A “Gross Conceptual Error” in Care

Reprinted from PN/Paraplegia News October 2014

Veterans with SCI need more than physical care, more counseling should be given to treat PTSD.

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I remember courses in Officer Candidate School and later at the Navy Nuclear Power School and how the grading and overall attitudes were different than conventional education.

For example, many of the grading matrices were given partial credit, but placed with an initial alongside the problem such as conceptual error (CE), mathematical error (ME) and worst of all, gross conceptual error (GCE).

I believe this is a superior way to grade an assignment since it forces the teacher to be fair in the grading. For example, if the mathematics of your problem were correct, but you were incorrect on the formula, you would only lose one point for the CE.

But instead of simply accepting a paper with careless errors on it, many times we received our papers with a “resubmit” order on it and we would have to redo the assignment with no errors. More work, yet more learning.

Now, if your work was marked with GCE, it meant you were so far off you had to go back to your original concept of the problem to be able to answer it.

One or The Other

Psychological and psychiatric communities have committed a GCE when it comes to treatment of post-traumatic stress disorder (PTSD).

PTSD is a mental health condition that’s triggered by experiencing a terrifying event. However, I’ve uncovered a policy in military and veteran treatment where those who become physically injured undergo extensive rehabilitation. Those that go through a horrible event are diagnosed with PTSD.

There are counselors who believe someone can have an experience that ends up paralyzing them for life, yet not develop PTSD. However, those that witness a terrifying event can develop PTSD.

If your Department of Veterans Affairs (VA) facility is anything like mine, the PTSD wing is full of individuals suffering from a horrific experience and the area is staffed to accompany the patients’ needs.

If it wasn’t for lobbying by the Paralyzed Veterans of America (PVA), there wouldn’t be the psychologists we have to help us. We receive rehab, not counseling. With VA/military budgets, we get one or the other. Not both.

No Need for Counseling

A website designed to help vets with PTSD,, lists factors that increase the likelihood of a traumatic event leading to PTSD:

-The intensity of the trauma

-Being hurt or losing a loved one

-Being physically close to the traumatic event

-Feeling you weren’t in control

-Having a lack of support after the event

It’s easy to say all five factors affect our PTSD, and yet, we need to fight for counseling time because there aren’t enough counselors.

This is where I hit you with the VA’s GCE. I’ve since learned the PTSD ward is staffed to cover the outpatients in the area, while the spinal-cord injury (SCI) ward is staffed to cover the inpatients in the SCI wing.

I can only assume this is because an SCI outpatient has no need for PTSD counseling.

Physically Altered

Counseling for PTSD isn’t something that should occur once a week during rehab; we should be receiving it for the remainder of our lives.

The one difference between having PTSD with SCI versus the rest of the military is our injuries left us physically altered. This alteration will never go away, yet we’re supposed to cope with this inner turmoil alone as soon as we leave the hospital.

The GCE here is the suffering never ends, and our families feel our pain as much as we do. Sometimes our families get tired of our moods, impatience, anger, fear and frustrations, and we get left alone.

Maybe with a bit of guidance, for us and our families, the sad endings don’t have to be such a big part of our lives. I know my parents are tired, my brothers and sisters, too, and even my wife has her days of frustration.

What Can be Done?

Paraplegia brings limits and PTSD makes them seem to go on forever. If your experience is anywhere close to mine, it hasn’t taken much for you to nod your head or whisper a small “hell yeah” under your breath.

My question is what can be done? I’m a PVA member, but only one man. What if every member went to his or her PVA chapter president and pushed for more counselors in the SCI wards?

The Long Beach (Calif.) VA has individual counseling, group counseling and mentorship programs. But still, it’s not enough. Every few months or so, I get that little reminder in the middle of the night called a nightmare that lets me know that fateful day years back hasn’t cleared my system.

My next PVA visit will involve a request for more counseling time via my president. If you also need it, ask without fear. It may save your family, marriage or even your life.


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A “Gross Conceptual Error” in Care


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