A major trauma center in a war zone where troops are treated is no place for distrust and dysfunction. dysfunctional command climate is a problem anywhere in the Navy, but it's particularly worrying in a life and death situation like a major trauma center in an active war zone.

But that's exactly what happened over nine months, during which the commanding officer of the center in Afghanistan NATO Role III Multinational Medical Unit turned into its own battleground last year, lead by a commanding officer known for trash-talked her colleagues behind their backs, a verbally abusive command master chief verbally abused his sailors and an executive officer known for his ineptitude as a physician who made sexual comments to nurses.

Staffers said the environment at the center went beyond toxic — to repulsive. Staffers across the board hesitated to report their leadership for fear of reprisal from leaders they described as not only toxic, but in some cases, repulsive.

Many hesitated to report the problems out of fear of reprisal. But once they did report to them, the results were swift: Capt. Maria Majar and CMC Chief Hospital Corpsman Shane Reece of the NATO Role III Multinational Medical Unit were fired on March 31, 2015, at the tail-end of their six-month rotation at the Kandahar, Afghanistan-based unit.

Then the next rotation came in, naming Capt. Kurt Henry to the XO position a few months in. But he, too, was fired for inappropriate behavior.

"Capt. Henry is always looking at me like I am a piece of candy," one intensive care unit nurse said in an official statement. Others reported Henry's defensiveness in the medical settings could lead to treatment errors. Henry was later fired.

The two official investigations, obtained by Navy Times via open records requests, reveal abusive and inappropriate conduct by all three command leaders over two rotations of Navy medicine individual augmentees Both command investigations included hundreds of pages of statements from hospital staff at the Kandahar Air Field, Afghanistan, hospital, detailing the abusive and inappropriate conduct from all three command triad members, over two rotations of Navy medicine individual augmentees in the first half of 2015. They paint a picture of an out-of-control command where both junior officers and enlisted felt intimidated or repulsed by their leadership, in back-to-back but unrelated deployments. The discomfort spread to the command's clinical side, with questions of medical competence and violations of patient privacy swirling.

"I remain concerned, however, about the risk of a re-occurrence, particularly since this is now the second incident in a very short time at Role 3 resulting in the relief of command leadership," then-5th Fleet boss Vice Adm. John Miller wrote in his endorsement of Henry's investigation.

However, None of the three were formally reprimanded, but Majar and Reece, who was serving as the command master chief, were detached for cause. She is now a professor at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, Henry has retired from active-duty and Reece is working as a manager at Naval Hospital Pensacola, Florida, until he retires at the end of this month.

"I'm disappointed in how everything went down," Reece told Navy Times in an Aug. 10 Wednesday phone interview. "We tried to handle things the best that we thought we should."

But for some in the medical community, news of the dysfunction in Kandahar was shocking but not totally surprising.

"The Majar investigation is mortifying. Period," said an O-5 Navy physician, who asked for anonymity to avoid career repercussions. spoke to Navy Times on background to avoid career repercussions. "The Henry investigation is not much better."

The Bureau of Navy Medicine and Surgery had just cut the command size by a third and done away with the center's executive officer position when Majar and Reece's rotation came in, on the recommendations of the previous command, according to one of the investigations.

"Navy medical leadership blindly followed that recommendation on the very next deployment? That is concerning to say the least," the O-5 said. "Why was that not vetted and verified as an appropriate course of action based on data or input from multiple groups? The next group may have been set up for failure to some extent."

A spokeswoman for BUMED declined to comment on the investigations.

Majar did not respond to emails an emails requesting comment and could not be reached by phone. Henry declined to comment.

'Fearful, bullied, intimidated'

"Simply put, there was a systematic breakdown within the command which was set up for failure," Miller said in his comments on the Majar/Reece report. "The command was designed to survive on personalities, which set the conditions for the behavior that existed in the command."

Out of 30 witnesses who gave statements during the investigation, 22 described the command climate as stressful, toxic, intimidating or poor. Many said they had contemplated filing official complaints but either were unsure how to start the process or were fearful of reprisal.

"Physicians were at odd with nurses, junior officers were openly hostile to their department heads and directorates…" the investigator wrote.

Much of that stemmed from personal conduct bye senior officers, the investigation found, and tacitly ignored by Majar. Allegations included bigoted remarks, threatening and condescending language, and a reluctance by junior personnel to report any of these issues.

That included possible HIPAA violations, including an instance where Reece — who did not care for patients as CMC — allegedly viewed a junior sailor's medical records.

"The command was riddled with senior officers taking inappropriate actions and possessed a blatant disregard for the need to practice proactive, sustained and intrusive leadership," Miller wrote, calling out four redacted names in particular.

Majar was at the center of the problem was Majar, the investigator concluded, with Reece as her sidekick.

It was Reece's conduct — displaying "hostile, intimidating and threatening behaviors riddled with foul and abusive language," according to the report — that prompted complaints that launched the command investigation. 

Looking back, Reece said, the hospital was dealing with a reduction in staff — from about 130 in the previous rotation down to 89 — while dealing with the same workload, which created a lot of stress.

It was also chiefs season, he said, and as the senior enlisted sailor he was spending a lot of time trying to corral the chief-selects into their CPO-365 training.

"With everything being said and done, the only thing I wouldn’t have changed from what I did, is I wouldn’t have cursed," Reece said in the phone interview, explaining that it was never a problem when he was coming up in the submarine community.

On March 12, a CO's suggestion box complaint came in. It blamed the enlisted sailors' low morale on Reece's "communication style, lack of respect for others and his condescending attitude."

Majar called him into her office on March 13, where they agreed he would talk to his chief's mess about the issue. Four days later, he held that meeting, where witnessesd said he appeared "pissed off" and felt "betrayed" that his sailors were talking to junior officers behind his back.

"We didn't know who was writing the statements and all the time the person that was writing the statements was right there, never once came forward," he told Navy Times. "Some of the junior officers felt like they didn't need to come to me with issues from the enlisted."

In an all-hands call later that day, he told sailors he would try to control his language. Then the meeting went downhill.

One witness said he used profanity and "informed the all-hands he does not give a s--- about their concerns and that they make their own morale."

Another sailor quoted him more directly: "I don't give a f--- about your morale."

Majar considered the matter settled, she said in a statement, but suggestion box entries started rolling in.

"It was completely inappropriate for the command master chief to yell at the entire enlisted crew following a complaint about him in your suggestion box," one sailor wrote. "We're already six months into this problem and it's become apparent that the leadership has no real interest in taking this matter seriously."

At that point, word had gotten around to Task Force Individual Augmentee, the MMU's parent command, who sent an O-6 to investigate. Majar and Reece were relieved of command but stayed in Kandahar to finish out the investigation.

"Capt. Majar demonstrated a complete lack of situational awareness to the command's concerns about Master Chief Reece, which is evident by her 'surprised' reaction to the complaints in the CO's suggesting box," the report said. "Capt. Majar was made aware of Master Chief Reece's inappropriate behaviors as early as October 2015 but continuously failed to effectively address them."

And as it turned around, the CO herself had a long history of inappropriate behavior. Her staff stated that she used foul language, made derogatory remarks about her subordinates, and openly referred to her junior officers as "toddlers" when speaking about them to her peers.

In her statement, she insisted she never swore about patients.

To be fair, the investigator Vogt wrote, many of those he interviewed said that Majar was "lovely" and generous with rewarding her staff for their work.

"However, there were just as many interviews and individuals citing specific and unrelated instances where both Capt. Majar's and Master Chief Reece's actions, or in some cases inactions, resulted in command members who felt fearful, bullied, and intimidated."

The environment at the MMU is not the problem, necessarily, according to the O-5 physician who reviewed the case for Navy Times. Instead, she said, it has to do with a certain type of person who either volunteers for that job or is strategically sent to Kandahar.

"The 'leaders' that deploy to Kandahar — and particularly those described in these investigations — are flawed in a fashion in which I imagine they either volunteer to deploy to Kandahar to 'move up' in the world and attempt to gain respect and relevance, or they deploy there as 'leadership' because they are basically being banished to lands afar for a period of time for some previous inability to function in their own community in a meaningful way."

But with so much training and experience under their belts, the Navy has to figure out where to move them.

"Kandahar seems to be the perfect 'penalty box' for this situation but yet serves to magnify the personality disorders that exist in this kind of vacuum," she said.

'Creepy' XO

Following those reliefs, the command recommitted itself to regularly scheduled command climate surveys and boosted training for the Command Managed Equal Opportunity supervisoranager position.

Still, once the "Mike" rotation had gotten situated, dysfunction continued. This time it centered around an intensive care doctor who harassed and intimidated women at the command for months before anyone blew the whistle.

Capt Kurt Henry was bumped up to XO — a newly created position — midway through that rotation, but hadn't ever received any formal command leadership training.

He had a gruff, authoritative demeanor, according to witness statements, and a propensity to get inappropriate with the nurses.

"People perceived Capt. Henry as 'creepy' or offensive because he tended to say socially awkward or inappropriate things that made others uncomfortable," Capt. Erik Wright wrote in his investigation, which carried over as a "negative perception regarding Capt. Henry's clinical decision-making and competence."

A command climate survey with 87 responses included 27 with a negative view of Henry, to the point where Wright determined his reputation at the unit was beyond repair.

Nurses from the ICU wrote that Henry acted harshly and defensively when corrected in a medical setting, to the point where they felt intimidated to point out errors. Some said they felt his attitude would end up harming patients.

And then there were the personal missteps. He once asked a nurse what kind men she was into.

"He told me to stay [away] from people, indicating a Special Forces patient we were seeing," a female O-2, who happened to be the CMEO, said in her statement. "He said that they often had a history of STDs and were generally not people I should be around."

He then proceeded to tell her about a swinger's club he was aware of back when he worked at Walter Reed National Medical Center in Bethesda, Maryland, but lamented not being able to join because he was single.

When she mentioned to him that she thought their body armor was uncomfortable, she recalled, he responded that " 'Yes, with females, especially with large breasts, it would be uncomfortable,' and gestured to towards my breasts as he said that."

"If I were not in a room, or present at an event where he was, I am told he would leave, but never tell anyone why he was looking for me," she added. "He would just ask where I was."

She started leaving her shift early to avoiding having to run into him during turn-over.

"You should come to my spin class," he told another nurse. "You look like you have the body for spinning."

When confronted with these statements, Henry responded that people were intimidated by him because he was a big, tall, white man, and he dismissed his comments to the nurses as jokes.

"That's what I get for trying to be a funny guy?" he told the investigator. "The Navy's not like it used to be. It's a good thing I've put in my retirement papers, because I've had enough."

And retire, he did, after he was sent home from Afghanistan in July.

"If Capt. Henry continues working as an intensive care physician within the ICU, his clinical decisions will not be trusted by most members of the ICU," Wright wrote.

Henry's reputation at the MMU was consistent in other parts of the community, the O-5 told Navy Times. At a previous duty station, she said, he was not allowed to act asn attending physician, making rounds through the clinic or leading a team.

"He was deemed good enough to see patients but not good enough to teach residents, which is a big red flag in medicine," she said.

With that history preceding him, she added, it's both not surprising that he ended up at the MMU and troublingconcerning that he ended up in a command position.

"The egregious behavior by the individuals cited in these investigations was apparent prior to their deployment. The deployment just accentuated their previously dysfunctional behavior," she said. "The real question is, why were these folks chosen to deploy here?"

Meghann Myers is the Pentagon bureau chief at Military Times. She covers operations, policy, personnel, leadership and other issues affecting service members.

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