Tuesday, December 15, 2009

Commanding Officer Prevents Navy Corpsman with TBI, PTSD and Dissociative Amnesia from Getting a Service Dog

Terry Henry, The paws4vets Advocate
Jacksonville, NC

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“Tell him to get a f * * k’n Shih Tzu and he can pet it when he’s sitting at home,” said the sharp, dismissive and flippant voice of U.S. Navy Captain, Gerard R. Cox, Commanding Officer, Naval Hospital Camp Lejeune, Jacksonville, NC. This statement subsequently ended the second attempt by HM2 Kloppenborg’s psychological treatment team to place him on convalescent leave so that he could begin the process of obtaining a Psychiatric Service Dog. It also began the second period of deliberately inflicted psychological trauma HM2 Kloppenborg had to endure; caused, not by the Taliban, not by an al-Qaeda terrorist or an Iraqi militant, but by his own NAVY and his own Commanding Officer.

Hospital Corpsman, Petty Officer 2nd Class, Buf Kloppenborg is a true hero although the humble, highly decorated Combat Medic would never admit this himself. With 14 years of service in the U.S. Navy, three combat tours in Iraq, which resulted in TBI (Traumatic Brain Injury) and Complex-PTSD (Post Traumatic Stress Disorder), and countless other assignments; HM2 Kloppenborg is now confronting another diagnosis; Dissociative Amnesia. Between HM2 Kloppenborg’s return from his third combat tour in Iraq in October 2008 and again in late January, 2009, he underwent many turbulent and traumatic personal psychological events which culminated when he attended the funeral of a Marine; a close personal friend in Western North Carolina. ”I woke up on January 31, 2009 curled up in the back of my vehicle in a totally confused state of mind. I could not remember anything in my life after to 1994”, related Kloppenborg, “I thought I was 25 years old and I didn’t know what I was doing in North Carolina.” HM2 Kloppenborg was able to contact a friend from Denver he had known for over 20 years. With the help of this friend, Buf returned to Camp Lejeune, not remembering anything other than what his friend had told him about why he was returning. He followed his friend’s advice and instructions and checked himself into the U.S. Naval Hospital Camp Lejeune.

For the next several weeks Buf was a medical mystery. He was back at his duty station. He had supervised, reported to, and worked side-by-side with these people just days before, but he couldn’t remember anything or anyone. In fact, he couldn’t remember the past 14 years of his life. Buf does not remember his ex-wife or his children, his three combat tours in Iraq, or his other duty rotations. He has no recollection of his friends or the hundreds of Marines whose lives he has saved, or the injuries he has treated. HM2 Kloppenborg has Dissociative Amnesia; very simply stated, this is when a person blocks out a time period of their life that is frequently associated with a stressful or traumatic event. “Buf has an extreme case as his time period is quite substantial,” said Dr. (Commander) Rebecca Webster, USN, a member of Buf’s psychological treatment team. “Buf’s case is also quite unique in that his amnesia has lasted for such a long period of time,” continued Dr. Webster.

Buf is constantly approached by Marines who thank him for saving their lives or the life of one of their buddies. Buf has “old friends” who come up and engage him in conversations about events and people he should remember – but he does not.

Buf lives with the after effects of his TBI and Complex-PTSD due to events and injuries he does not remember. “Try answering questions in a therapy session about what happened to cause your PTSD symptoms when you can’t even remember being in the country, let alone the actual event that caused the injury. It’s very hard,” said Buf. His brother related that Buf’s injuries were the result of an IED explosion in Iraq.

Buf has an ever increasing fear of touching other people and of being touched. Of particular difficulty for him is being approached unknowingly from behind; the “Fight-or-Flight Response” immediately kicks in. Buf constantly has to “check his 6” to the point that, at times, it could be called an obsession. “I am very afraid of what I might do to a person if they were to surprise me by tapping me on the shoulder. I am very afraid that I might hurt someone. I don’t know how I would handle it if I hurt someone, so I pretty much try to stay away from people or situations where that might happen,” explained Buf. Buf has experienced the “Fight-or-Flight” response at the slightest brush of physical contact (i.e., a store clerk brushing his hand while giving him change).

Because of this fear, Buf is no longer able to provide treatment to patients which is what he loves to do. “I stay in an office and the other Corpsman comes in and consults with me about their patients.” “The Dissociative Amnesia (DA) has changed many aspects of my life,” Buf said, with a dejected tone in his voice.

Buf cannot function in crowds, (defined as more than two people). Any crowd has the potential to initiate an anxiety or panic attack. Therefore, Buf has developed the coping mechanism of shopping for his food at his “local-friendly corner convenience store” at 0300 in the morning and only if and when there are no other customers in the store.

Buf lives in the house that was his home. “I don’t remember anything about living here before. They told me it was my home, but I don’t remember it”, said Buf. Buf is very sensitive to having females or children around him, although he cannot explain why. “Having kids come running up to me is especially hard to deal with,” Buf advised.

Perhaps the most devastating aspect of Buf’s situation is his inability to remember his ex-wife and children, the death of his Mother, countless Sailors and Marines who should or could (now) be his friends and/or supporters, and the death of his favorite dog, WILLIE, who he still looks for when he awakens at night.

In August 2009, with the enthusiastic support of his medical treatment team, Dr. Sara Spar, Dr. Rebecca Webster, and his Command Master Chief, Terry Prince, HM2 Kloppenborg, applied for a Psychiatric Service Dog from the paws4vets program. “We had witnessed the incredible positive effects going on with the paws4vets PTSD Intervention Program and its process for obtaining a Psychiatric Service Dog and what positive results were being seen with one of our Marines, so we thought it would be very beneficial for Buf to do the same thing,” said Dr. Spar.

paws4vets is a program within the paws4people foundation ( The paws4people foundation privately places trained, certified and insured Assistance Dogs (AD) with individuals with physical, neurological, psychological and/or emotional disabilities, including civilians (generally adolescents under the age of fourteen) through its paws4people Assistance Dog Placement Program (p4pADPP) and with Veterans (active-duty military and/or their dependents) through its paws4vets ( Assistance Dog Placement Program (p4vADPP). All paws4people Assistance Dogs are trained by federal inmates within one of five federal prisons ( paws4people is also a member of the U.S. Army Wounded Warrior Program’s (AW2) Community Support Network.

HM2 Kloppenborg’s application was accepted by the paws4vets Application Committee in August 2009. Two dogs were identified within the p4vADPP as potential Psychiatric Services Dogs for him. “Buf’s Service Dog would need customized training; to “check Buf’s 6” and alert him to someone approaching him and then increase the alert level if someone tries to reach out to touch Buf,” said Mrs. Allison Kaminsky, Director, Medical Evaluation Team, paws4vets. “Our training team and the inmates have Service Dogs doing just about everything you can think of, including retrieving laser-designated items, relieving themselves on command and on “piddle-pads” to facilitate long airplane flights, and waking Client’s during nightmares, but Buf presented with a unique skill set requirement.”

Within days, SALLY, a 22 month-old Yellow Labrador Retriever, and a Certified, Public Access, Service Dog began her customized training protocols under the guidance of Mrs. Karen Owens, paws4prisons Chief Trainer, Federal Prison Camp, Alderson, Alderson, WV. SALLY began her training of the command; PAY ATTENTION. The PAY ATTENTION command will have SALLY sitting at her handler’s left or right side facing backwards to the handler. [Sally’s handler is the person she is in essence working for. Her handlers are her trainers right now, but could be Buf in the future.]

SALLY then observes people as they move around behind her handler. If a person comes within 5-8 feet of the handler, SALLY will use her nose to “nudge alert” the handler’s hand or leg. If the person continues toward her handler, and begins to reach out to touch her handler, SALLY will “bark alert.” SALLY also began her customized training to learn how to awaken her handler should he/she experience a nightmare or flashback while they are sleeping. Simultaneously, JAKE, an 18 month-old Black Labrador Retriever, a Service Dog In-Training, began the identical training protocols under the tutelage of Ms. Heidi Livengood, Chief Trainer, paws4prsions, Federal Prison Camp Hazelton, U.S. Penitentiary Hazelton, Bruceton Mills, WV.

paws4vets began coordinating schedules with Buf’s Command and with the prison in order to place Buf on Temporary Active Duty (TAD) orders or convalescent leave so that he could travel to Alderson and Bruceton Mills, WV to visit the paws4prisons training facilities and meet both potential Service Dogs. The process to gain Buf’s security clearance for entry into the federal prisons was obtained. On September 9, 2009, everything was set for Buf to begin the process of obtaining his Psychiatric Service Dog.. The day before Buf was scheduled to leave Camp Lejeune he was informed that “somewhere up the Chain-of-Command” his orders were denied and that he would not be able to visit the dogs. There were questions raised regarding the Service Dog being considered a gift and the fact that paws4people/paws4vets was not officially affiliated with the Navy. Needless to say, Buf was completely disappointed; he felt betrayed by his Command, which subsequently led to escalation of his symptoms, including increased stress, anxiety, and depression.

During the next two weeks Buf experienced his worst fear. On two occasions an individual came up from behind Buf and touched him on the shoulder to simply get his attention. Both individuals were old friends who were not aware of Buf’s situation. They were simply glad to see him and neither had malicious intent. Buf experienced the Fight-or-Flight response during both events; he felt the need to protect himself. In both cases Buf was able to control his reaction at the last possible second. “Both of those people are extremely lucky Buf was able to have controlled his reaction,” said Ms. Kyria Henry, Founder and Deputy Executive Director, paws4people and Executive Director, paws4prisons. “What would have happened to Buf if his control would have been just a little slower and he had actually assaulted either or both of those people? He would be in jail. We have a Service Dog for him that would prevent such an occurrence from happening. I wonder how his “Command” would have felt then?”

“These two events have only caused all of us at paws4vets and paws4prisons to double our efforts on Buf’s behalf,” said Mrs. Kaminsky, “We have made phone calls and sent emails; to anyone and everyone that we can think of in order to get someone, somewhere to help Buf obtain the permission he needs to start his Service Dog selection and placement process.” Buf said that if he had hurt either of his friends that he “could never forgive himself.” Buf then requested to take personal leave in order to meet the dogs, however, his request was denied by his Unit Commander, Commander Buchanan, because he knew where Buf planned to go during his personal leave - and he knew his boss was against it.

“One of the people we sought assistance from for Buf was Clay Rankin,” said Mrs. Kaminsky. Clay Rankin (medically retired MSgt. Clay Rankin, USA, is an Advocate for the U.S. Army Wounded Warrior Program (AW2)). Clay, as a result of injuries received in Iraq, is best known by his permanent sidekick; ARCHIE. ARCHIE is a Service Dog; a Black Labrador Retriever that has been Clay’s constant alter-ego for the past 6 years. ARCHIE enables Clay to walk, travel and conduct his life with minimal limitations. “He’s also helped me battle PTSD and depression,” added Clay. ARCHIE was recently named the ASPCA’s Service Dog of the Year for 20091. Clay works everyday in one of three VA Medical Centers with ARCHIE by his side. Clay also serves as the Army’s AW2 Single Point of Contact for Service Dog Placement. Clay contacted and spoke extensively with Command Master Chief, Terry Prince, Naval Hospital Camp Lejeune. Clay and Master Chief Prince discussed the ADA (Americans with Disabilities Act), and the VA (Veterans Affairs) and DOD (Department of Defense) laws, rules and regulations regarding the placement, use and utilization of Service Dogs within a hospital environment and countless other topics. Mr. Rankin requested that his conversation be conveyed by Master Chief Prince to the Commander, Naval Hospital Camp Lejeune.

Weeks passed while Buf’s emotional well-being diminished. On November 6th, all indications were made that Buf would be allowed to take personal leave if paws4vets would pay for Buf’s travel expenses provided those expenses did not exceed $1,000.00. Buf’s Command would allow him to travel to West Virginia to begin the Service Dog selection process, on November 8th. A paws4vets volunteer was dispatched to Jacksonville, NC. At approximately 1500 on November 7th, Buf called the volunteer to inform him that he had just been told that his personal leave had been denied by order of the Hospital Commander. He told the volunteer that he was “very sorry to have wasted his time” with such a tone of despair and anger that the volunteer was concerned for Buf’s well-being.

In the hours that followed Captain Cox’s orders, Buf’s Mental Health treatment team scrambled to ensure that he was immediately cared for as they recognized the possibility of the emotional toll Captain Cox’s decision would have on Buf’s emotional well-being. One would have to question whether Captain Cox supports the Hippocratic Oath because his decision to deny HM2 Kloppenborg convalescent leave and subsequently personal leave was going to cause considerable emotional distress to Buf, a Sailor, AND a patient under his Command.

Several members of Buf’s treatment team and enlisted advisors within the command courageously, (without regard for potentially damaging repercussions to their careers) attempted to counsel Captain Cox in order to change his mind regarding Buf’s personal leave. Captain Gerard Cox, reiterated his denial of HM2 Kloppenborg’s request to take personal leave. Sources revealed that “Captain Cox is an ER doctor; he has nothing but contempt and disdain for Mental Health.” “Captain Cox has the opinion that if he allows one person in the hospital to get a dog, then he will have dogs running all around the hospital sooner or later.” Captain Cox’s statement; “Tell him to get a f * * k’n Shih Tzu and he can pet it when he’s sitting at home,” adequately communicates the Captain’s complete lack of knowledge and ignorance regarding the medically recognized value afforded a patient by an Assistance Dog, or it may be further evidence of the Captain’s “contempt and disdain for anything Mental Health,” maybe both.

A Service Dog is a highly trained and sophisticated therapeutic resource that is custom trained to assist their handler with physical and/or psychiatric disabilities. For those with physical disabilities, the dog can be viewed as an augmentative medical device which provides its handler with not only physical benefits, such as a balance, mobility (i.e., pulling a wheelchair), and picking up and retrieving objects, but also with, psychological and emotional benefits that no other device can deliver. Could you imagine Captain Cox denying a patient a wheelchair, a prosthetic arm or leg, a shunt, or a respirator? And if he did attempt to deny the utilization of one of these commonly accepted augmentative medical devices, could you imagine the public outcry that would result from such a Neanderthal decision?

Where is the public outcry for denying a Service Dog to a patient?

The benefits of a Service Dog may also be viewed as an adjunct therapy, in terms of Animal-Assisted Therapy, when addressing a patient’s treatment/recovery intervention plan. For those with psychiatric disabilities, a Service Dog can provide the emotional support a person needs in order to be able to function in society by providing environmental assessments or “alerting” behaviors for their handlers. These dogs also foster feelings of safety and acceptance, provide a sense of purpose, and allow people to forget their pain and limitations by focusing outward. The benefits of animal-assisted therapy often times surpass the benefits of prescription medication.

“You know the really ironic thing?” said a Sailor who did not want his name used, “Right across the parking lot, in the WWB (Wounded Warrior Battalion) there is a Marine with a Service Dog and there is supposed to be another Marine getting one2.. What’s he (the Hospital Commander) going to do when they have to come to the hospital for treatment? Kick the dogs out?” According to this same Sailor, the Commanding General, Camp Lejeune, has an “administrative-type” within his Command suite that has a Service Dog.

It was discovered that “Safe Harbor,” a program out of the Vice Chief of Naval Operations’ Office, was made aware of Buf’s difficulties.

Between November 30 and December 3, 2009, conversations were conducted between Chief Hellman and Mrs. Kaminsky, in which it was disclosed that Buf’s most recent request for personal leave would be granted. Buf would be allowed to travel to the paws4prisons training facilities and begin the process of obtaining his Service Dog. In order for Buf to travel, it was requested that paws4people pay for Buf’s travel expenses. As of December 4, 2009, Buf advised the paws4vets staff that his request for “personal leave” was granted and that he would be leaving Camp Lejeune on Monday, December 7th. Buf further related that he had been told that since he was in “non-deployable” status, he was going to be medically discharged from the Navy, and that this process was going to be “fast-tracked” (to take place within the next 90 days). Buf also related that there were conditions placed on his travel; he was not allowed to tell anyone that he was in the Navy or that he was a Corpsman. It had also been suggested that he tell paws4vets to remove his profile from their web site.

As a point of information; the process of obtaining a Service Dog from paws4vets, for someone like Buf, usually takes between 3-6 months. This fact was explained to Buf’s Command when he submitted his application in August 2009. If events take their pre-described courses of action, Buf will be discharged from the Navy before he receives his Service Dog. Does anyone see the plan of action being plotted by the Commander of the Naval Hospital Camp Lejeune?

Parting questions:
Does Buf want to be discharged from the Navy?
Does anyone care what Buf wants?
Is this the way we (as a society) want our heroes to be treated?
Does any U.S. Navy parent want their son or daughter serving under the command of Captain Gerard R. Cox?

© 2009, paws4people, All Rights Reserved.

Disclosure: The author, Terry Henry is the Executive Director, paws4people and the Executive Director, paws4vets. He is a Veteran and has been living with the effects of Complex-PTSD for the past 24 years.

1. ARCHIE passed away two weeks after he received his Service Dog of the Year Award. All of us at paws4people, paws4prisons and paws4vets extend our deepest sympathies to Clay for his loss. We also wish ARCHIE a fond farewell, as he exemplified every aspect of service and loyalty a Service Dog should have. We are dedicated to training and placing Assistance Dogs that even ARCHIE would be proud of.

2. The individual this source was referring to is Sgt. Paul Martin, USMC, Wounded Warrior Battalion – East, Camp Lejeune. Sgt. Martin is a Client of paws4vets and is in the process of obtaining his Psychiatric Service Dog; LIA. LIA and Sgt. Martin should be permanently teamed together in January 2010. Preparations are underway for LIA to transfer to Camp Lejeune to begin her service with Sgt. Martin.

To learn more about HM2 Kloppenborg, click here:

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