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The Hospital on the Hill

From a distance, the West Palm Beach Veterans Administration Medical Center sits there like a castle on a hill. Just west of I-95 on Blue Heron Road, the veterans hospital perches atop a man-made knoll anchored by a cavernous parking garage. A single, narrow drive curls up to the hospital's entrance, a bottleneck for patients being pushed in wheelchairs or perambulating slowly with crutches or walkers.

The surrounding grounds are a labyrinth of parking lots, one-way loops, and footpaths. So busy is the medical center that parked cars swell onto the grassy swales on the periphery.

As impressive as the hospital looks from a distance, the ten-story building's design was virtually obsolete upon completion ten years ago. By then, medical cost-cutting had moved away from admitting patients into hospitals in favor of treating them on an outpatient basis. It was like building a high-rise hotel and then turning it into a fast-food restaurant: wasted vertical space and an obstructively narrow entry. On any given weekday morning, hundreds of visitors -- many aged veterans of World War II and the Korean War -- trudge toward the hospital entrance on high. The less hearty wait at various pickup points to ride shuttles.

By the time they get to the striking, sunlit atrium that serves as the hospital's anteroom, they can start tracking their waiting time on a giant clock hanging there. Uniformed nurses, technicians, and doctors zip through the space and scuttle down the tangle of hallways stretching into the vast medical complex.

With a budget of about $220 million this year, the West Palm Beach VA Medical Center treats about 2,000 veterans a day as outpatients. It's the fastest-growing veterans hospital in the state, serving the counties of Palm Beach, St. Lucie, Martin, Okeechobee, Indian River, Hendry, and Glades. As aging veterans have migrated from the chilly north to the Sun Belt -- along with a good share of younger vets -- this medical center has become crucial in caring for those who served in America's military. The veteran medical system is part of the nation's social contract with former draftees and volunteers of the military: Give your time, your health, your limbs for the defense of the country and our country will care for you. With the ongoing battles in Afghanistan and Iraq, hospitals like this will be all the more indispensable.

But some employees of the hospital -- many of whom are veterans -- describe it as a workplace rent with nepotism, favoritism, retaliation, and self-dealing. They claim, with considerable support from the VA Inspector General's Office, an investigative arm of the federal agency, that the institution's management is more concerned about manufacturing rosy budget numbers in order to receive bonuses and pay incentives than it is in solving problems and serving veterans.



"It's pounded into us: Do what's right for the veteran, do what's right for the veteran," one long-time employee says. "And there are a lot of good workers who do that. But that has now become a sarcastic comment for those of us who've been here a long time. 'Do what's right for the veteran,' from the top down, is nothing but a lot of bullshit from management. Doing what's right from the management's standpoint is: Do what's right for me to get my bonus. Screw the veteran."

The past years have brought about a bevy of complaints to the union and the VA Inspector General's Office. But the grievances, even when they were substantiated, have led to little in the way of reform. In fact, whistle-blowing often leads only to retaliation.

"What I learned," says one employee who decried favoritism by management and felt the wrath of his superiors, "is that they all gang up on you with the hope that you'll give in and say, 'I'm tired of this crap. '" (He asked not to be identified to avoid further retaliation.) He adds: "Anyone who has a title in this administration thinks the rules are there to punish the rest of us but that none of that stuff applies to them."


Such an atmosphere of reprisal can't occur in a vacuum, and many employees blame the man in charge of the hospital, Edward H. Seiler, for fostering it. Director since 1998, Seiler is a Teflon chief, protected by what critics describe as a good ol' boy mentality that permeates the Veterans Administration. Insulated from the public by handpicked staff and an on-site federal police force, Seiler is obsessively parsimonious, sometimes petty, and at all times in control. Divorced last year, he lives in a modest, two-bedroom home adjacent to the hospital, but the medical center is the castle he calls home.

His leadership has demoralized many employees and, ultimately, lessened the quality of care, critics say. "In the face of a punitive leader -- who hires managers who are afraid of him -- you don't get much creativity," one long-time doctor at the medical center says.

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Wyatt Olson
Contact: Wyatt Olson