Nick Cutter’s Death Exposes Neglect Scandal at Miami VA Hospital — (Miami New Times)

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Miami New Times

By Michael E. Miller

Thursday, July 31, 2014

The man eating breakfast certainly looked like Nicholas Cutter. He had the same pale skin. The same shaved head. The same technicolor tattoos peeking from beneath his T-shirt like graffiti on a whitewashed wall.

Yet, from across the kitchen table, his sister Rainy saw a stranger. Once an extroverted older brother, Nick was now buried inside himself. His goofy, jack-o’-lantern grin had hardened into a grimace. His eyes were clouded, as if the former soldier were still lost in an Iraqi sandstorm. He sat shoveling cereal into his mouth, staring into the past — into the perpetual war raging inside his head.

Suddenly the doorknob on the Boynton Beach ranch house began to rattle. Nick’s eyes rekindled. The knob rattled again, and he rose from his seat.

“Someone is trying to break in,” Rainy said. She reached for her phone to call 911, but Nick was already walking toward his bedroom. When he emerged a few seconds later, he was carrying the biggest weapon his sister had ever seen.

“Go into your room and lock it,” he said. Then Nick slipped the safety off the massive rifle and strolled toward the silhouette at the back door.

“Oh, I’ll open up for you,” he bellowed to the intruder, pointing the barrel toward the door, “because you’re gonna want to meet what’s on the other side.”

The rattling stopped. A shadow disappeared into the shady suburban backyard. Nick slumped back into his seat at the table and started spooning cereal into his mouth. From the doorway of her room, Rainy wondered, Who has my brother become?

Specialist Nicholas Cutter had stepped off an Army supply plane only a few weeks earlier, ending 15 months of mayhem in Samarra, Iraq — an ordeal told in New Times last week in Part 1 of this story. His family considered him lucky. Though several of Nick’s friends had died in combat, the 22-year-old appeared to have escaped unharmed. But Rainy could now see that something inside him had cracked. No one — not even his family — knew how to repair it. Or if it could even be repaired.

“It didn’t even faze him,” Rainy says of the attempted break-in in early 2009. “If that guy came in the house, he was ready to kill him.”

Nick’s war had ended, but his battle was just beginning. Over the next year, the model soldier and protective big brother would descend into violence, depression, and drug addiction. He would steal from his family and spurn his own sister. Then he would turn his anger on himself.

Cutter’s story sheds light on the tortured experiences of millions of American veterans. But his demise is also a window into something even darker: the VA scandal consuming newspapers around the country. The same negligence that would cost Nick his life in Miami is now being blamed for scores of deaths across the United States.

In Washington, D.C., politicians have expressed outrage, top officials have resigned, and new legislation has been proposed. In Miami, however, very little has changed. Nick’s story is at risk of being forgotten.

“My brother was not a number. He was not a social security check,” Rainy says. “He was a person. He was a patient. And someone needs to be held accountable for his death.”

Nicholas Cutter drained his glass and ordered another. Around him swirled the lazy energy of a Wednesday night at the Blue Boar Tavern in West Palm Beach. This was the America that Nick had dreamed of during his 15 months in Iraq — the simple fantasies of real food, real music, and real women that he and his fellow soldiers had shared over ready-to-eat meals. Now many of those soldiers were dead or missing limbs, and this hard-fought fantasy suddenly felt cheap. Nick downed his drink, shakily stood up, and told his girlfriend, Danielle Watson, it was time to go.

“Nick, you’ve had too many to drive,” said Danielle’s friend, Jenna Uram. When her boyfriend offered to call the couple a cab, Nick became enraged. He pulled a .32-caliber Kel-Tec handgun from his pocket and pointed it at Angel Rodriguez. The laid-back Wednesday night had become electric.

“He has a gun!” Danielle screamed. Angel reached for the weapon, and the two men went tumbling to the bar floor. A bouncer and bartender helped hold Nick down until the cops arrived.

The August 26, 2010 incident at the Blue Boar was just the beginning of Nick’s downward spiral. Welcome-home parties soon gave way to something sinister. As his paranoia devolved into full-blown posttraumatic stress disorder (PTSD), the lines between South Florida and Samarra began to blur dangerously. Nick would turn to drugs to blunt his pain, and he’d fall further than his family could have imagined.

Perhaps if Nick had been sent to prison for the bar brawl, his life would have progressed differently. Instead, a judge took pity on the recently discharged soldier with PTSD and dropped the charges. His girlfriend, however, was terrified. Danielle dumped him, leaving only his mother, Mary Zielinski, to notice the worrying changes in her son.

At first, Mary thought God had given her a second chance at motherhood. She had given birth to Nick when she was only 20 years old and then left him and his sister after suffering a mental breakdown. Now her oldest child had returned from the war and needed her help. “I finally had the time and the money to take care of him,” she says. “He was my plan.”

But that plan would be tested. Nick had spent 15 months in Iraq on a razor’s edge, chugging caffeine and pulling double watch duty. Now seemed like the time to make up the sleep deficit. Instead, he stayed up late watching movies, anything to keep from going to bed. When his mom woke up in the morning, he was often just getting back from a six-mile run on no rest.

Sometimes she would find him passed out in a chair. It was the only way he could sleep, he said, because it reminded him of the seats inside the Humvees in Iraq. Whenever Nick did close his eyes, he was visited by terrible nightmares. His mom would wake up to the sound of her son screaming orders to a phantom platoon or sobbing as friends died over and over again in his arms during his dreams.

The flashbacks could come at any moment. When high school friends flew in from Illinois and took Nick to dinner in South Beach, they initially thought he was recovering well. Then a passing car blew a tire. Nick grabbed a steak knife, flipped the outdoor table, and screamed for everyone to get down.

Nick also began to disappear. He would say he was going to the mailbox and return hours later, either talking a mile a minute or slurring his speech. A journal he later kept for therapy sheds light on how his addiction began.

“I started drinking very heavy when I came back,” he wrote. “I also started ­smoking weed at night to be able to go to sleep. But I found out that it was a temporary solution to the problem. So I thought since I’m having nightmares when I sleep, why sleep? Just stay up. So I started using coke.”

Items around the house began to go missing. When Mary’s iPod vanished, she confronted her son. He said he would return it when his disability check arrived and he could buy it back from the pawnshop.

By early 2011, Nick’s drug habit was so bad the decorated soldier was stealing from strangers. On January 16, he picked up an older woman at a bar on Ocean Drive in Boynton Beach. But as the two were walking to a motel, Nick grabbed her purse and began running. When a police dog found him 15 minutes later, he was hiding in the bushes with the purse in his hands.

Once again, the charges were dropped. But the second arrest was a wake-up call for Mary. She began taking her son to the West Palm Beach VA hospital for treatment.

They gave him pill after pill — pills for his pain, pills for his nightmares, pills to fall asleep — until Mary had to keep a detailed list of his medications. He slept more but began sleepwalking. He put on weight and stopped shaving.

Nick wasn’t the only member of his platoon who was struggling. In the two years since returning from Iraq, two battle buddies from Patrol Base Olson had killed themselves — one by bullet, another by drug overdose. Ronnie Campbell, one of Nick’s best friends from Iraq, lived in Brevard County, and he and his wife would occasionally visit Nick. When his wife left him, however, he plunged into a severe depression. Just days before he was supposed to meet up with Nick and other vets from the 232nd Engineer Company, Campbell killed himself.

Nick confessed to having suicidal impulses of his own, but the VA programs seemed to help. When Rainy’s high school graduation arrived in May 2011, Mary flew up to Illinois for a week, calling Nick every day to make sure he was getting treatment.

When she returned, Nick picked her up at the airport. But something wasn’t right. He was disheveled and silent. As soon as they got home, he disappeared. While Mary was unpacking, she heard a strange clicking noise. She followed it to Nick’s room, where she found him slicing his own neck with a knife, its metal edge clacking against his dog tags.

“Honey,” she said, “put the knife down.” Mary tried to calm him, but he didn’t seem to hear. She dialed 911. After a two-hour standoff, Nick was Baker Acted and placed in a psychiatric ward. It was the first of seven stays there.

When Rainy moved down from Illinois after graduation, she was shocked at how much he had deteriorated. The stress of having a suicidal brother stirred panic attacks of her own, but her brother just laughed at her. “You think you’re stressed?” he said. “Try having people shoot at you.”

After a few months in South Florida, Rainy couldn’t live with the anxiety any longer. She moved back to Illinois and never spoke to her brother again.

Mary, meanwhile, saw that her son wouldn’t survive without more help. She took a course to become his caretaker and badgered the West Palm Beach VA hospital until it admitted Nick to the Mental Health Intensive Case Management (MHICM) program. He was given an apartment close to the hospital. A team of nurses made sure he took his meds and attended therapy every day.

But the outpatient program also provided Nick ample opportunity to get high. He was still snorting coke to stay up and smoking weed to evade his nightmares.

Finally, in September 2012, Mary told Nick she had good news. The Miami VA hospital had agreed to allow him into its residential rehabilitation treatment program, the only 24/7 program for veterans in the state.

With three 90-day courses devoted to overcoming social problems, PTSD, and drug abuse, Miami’s VA medical center marketed itself as a troubled soldier’s salvation. Mary was sold. “Do you trust me, honey?” she asked her son. “This is what you need. They are going to help you.”

Mary Zielinski first felt a pang of doubt while driving down I-95. As she and Nick followed the interstate south, Miami’s VA hospital rose on the western horizon. Compared to the gleaming new facility Nick had attended in West Palm Beach, the Miami VA looked like a ruin. It was drab and ancient. It was also more than three times the size.

Nick and Mary had traveled to Miami with the belief that it was his best chance at recovery. In reality, the hospital was arguably the worst of Florida’s seven VA medical centers. It was half a century old, deeply in debt, and plagued by scandal. When Nick stepped out of his mother’s Chevy Cruze on October 1, 2013, he knew the fifth floor would be his new home. He had no idea it would also be his grave.

Miami’s VA system was founded in 1942 when the government commandeered the Nautilus Hotel — where Mount Sinai Medical Center now stands in Miami Beach — to house wounded soldiers. In 1946, returning troops transformed the Biltmore Hotel in Coral Gables into a veterans’ hospital. It served as Miami’s VA until 1968, when the current building was completed next to Jackson Memorial Hospital.

For decades, the Bruce W. Carter Center was the gem of the nation’s VA system. But its luster began to fade in the 1980s amid federal cutbacks. In 1989, the Miami Herald reported the hospital was $1.7 million in debt and had turned away at least 2,444 veterans.

Over the next 20 years, the hospital’s debt would balloon to $30 million. Then, in 2009, the VA’s own Administrative Investigation Board revealed that the hospital had used improperly cleaned colonoscopy equipment on 2,500 veterans. Blood tests found that five of the exposed veterans were now positive for HIV, eight for hepatitis C, and one for hepatitis B.

The scandal was a public relations disaster for the already-reeling hospital and its director, Mary Berrocal. That same year, the West Palm Beach VA hospital had been voted best in the nation. Miami was nowhere close. Patients were bolting Miami for Palm Beach, taking with them millions in federal funds. On November 16, 2011, the Miami VA removed Berrocal, and four months later, Paul M. Russo — credited as the man behind West Palm’s success — took over.

Under Russo, the Miami VA hospital appeared to have turned a corner. Debt was down, patients were up, problems were unheard of, and a $33 million renovation went off without a hitch.

If there was any hint that Russo’s miracle wasn’t what it seemed, it was buried in a newspaper clipping one year after he had left the West Palm Beach hospital.

“VA Hospital Employees, Patients Charged With Selling Pills” read the headline in the August 18, 2011 Sun Sentinel. A federal investigation that had begun shortly after Russo’s departure had uncovered widespread drug dealing. At least 18 employees and patients were caught stealing thousands of pills and “selling [the] drugs in the hospital’s stairwells and parking lots.”

The findings would be echoed by an eerily similar report in Miami three years later, when Russo would be in charge and Nick would be a patient.

It had been a long time since Nick felt this good. It was Friday evening, May 31, 2013. The government had just awarded him 100 percent disability, meaning Uncle Sam now owed him almost $40,000 in back pay. He planned to spend it on a vacation for his sister to make things right between them. Most important, after eight straight months in the Miami VA hospital’s various rehab programs, he was just ten days from going home.

Nick shoved $300 in his pocket and strolled to the sign-out desk. No one asked where he was headed, but he volunteered the information anyway. “I’m gonna go get high,” he said, according to a police report.

Although Nick and Mary had been told Miami’s VA hospital was a leading rehab center, the program was in fact awash in drugs and short on controls. Investigations would later show the staff failed Nick by ignoring evidence of his drug use inside the hospital. Even worse, VA staff hid the truth about Nick’s drug use and his death from his own mother.

“They were supposed to save my son,” Mary says. “Instead, they killed him.”

Philip Nall remembers the moment Mary and Nick walked into the waiting room. It was October 1, 2012. Mary toted a huge red purse stuffed with her son’s never-ending paperwork and pills. Beside her sat Nick. His once-trim frame now carried 50 extra pounds. Sporting a prickly goatee, he looked more like Mary’s husband than her 27-year-old son.

Nall was a bowling ball of a man. The stocky former marine hailed from the tiny Central Florida town of LaBelle. He had fought Manuel Noriega’s troops in the jungles of Panama in 1989 and had struggled with PTSD ever since. Like Nick, he had been overcome by nightmares, guilt, and depression. He had tried to kill himself, abused alcohol and cocaine, and wound up here. This was Nall’s third swing at rehab in four years.

“Welcome to the club, buddy,” he said with a meaty palm to the newbie’s back.

The fifth floor of Miami’s VA hospital was split into three 90-day programs, each with unwieldy military acronyms. Nick and Phil found themselves in the Psychosocial Residential Rehabilitation Treatment Program (PRRTP). There were similar programs for substance abuse (SARRTP) and posttraumatic stress disorder (PTSD RRTP).

There were roughly 20 vets in each program, all of whom lived, ate, and slept at the hospital. Every morning and afternoon, they gathered in small groups and then met with one doctor after another: psychiatrists, psychologists, general practitioners, drug addiction specialists. The only constant was that they almost never saw the same doctor more than once.

“Every time, Nick would have to tell them his whole story all over again,” remembers Mary, who often sat in on the sessions. “It got to the point where he didn’t want to bother anymore.”

His meds changed even more often than his doctors. “Omaprazole, gabapentin, cyclobenzaprine, propanol, olanzapine, naproxen, venlafaxine, hydroxyzine, and lorazepam,” Mary wrote at one point. And that was just his morning regimen. “I was taking 200 milligrams of trazodone, and he was taking twice that,” Nall says, referring to a powerful antidepressant. “[It] would have knocked out a horse.”

Then there was the morphine. The drugs would often make Nick so woozy that he would pass out while sitting in the TV room. And the nurses were nowhere to be found. Not even the security cameras worked. “Most of the staff didn’t give a shit about us,” Nall claims. “They just stayed in the back and watched TV.”

Despite his heavy dosage, Nick still had occasional flashbacks. He would wake Phil while screaming about insurgents surrounding the building. Phil would talk him down until Nick passed out again.

Talking was the one thing that did seem to help. Nick kept a trauma log that he discussed with his doctors. It was full of fear and guilt. “I was very scared of all the mortars coming in and the rounds hitting all around us,” he wrote of an attack on his base in Iraq. “Afterwards I believed I should have taken a hit so I could have fit in with the rest of the guys, instead of feeling on the outside looking in.”

More than anything, however, it helped to talk to Nall. The Panama vet had also seen buddies die in combat, only to return home and have one son stillborn and another paralyzed in a car accident. He too had been driven to drugs by PTSD and personal tragedy. Nick trusted the burly, bald-headed marine. He told him about the friends he had lost in Iraq, as well as the ones he had lost since he returned. And he talked about the people he had killed, including a young Iraqi girl he mistakenly thought was strapped with a suicide vest. “It just seemed like everything he was going through, I was going through,” Nall says.

But stories opened old wounds, whose pain demanded to be dulled. The VA made it easy. Rehab residents were required to check in only every two hours and had weekends free. Several times, Nick and Phil signed out and sauntered down the street to a Honduran bar. Before they knew it, they were back at the VA hospital and doing blow in the bathroom.

Cocaine could be purchased right across the road, Nall says. Sometimes new arrivals would bring it in with them. Prescription pills were openly swapped outside at the bus stop. When VA police suspected Nick of possessing drugs, he simply hid them in a bush outside the hospital.

Nall says VA staffers knew about the drug abuse but didn’t care — an opinion later backed up by a scathing internal investigation. Drug tests were always at the same time on Sundays, so it was easy to clean up for a couple of days beforehand. And even if patients pissed positive, the punishment was just staying in the next weekend.

Nick tested positive for amphetamines four times within his first two months in the PRRTP, but the VA did nothing because some of his medications could have caused false positives. He failed a Breathalyzer test near the end of his first 90-day program and then refused to take one the next weekend.

Instead of kicking him out or calling the cops or his mother, the VA simply transferred him into the PTSD program. When he popped positive again for coke in his new program, staffers told him drug use would “not be tolerated.” But it was. He tested positive for cocaine and alcohol a few weeks later, and the VA put him in the mental health unit to detox. Then it promptly transferred him to another rehab program.

It’s unclear why Nick was allowed to remain in the programs when other vets were discharged. Nall, for instance, was booted for refusing to let a nurse watch him pee into a cup. Ultimately, the decision was left up to Miami VA administrators.

With Nall gone, things got worse for Nick. Once in the substance abuse program, he immediately tested positive for cocaine. He admitted he had left the hospital on a two-hour pass, withdrawn money, and bought some coke. His weekend passes were revoked. Then he failed another drug test. His wetraxekend passes were re-revoked.

On May 31, despite failing almost a dozen drug tests and supposedly forbidden to leave the hospital, Nick was nonetheless awarded a two-hour pass. He had just received his 100 percent disability notice. He planned to take Rainy to Butterfly World in Coconut Creek and meet Phil in Costa Rica. But first he was going to get high — one last time.

Nick staggered back into the VA hospital just after midnight and slumped into his usual position in the TV room. When two of his roommates found him passed out, they dragged him to his bed. Had staffers checked on him, they would have noticed he was lying with his feet on his pillow.

When his roommate woke up at 5:30 a.m., he saw Nick sitting upright on his heels as if praying. His head was tilted forward. A bologna sandwich lay nearby on the floor. He was as white as the walls of the hospital.

By the time Miami Police detectives arrived seven hours later, Nick’s body had already been stripped, tagged, and placed inside a body bag. His belongings had been dumped into a trash bag for his mother to retrieve. When someone from the VA finally called Mary, there was no mention of the drugs or the broken security cameras or the failed procedures.

Instead, Mary was told that her son had choked on a sandwich.