Supervisors of the Army psychiatrist accused in the massacre at Fort Hood sanitized his performance appraisals in the years prior to the shootings, according to government documents obtained by The Associated Press that reveal concerns about Nidal Hasan at almost every stage of his Army education.
Officers in charge of Hasan piled praise into the alleged gunman's record despite knowing he was chronically late for work, saw few patients, disappeared when he was on call and confronted those around him with his Islamic views.
The materials also disclose concerns that the psychiatrist-in-training might have been developing a psychosis, according to the documents, yet no mental health evaluation was done.
Defense Secretary Robert Gates released an internal Pentagon review last week that found several unidentified medical officers failed to use "appropriate judgment and standards of officership" when reviewing Hasan's performance as a student, internist and psychiatric resident.
Added ‘Allah willing’ to patient chart
Gates withheld details, noting disciplinary action is possible. But the disjointed picture emerges through information gathered during the internal review. The material shows that the same supervisor who meticulously catalogued Hasan's problems suddenly swept them under the rug when graduation arrived.
Nothing in this record points specifically to a risk he would turn violent.
But after Hasan moved to a fellowship from his residency at Walter Reed — where he once appended "Allah willing" to a patient's medical chart — one instructor, Lt. Col. Donald Lundy, thought Hasan was at risk of developing a psychosis. Lundy did not immediately return AP's telephone calls.
The documents do not address why officers who kept Hasan's academic career moving on a glide path did so despite all his known deficiencies. An Army review is expected to examine these issues.
One possibility: a shortage of Army psychiatrists so acute that bad work and strange traits were tolerated. Whatever the answer, investigators have found a sharp disconnect between close-up performance reports that noted a multitude of deficiencies with Hasan and a higher level of reports that make up the subject's permanent career record.
The information disclosed many details about Hasan's rocky path to the huge Army base in central Texas, where he allegedly killed 13 people and wounded dozens more.
Despite a checkered record at Uniformed Services University of the Health Sciences, the military's medical school in Maryland, Hasan was admitted into a four-year psychiatry internship and residency at Walter Reed.
Record marred after patient walked out
In his second year there, his record was marred when a potentially suicidal and homicidal patient of his walked out of the emergency room without authorization.
His supervisor, Col. Douglas Waldrep, "met with him regarding professionalism, religious conflicts, etc.," according to minutes of a meeting the next month. Waldrep has retired from the military. The AP made repeated telephone calls to Waldrep's office in North Carolina, but he could not be reached.
In June 2005, a policy committee that oversees Walter Reed's psychiatry program knocked him for "a continuous trend of poor performance" and said it is "difficult for him to involve completely with Army processes because of his religious issues."
Weeks later, he received a glowing review covering the same period.
His officer evaluation report — the official assessment that determines promotions and future assignments — credited him with "Outstanding Performance," and an officer wrote that he was a "fine military physician officer."
It was one of several such reports that ignored documented problems.
Starting in March 2007, Hasan began going sharply downhill.
Maj. Scott Moran, who replaced Waldrep, proposed a remediation plan because Hasan was seeing less than one patient each week and acting unprofessionally. Moran reprimanded him for being out of reach when he was on call, criticized his scholarly research as being overloaded with verses from the Quran, and said in a letter that Hasan was graduating despite "documented evidence of unethical or unprofessional behavior" and serious concerns about his performance. Moran declined to speak with the AP.
Rated as having ‘Outstanding Performance’
Yet less than two weeks after that letter, Moran wrote to the American Board of Psychiatry and Neurology, which certifies psychiatrists, and declared there was "no documented evidence of unethical or unprofessional behavior, nor any serious question regarding clinical competence during his residency."
And in Hasan's officer evaluation report from that time, Moran rated him as having "Outstanding Performance."
Hasan raised more red flags during a two-year fellowship before he was sent to Fort Hood in July, where he proved uncharacteristically diligent and cordial in the months before his scheduled Afghanistan deployment at the end of November.
His last officer evaluation report that covered his time at Fort Hood was to be his best. On the morning of Nov. 5, he called a superior to ask about it and was told it was ready for him to see and sign.
Instead, authorities say, he went on a killing spree.