Shimkus, Albert - Interview master file
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Transcript
Transcripts may contain inaccuracies.
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 | |
related back to the malaria question. | 1:48:52 | |
And there's always a possibility | 1:48:54 | |
of a mosquito getting in and doing, doing harm. | 1:48:58 | |
So we did have mosquito eradication routinely | 1:49:00 | |
but people coming in | 1:49:06 | |
who had malaria, | 1:49:08 | |
being bitten by a mosquito, | 1:49:12 | |
and then that mosquito biting someone else | 1:49:14 | |
could create a problem with an endemic situation, | 1:49:16 | |
which we didn't want to introduce into Cuba. | 1:49:19 | |
Interviewer | Was the weather an issue at all? | 1:49:23 |
You know, | 1:49:27 | |
the fact that they weren't exposed, | 1:49:28 | |
at X-ray, they weren't exposed | 1:49:30 | |
- | General Leonard was very aware of that. | 1:49:34 |
And although the areas of detention were with wire, | 1:49:36 | |
shades and tarps were put on | 1:49:42 | |
so they wouldn't have direct sunlight. | 1:49:45 | |
Once Camp Delta was built, | 1:49:47 | |
there were hardly any area | 1:49:49 | |
which had direct exposure to the sun. | 1:49:51 | |
So environmentally, | 1:49:53 | |
there's always a breeze in Guantanamo, | 1:49:55 | |
so there was always like 80, 85 degrees, | 1:49:56 | |
no more than that. | 1:49:59 | |
And so it was always a gentle breeze | 1:50:00 | |
going through the camp. | 1:50:02 | |
Interviewer | Did you ever ride | 1:50:05 |
on any of the planes where the detainees came in? | 1:50:06 | |
- | No. | 1:50:08 |
Interviewer | Did you ever board those planes at all? | 1:50:08 |
- | No. | 1:50:10 |
Interviewer | And were you ever present | 1:50:12 |
when detainees left? | 1:50:13 | |
- | Did any be repatriated? | 1:50:18 |
I don't think anybody was repatriated | 1:50:19 | |
during my watch. | 1:50:20 | |
Interviewer | Something else I didn't ask you | 1:50:23 |
that you wanted to share with us. | 1:50:24 | |
- | Oh, no. | 1:50:27 |
I think this is a, again, like the, you know | 1:50:28 | |
for the record, anything that's comes up | 1:50:31 | |
in other discussions | 1:50:34 | |
that you'd like to talk to me about, | 1:50:35 | |
I'd be happy to talk further. | 1:50:35 | |
Interviewer | Oh, okay. | 1:50:38 |
Well, we'll bring you back for round two. | 1:50:39 | |
- | I'm sorry that we had this discussion | 1:50:43 |
when, not being able to go to San Francisco, | 1:50:45 | |
but jury duty being what it is. | 1:50:46 | |
No, I'm relatively comfortable | 1:50:48 | |
with what decisions I made at Guantanamo. | 1:50:52 | |
I think under different conditions of transparency. | 1:50:54 | |
maybe I would've made different decisions | 1:51:00 | |
as a Joint Taskforce Surgeon, | 1:51:02 | |
but generally I'm comfortable | 1:51:03 | |
knowing what I knew then, | 1:51:06 | |
we made the right choices based | 1:51:10 | |
on everything I knew for the individual human being. | 1:51:11 | |
Interviewer | And I guess we'll just repeat this | 1:51:16 |
since we have this whole card, | 1:51:18 | |
other than transparency issues is something else | 1:51:20 | |
that you'd like to advise people in the future | 1:51:23 | |
as to what they should do to do it right? | 1:51:26 | |
- | I think adhering to Hippocratic oath, | 1:51:30 |
adhering to the principles | 1:51:33 | |
of do no harm, | 1:51:35 | |
supporting the country in the context | 1:51:36 | |
of where you're placed in responsibility, | 1:51:39 | |
and being, | 1:51:41 | |
having enough courage | 1:51:44 | |
to bring to the surface areas | 1:51:45 | |
in which you don't believe to be appropriate. | 1:51:47 | |
Interviewer | Amen. | 1:51:52 |
- | Amen. | 1:51:53 |
Interviewer | Well, thank you. | 1:51:55 |
We need 20 seconds. | 1:51:56 | |
Johnny needs 20 seconds of quiet time | 1:51:57 | |
before we are close. | 1:51:59 | |
- | Sure. | 1:52:01 |
Johnny | Begin room tone. | 1:52:02 |
And room tone. | 1:52:27 |
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