Monday, February 11, 2008

Veterans' deaths raise questions about Dallas VA care

Dallas VAMC under fire

Veterans' deaths raise questions about Dallas VA care
10:27 PM CST on Saturday, February 9, 2008
By SCOTT FARWELL / The Dallas Morning News

Pat Ahrens and Chris Demopoulos had many things in common. But in the end, only one really mattered: their desire to die.

It was a desire that landed them both in the psychiatric ward of the Dallas VA hospital late last month, locked down on suicide watch. It was a desire that scrambled their family lives and bedeviled doctors, and after years of medical treatment, it was a desire that overtook them.

Cordelia Demopoulos, with son William Boothman II, visits Dallas-Fort Worth National Cemetery in Grand Prairie, near the ashes of her husband Chris Demopoulos. Within days of their discharge from the Veterans Affairs Medical Center in southeast Oak Cliff, both men were dead.

Mr. Demopoulos hanged himself off the second-story balcony of a La Quinta Inn in Plano on Jan. 23. Mr. Ahrens discovered the body the next morning dangling above Room 115.

Two nights later, he backed his silver Lincoln Navigator into an oversized storage unit on 14th Street in McKinney, reached into a bag of medicine prescribed by the VA, stuffed pills in his mouth and washed them down with Bacardi and Coke.

His ex-wife Dawn and daughter Amy found him the next morning.

"I started screaming, Amy started screaming, we kinda went nuts," said Ms. Ahrens, whose divorce was finalized last month. "He was sitting in the front seat, his head was drooped down, he had pictures of his daughters and a picture of me sitting on the dashboard."

Mr. Ahrens, a 50-year-old Air Force veteran diagnosed with bipolar disorder, died later at Medical Center of Plano after a series of heart attacks. Police said their investigation would remain open pending a toxicology report.

Mr. Demopoulos' death was ruled a suicide. The 58-year-old ex-Marine suffered from post-traumatic stress disorder related to his four-year stint in Vietnam.

"We in the VA are all affected by what we heard in Dallas, and we're looking for lessons to be learned," said Dr. Ira Katz, head of mental health for the U.S. Department of Veterans Affairs. "But we want to stress the point that in the overwhelming number of cases, treatment works."

Both of the local men had been treated for their psychiatric disorders for several years, and both families say they had stopped taking their medicine.

Family members said the men would be possessed by fits of rage one moment, then awash in a sea of regret the next. Both men had been in trouble with police for assaulting their wives, and both were assigned to court-ordered anger management classes.

'I can't be here for you'

Mr. Demopoulos was admitted to the psychiatric unit at the Dallas VA Medical Center twice in January, the last time after cutting the cord to a coffee grinder, skinning the wires and attempting to electrocute himself.

His wife, Cordelia, found her husband standing in the kitchen trembling as the current ran through his body.

"I broke down and I said, 'Good God, you promised not to kill yourself, you promised,' " she said recently, eyes pleading. "And he just very calmly looks at me and he goes, 'I can't be here for you ... anymore. I just can't do this anymore."

Mrs. Demopoulos called the police, and her husband eventually was admitted to the Dallas VA, where he met Mr. Ahrens, a bespectacled and barrel-chested owner of a McKinney landscaping company.

Mr. Ahrens grew up in Tyler, the youngest of three children in a devoutly Catholic family. He was deployed to Germany while in the Air Force, where he met his first wife, the mother of his two daughters. He had lived in the Dallas area about 20 years.

Mr. Demopoulos served four years as a radio operator in Vietnam, two years in the Marine Reserves and nine years in the National Guard. Originally from Maine, he was the only child in a traditional Greek family. He was married four times. He had been living with his current wife and two Chihuahuas in an apartment in Hillsboro, where he liked to listen to a police scanner.

"They struck up a friendship right away," said Ray Daniel, 35, of DeSoto, a Gulf War veteran who said he was in the VA psychiatric ward being treated for schizophrenia and depression. Once, he said, he walked up to the men as they were discussing suicide. "To me it just seemed like they were joking around, saying, 'If I was gone my family wouldn't have to deal with me and everything I put them through anymore.' "

One man, two sides

Ms. Ahrens said that her ex-husband's instability broke up their marriage but that their love endured. During a late-night argument in November, she said, Mr. Ahrens rushed into her teenage daughter's bedroom, wild-eyed and screaming.

Chris Demopoulos "I was so scared he was going to hurt her, I had a knife in my hand," she said. "He was unlike I had ever seen him. He had lost it totally."

But at other times, she described a man who was charming and goofy and irresistibly vulnerable.

"The highs were great, the lows were horrible," she said. "We saw each other every single day. He was my best friend, he was my lover, he was my husband in my heart. I just couldn't put my family at risk."

In journals and letters, both men wrote about their inner struggles.

"I am an adult, I must cope," Mr. Demopoulos wrote in one of his final journal entries.

He repeated the line 27 times in capital letters, filling an entire page.

His wife said that legal and financial problems sent her husband into a self-destructive spiral and that he had begun telling her he planned to take both of their lives.

Mr. Ahrens was released from the VA hospital on Jan. 22.

Mr. Demopoulos got out the next day and called his friend to ask for a ride to Hillsboro.

Terrible discovery

Because it was late in the day, Mr. Ahrens picked up Mr. Demopoulos, put him up at the La Quinta and gave him $20 for dinner.

He discovered his friend's body the next morning when he arrived to pick him up.

After calling police and waiting for them to arrive, Mr. Ahrens visited his ex-wife to talk. They drove to St. Mark Catholic Church in Plano, walked into the sanctuary and sat down in the first pew.

"He went there and he saw the door to Room 115 was cracked, and he said that made him nervous ... and he looked up and he just freaked out," Ms. Ahrens said. "He said he'd never seen anything like that in his life."

The next morning, Mr. Ahrens called a reporter for the Plano Star Courier to complain about the care veterans receive at the Dallas VA, which was ranked worst among the nation's VA medical centers in a 1995 federal report. The report criticized the hospital for being dirty, dangerous and poorly managed.

Pat Ahrens "Would it be a bigger story if something happened to another one of us?" he asked in the story.

Later that night, he wrote a final letter to his ex-wife. In it, he listed the men he'd like to be pallbearers at his funeral, even which side of the casket they should stand on.

"Please always love me like you said you would, 100%," he wrote in longhand. "To you I say again, thank you for marrying me, it was the most precious five years of my life."

Hospital care

Ms. Ahrens and Mrs. Demopoulos blame the Dallas VA hospital for the men's deaths. They say doctors released them too soon.

Dr. Catherine Orsak, head of mental health for the VA's North Texas Health Care System, said five out of her department's approximately 20,000 patients committed suicide in 2007. In the aftermath of the recent deaths, she said, the system is considering adding nurses and therapy groups and recalibrating its discharge policies.

She said the fact that two men committed suicide after being released from the hospital does not mean doctors made a mistake.

"You could ask that same question of a cardiologist," she said. "If a patient is released from a hospital and has a heart attack, is that a direct failure? No. Suicide is a risk of psychiatric illness."

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