Area veteran battling VA over covering Agent Orange-related health problems

Charles Phillip Jestus worked, ate and slept in the stench and horror of war, somewhere between Khe Sanh and hell.

The Vietnam vet spent 13 months in 1968 and 1969 supplying helicopters and troops at a landing strip in the valley village of Ca Lu. He would see things -- death, dying, suffering, fear, degradations and debasements -- unimaginable to all but those who have lived in the carnage of war.

But Jestus, unlike nearly a quarter-million of his brethren in arms, left Vietnam without a scratch.

It wasn't until he got home that the hurting would begin.

Jestus is among several veterans who in recent weeks have shared with the Southeast Missourian their concerns and accusations about the Department of Veterans Affairs health care system, a system they assert is riddled with incompetence and in bureaucracy. The 63-year-old Cape Girardeau resident approached the Southeast Missourian following a recent series on Lucky Sands, a decorated veteran of the war in Iraq who died in February 2010 following a long illness. Sands' family and friends are critical of her care and treatment in the VA system, particularly at hospitals in Poplar Bluff, Mo., and St. Louis.

After the VA certified Jestus' full disability coverage for serious health problems caused by his exposure to the deadly chemical Agent Orange in Vietnam, he says he has accrued tens of thousands of dollars in medical bills, many of which the VA has refused to cover. While he acknowledges being treated outside the VA health care system, which can affect VA coverage, Jestus said his treatment involved emergency care, leaving him little choice.

He claims the VA health system at times has complicated his medical condition with overcrowded facilities, uncaring health care providers and a "chain of command" system of paperwork that has left him buried under a mountain of debt and mental stress.

"Am I supposed to be a pingpong ball going back and forth until I die?" Jestus said.

Cases like Jestus' have angered and frustrated U.S. Rep. Jo Ann Emerson, who says she has heard from hundreds of veterans struggling under the bureaucracy of a VA health care system that she believes is in need of a massive overhaul.

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Charles Phillip Jestus was 18 when he joined the U.S. Army in 1966. He served his first tour in Korea, quickly rising to sergeant.

In 1968, when his first hitch was up, he re-enlisted, eager to serve in Vietnam. He would soon lose his youthful exuberance for a conflict that was taking a toll on service members in country and at home, and on a nation growing weary of war.

Jestus was stationed at a place called LZ -- or Landing Zone -- Vandegrift, named after the 18th commandant of the Marine Corps and Medal of Honor winner, Gen. Alexander A. Vandegrift. Originally billed as LZ stud, the combat base, reminiscent of a hobo camp from the air, served as a jumping-off point for operations to open the path leading to Khe Sanh. Jestus' unit supplied helicopters at the landing strip, resupplying Army units on search-and-destroy missions.

When Jestus arrived, Vandegrift was nothing more than an airstrip surrounded by mud, dirt and lush jungle. Housing at first was nothing more than a ditch, buttressed by sandbags.

When the airstrikes hit -- and they hit frequently -- 15 soldiers would pile together in a bunker built for three, Jestus said.

He says he has buried the horrors of that tour, but they burst through with brutal clarity at times, like waking nightmares. He describes the violent scenes: A good friend and fellow soldier standing across the compound one moment; then the explosion, the ground rumbling, and all that remained were legs; there were the Viet Cong dead, mounted like trophies on the Army tanks as they passed through; the choppers carrying troops flying in, or worse, troops on their way home, exploding on the landing pad or in the Vietnam skies above.

But every day at 7 p.m. -- you could set your watch by it -- there was "Mad Minute."

"We would shoot and fire everything we had up into the hills, constantly. Big guns. Rifles. Pistols. The ground would jump up," he said.

Jestus survived it all. He wore a crucifix, the one he now keeps in a lockbox. He said he felt blessed by God.

His military dreams, however, were over. Jestus said he had planned to make a career in the Army. Vietnam changed that.

"That wiped everything out. My whole life was wiped out," he said. "It was 13 months of hell. I came home a different person."

But his war was just beginning at home.

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Jestus left Vietnam in 1969, like so many of his comrades, believing he was returning a hero. He stepped off the plane in Seattle to a crowd of angry protesters. The war at home was heating up.

"I was called a 'baby killer' and 'murderer,'" Jestus said. "One girl, I'll never forget her, she had long hair, she came up and spit on me and called me 'murderer.'"

He tried to put the war out of his mind. But it's always there, waiting, underneath it all. And the frightening memories flashback in sounds and smells -- fireworks on the Fourth of July, smoke in summertime.

His health, Jestus said, was perfect for a long time. He worked in the floral business, got on with his life and didn't have any real complaints until he turned 50. That's when the diabetes showed up. By 2006, his health was deteriorating rapidly. He was diagnosed with diabetic nephropathy associated with diabetes mellitus Type II, a related kidney disease, and peripheral neuropathy of the lower extremities, which causes pain, loss of sensation and an inability to control muscles.

In 2006, the VA awarded Jestus full disability compensation for his medical conditions, considered to be caused during his service in Vietnam. And the presumed cause of it all, according to VA medical records obtained by the Southeast Missourian, was Agent Orange.

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Agent Orange wasn't really orange at all. It was white and came in powder form before being sprayed over the vast vegetation that made up the hills and valleys of Vietnam between 1961 and 1971. The name was derived from the orange stripe used on the 55-gallon drums in which it was stored. The chemical was produced to defoliate the trees providing enemy cover, and it worked remarkably well. And it was everywhere.

"There were many times that your boots were covered in this stuff. Your clothes were covered and you breathed it in every day," Jestus said. "The helicopter blades were whipping up the dust, and my bunker was right off the strip."

Jestus said he didn't think anything of it. The chemical was a curiosity when reports about its detrimental effects first surfaced in the 1970s and 1980s. It became worrisome when his health began to decline, and worry turned into fear when several of his classmates who served in Vietnam began dying from the effects of Agent Orange.

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When he first sought medical care through the VA health system, Jestus said, he experienced superb care and had no complaints. His bills were paid through VA and Medicare, and he received full disability, including Social Security.

Things changed, Jestus said, in spring 2008, when he had a massive heart attack. He was rushed to Southeast Hospital and spent time in the intensive care unit. He said he was stabilized and cleared for release on Memorial Day weekend for an Army medal presentation in his honor. After the ceremony, he was hospitalized and underwent quadruple bypass surgery.

Jestus said the VA would not cover the cost of his medical bills because he wasn't treated in a VA-approved health care center. By protocol, Jestus was supposed to contact Veterans Affairs "as soon as possible" about his treatment. He said that's a tall order when you're in your underwear, incapacitated and in the back of an ambulance.

"Am I supposed to tell the ambulance driver to call St. Louis, 'I'm in the back of this ambulance, can I go to the hospital?'"

At one point, Jestus said, he was on his way to St. Louis for a scheduled appointment approved by the VA and had a heart attack on his way into the hospital, a private health care provider.

"I was admitted, by no choice of my own, and the VA said the bill was to be denied because it was not an approved admission," Jestus wrote in a letter to Emerson. "Another stipulation of the VA rules say that once stabilized, the Veteran should be transferred to St. Louis VA or Memphis VA for further treatment. Why should we have to leave the local area to receive the care needed when it is available locally also?"

In a written response to Emerson, Glenn Costie, medical center director of John J. Pershing VA Medical Center in Poplar Bluff, Mo., said bills for emergency treatment may be considered for payment by VA under the Millennium Health Care and Benefits Act.

"Under this authority, the services must be of an emergent nature, meaning the injury or illness is so severe that without immediate treatment the injury or illness threatens health or life, and the Veteran has no other coverage under a health plan that would pay in whole or in part for the emergency treatment," Costie wrote. He said the VA Medical Center should be notified, preferably within 72 hours, to arrange a suitable care plan, and provide billing information.

While Emerson said she can't comment specifically on any particular case, the Cape Girardeau Republican said she thinks it's "crazy" that veterans must often seek treatment so far from home in order to remain in a VA system, a system that has been criticized for its medical shortcomings. She said a constituent, a World War II veteran, had to go to St. Louis for chemotherapy treatments, hours from his home.

"It's the dumbest thing I've ever heard in my life," she said. "I have intervened in some of those cases. I say, 'This is ridiculous. Let's get them closer to home and reimburse the private practitioners.'"

Emerson said she believes the entire VA health care system needs a "wholesale revamping" and that she's working with fellow House members to set up congressional hearings on the matter.

"I think it's a very cumbersome system, and we need to have somebody outside the system to look at it," she said.

Jestus also has been critical about the quality of care at VA hospitals like John Cochran Veterans Affairs Medical Center in St. Louis, where he said he was placed as a cardiac patient in a recovery room with "loud, obnoxious alcoholics and drug addicts."

In a letter to Emerson, a hospital administrator acknowledged the space constraints at the hospital.

"We strive to place patients in a comfortable environment. He was on 7 North, which is a busy telemetry ward, full to capacity on most days. We are limited by the number of Veterans requiring cardiac care," the letter says. The administrator goes on to say that medical center has plans to add 12 beds on 7 South, a medical ward.

"We apologize that Mr. Jestus' needs were not met to his satisfaction," the administrator wrote.

The Southeast Missourian attempted to contact the VA hospital in Poplar Bluff. Jestus was advised to send the facility a medical waiver, clearing administrators to speak to his case. He did but did not date the document. Late Tuesday afternoon an official with the health care center said administrators could not talk about Jestus' case because he did not date the form.

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For now, Jestus waits for medical reimbursement. He has a stack of private health care provider bills he says tops $287,000. The VA, in correspondence to Jestus, says it is still processing his application for compensation. In a letter dated Jan. 10, the VA apologizes for the delay.

Jestus said his basic bills are met through the $3,730 in monthly VA disability and Social Security checks, but the mounting hospital bills are beginning to drag down his credit. He worries he could lose the home he has lived in for 25 years.

In his letter to Emerson, Jestus complains that the process for veterans to obtain medical care is too long, filled with too many obstructions and that the care often is substandard compared to civilian health systems. He said there has to be a better way.

"We were willing to put our life on the line in service to our country. We should now be able to receive the medical care that we need without all the hassles and without jumping through unnecessary hoops," Jestus wrote. "I shouldn't have to fight with VA to get the quality care that I deserve in exchange for my service to this country."

mkittle@semissourian.com

388-3627