

1:12:49

but the psychologist did not prescribe medication.

1:12:51

So it was counseling,

1:12:55

it was talking about it rather.

1:12:56

And there were probably signs

1:12:58

of aggression or depression

1:13:00

and they were dealing with that

1:13:02

because that's what their job was,

1:13:03

to deal with the soldier.

1:13:06

Interviewer

Would you ever remove a prison guard then

1:13:09

from the location because the prison guard

1:13:11

just couldn't handle?

1:13:14

-

Certainly.

1:13:15

It would be a recommendation to the commander.

1:13:16

We wouldn't remove medically.

1:13:18

We would recommend that that person would be removed based

1:13:20

on behaviors we observed.

1:13:23

Interviewer

This might seem like an odd question,

1:13:28

but you seem to have a lot of integrity,

1:13:29

so I'll ask it.

1:13:31

And that is, looking back,

1:13:33

do you think you made some mistakes

1:13:34

that maybe could have done it differently?

1:13:36

-

There's no question.

1:13:38

If I knew today what I knew,

1:13:41

If I knew then what I know today.

1:13:45

Certainly,

1:13:46

I think the context of my investment

1:13:47

into what is reported to have occurred

1:13:50

with abuse and interrogation,

1:13:53

I would have probably would have insisted

1:13:56

on transparency between me and previous commanders.

1:13:57

You know, after General Leonard,

1:14:00

General Backus, and General Miller,

1:14:02

and others,

1:14:03

I would have insisted on transparency

1:14:05

for the JTF Surgeon to know what was going on

1:14:07

So we could make an ethical choice

1:14:09

to disagree with whatever was occurring.

1:14:11

No question.

1:14:15

I would have gone back.

1:14:16

Yeah.

1:14:17

Interviewer

Well, had you heard rumors

1:14:18

that things were occurring in the interrogations?

1:14:19

-

Well, that's a good question too.

1:14:23

And I've thought about that

1:14:25

cause I knew you were probably asking that question.

1:14:26

My scope of of interest

1:14:34

was the care of detainee population.

1:14:35

And in my professional life,

1:14:39

I, as a certified registered nurse anesthetist,

1:14:43

I deal in very significant physiological situations

1:14:46

in which I resuscitate

1:14:51

and deal with issues during surgery.

1:14:52

As I toured more, I began to think

1:14:56

about other things outside of my area of expertise.

1:14:59

And my background is not forensic medicine

1:15:03

and knowing what I know now,

1:15:10

I would've done things differently,

1:15:11

but if I had put two and two together

1:15:13

for a number of,

1:15:15

no for a few situations

1:15:16

that occurred under my watch,

1:15:17

and if I were thinking forensically,

1:15:19

I would have concluded something else

1:15:21

than what I concluded.

1:15:24

And so I think

1:15:26

by putting two together now,

1:15:28

I think, you know,

1:15:31

I would've asked some very difficult questions

1:15:32

of the commander and or of others

1:15:34

with physiological symptoms that have been seen, you know

1:15:37

medicine treats what we're given.

1:15:41

Emergency rooms and so forth,

1:15:45

we just treat what is given to us in that context.

1:15:46

And so I think the questioning perspective

1:15:50

of a forensic physician,

1:15:54

or me thinking forensically,

1:15:56

we would've made a different choice

1:15:59

about different things.

1:16:01

Interviewer

Can you give me a better

1:16:02

understanding of that?

1:16:04

I mean, what could you have done

1:16:05

if you had discovered that in fact,

1:16:06

somebody

1:16:09

-

I wouldn't have gone

1:16:10

to the JTF commander and said what's happening.

1:16:11

You know, what is happening

1:16:14

to present these kinds of symptoms,

1:16:15

for example.

1:16:17

Interviewer

And what if he says to you

1:16:18

it's none of your business,

1:16:20

you just treat symptoms.

1:16:20

-

Well, that's a good point.

1:16:22

And that that conversation never occurred.

1:16:24

And if it did,

1:16:26

I think I then would have used the chain of command,

1:16:27

as I can use the chain of command,

1:16:31

to allow others to understand it.

1:16:33

But, you know, and we all know

1:16:35

that these kinds of things were maybe authorized

1:16:37

at significantly higher authority

1:16:40

than the Joint Task Force Commander.

1:16:42

Whether it would've made a difference or not,

1:16:45

I'm uncertain.

1:16:48

But the clarity that I have now

1:16:49

was not the clarity I had then.

1:16:51

Interviewer

Well, okay.

1:16:55

Let me ask you, you know, this is really fascinating.

1:16:56

Were there rumors around that early

1:17:01

that maybe people were mistreated just in the air?

1:17:04

You know, even if you had

1:17:09

-

Not at my level, not at my level.

1:17:11

I'm again,

1:17:13

I'm at the 06 level now, very senior level commander.

1:17:14

And I trusted the people in the JTF essentially.

1:17:17

Senior JAG Diane Beaver and others.

1:17:22

I trusted them in their ability

1:17:25

to make the good choices,

1:17:27

retrospectively,

1:17:29

maybe I should have been more caring,

1:17:31

more forensic in my addition, observations

1:17:33

Interviewer

Did you know General Miller?

1:17:38

-

Did I what?

1:17:40

Interviewer

Did you know General Miller?

1:17:41

-

Yeah, very well.

1:17:41

Interviewer

Did you get,

1:17:44

you didn't get any sense,

1:17:44

he never revealed to you or give you any sense

1:17:46

that maybe

1:17:48

-

General Miller came to us from Korea.

1:17:49

I found him to be

1:17:53

a remarkably

1:17:54

brilliant soldier,

1:17:58

doing what was best for the country.

1:18:02

And essentially I trusted him

1:18:07

and what he was trying to do.

1:18:08

And obviously he was given significant authority

1:18:11

to do whatever was necessary to gain intelligence

1:18:15

to prevent the next 9/11.

1:18:17

And, you know, I trusted that in the context

1:18:20

of who he was and why he was positioned there,

1:18:22

and then his ability

1:18:25

to engender support

1:18:28

from the JTF on his mission.

1:18:34

Interviewer

Did you ever have conversations

1:18:39

with Diane Beaver too?

1:18:40

Did you have conversations with her?

1:18:42

-

She was the JAG attorney.

1:18:43

-

Right.

-

And we had conversations

1:18:46

in the context

1:18:48

of the medical-legal context of,

1:18:50

I think medical records.

1:18:54

And I thought

1:18:55

that medical records should be privileged relationship

1:18:58

to the physician-patient relationship.

1:19:01

Interviewer

And she felt that they?

1:19:03

-

Well, it was, you know

1:19:06

we were an intelligence gathering organization.

1:19:07

And the next question you wanted to ask as well,

1:19:09

were medical records compromised?

1:19:11

And there wasn't a policy

1:19:13

in which medical records were being used by interrogators,

1:19:15

but I am reasonably certain that,

1:19:18

you know, at 2:00 AM in the morning,

1:19:20

someone came into the detention facility hospital

1:19:21

and asked a young corpsman,

1:19:25

"Hey, let me look at the record?"

1:19:28

I'm sure.

1:19:30

(Albert stutters)

1:19:31

But I didn't, you know.

1:19:34

Interviewer

Would it be uncommon,

1:19:34

wouldn't be obligated to inform you?

1:19:35

-

Oh no,

1:19:37

he'd be obligated to inform the nurse.

1:19:38

And, you know, I think, you know,

1:19:39

maybe it became something that was simply routine,

1:19:43

but I'm not sure.

1:19:47

But it wasn't a policy

1:19:49

that medical information would be used

1:19:50

in the context of information

1:19:52

that the interrogators would use in other situations.

1:19:55

Interviewer

Why'd you leave?

1:19:59

-

Transferred out.

1:20:01

Time to go.

1:20:03

-

Was it time to go or was it

-

Well I was extended an additional year.

1:20:06

I was only going to be there for two years

1:20:08

and I was there three,

1:20:10

and it became, you know,

1:20:13

intellectually exhausting to deal

1:20:14

in this kind of environment.

1:20:17

My initial tour was from August of 2000 to 2002.

1:20:18

And I was extended at the request

1:20:23

of the Department of Defense

1:20:25

for another year

1:20:28

for both dual-hatted roles.

1:20:29

Interviewer

Were you glad to leave?

1:20:32

-

No, I thought I was making a difference.

1:20:35

Cause I went into my next job was to be BRAC,

1:20:36

you know, BRAC 2005?

1:20:40

I was the BRAC lead in military medicine

1:20:42

in the Joint Cross Service Group.

1:20:44

So I went to a huge thick bureaucracy.

1:20:46

It was no fun.

1:20:48

I thought I was doing the mission,

1:20:49

I was doing well for the mission

1:20:53

in Guantanamo.

1:20:55

Interviewer

But looking back now,

1:20:56

if you hadn't left,

1:20:57

wouldn't you have been caught up in a lot of the

1:20:59

-

I thought about that too.

1:21:02

And probably,

1:21:03

but you know I think we would have dealt with that.

1:21:05

Interviewer

You think it could have been dealt with?

1:21:10

-

Well, somebody has to say no.

1:21:13

Somebody has to say something.

1:21:15

Interviewer

Well, who replaced you?

1:21:17

-

Steve Edmondson.

1:21:18

Interviewer

Did he say no?

1:21:20

-

I don't know.

1:21:21

I mean,

1:21:24

in the context of what Dr. Edmondson inherited from me,

1:21:25

I thought I had a reasonably stable medical environment

1:21:31

in which he inherited.

1:21:33

And frankly,

1:21:35

Steve and I have not spoken directly

1:21:37

about anything that occurred

1:21:40

in Gitmo under his watch.

1:21:41

Interviewer

How long was he there?

1:21:42

-

I think two years.

1:21:44

Interviewer

And force feeding.

1:21:46

must've begun under his watch then if it didn't

1:21:47

-

I think so.

1:21:49

Interviewer

Did you have ever meet

1:21:53

with people like Rumsfeld or Cheney or Addington?

1:21:54

They come through?

1:21:59

-

I only met Secretary Rumsfeld once,

1:22:01

and that was reasonably early in the mission.

1:22:04

And we just had, you know

1:22:07

casual conversation, nothing specific.

1:22:08

Interviewer

Did he ever say to you

1:22:11

these are the worst of the worst and you need to

1:22:11

-

Not to me directly.

1:22:14

He said it to the world.

1:22:14

Interviewer

Did he tell you

1:22:16

you're doing a great job?

1:22:17

-

Probably, you know,

1:22:18

that was early in the mission,

1:22:19

but he, you know,

1:22:20

he was the Sec of Def,

1:22:21

he would say that anyway.

1:22:23

But let me go back to another thing

1:22:24

that I think's important

1:22:25

for you to put in the context.

1:22:27

I don't know how much time you want to spend

1:22:29

because I can.

1:22:30

Interviewer

No, we have time.

1:22:31

We have time.

1:22:32

-

The National Community Red Cross was invited

1:22:35

to Guantanamo

1:22:38

as the detainees were first arriving.

1:22:39

And I established a very significant

1:22:43

and positive relationship with the ICRC.

1:22:46

And because of my lack of education

1:22:50

and experience in detention,

1:22:53

and because the ICRC are the most important people

1:22:56

in the world in relationship

1:22:58

to bringing sanity to a chaotic environment

1:23:00

in which they practice every day,

1:23:02

I found them to be an invaluable resource

1:23:05

of information on how to deal

1:23:07

with the detainee population.

1:23:09

And so I became very, very,

1:23:11

very, very involved with discussing

1:23:18

how do you do medicine in detention

1:23:22

in this kind of environment with the ICRC.

1:23:24

And in fact, I brought in an ICRC training team

1:23:27

which educated our medical staff

1:23:33

on the kind of things

1:23:37

that have occurred other places

1:23:39

in the world in detention,

1:23:40

untoward things.

1:23:43

And we talked about that collaboratively.

1:23:46

We did a three-day three-day course,

1:23:48

I think in April of 2003,

1:23:51

taught by the ICRC.

1:23:53

And so I needed raise the awareness of

1:23:55

of my medical staff about the things

1:23:58

that could occur in detention.

1:24:00

And the ICRC brought us,

1:24:01

to a point of understanding better the environment

1:24:05

in which we were working.

1:24:07

And another thing that,

1:24:09

you know, we read,

1:24:11

and I really it's unfortunate in my view

1:24:12

that WikiLeaks occurred in the context

1:24:14

of the trust that ICRC had in,

1:24:17

they call it the confining authority,

1:24:21

because they were rather blunt

1:24:25

and rather open about the criticisms

1:24:26

about what was going on in the camp.

1:24:28

And I think the trust

1:24:33

between the ICRC and the United States

1:24:35

was eroded based on WikiLeaks.

1:24:36

And I thought, I feel bad about that.

1:24:38

But I trusted the ICRC

1:24:40

and we sat down and talked

1:24:41

about individual detainees

1:24:42

prior to the,

1:24:48

after the ICRC physicians had interviewed many.

1:24:49

And we sat and talked about the kinds

1:24:53

of things that we could do to make the detainee

1:24:54

in the context, the medical context,

1:24:56

better for the detainee.

1:25:00

And I valued the ICRC tremendously.

1:25:02

Interviewer

Well, I'm really glad you brought them up

1:25:07

because it seems to me by April of 2003,

1:25:09

the ICRC could have hinted

1:25:13

to you that maybe there was something amiss

1:25:16

in the way that the interrogations were moving forward

1:25:20

and they didn't, they didn't

1:25:24

-

Well again,

1:25:26

I respect the confidentiality of communications

1:25:28

between the ICRC and myself.

1:25:31

And so I want to leave that at that point,

1:25:34

but I think

1:25:36

the ICRC certainly was in the context

1:25:41

of understanding better than I was even

1:25:45

what was going on.

1:25:48

-

Right.

-

And so,

1:25:49

but the confidential information that was shared with me,

1:25:52

I want to remain that.

1:25:53

I want to keep that confidential

1:25:54

because I think the trust relationships

1:25:56

that exhibit there are important

1:25:57

for the future.

1:25:59

And I'm not gonna speak

1:26:03

to the ICRC and what we discuss confidentially.

1:26:04

Interviewer

The detainees have a very different attitude

1:26:08

or many of them have very different attitude

1:26:11

about the ICRC.

1:26:13

They felt the ICRC didn't look out for them.

1:26:14

And if they told the ICRC problems

1:26:16

that they're having,

1:26:19

the ICRC said they were restricted

1:26:20

by the US government to really do anything

1:26:23

to help them.

1:26:26

-

I saw the ICRC as being honest and frank

1:26:28

in their report to the Joint Task Force Commander

1:26:31

Bad news was something that they didn't mind telling.

1:26:36

Interviewer

And did you know about the letters

1:26:40

and the redactions on the letters?

1:26:43

That's really not your concern,

1:26:44

but that was one of the concerns

1:26:46

that detainees had,

1:26:47

that mail they got, if they got any at all.

1:26:49

-

I don't recall that specifically

1:26:53

but it may have been reported

1:26:55

to the JTF commander in a confidential way

1:26:56

but I'm not familiar with that information.

1:26:59

Interviewer

The detainees always told us

1:27:02

that you have better food just before the ICRC showed up.

1:27:04

-

Well, you know, basically, you know

1:27:07

we went into this environment

1:27:10

not understanding what halal and halal meal was.

1:27:11

And so we wanted to give them

1:27:15

the American standard of meals,

1:27:16

but we became very sophisticated,

1:27:18

I think in the context

1:27:20

of making their dietary regime

1:27:21

in equivalent to what they'd receive

1:27:25

as a halal meal, for example.

1:27:28

And I think we became better stewards

1:27:30

of their confinement by doing things

1:27:35

like the halal meal and the Quran

1:27:38

and other things that we thought to be important

1:27:40

for them as human beings.

1:27:43

Interviewer

You know,

1:27:45

it's interesting when you were talking,

1:27:46

I was thinking if someone was thinking

1:27:47

and it's clear from all my interviews,

1:27:49

many people weren't thinking,

1:27:52

maybe just started acting

1:27:53

and Guantanamo came on too fast.

1:27:54

So I was thinking though,

1:27:56

they would have removed you early

1:27:57

and put in someone who knows the detentions

1:27:59

and medical facilities from the beginning,

1:28:02

as opposed to having you learn it

1:28:04

by seat of your pants.

1:28:06

That makes sense to you or no?

1:28:08

-

Well, sure.

1:28:10

I don't know of anybody in military medicine

1:28:13

that had any experience.

1:28:16

Interviewer

Really?

1:28:17

except maybe except in Leavenworth.

1:28:19

And I don't know how many Army physicians are,

1:28:22

I think of civilians in Leavenworth.

1:28:24

So this was a military mission.

1:28:26

And so they got who they got

1:28:28

and I was just there.

1:28:30

So they got me.

1:28:31

And so, yeah,

1:28:33

I think we've become more educated and sophisticated

1:28:34

in our context of military medicine

1:28:37

in detention facilities.

1:28:39

And I think,

1:28:42

but at that time of 2002,

1:28:43

there was no military medical officer

1:28:47

who had any experience.

1:28:51

Interviewer

And that is interesting.

1:28:53

So have you seen the medical facilities

1:28:55

and a profession evolve in Guantanamo

1:28:59

since you've been gone?

1:29:03

-

Well, again,

1:29:04

-

Or you haven't

-

I haven't communicated

1:29:05

-

paid attention?

-

Well, I paid attention,

1:29:06

very close attention,

1:29:07

but I'm there physically.

1:29:08

I think we're doing a reasonably good job now.

1:29:10

I think based on the media

1:29:12

and the public scrutiny

1:29:14

and the inability

1:29:18

of the United States

1:29:21

to begin the trial process, you know,

1:29:22

military or civilian,

1:29:27

I'm not sure what's best,

1:29:29

but tribunal process.

1:29:30

I think we're doing,

1:29:31

because we're under a significant scrutiny,

1:29:33

doing a better job across the spectrum.

1:29:35

Interviewer

When the med techs, I want to just go back

1:29:39

to the med techs.

1:29:43

You supervised them or they were under your

1:29:43

-

Two or three echelons below me, yes.

1:29:46

Interviewer

Would they, we interviewed one person.

1:29:48

He was very young

1:29:51

Is that typical, were most of them very young?

1:29:52

-

19, 22, yeah.

1:29:55

Interviewer

And did you see them

1:29:56

as having a different reaction

1:29:59

to what they were observing from the more

1:30:01

professional staff who've made military a career?

1:30:03

-

No, I can't speak to that specifically.

1:30:13

Interviewer

Right.

1:30:15

If you were going to make changes

1:30:18

for the next time,

1:30:25

if this were to happen again,

1:30:26

what would you advise people in the future?

1:30:27

Because obviously the purpose

1:30:31

of this project is so that this doesn't happen again.

1:30:32

-

I think in the medical context specifically,

1:30:35

the transparency of the mission intent

1:30:37

with regard to the JTF Surgeon

1:30:42

would be important,

1:30:44

and then let them struggle

1:30:46

with the ethical and moral dilemma,

1:30:47

how they deal with that.

1:30:50

You know, when you have retrospectively,

1:30:54

you know,

1:30:56

the attorney general and the vice-president

1:30:56

and others agreeing that this enhanced interrogation

1:30:57

is appropriate for the context of national security

1:31:02

which we are dealing,

1:31:05

you know, that that's a dilemma

1:31:07

that people have to face.

1:31:08

I had no idea that these kinds

1:31:11

of decisions were made at that level

1:31:12

at that time, but certainly with everything going on,

1:31:14

I mean, the plethora of information

1:31:17

that has been put out now,

1:31:19

we do understand that these people

1:31:21

had influence at a very high level

1:31:23

Interviewer

Would you like the Surgeon involved

1:31:25

with those decision-making processes.

1:31:26

Is that what you're saying?

1:31:28

The surgeon should be involved in the

1:31:30

-

Based on security clearance,

1:31:31

based on, you know, the wellbeing

1:31:33

of the individual human being.

1:31:35

My view is that the transparency should be

1:31:36

at least given to the surgeon to be informed.

1:31:38

Interviewer

Informed and make policy?

1:31:45

-

Not make policy, but be informed in relationship

1:31:46

to that process of gaining information.

1:31:50

And there's always going to be somebody

1:31:55

who's going to say okay,

1:31:57

but maybe there'd be people who say,

1:31:58

"No, that's not appropriate."

1:32:00

Interviewer

But if they inform them and they say,

1:32:02

"No, that's not appropriate,"

1:32:04

what happens then?

1:32:05

How do we stop it next time?

1:32:06

-

Well, I thought about that too.

1:32:09

You know, resigning,

1:32:12

then going to the press,

1:32:14

say what's occurring.

1:32:15

I'm not sure what the appropriate alternative is

1:32:17

in our society,

1:32:18

but I think the things that we need to consider

1:32:20

are the things that have been seen to be important

1:32:23

to our culture and our way of life, and,

1:32:26

you know,

1:32:29

somebody has to have the courage to say,

1:32:30

"No, stop."

1:32:31

Interviewer

So is that why you're speaking

1:32:37

to us today because you want that message out there?

1:32:38

-

I'm speaking to you

1:32:41

because I think the context

1:32:42

of our commitment to do the right thing

1:32:44

for the human being that was a detainee

1:32:49

permeated our medical component

1:32:52

in Guantanamo.

1:32:56

And I think it was demonstrated consistently

1:32:58

that we were going to do the right thing,

1:33:03

in spite of these people being the enemies

1:33:04

of our state.

1:33:06

For example, you didn't ask me about this

1:33:08

and I don't know if you know it or not

1:33:10

but we brought in a cardiothoracic unit

1:33:11

from Texas

1:33:15

because of a symptomatology

1:33:17

that one of the detainees was experiencing,

1:33:19

just a precursor to a heart attack.

1:33:22

And so we brought in a cardiothoracic unit

1:33:24

along with a with a trailer that can do stenting

1:33:26

of the coronary arteries.

1:33:29

And we were prepared to open his chest

1:33:31

and do a coronary bypass procedure in Guantanamo.

1:33:33

And we didn't have to do that,

1:33:37

but we did stenting of the

1:33:39

of the heart, of the coronary arteries.

1:33:41

And so,

1:33:43

the level in which we believed

1:33:46

that these detainees required the appropriate level

1:33:48

of care equivalent

1:33:51

to an American service member's

1:33:53

level of care was that important.

1:33:54

So we brought in cardiothoracic surgeons,

1:33:56

you know, all the things necessary

1:33:58

to do this procedure safely.

1:33:58

And we did.

1:34:00

And that's just an example

1:34:01

of the commitment

1:34:02

that we had to do the right thing.

1:34:03

We also had a CT scan there

1:34:05

and we didn't have that before,

1:34:07

but the physicians wanted to be able

1:34:10

to see the detainee in a CAT scan environment

1:34:11

versus an x-ray environment.

1:34:14

So again, the commitment of the nation medically

1:34:16

to do the right thing was always right there.

1:34:19

Interviewer

Would you use the same procedures

1:34:22

or equipment on the soldier

1:34:25

or was it limited to the detainees?

1:34:27

-

Limited detainees based

1:34:29

on their inability to leave the island.

1:34:31

For a soldier who's exhibiting these symptoms,

1:34:32

we would stabilize and get them into a environment

1:34:34

in which they did 50 cases a week

1:34:38

of open heart surgery,

1:34:41

but we were ready to do it

1:34:43

for the detainee,

1:34:44

because politically they couldn't leave Gitmo.

1:34:45

Interviewer

Would you fly experts in as well?

1:34:46

-

There would be there within 12 hours of being asked.

1:34:50

Interviewer

Were they military doctors

1:34:54

or not necessarily?

1:34:55

-

Military doctors.

1:34:56

Interviewer

Who had clearance?

1:34:58

-

Well, they were qualified to do the procedures

1:35:00

that we asked them to do.

1:35:05

I don't know

1:35:06

about the security clearance context,

1:35:07

but most officers have secret clearance at least,

1:35:08

but they were not involved

1:35:11

in any kind of, you know, intelligence stuff.

1:35:12

Interviewer

Do you have any other,

1:35:16

(someone indistinctly speaking to interviewer)

1:35:18

okay.

1:35:19

Do you have any other anecdotes

1:35:20

that might be illustrative of the kinds

1:35:21

of things that you did

1:35:25

that might help the viewer?

1:35:26

Is there some stories that you tell people

1:35:31

that you always think about

1:35:33

that maybe you haven't told us?

1:35:35

-

I think the key to the commitment

1:35:37

of each of the medical providers

1:35:40

who were in this environment

1:35:43

was a commitment to the human being.

1:35:45

And not the fact that this person

1:35:48

may be an enemy of the state.

1:35:50

And I think that permeated the command as a whole.

1:35:52

I think everyone

1:35:56

that I was associated with was committed

1:35:58

to the principle of doing no harm.

1:36:01

And I think that permeated many people's lives

1:36:03

in the medical context,

1:36:08

Interviewer

Is this something about,

1:36:13

do you think Guantanamo,

1:36:17

I know you're not really involved in this,

1:36:18

but I'll ask you in the few minutes left.

1:36:20

Do you think Guantanamo should be closed

1:36:23

or does it not really matter

1:36:25

if treatment is done well down there,

1:36:26

does it matter to you

1:36:29

whether Guantanamo is closed?

1:36:30

-

From a medical context,

1:36:32

these people should be in another place.

1:36:34

Politically, it's another story.

1:36:36

Interviewer

Why should they be in another place

1:36:38

from medical context if we have the

1:36:39

-

Because of the

1:36:40

-

facilities down there?

-

Because, well, we have the facilities now,

1:36:41

but I think as the population ages,

1:36:43

there's going to be environments

1:36:45

in which they're going to need more sophisticated care.

1:36:47

And so the resources bringing them in,

1:36:50

bringing them into a more stable community

1:36:53

would be easier to provide the appropriate care

1:36:55

rather than bringing others in.

1:36:58

You didn't ask me

1:37:00

about the juvenile enemy combatants.

1:37:01

Do you know about those people?

1:37:03

Interviewer

Yes, I do know.

1:37:04

Were they treated ethically, medically?

1:37:05

-

Let me,

1:37:07

I know we only have a

1:37:07

Interviewer

We can always put

1:37:10

another tape in.

1:37:10

-

Okay, during,

1:37:12

say mid, maybe about the nine month period of time,

1:37:16

we had some very appearing

1:37:19

to be young people coming

1:37:21

into the detainees population

1:37:23

from Afghanistan

1:37:26

and in questioning how old they were,

1:37:27

they didn't know how old they were.

1:37:31

So I made the decision

1:37:33

to do some radiological examinations

1:37:34

of their long bones in their arm

1:37:39

and which by a radiologist

1:37:41

and a forensic radiologist can determine the age

1:37:44

of the individual within a two or three months.

1:37:46

And let us know how old they were.

1:37:50

They looked pretty young.

1:37:52

And so these three young men were,

1:37:54

were very young.

1:37:57

They were like 12, 13, 14 years old,

1:37:58

something like that.

1:38:00

And they were caught up in the,

1:38:01

however people were being caught up

1:38:02

in the environment.

1:38:04

And one was I think maybe a driver,

1:38:05

one was a cook on something else.

1:38:10

And so as soon as we found out they were young,

1:38:13

we immediately removed them

1:38:16

from the general population,

1:38:17

because as we learned in Afghanistan

1:38:19

or wherever they were,

1:38:24

they were being abused by their elders,

1:38:24

sexually abused by their elders.

1:38:26

And so whether they were known to the people

1:38:29

in the camp or not as being who they were,

1:38:31

we removed them from the base population

1:38:36

and put them in a place called Camp Iguana,

1:38:38

in which they were separated.

1:38:42

And because of their age,

1:38:47

we began to,

1:38:49

under General Miller's purview,

1:38:51

begin to treat them differently

1:38:55

than the average detainee.

1:38:57

They weren't there for intelligence purposes.

1:38:59

They were there because they were just picked up

1:39:00

you know, from the field, I guess.

1:39:02

And so again,

1:39:05

we had psychologists and nurse practitioners

1:39:06

see them frequently to be sure things were going okay.

1:39:10

And then I think

1:39:12

there was an education program for them,

1:39:13

which we brought in educators

1:39:16

to teach them English and math and science.

1:39:19

And they watched video and so forth

1:39:21

in Camp Iguana.

1:39:24

Interviewer

Is this the three?

1:39:25

-

I think it was three.

1:39:26

Interviewer

They were 12 & 13, I understood.

1:39:27

-

Something like that.

1:39:29

Interviewer

Johnny, how much time is left?

1:39:30

Johnny

Five minutes.

1:39:32

Interviewer

Why don't we,

1:39:33

can we stop for a minute

1:39:34

-

Sure.

-

and then I can

1:39:35

-

Sure.

-

follow up

1:39:36

-

Sure.

-

with another question.

1:39:37

-

Sure.

Interviewer

Johnny can we switch tapes

1:39:38

whenever you're ready?

1:39:39

Johnny

Yeah, go ahead.

1:39:40

Interviewer

Did you want to finish up

1:39:41

on the juveniles?

1:39:42

Otherwise, I'll ask you some questions about the juveniles

1:39:43

before we go on to the

1:39:44

-

On to the geriatricians?

1:39:45

Interviewer

Yeah.

1:39:47

-

Yeah, okay.

1:39:48

Interviewer

So on the juveniles,

1:39:49

my understanding was there were more than those three.

1:39:50

Those three were the youngest by far

1:39:53

and they were really obvious,

1:39:55

but there was a 14 year old,

1:39:56

several 14 year olds,

1:40:00

and 15, 16 year olds.

1:40:01

-

Yeah.

1:40:03

I don't recall specifically,

1:40:03

but we moved the younger ones

1:40:05

I think for accuracy purposes,

1:40:08

I think we were allowing 18 year olds

1:40:11

to remain.

1:40:15

I don't remember more than three

1:40:17

during my time there.

1:40:20

Interviewer

Did you see Omar Khadr?

1:40:21

Cause he

1:40:25

-

Again, I don't remember.

1:40:26

I didn't know anybody by name.

1:40:27

I knew by numbers.

1:40:28

Interviewer

This was a man

1:40:29

who lost an eye.

1:40:30

He was young, really young boy actually

1:40:32

-

Right.

1:40:35

Interviewer

had lost an eye in a fire fight

1:40:35

and had a really damaged, I guess back or,

1:40:36

I can't remember where the other wounds were.

1:40:44

But I remember the loss of the eye.

1:40:46

You don't recall that.

1:40:49

-

I don't.

1:40:50

Interviewer

As far you understood then,

1:40:51

the only juveniles were those three.

1:40:56

-

Right.

1:40:59

Johnny

Otherwise they were over 18

1:40:59

-

At least.

1:41:01

-

Okay.

-

Yeah, during my time we didn't,

1:41:02

I don't know how long they were in the population

1:41:04

but probably not more than a week or two

1:41:06

because they were seen as small in stature.

1:41:07

Interviewer

Right.

1:41:09

-

But many in that culture are small in stature

1:41:10

but these people were really like pubescent.

1:41:12

And so we did the x-ray studies

1:41:14

and once they were removed,

1:41:17

I let the general know,

1:41:19

and they were removed

1:41:19

within an hour

1:41:20

of my telling them how young they were.

1:41:21

Interviewer

And you said you had a pediatrician on staff

1:41:24

or you brought one in?

1:41:26

-

We had a pediatrician on staff

1:41:26

and we also brought one in.

1:41:27

Interviewer

And then,

1:41:30

so do you want to go to the other end

1:41:31

with where there were some,

1:41:32

apparently you really old.

1:41:34

-

Yeah.

1:41:35

Father Time, we used to call him.

1:41:36

I forget exactly what his name was

1:41:37

but our name was Father Time.

1:41:40

And he was probably in his mid, late eighties.

1:41:41

And then we had others who were older

1:41:43

and, you know, people like us,

1:41:45

when we get older,

1:41:47

we have certain maladies.

1:41:48

We wouldn't have exhibited

1:41:49

or thought about earlier in our lives.

1:41:50

So I bought a geriatrician in from San Diego

1:41:51

and I think we had a cohort

1:41:54

of about 16 to 20, over 70,

1:41:55

I think, over 65 at least.

1:42:01

And I think they deserved,

1:42:02

based on my getting close to that age, myself

1:42:04

at that point needed some specific care.

1:42:08

And so we brought him in every quarter

1:42:11

to monitor the health of the geriatricians.

1:42:14

Interviewer

Were they separated too?

1:42:18

Or they were

1:42:19

-

I think they separated out because

1:42:21

of their seniority

1:42:23

by the detainee population themselves.

1:42:25

Interviewer

But they were kept

1:42:29

within the general population.

1:42:30

-

But they were,

1:42:31

they were deferred to by general population,

1:42:32

very differential to the older and more wisened men.

1:42:35

Interviewer

And then you were going to talk

1:42:41

to us about nutrition

1:42:42

-

Right.

-

What did you want to

1:42:44

-

One of the things

that we felt is that

1:42:45

if we gave these detainees,

1:42:47

the typical American diet

1:42:49

once they transitioned from halal,

1:42:50

that there would be a significant

1:42:53

amount of weight gain.

1:42:54

And so we borrowed a nutritionist

1:42:55

in from Portsmouth

1:42:57

and she devised a nutritional menu

1:42:59

for the detainees

1:43:04

if they didn't wish to have halal meals.

1:43:05

And so unfortunately,

1:43:07

there was still significant weight gain

1:43:10

over a period of time within the population.

1:43:12

And in fact,

1:43:14

there wasn't anybody obese when I left,

1:43:15

but there are certainly detainees now

1:43:18

that are close to obesity,

1:43:19

but we did bring the nutritionist in

1:43:22

and we thought we wanted to have a balanced diet

1:43:24

for the detainee.

1:43:28

And so she devised,

1:43:29

based on cultural standards,

1:43:31

a diet that would be acceptable for them,

1:43:34

even though it was an American product.

1:43:37

Interviewer

My understanding,

1:43:40

and I don't know if it's true

1:43:41

when you were there

1:43:42

is that the detainees were given

1:43:43

4 to 5,000 calories a day,

1:43:46

and that's why there was this continued weight gain.

1:43:49

Is that possible?

1:43:52

-

They weren't given that number

1:43:55

of calories when I was there,

1:43:56

but maybe later

1:43:58

as they increased their physical activity,

1:44:00

they may have been seen

1:44:02

to be needing that number of calories,

1:44:04

but that's even a lot for an athlete.

1:44:05

Interviewer

Right.

1:44:07

But I think it was tried, it was done

1:44:08

so that they would, "Look healthy with the left"

1:44:11

at Guantanamo.

1:44:14

That was never something that was said to you?

1:44:15

-

No, no.

1:44:19

Interviewer

In terms of exercise,

1:44:20

were you involved in the exercise program for the detainees?

1:44:22

-

Not directly.

1:44:25

Indirectly, I advocated

1:44:26

for some kind of physical exercise to take place

1:44:28

for each detainee every day.

1:44:30

Interviewer

Did they hear you?

1:44:32

Was that the reason why they got some

1:44:33

or did they not get it?

1:44:35

-

Oh there was an exercise area

1:44:37

outside each of the areas of detention,

1:44:39

which they could play basketball

1:44:42

or do whatever they wanted to do.

1:44:44

And so exercise was part of their daily routine.

1:44:45

Interviewer

Did all of them get exercise

1:44:50

-

Probably not.

1:44:52

Some would choose not to.

1:44:53

Interviewer

Was it punishment also

1:44:56

that they wouldn't get exercise.

1:44:57

-

I'm not sure.

1:44:59

Interviewer

And who did you suggest

1:45:02

that they get exercise?

1:45:04

Who were you talking

1:45:05

-

Well, I think it was just,

1:45:06

you know, good overall care.

1:45:07

It was probably the JTF commander.

1:45:09

Interviewer

Were the halal meals

1:45:13

also a nutritionally balanced meal,

1:45:14

or was it just

1:45:17

-

You'd have to ask nutritionist about that.

1:45:18

We thought we'd need to be culturally sensitive

1:45:20

to their dietary requirements.

1:45:22

Then halal meals were ones,

1:45:24

in which we surprisingly,

1:45:26

already had an inventory.

1:45:28

And so they were brought down to Guantanamo

1:45:30

once we recognized

1:45:31

that this would be culturally appropriate.

1:45:32

Interviewer

How many meals were given a day

1:45:36

to the detainees?

1:45:37

-

Two, I think.

Interviewer

Can you describe what they might've been?

1:45:39

-

No.

1:45:44

-

You never saw

-

I may have known at the time.

1:45:45

I don't remember what they are now.

1:45:46

Interviewer

And did they get MREs at all?

1:45:50

Do you remember?

1:45:52

-

I think initially MREs we used at Camp X-ray

1:45:53

because that's what we had.

1:45:56

But as General Leonard and others understood

1:45:58

MREs were not good.

1:46:03

Again, this MRE was probably somewhat intolerant

1:46:04

of the digestive systems of the detainee.

1:46:09

So as soon as we found that out,

1:46:13

we felt that it would be doing something better.

1:46:14

Interviewer

So is there something else

1:46:19

that I didn't ask you

1:46:20

that you were expecting me to ask

1:46:21

that you want to address?

1:46:23

-

I think recognizing the fact that we were in a situation

1:46:27

in which we could have deaths,

1:46:30

I developed an appropriate burial place

1:46:33

for the detainee population,

1:46:39

and we also went

1:46:41

and made a protocol

1:46:43

for any death that would occur,

1:46:44

the post-mortem would occur within 24 hours

1:46:51

of the death,

1:46:53

recognizing the fact

1:46:55

that they needed to be interned

1:46:56

within a certain period of time.

1:46:58

So when we had that protocol culturally appropriate

1:46:59

for them,

1:47:02

and we did set aside a Muslim area

1:47:03

of our cemetery in Guantanamo,

1:47:08

since we have a cemetery in Guantanamo

1:47:09

among other things.

1:47:12

And so we set aside an area for

1:47:13

if they did die, they would be there.

1:47:15

So we did,

1:47:17

we went a long way

1:47:18

to ascribe to their beliefs.

1:47:21

Interviewer

Burying them Guantanamo

1:47:24

as opposed to sending them back home.

1:47:27

-

Again, the message early was

1:47:29

they weren't going any place

1:47:31

except Guantanamo.

1:47:32

Having been deceased,

1:47:33

certainly that would have been

1:47:34

another national security issue of less importance,

1:47:35

but we had to make provision

1:47:38

in case that occurred.

1:47:41

And I think initially we did that.

1:47:42

And of course now

1:47:45

that people have passed away there,

1:47:46

they are sent back to their home,

1:47:47

country of origin.

1:47:49

Interviewer

Do you consult just with,

1:47:52

besides sending people over to federal prisons,

1:47:55

as you said earlier, try to understand,

1:47:58

did you do other consulting for yourself

1:47:59

just to see what you will help you.

1:48:01

-

CDC, Center for Disease Control

1:48:05

Interviewer

You went there or

1:48:08

-

CDC, I don't believe came down,

1:48:09

but we did,

1:48:11

our people

1:48:17

who are doing public health were in contact

1:48:18

with CDC by telephone and by email.

1:48:22

Interviewer

You have public health people

1:48:26

on staff, the military.

1:48:27

-

Yes, and they in turn

1:48:29

were responsible for sanitation

1:48:31

and all the other things

1:48:33

that are related to, you know

1:48:34

vector control, mosquito control,

1:48:36

and other things that would be associated

1:48:37

with a large a stationary population.

1:48:39

Interviewer

Are the mosquito control issues

1:48:44

in Guantanamo?

1:48:45

-

No, because we're pretty aggressive

1:48:47

at keeping the mosquito population down.

1:48:48

Which again,

1:48:51

Shimkus, Albert - Interview master file

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