In a nondescript conference room at Walter Reed Army Medical Center, 1st Lt. Elizabeth Whiteside listened last week as an Army prosecutor...

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WASHINGTON — In a nondescript conference room at Walter Reed Army Medical Center, 1st Lt. Elizabeth Whiteside listened last week as an Army prosecutor outlined the criminal case against her. The charges: attempting suicide and endangering the life of another soldier while serving in Iraq.

Her hands trembled as Maj. Stefan Wolfe, the prosecutor, argued that Whiteside, now a psychiatric outpatient at Walter Reed, should be court-martialed. After seven years of exemplary service, the Army reservist faces the possibility of life in prison if she is tried and convicted.

Military psychiatrists at Walter Reed who examined Whiteside, 25, after she recovered from her self-inflicted gun wound diagnosed her with a severe mental disorder, possibly triggered by the stresses of a war zone. But Whiteside’s superiors considered her mental illness “an excuse” for criminal conduct, according to documents obtained by The Washington Post.

At the hearing, Wolfe, who had warned Whiteside’s lawyer of the risk of using a “psychobabble” defense, pressed a senior psychiatrist at Walter Reed to justify his diagnosis.

“I’m not here to play legal games,” Col. George Brandt, chief of Behavioral Health Services in Walter Reed’s Department of Psychiatry, responded angrily, according to a recording of the hearing. “I am here out of the genuine concern for a human being that’s breaking and that is broken. She has a severe and significant illness. Let’s treat her as a human being, for Christ’s sake!”

In recent months, prodded by outrage over poor conditions at Walter Reed, the Army has made a highly publicized effort to improve treatment of Iraq veterans and change a culture that stigmatizes mental illness. The Pentagon has allocated hundreds of millions of dollars to new research and to care for soldiers with post-traumatic stress disorder. On Friday, it said it had opened a new center for psychological health in Arlington, Va.

But outside the Pentagon, the military still largely deals with mental-health problems in an ad-hoc way, often relying on the judgment of combat-hardened commanders whose understanding of mental illness is vague or misinformed.

The stigma around psychological wounds can be seen in the smallest of Army policies. While family members of soldiers recovering at Walter Reed from physical injuries are provided free lodging and a per diem to care for loved ones, families of psychiatric outpatients usually have to pay their own way.

“It’s a disgrace,” said Tom Whiteside, a former Marine and retired federal law-enforcement officer who lost his free housing after his daughter’s physical wounds had healed enough that she could be moved to the psychiatric ward.

Under military law, soldiers who attempt suicide can be prosecuted under the theory that it affects the order and discipline of a unit and brings discredit to the armed forces. In reality, criminal charges are extremely rare unless there is evidence the attempt was an effort to avoid service or endangered others.

At one point, Whiteside almost accepted the Army’s offer to resign in lieu of a court-martial. But it meant she would have to explain for the rest of her life why she was not given an honorable discharge. Her attorney also thought she would have been left without the medical care and benefits she needed.

No decision has been made on whether Whiteside’s case will proceed to court-martial.

The commander of the U.S. Army Military District of Washington, Maj. Gen. Richard Rowe Jr., who has jurisdiction over the case, “must determine whether there is sufficient evidence to support the charges against Lt. Whiteside and recommend how to dispose of the charges,” said his spokesman.

In her father’s footsteps

Whiteside, a valedictorian at James Madison High School in Vienna, Va., a wrestler and varsity soccer player, followed in her father’s footsteps by joining the military. She enlisted in the Army Reserve in 2001 and later joined ROTC while studying economics at the University of Virginia. In college, Whiteside said, she experienced periods of depression, but she graduated and was commissioned as an officer in the Army Reserve.

In 2005, she received her first assignment as an officer: at Walter Reed. As an executive officer of a support company, she supervised 150 soldiers and officers, and her evaluations from that time presaged the high marks she would receive most of her career.

“This superior officer is in the top 10 percent of Officers I have worked with in my 16 years of military service,” said her rater, Capt. Joel Grant. She “must be promoted immediately, ahead of all peers.”

Seeing so many casualties at Walter Reed made Whiteside feel she was not bearing her full responsibility, she said, so she volunteered for duty in Iraq. When she left in fall 2006, she carried with her a gift from her father: the double-bladed Buck knife he had used in Vietnam.

She was assigned as a platoon leader in the 329th Medical Company (Ground Ambulance) at the Camp Cropper detainee prison near Baghdad International Airport. Cropper housed 4,000 detainees, including high-security prisoners such as Saddam Hussein, and suspected terrorists and insurgents.

Whiteside, given the radio handle “Trauma Mama,” supervised nine medics who worked the night shift at the prison.

“I loved our mission,” Whiteside said, “because it represented the best of America: taking care of the enemy, regardless of what they are doing to us.”

The hours were brutal. She ate one meal a day, slept in two four-hour shifts in the barracks inside the prison and worked seven days a week. Her superiors credited her with her unit’s success. “She has produced outstanding results in one of the most demanding and challenging Combat Zones,” her commander, Lt. Col. Darlene McCurdy, wrote in her evaluation.

But the dynamics outside her unit were rockier. Whiteside and some of her female soldiers had conflicts with one of the company’s male officers. They believed he hindered female promotions and undercut Whiteside’s authority, according to Army investigative documents.

As the tensions with the officer increased, Whiteside said, she began having panic attacks. She stopped sleeping, she said, and started self-medicating with NyQuil and Benadryl but didn’t seek help from the mental-health clinic because she feared the Army would send her home, as it had recently done with a colonel.

On Dec. 30, U.S. military officials took Saddam from his cell at Camp Cropper for execution. The next day, thousands of inmates rioted, and military police used rubber bullets, flash-bang grenades and tear gas to restore order.

Whiteside took charge in the chaos, according to written statements by troops in her unit. The next day, weary from the riots, she ran into the problem officer. They had another argument.

Army documents describe what happened next.

At 6:20 p.m. a soldier frantically approached Maj. Ana Luisa Ramirez, a mental-health nurse, and said Whiteside was “freaking out” and wanted to see Ramirez. The nurse found Whiteside sitting on her bed, mumbling and visibly upset. Ramirez left to get medication.

Later, she saw Whiteside in a dark hallway with her sweat-shirt hood pulled over her head and her hands in her pockets. Ramirez asked Whiteside to come into her room and noticed what appeared to be dried blood on her neck and hands. When she tried to take a closer look, Ramirez said, Whiteside pointed an M-9 pistol at her and “told me to move away and she locked the door,” according to a statement Ramirez gave to the Army.

Ramirez tried to take Whiteside’s gun, but Whiteside pushed her away and expressed her hatred of the officer she thought was sabotaging her. She twice fired into the ceiling.

Nurses began yelling, and Whiteside shouted that she wanted to kill them, the report said. She opened the door and saw armed soldiers coming her way. Slamming the door, she discharged the weapon once into her stomach.

Whiteside said she has little recollection of the events. She declined to comment on whether she was trying to kill herself.

The medics who responded to the shooting scene were Whiteside’s own crew.

Lockdown psych unit

Whiteside was still unconscious when she arrived at Walter Reed a few days later. The bullet had ripped through one of her lungs, her liver, her spleen and several other organs. Within two weeks, an Army criminal investigator showed up in her hospital room, but a doctor shooed him away.

After a month, Whiteside was moved to Ward 54, the hospital’s lockdown psychiatric unit, where she was diagnosed with a severe major depressive disorder and a personality disorder. According to a statement by an Army psychiatrist, she was suffering from a disassociation with reality.

On Ward 54, Whiteside befriended a private, Sammantha Owen-Ewing, 20. She was training to be a nurse when she suffered mental problems and was admitted to Ward 54. She was still receiving psychiatric care at Walter Reed when the Army discharged her. According to her husband, she was dropped off at a nearby hotel with a plane ticket.

After being released from Ward 54, Whiteside joined the outpatient ranks just as the Army was scrambling to overhaul its system for treating wounded soldiers and President Bush ordered a commission to study military care for Iraq veterans.

At Walter Reed, the Army brought in combat-experienced officers to replace the recovering patients whom it had asked to manage the lives of the 700 outpatients on post. The new Warrior Transition Brigade and its more experienced leaders were supposed to manage more adeptly the tension between soldiering and patient recovery.

It was Whiteside’s commanders in this unit, a captain and a colonel, who drew up criminal charges against her in April. The accusations included assault on a superior commissioned officer, aggravated assault, kidnapping, reckless endangerment, wrongful discharge of a firearm, communication of a threat and two attempts of intentional self-injury without intent to avoid service.

The Army ordered Whiteside to undergo a sanity board evaluation.

By early August, Elizabeth Whiteside sought an alternative to court-martial. She requested permission to resign, a measure the military often accepts.

After a review, district commander Rowe agreed to accept Whiteside’s resignation with a “general under honorable conditions” discharge that would deprive her of most benefits, according to her pro bono civilian attorney, Matthew MacLean.

But then, from her battalion commander in Iraq, Whiteside learned an investigation had concluded there was “insufficient evidence for any criminal action to be taken against” her. Furthermore, it had found a hostile command climate and recommended that the officer who had been her nemesis be removed from his position.

With this news, Whiteside asked that her letter of resignation be withdrawn. She would fight the charges.

In an e-mail exchange, the prosecutor, Wolfe, told MacLean that even if Whiteside won in court she would probably end up stigmatized and in a mental institution, just like John Hinckley, who shot President Reagan.

Wolfe suggested the military court might not buy the mental-illness defense. “Who doesn’t find psychobabble unclear … how many people out there believe that insanity should never be a defense, that it is just … an ‘excuse.’ “

Encouraging a friend

As her hearing approached, Whiteside lived with other outpatient soldiers in a building on the grounds of Walter Reed. She kept her quarters neat and orderly.

She also offered encouragement over the phone to her friend Sammantha Owen-Ewing. Owen-Ewing was waiting to see if she could receive her care from the Department of Veterans Affairs.

At Whiteside’s hearing, testimony focused on her state of mind at the time of the shooting. The hearing officer has seven days to make a recommendation on whether to dismiss the charges, offer a lesser punishment or go to court-martial. The decision will be Rowe’s.

A psychiatrist who performed Whiteside’s sanity-board evaluation testified that he found the lieutenant insane at the time of the shooting. One of the doctors said Whiteside had a “severe mental disease or affect” and “did not appreciate the nature and quality of her actions.” Brandt testified that Whiteside was “grappling with holding on to her sanity,” adding: “She was right on the edge, and she fell off.”

Wolfe made his argument for a court-martial. “These are very serious charges,” he said. “The government’s position is it should be a court-martial.”

After the hearing ended, Whiteside’s phone buzzed with a text message from Owen-Ewing’s husband, asking Whiteside to call right away. His wife had hanged herself the night before.

Grief-stricken by the death of her friend and bitter at the Army, Whiteside awaits the Army’s decision on her fate this week. “I can fight them,” she said, “because I’m alive.”