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26 January 2017

How many hoops do I have to jump through?

Tuesday January 17

First actual appointment at the Vet Center

Allowing for Atlanta Traffic, and with the help of my iPhone, I'm there a few minutes early. A few things to say about getting *to* the appointment-- if you've ever spent any time around the city of Atlanta (and within, let's say, about a 50 mile radius) you know why Atlanta Traffic is capitalized. I kinda like driving here, because in general the rule is a lot like Chicago Traffic. Go fast when you can, be careful, be chill, and slow down when (and only when) you have to do so. It's important to note that I've not been honked at, or flipped off, once since I arrived here. I'm a decent driver, I think, but I've also made mistakes that certainly justified my being honked at. People just seem to accept that we're all in this together and move on.

I mention my iPhone, because it runs my life. I'm chronologically challenged (PTSD and depression combined take away my sense of time.) I have the option to enter a location for calendar events, and the option to have calendar alert me when it's time to leave based on traffic conditions to that location. I also by default set an alarm for one hour before time to leave, to allow time for getting my shit together and getting out the door. I know where I'd be without this-- always late. I totally subscribe to the military theory that ten minutes early is still late, but it's difficult to acheive without help from technology.

The appointment: I check in at the desk. The Desk is actually a sub-office, one of those where there's a sliding glass window that marks the boundary between Inner and Outer. As at my first visit, there is a coffee pot but no coffee or offer to make some. I'm asked again for a copy of my DD214, which I have and which I provide. Desk Person tries to hand me a clipboard with the same forms I filled out during my initial visit, and I explain that I've already filled those out. After a few minutes wait, Counselor opens the Door and comes out to look for me. The Door is the entry to the Back. A handshake is not offered, or even suggested. I follow Counselor down a hallway to an office that is somewhat dimly lit. There is a standard desk, with two standard chairs that face each other.

As expected, this is an intake appointment, intake meaning "tell us your life story so we can help you". I am asked, again, where and when I served. The initial questions are all the same questions I answered on the form I was given during my first visit, which tells me that a) no one even read those and b) no one's even looked at my records to see what I'm about. At more than one point the phone on the desk rings several times before voicemail picks up. During the part of the form where I describe my PTSD symptoms, I note that things like phones ringing can be very triggering and distracting, but the phone is not silenced.

There are several times, when describing parts of my life, that Counselor stops and says "Wow", with the kind of look that implies "really? holy shit". One of the most pronounced is when I relate that I've applied for, and been denied, and appealed, and been denied again for, service connection for PTSD. Many notes are taken. I've answered all of these questions before, pretty much every time I've either switched or been switched to a new mental health care provider.

The hour is up. An appointment is scheduled for next week. I'm politely escorted out of the Back into the Front through the Door. Again, a handshake is not offered.

Monday January 23

Second appointment at the Vet Center

See above relating to Atlanta Traffic.

Again, I'm a few minutes early. I check in with Desk person, and coffee is again not offered.

As I'm waiting for the Door to open, I look around. Something about this Vet Center bothers me, and I realize that it doesn't look anything like a Vet Center. There's some Vet Center stuff on the walls, and a table of flyers and brochures, but it looks like probably any other doctor's (or similar professional's) office. A number of years ago, I worked as a courier. I picked up and delivered small packages, envelopes, etc. which meant that I visited just about every office around Milwaukee and a decent number of offices around Chicago. They all look kinda the same inside. Outside, many of them are in the same subdivision style office park that's on a main street or highway, yet just off the main street or highway. That's what, and where, this Vet Center is. It looks, and feels, just like any other random doctor's office.

Counselor opens the Door, which I get up and head towards. As before, a handshake is not offered. As before, we go back through the hallway to the same office. I sit in the same chair. Counselor gets out the clipboard and form and we go through more questions. The phone rings several times, making me jump a little each time, before it finally forwards to voicemail.

The questions are still more of the same. I've answered all of them, for the VA, before. When I'm asked to describe, again, the stressors I encountered in combat in the Desert I notice my voice cracking a little, I notice I'm shaking a little. If Counselor notices, she doesn't give any indication. At one point I ask about how to go about getting the pages from my medical records removed where the VA Community Programs person in Madison said I was just looking for free meals and a free bed; when she mentions Records at the Atlanta VA Hospital I observe that it's probably on the first basement level to the left of the elevators, right? We both laugh at this, but I'm not sure the irony is caught that I already know where things are in a hospital facility I've never been in.

After a while, towards the end, I ask how many sheets of "attach additional sheets here" she's used up. Like I said, I've seen the form she's filling out with my answers before.

Time's up. The form still isn't complete, next we need to talk about Goals. An appointment is made for next week Friday. I'm again escorted back to the Outside, through the Door. Again, a handshake is not offered.

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This all starts on January 3 when I made my first visit to this Vet Center. My next appointment, when I (we) will hopefully and finally be finished with the intake questionnaire, is on February 3. It's only after the intake is done that anything that can be considered "counseling" will happen. Nothing so far has been any kind of treatment. Sure, I got a first appointment at the Vet Center in about a week. How long will it be before I actually get any real help?

For those of you keeping score at home, at least a month.

How far do you think that a veteran who was having enough trouble with their life that they drove to a Vet Center to talk to someone could slide in a month?

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I've noted several times now that there was no offer of coffee (even though there's a coffee pot) at this Vet Center. I've also noted the several cases where a handshake might have been appropriate, but it was not offered.

The majority of the people in the hundreds of medical and professional offices I visited as a courier were polite and professional. You're welcome here to pick up or drop off the package, and we might exchange some pleasantries along the way but that's as far as it went. I was never offered a handshake (or a cup of coffee) over pickup or delivery of a package, because I was a worker drone (and so was the other party, usually). Being a courier did involve politeness, but it wasn't something that warranted extended formality from either me or the customer on either end.

The people I've encountered at this Vet Center are polite and professional in exactly the same way.

It matters to a veteran (to me, anyway) that a Vet Center is supposed to be different than just going to mental health at the VA Hospital. That there's a coffee pot implies respect, because offering a veteran a cup of coffee is an act of respect. At the VA Hospital, you have to go buy your own coffee and someone else profits from the sale. A handshake as a veteran (as a civilian) is a lot like a salute when you're in uniform-- there's a deeper meaning that it's appreciated on both sides what it means to be a combat veteran and be in a Vet Center.

If it's just another clinic, just another office, then what's the point of having Vet Centers? Just call them mental health clinics if that's what they are.

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Right now, I get more out of having somewhere to drive to once a week than what I'm getting out of the appointment itself. Being in traffic for 40 minutes each way, stopping on the way there or on the way back for a diet Dew, listening to the radio in the truck, is at least something that resembles normal human behavior. I feel better having just made the trip.

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Next appointment, the remaining part of the intake questions will be Goals.

Whenever I hear "setting goals" I'm reminded of the mandatory goal setting that happened in transitional housing-- goals like "eliminate depression" and "eliminate PTSD symptoms". Goals mattered because the paperwork required them. They were pencil whipped, so when the VA inspected the place once a year and said "are veterans setting goals and are these goal being tracked" the person with the clipboard would check "yes" and the place would pass inspection. This kept the grant per diem money flowing freely.

Still, it's important to think about what my goals are for this whatever-it-is I'm going through with the Vet Center now. Otherwise what's the point of going through all of it?

In one sense I've been out of mainstream society for the past two years. I spent most of my time either at home, at work, at McDonalds or the student union getting food/coffee/soda, or at hackathons. I spent more time exploring other cities on hackathon trips than I went out of my home-McDs-work-McDs-home daily circuit. For the two years before that, I was homeless. There never was any followup from the VA, one day I was in transitional housing and the next I was on the street. When I found a permanent place to live on my own, as far as the VA was concerned, I wasn't homeless-- or even at risk of being homeless. Mentally, emotionally, I was left to deal with all of that on my own, on top of the (social) anxiety, depression, and PTSD.

I'm still dealing with all of that on my own, and could use some help trying to make sense of it.

Whatever friends I thought I had in Wisconsin before I left, only one person has given any indication of wondering where I am or how I'm doing (and that person left around the same time I did). That's not to say I didn't have an impact there-- I did a lot of things for a lot of people-- but none of that matters now, and that's sad and disappointing. When I say I'm from Wisconsin, I cringe a little, because to me being from someplace where people can forget you that quickly isn't something I'm that proud of.

If I didn't trust people before (and I didn't), I most certainly don't now. About the only people I trust any more are veterans.

Romantic life? Dating? What's that? I haven't been on a date in over two years. I haven't been in a relationship since the spring before I became homeless (and that was in 2012). Before that the last longer-than-a-month relationship I was in, I ended because it was a train wreck even after we went through VA couples therapy for veterans with PTSD (actually to clarify, I attended the last session of that workshop alone). It's probably been that long since I was even on a second date. In that time, things like Tinder happened, and at the risk of sounding old, I don't really know what the rules are any more. And again, I don't trust people. I don't believe in soulmates any more. It's quite hard to believe that there's a woman that would truly stick with me no-matter-what given past experience.



It's bothering me a great deal that I don't have steady work to do; I have a more or less quiet place to work in a bedroom office, and I have enough learning material to keep me busy, but it's not the same as having something with purpose to do. Work, hacking (same thing) helps fight off the anxiety and depression and PTSD. I've thought a lot about what happened working at the University of Wisconsin, with the open office and ADA accommodations and all of the bullshit I had to wade through just to be able to code. The interviews I've had since leaving Wisconsin haven't given me much hope that things will be different anywhere else. I have encountered some consulting opportunities, and it's making sense to just be my own employer, but it's so far been really difficult to get past the same (social) anxiety, depression, and PTSD to make those connections.

It's looking into the future a bit, but it'd be a good thing to run my own shop made up only of veterans. I'm not sure I'd trust anyone else. If you want an idea of the kind of business I'd like to run, watch Sacred Steel Bikes on Discovery, but for infosec.

I need to resurrect my service connection claim process with the VA, which means I need to talk to a service officer of some sort, which means I need to connect with a veterans organization of some sort-- American Legion, VFW, etc. My last experience with VFW, where I left and have never gone back, doesn't make the idea seem like much fun.

I also recognize that I want (and probably need) to connect with other veterans again. There were of course a lot of student veterans at Wisconsin, but when my PTSD really kicked in and caused problems, and when I became homeless, the student veterans organization there wasn't equipped to help with that. So that leaves, again, American Legion and VFW. Maybe being in a place different than Wisconsin, things will be different enough, but I have to get over the associated anxiety to even find out.

These are the things I'll bring up when we start talking about goals.

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