Vietnam vet fights on after fifth cancer strikes

By MILAN SIMONICH | The Santa Fe New Mexican | Published: April 24, 2019

SANTA FE, N.M.(Tribune News Service) — It’s still not easy to be a Vietnam veteran in America.

The taunts and accusations hurled at troops who returned from that most unpopular of wars ended long ago. Now a Vietnam veteran’s adversaries at home are age, illness and bouts with bureaucracy.

Patrick Toal, who’s retired in Santa Fe, knows about all of them. At 75, he is lean, whip-smart, self-deprecating and living in pain. His body has been deteriorating for a long time, but his health got worse this month.

Doctors diagnosed Toal with late-stage bone cancer.

“They say I have two to four years, maybe longer,” Toal said.

He has had four other cancers since 1998 — prostate, kidney, lung and bladder. He’s also had coronary artery disease. Physicians have equipped his heart with five stents to keep the arteries open.

Toal’s wartime service figures in many of the diseases. Raised in Appleton, Wis., he enlisted in the Army and then gave up a soft assignment in Germany for duty in Vietnam. Toal thought he might want to make a career of the military, so he figured he should see war firsthand.

He was in Vietnam for a total of 12 months in 1965 and 1966 as a clerk and as a gunner on an Army helicopter. That was a time when the fighting was fierce and heavy. But Toal tells everyone who asks that he did nothing heroic in the war, nor did he come under fire by enemy soldiers.

“I never had to pull the trigger,” he said.

Still, he served in combat zones where U.S. forces sprayed the defoliant Agent Orange. It leveled crops and stripped forests that the North Vietnamese Army might have needed for food or camouflage.

Agent Orange also caused cancer. How much is anybody’s guess, but the U.S. Department of Veterans Affairs has long awarded service-connected compensation to former soldiers who were in Southeast Asia when Agent Orange was used.

The VA initially denied Toal’s claim for monetary benefits when his first cancer was diagnosed 21 years ago. But the agency in 2007 awarded him a 30 percent disability benefit. His government medical records show that the VA gradually increased his compensation until it reached 100 percent in February 2018. By then, he had been diagnosed with lung cancer, his fourth cancer overall.

Toal said he believed he had ongoing medical coverage after that designation by the VA, which also provided him with $3,537 per month.

He found out how wrong he could be.

This spring, Toal could tell something else was wrong with him. Pain proved him right. His back ached. His fingers became tender and sore, the tips discolored.

He headed for an emergency room. The staff ran tests and a doctor told him he probably had bone cancer. The next step was a positron emission tomography scan. It would reveal whether the emergency room doctor was correct.

Toal said the VA Hospital in Albuquerque doesn’t directly handle oncology cases anymore. Instead, its patients are seen by private providers.

Toal arrived for his scan April 9. The outside provider told him the test he needed was not authorized by the VA.

Having worked for decades in media sales, Toal also has a Medicare card. He had to use it to obtain the scan. It confirmed he has bone cancer.

But why hadn’t his VA coverage been accessible at the time he needed it most, the day doctors were supposed to pin down whether he had bone cancer?

It turned out that his VA coverage has to be reauthorized annually, and it had lapsed March 27. That, coincidentally, was just days before he felt so sick he headed for an emergency room.

“I think I fell through the cracks,” Toal said.

Then, seeming to speak for other veterans he believes might be in a similar bad spot, he said, “He’s sick. He’s tired. His fingers don’t work. He knows he has terminal cancer. He doesn’t know where to turn.”

Toal had the depressing assignment in Vietnam of compiling battlefield casualty reports for his unit. Later, as a salesman in Chicago, Atlanta and northern Florida, he kept meticulous records of business transactions.

“I’m used to paperwork,” Toal said, “yet I never knew I had to get my VA coverage reauthorized. I’ve probably kept pretty good medical records, and I didn’t know.”

Not sure where to turn, Toal phoned the Raymond G. Murphy VA Medical Center in Albuquerque and was connected to the office of Dr. Juliet Lopez. He learned that his medical coverage doesn’t carry over from one year to the next unless there’s an affirmative step to reauthorize it.

Lopez’s support staffers were helpful, and Toal’s VA coverage was back in place by April 12. It’s good until the spring of 2020. Toal said he knows now to speak with his primary care physician, who is not with the VA, to make certain that it will be reauthorized then.

He twice has made trips to the newspaper office to share two binders of records. He figures his story might help another veteran.

The trips weren’t easy. Toal’s hands are so sore it hurts to hold the steering wheel of his car. His back tightens and pains him when he sits through an interview.

He’s on cancer No. 5 and says this one is terminal.

The war in Vietnam ended in 1975. Fallout continues as veterans age.

And Patrick Toal soldiers on.

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