Adding Insult to Brain Injury

The American taxpayers officially fired Dr. Robert Van Boven on his birthday, Jan. 27. The former director of the Brain Imaging and Recovering Laboratory in Austin has taken temporary work at an Illinois hospital, flying home once a month to visit his wife and 7-year-old daughter. The lab, which is currently inactive, was run by the Veterans Admin­i­stra­tion's Central Texas Veterans Health Care System, based in Temple.

Van Boven says he was fired for disclosing fraud, waste, and mismanagement at the Central Texas system. Retaliating against whistle-blowers who expose wrongdoing at federal agencies violates federal law. The Office of Special Counsel, the federal agency charged with protecting whistle-blowers against reprisals, is currently investigating Van Boven's case.

On March 5, Van Boven endured yet another blow when he discovered that the VA had reported his termination to the National Practitioner Data Bank, an information clearinghouse created by Congress in 1986. Its purpose is to identify incompetent doctors and other health-care providers and restrict them from moving state to state without disclosing their malpractice history. The report states that Van Boven was terminated for "unprofessional conduct" – a sweeping phrase that calls into question his competence as a physician. However, according to the VA's own documents, he was fired as an administrator and not as a physician.

The report, Van Boven says, makes it nearly impossible for him to seek permanent employment. "It's the kiss of death," he says. "The National Practitioner Data [Bank] is the 'bad doctor list'; if you're being reported, good luck getting a license, keeping a license, or getting a job anywhere."

"They dug me out of the grave and then struck me up from a tree so the ravens can pluck my eyes out," he adds.

The VA would not discuss Van Boven's case. But in an e-mail to the Chronicle, VA regional public affairs officer Diana Struski confirms that "if a clinical provider has other than clinical personnel action, they are not reportable to the National Practitioner Data Base." Van Boven, a neurologist, worked as a clinician at the lab in addition to his administrative duties. However, according to the Central Texas VA's own documents, his firing was related to his performance as an administrator and had nothing to do with patient care. In a November 2008 proficiency report – his only job evaluation at the VA – Van Boven scored an overall "satisfactory" and a "high satisfactory" in "clinical competence." Moreover, in a Sept. 10, 2008, memo, a VA review board charged with investigating complaints against Van Boven states that the "inappropriate conduct and behavior" of which he was being accused "are not associated with professional conduct or competence." And his clinical supervisor, Dr. Abraham Del­gado, wrote Van Boven a positive letter of reference in September.

Meanwhile, the Brain Imaging Lab may be in for its own kiss of death. As first reported by the Chronicle on Dec. 12, 2008, the lab could be permanently shuttered. A committee of VA officials has written a recommendation and sent it to Dr. Michael Kuss­man, the VA's undersecretary for health in Washington, D.C, who will decide what to do with the BIRL and its funding. The VA would not release the committee's recommendation or offer an expected date for Kussman's decision.

The BIRL opened in the J.J. Pickle Research Campus in 2007 to research and develop treatment for combat-related traumatic brain injury, the "signature injury" of the war in Iraq. The possibility of the lab closing has reaped protest from veterans groups and public officials. Sen. John Cornyn and U.S. Reps. Lloyd Doggett, Mike McCaul, Lamar Smith, and John Carter wrote letters to then-Secretary of Veterans Affairs James Peake in December expressing opposition to the closing.

A report released this month by the Congressional Brain Injury Task Force reinvigorated the call to save the BIRL. The report concludes that 320,000 U.S. soldiers returning from Iraq and Afghanistan suffer from traumatic brain injury, usually the result of blasts from explosives.

"We must devote as much attention and as many resources as possible to help returning soldiers with the invisible wounds of war – mental health conditions like Post Traumatic Stress Disorder, Traumatic Brain Injury, depression, and anxiety," Cornyn says. "The efforts of facilities like the Veterans Brain Imaging and Recovery Lab in Austin and other treatment centers across the country are critical to this effort."

Van Boven's woes began shortly after he was hired to run the BIRL in 2007. Van Boven asserted that a research project being conducted with the BIRL's brain scanner was not in keeping with the BIRL's mission and that a contractor working on the project was padding his time sheet. Overall, he estimated that $1.2 million in taxpayer money has been wasted on the project.

Instead of investigating Van Boven's claims, his supervisors in Temple – including Bruce Gordon, then-director of the Central Texas system; chief of staff Edward Sherwood; and associate chief of staff for research Dr. Paul Hicks – refused to take action. Van Boven went over their heads and called in VA investigators. Two reports issued after internal investigations – a July 29 report by the VA Office of Inspector General and a Dec. 23 report by the VA Office of Research Oversight – substantiated many of his allegations.

In the wake of Van Boven's complaints, his bosses at the Central Texas system found cause to investigate him. (It should be noted that Van Boven doesn't make it easy to like him. His kinetic personality often comes across as abrasive, and he drives his points home with frequent, aggressive communications.) Van Boven says the charges against him were meant to punish him for blowing the whistle on his bosses. They included:

• Insubordination for defying orders to refrain from organizing a fun run to benefit traumatic brain injury research. A VA regional counsel opined that Van Boven was free to organize the event as a private citizen.

• The use of profanity and "threatening gestures" at work. Van Boven admits he occasionally used profanity at work but says it was never directed toward a person. He denies making threatening gestures.

• "Disrespecting" Cornyn at a BIRL event attended by the senator. The VA alleges Van Boven inconvenienced the senator by letting the event run long in order to allow two injured veterans to speak. Cornyn's office wrote a letter denying that Cornyn felt disrespected.

Van Boven was fired in November for "unprofessional conduct." The VA agreed to an Office of Special Counsel request for a 60-day termination stay while the agency conducted its investigation. The stay ended Jan. 27. A second request from the office for a stay was denied by the VA. The office has yet to complete its investigation, but given the agency's dismal record – only about 1% of its cases in 2007 were remedied – Van Boven has little hope that he'll be vindicated. Meanwhile, he's fighting for his career.

"I've got a patient dying of encephalitis in the ICU right now, and I'm supposed to put all my focus and all my might into saving her life, and at the same time I'm putting all this energy into fighting these bastards to salvage my reputation and my career," Van Bov­en says, his voice cracking over the phone. "Then I go home and sleep in a frickin' hotel room."