MOVIES : Article of Faith? : Veterans hope ‘Article 99’ will create debate about the way they’re treated by a bureaucracy that’s supposed to serve them

It is a night when the audience is but another character in the movie. At a screening for “Article 99, “ which deals with abuses and bravery inside a veterans hospital, some are in jungle camouflage fatigues like those they wore in Vietnam. Others sport berets with service pins. A World War II veteran who was at Normandy on D-Day is in a wheelchair; he suffered a stroke two years ago. A victim of Agent Orange walks with a cane.

Not a minute into the movie--which opens nationally on Friday--a perfectly ordinary line becomes occasion for a rocket burst of bitter laughter.

In the scene, the character of Pat Travis, who fought in Korea, sits in his pickup while his wife in their front yard watches worriedly. He has everything he needs for the hospital, he tells her calmly, all the papers. “Don’t worry, baby. Uncle Sam is gonna take care of me just fine.”

Uncle Sam take care of them? Just as Travis (Troy Evans) waits and waits in the bizarre overcrowded lobby with its snaking lines, collapsing with a heart attack before he can get attention and begin to understand the VA system, this is an audience that professes to know the system well. They are, after all, its veterans.

“Article 99,” a drama with strong comic overtones, is a metaphor for the rat’s maze of complex government regulations that boils down to the reality that the implicit promise of full medical benefits for America’s veterans is easily broken--particularly in an era of tight budgets, galloping medical costs and an expanding pool of those in need. Eligibility doesn’t necessarily mean access. Triage also takes place on the home front. Now some veterans and supporters in Washington are hoping “Article 99” will provoke controversy the way “JFK” did.

The promise is contained in Lincoln’s “malice-toward-none, charity-for-all” second inaugural address in 1865--”to care for him who shall have borne the battle and for his widow and his orphan. . . .” Indeed, it is the longtime motto of the Veterans Administration--since 1989 the Department of Veterans Affairs.

For years, laws authorized hospital and medical care for veterans with non-service-connected disabilities if they were unable to pay for it. In 1986, the first economic means test was enacted by Congress, and VA medical priorities hardened into specific categories of “mandatory” and “discretionary” hospital care depending on such things as whether the ailment is service-connected, or the veteran’s income and number of dependents. Those in the discretionary category, if there’s space for them, have co-payments. Seasoned DVA veterans confess privately they’re sometimes confused by the rules, too.

It’s “Catch-22” for the 1990s, explains screenwriter Ron Cutler, who was led to the story by an unnamed physician friend who works at an unidentified veterans hospital. There is no Article 99 as such but he adds: “If you’re entitled to benefits and don’t get them, if you say, ‘Hey look I got screwed,’ that’s Article 99.”

Starring Ray Liotta (“GoodFellas”) as Richard Sturgess, chief resident and heart surgeon who has heart, and Kiefer Sutherland (“Flatliners”) as Peter Morgan, a spanking-new intern with an eye on a fancy Beverly Hills practice, “Article 99” tells the story of a band of brave young doctors who wage war on the bureaucracy as personified by their near-Capt. Queeg of a hospital director (John Mahoney).

The movie, directed by Howard Deutch, shows one Vietnam vet pulling off his wooden leg at the hospital desk to prove he is entitled to benefits; another with a clear case of post-traumatic stress driving his truck through the lobby doors and shooting up computer terminals after being denied admittance; a World War II veteran (Eli Wallach) who won the Silver Star at Omaha Beach spending the remainder of his days on a hospital ward ghetto.

At the screening, veterans erupt with glee as patient Luther Jerome (Keith David), a black Vietnam veteran who conducts the admitting lobby’s business with a mechanized wheelchair, portable telephone, stereo headgear and sass, tells Travis: “This is the VA, soldier. The enemy is behind those desks. . . .” They laugh as a middle-aged nurse in best drill-sergeant manner informs intern Morgan that for the next 36 hours his butt is hers.

But when another nurse in a minor scene says the hospital doesn’t treat victims of Agent Orange, a voice like a crack in the dark calls out, “Goodby. I got to get out of the room.” Leaning on his cane, the veteran walks.

At the world premiere in Washington (a benefit for homeless veterans) Feb. 26, the screen got another talking to. According to Rep. Lane Evans (D-Ill.), co-chairman of Vietnam-Era Veterans in Congress, when Ray Liotta’s character tells off the hospital director, “one African-American veteran says, ‘Give him hell, Ray.’ ”

Although the “Article 99” trailers might have you think that this is the umpteenth coming of “MASH,” it is also a serious, indeed a political, movie. In the movie hospital, medical research, in this case on monkeys, appears to have a higher priority than patient care, and the doctors have to go on a midnight raid to the research area to get supplies they need. “They must vote Republican,” a doctor says of the chimps as he is stunned by the well-stocked basement.

The director, a consummate bureaucrat who obsesses about conserving such items as bandages--he has a wood-paneled office with a photo of President Bush on the wall--points out that everyone has to cut back including the Defense Department. And toward the movie’s end, when the doctors, aided by an armed brigade of patients, stage a takeover of the hospital and the director asks a black security guard to break it up, the guard retorts: “At $4.25 an hour?”

As the next-to-last movie likely to be issued under the Orion label because of the studio’s bankruptcy, “Article 99” may just be in the right place at the right time. With health care emerging as a key issue of the presidential campaign, Orion is trying to catch the wave. Two nights before the New Hampshire primary, the studio screened the film in Concord, hoping to attract candidates and staff. The effort failed. Still, producer Michael Levy says: “We’re going to follow the whole campaign trail with this movie . . . Super Tuesday, wherever they go.”

Glomming onto veterans’ health care was a “freak of circumstances,” Cutler notes.

“I got my first look at this world four years ago. My friend told me dinner stories. Very bizarre and funny dinner stories, and he always said, ‘Hey, this might make an interesting film.’ But more ‘The Young Interns’ type of movie.

“He told me about midnight requisitions, doctors having to go around and steal supplies. Then he told me about his office and his file cabinets being broken into by the (hospital) administration in order to get stuff on him” because his friend was bending the rules to help his patients. He suggested, ‘Come down, I’ll introduce you as a doctor; you’ll get a look at this place.’

“I went several times,” says Cutler, “and I saw a kind of attitude, a bureaucratic kind of indifference. I saw young doctors who were more interested in using these patients as practice bodies, which led to the Peter Morgan character (Sutherland). . . . He becomes a good guy through his relationship with (the character) Eli Wallach (plays).

“In fact,” continues Cutler, “the VA, I discovered later, is famous for this. They make up for their shortfall in doctors by being one of the main medical training areas for all levels. The operations have been criticized because (the doctors) don’t have the same supervision they have in other hospitals. From their point of view, it’s great practice. From the patient’s point of view, it ain’t so hot.”

However, “Article 99” turns the situation nearly upside down. The good-guy doctors first perform an unauthorized heart operation on a patient with an aneurysm on his aorta, though only prostate surgery has been authorized. As for inconsistencies with reality, explains Cutler, the movie is “not a documentary.”

Altogether Cutler spent time at five veterans’ hospital, including the ones in Westwood, Long Beach and Sepulveda. “I realized there was a very interesting story here, especially after I began to talk to the patients. In the lobby of many of these places you’ll find a lot of vets who are in the process of trying to get care being denied care. . . . All of them want to air their (VA) battle stories.”

He says he saw even worse conditions than those portrayed on screen. “I saw kind of a warehousing of old veterans, with no services and patient wheelchairs tied to railings with toweling.” The movie initially showed one of the key patient characters committing suicide, but that was cut during the film’s editing. A movie has “to entertain,” says Cutler.

After several months, Cutler retired to libraries, pouring through newspaper and magazine articles. Beyond the usual production notes, Orion supplies batches of article printouts and videotape, including Diane Sawyer’s devastating three-part series on veterans hospitals that aired on “PrimeTime Live” as “Article 99” was filming in Kansas City.

Actual incidents are in the movie, notes Cutler. “The first incident where the vet takes off his wood leg because they had lost his record? This was based on a (‘20/20’) story I had seen. The incident of the vet crashing his car? That happened right here at the Wadsworth VA. The records being placed in boxes and totally ignored is something that is prevalent nationwide. Now we have Agent Orange in the film. This year after our film was made they’re allowing a small number of Agent Orange cases to be treated.”

In real life, the patient who drove through the Westwood hospital doors back in March, 1981, was found dead two months later at home. In the movie, the character Shooter is dealt a happier fate.

As for message , Cutler does not shun the concept. “It has to do with community. For a long period of time, we have been a ‘Me’ generation. And the first priority is to take care of those who defended us.”

Although a number of recent articles have discussed the veterans’ generational war--World War II veterans wanting assurances of care as they got older vs. Vietnam veterans wanting recognition for psychological disorders--in “Article 99” all the vets are buddies.

“The generational conflict exists,” he says after a pause. “We feel there is more of a brotherhood between all veterans than this generational conflict. Now you’re beginning to see it fade away. World War II veterans are beginning to come forward and deal with their own post-traumatic stress. And so they are beginning to have affinity with the Vietnam veteran.” Director Deutch also did primary research. He says he felt the subject matter too important to deal with unless he verified it for himself. Donning a doctor’s jacket with a VA emblem, Deutch visited more than a dozen veterans hospitals across the country, “and I found to be true everything I read. ‘Turfing’--placing patients in different parts of the hospital--is almost like a shell game so you can give them the care they need even though the bureaucracy doesn’t want you to because it costs too much. I spoke to doctors who do it everyday.” Deutch, too, got access from unnamed doctors. In one hospital he was found out and tossed out, but he came away believing the script was “the tip of the iceberg.”

Troy Evans, the actor who plays Travis, got his own form of “Article 99” more than 20 years ago. But Evans (no relation to the congressman), who had been an infantryman in Vietnam and counts the Bronze Star and a presidential unit citation among his medals, says he experienced both good and bad within the VA.

After Vietnam, he came home to Montana a “severe alcoholic” and a “dangerous psychotic,”--after he’d been president of his high school class and once harbored dreams of becoming his state’s governor, a senator maybe, but certain he’d go to law school. That was before Evans’ 17 arrests in his two years post-Vietnam on charges ranging from drunk driving to aggravated assault, and the nearly two years he served in jail.

“I had my life saved in a (Veterans Administration) hospital,” Evans says of the several months he spent at the VA hospital in Sheridan, Wyo., in 1972 for treatment of his emotional problems before serving his term. “But I’ve also gone to a VA in the middle of the night with a severe injury, needing surgery and been turned back out on the street.” That was a year earlier in Spokane. The hospital there determined that the fight he had gotten into that “basically destroyed my shoulder” wasn’t “service-connected.”

But Evans attributes his “out of control” behavior to the stresses of war and the rage he felt after he got home.

“Article 99” was filmed at an unused wing of Trinity Lutheran Hospital in Kansas City with an old War War I memorial on its grounds, two blocks from the headquarters of Veteran of Foreign Wars. Vietnam veterans were used as extras and members of the crew.

One of them was Luke Sammons, who 14 months ago won his long fight for 100% disability because of post-traumatic stress disorder. The movie provided a reunion for Sammons and Troy Evans. On Thanksgiving Day, 1968, Sammons’ helicopter wing flew-in turkey dinners for the troops in Evans’ unit, and the helicopters flew out with body bags. “I had a picture of him and his unit, and his best friend’s in the picture. Troy was there the day the picture was taken and the following day he helped put his friend in the body bag.”

“This movie brought out the truth about trying to get medical help,” says Sammons “You’re told you don’t qualify. Or ‘we’ve had cutbacks and can no longer serve you.’ Or they lose your records and expect you to find them. All kinds of crazy stuff. The VA’s philosophy is drug and warehouse them.”

Veterans do not speak with one voice. Several Vietnam veterans said that they worried whether the image of the crazed, aggressive Shooter driving his truck through the lobby in “Article 99” was a good image for Vietnam veterans. But others, including one or two of those who made that point, said it is the “reality.”

Paul Egan, executive director of Vietnam Veterans of America, said he hopes the movie provokes discussion on veterans’ care. “The issue with the VA isn’t the inability to do surgery. I guess the term they used in the movie was unauthorized surgery. The problem with the VA is unnecessary surgery . . . the problem of veterans being operated (on) by students without any supervision by attending physicians.”

Howard Vander Clute, adjutant general of the VFW in Kansas City, which held its own premiere of “Article 99” Thursday night, said: “The only thing we didn’t like was that the blame was placed on the hospital director. It should be placed on the bureaucracy. . . .” And, he added, on the fact that there is not enough funding.

Rep. Lane Evans, chairman of the veterans affairs subcommittee of the House Armed Services Committee, said that “while there is no Article 99 on the VA’s books, it sounds a lot like what many vets have been experiencing nationwide. I really don’t know a single colleague of mine who hasn’t heard from hundreds of constituents about how they’ve been terminated from their VA health care. These are veterans who’ve gone to the VA for decades in some cases.”

After the Orion screening, World War II veteran Edward Gottesman, 68, of San Dimas allowed privately that he thought the movie “exaggerated” conditions. Still, he worries about getting to the Wadsworth Veterans Administration Hospital in Westwood now that van service to the facility has been discontinued due to lack of funds. “I’m just holding my breath,” he said.

The more prevalent view was expressed by Andy Harland, a consultant on Vietnam veterans issues, who led a panel discussion after the screening that was part revival meeting, therapy session and political rally. Harland, who confides he once saw a Wadsworth security guard urinate on a veteran outside the hospital, insists: “The movie was nice to the VA.”

“Everybody in Washington is running for cover because they know this is going to be ‘JFK 2’ and it’s up to us, the veterans,” Harland said to his buddies, “to . . . burn the torch under the VA so they can get the message that this is our hospital, it’s not theirs.”

Al Biernesser, who runs an engineering firm and heads Pasadena’s Vietnam Veterans of America, said: “The MIA, POW plight? The MIAs (missing in action) are right here. Missing in America. We have people living on the streets, dying on streets.”

A voice from the audience called out: “We ought to call in the National Guard against the Veterans Administration.”

A spokeswoman for the Department of Veterans Affairs, which oversees the vast VA network--172 hospitals, 339 outpatient clinics, 126 nursing homes, 32 “domiciliaries”--said the department will not comment on fiction, and read a statement by DVA Secretary Edward J. Derwinski:

“The real scenes of VA activity take place in our medical centers, not up on the movie screen. I’m proud of the dedication to our important mission shown by staff and management day in and day out in which they deliver health care services to thousands of veterans.”