Egads – My Wife is a Member of the Deep State!

 

VA, Deep State, Red/Blue Divide, Civil Service, Patriotism, U.S. Government, Psychology

Reluctant Wife's Office View

I was raised in a solidly Republican home.  My father came from a small town in rural Illinois and his father and grandfather before him had run a department store – they sold women’s clothes, and their cousin’s store sold men’s clothes.  They would travel to Chicago and buy what was in style for the regions, take it back, and they would be sold through departments that included things like sports clothes, formal wear, and lingerie.  Each department had employees who specialized in the department and they would serve the community and the surrounding rural folks who would come into the “city” to get the ready wear clothing they needed.  Being a retailer was lucrative and my grandfather and great grandfather were pillars of the community, contributing to the development of such things as a children’s home, but also a country club.  They went on regular vacations and educated their children at good schools. 

My mother was raised in Chicago.  Her father was an insurance salesman but also an early actuary, assessing risk in order to set rates.  I know that he, too, was successful, though it was a struggle to raise a family, especially during the depression.  He only had an employee or two, unlike my other grandfather who employed many, but he was an entrepreneur whose fortunes rose and fell with the economy but also as a result of the hard work that he put in, he was a believer in a country where people are free to raise themselves up by their own bootstraps.

Both families fancied themselves members of the upper middle class – less because of their income levels, which put them in this income bracket – but more because they were educated and hard working (actually, my paternal great- grandfather was self-educated – including learning and employing a new word a day throughout his adult life).  They were small business owners who were interested in a government that was small, in part because they didn’t want to pay more taxes, but also, I think, because they considered themselves to be moral members of a basically ethical community and didn’t see much need for governmental oversight of their conduct or that of their peers.

My father’s family believed in small town values – and believed that the local community was best situated to take care of their own because they knew who was worthy, who was not, who needed support and who needed to be taught a lesson.  My great-grandfather did not start his business on his own, but was backed by others and he, in turn, supported other ventures once his was up and running.  In addition to business support, my family contributed to local causes and individuals in need.  My father contributed to the United Negro College fund across the course of his life, and regularly donated blood.  Both sides of the family were involved in scouting and they lived by the scouting creed.

I grew up with a great deal of pride in being an American, with a sense of the importance of self-government, but also with a distrust of governmental institutions.  I remember that the word “bureaucrat” was said with a certain sense of disdain, and I associated bureaucracy with the government, saw it as a drain on the economy, and believed that bureaucrats sat in cushy government offices not doing much except creating “red tape” and waiting to retire so they could collect their handsome pension checks.

So, who would have thought that I would marry a member of the deep state?  Certainly not my mother.  She asked me how my sister and I grew up to be liberals.  I reminded her that she had us listen to Pete Seeger’s records as children, and that her lived values – her care and concern for others – values that are shared by the entire family – are liberal values.  What we differ about is how best to translate those values into actions and who should administer them.

The Reluctant Wife is actually my second wife.  We first met when we were both married to other people and she was working with my first wife at a local University based psychological practice.  I sometimes did some moonlighting work at that practice, but did not know the woman who would become my second wife at all well.

Years later, I was the chair of the department of psychology at another local University, recently divorced, and was called to the state capitol to evaluate whether to continue requiring a year of post-doctoral training for graduate students before they could be licensed to practice psychology.  My position was that students should be license eligible at graduation, based, in part, on their having completed a full-time year of internship as a pre-requisite for graduation in addition to three years of part-time practice before that.  I had personally engaged in three years of highly structured post-doctoral training that I found essential to my development as a clinician, but most post-doctoral positions were, in my experience, little more than excuse for more indentured servitude on the part of trainees, many of whom were already deeply in debt.

My future Reluctant Wife was now the director of psychological training at the local Veteran’s Administration (VA) hospital.  She, too, was called to the capitol to address the issue of post-doctoral training.  The future Reluctant Wife was in charge of that last year of training before, in the model being proposed to the government, former students would become license eligible.  Nationally, about half of all psychologists do their internship training at VA hospitals.  Her position could not have been more different from mine.  Seeing students practice during that year before they graduate, she recognized that many of them still did not know what they were doing and she was concerned that they needed additional supervision before being licensed to practice autonomously.  She was more focused on the well being of the citizens of the state and protecting them, while I was more focused on protecting the well being of the students – not wanting them to be exploited.

Well, sparks flew.  We were at the center of the argument and both passionate about our positions.  I accused her of simply wanting to sleep better at night knowing that someone else was watching over the trainees that she was concerned about at the end of their training with her, and she agreed that this was the case.  Shortly after the argument, she invited me to speak at a staff training at the VA.  Mostly because she thought I would do this without compensation, which was true.  But she greeted me so warmly that I assumed there was more than professional interest on her part.  What she was actually doing (she didn’t know that I was divorced) was just being her usual warm, inviting self.  That said, she did respond to my invitation to a meal together, and the rest is history.

Though she was the director of training, the central focus of her job was clinical.  She worked with Veterans who had alcohol and substance abuse issues.  These are veterans who are difficult to treat – they often have histories of trauma from war and/or their earlier lives and they are not socialized to engage in psychological treatment.  She worked on an inpatient unit and then followed some of the veterans after they left the hospital.

To be clear, despite my also being a psychologist, this is not work that I could imagine doing, certainly not for as long as she did.  At the beginning of her own internship experience, when she and the other interns were deciding which rotations to take, she was challenged by one of the staff members on the alcohol and substance abuse unit who said that this is a rotation for the brave.  She liked that challenge.  She was able to be compassionate and clearly cared about her patients while setting clear limits with them and challenging them.  They were very tough men (and occasionally women) with problems that seemed intractable, but she was able to connect with them and was able to appreciate them as needy individuals beneath their crusty exteriors.  She also had a respectful attitude towards their ability to accomplish what they needed to – both to address their addictions and to manage their lives.  She helped them feel safe enough to acknowledge the wounds they had received and caused and to come to grips with leading a sober life.

The reluctant wife’s family background was both similar to mine and very different.  Her father was an engineer who worked for GM and then IBM but left the corporate world to start his own business – a print shop – and then – as he used to say, his life went to hell.  That is an exaggeration, but the business did not do as well as he had hoped, and, being his own boss, he worked himself very hard and did not reap the rewards he expected.  He had married his High School sweetheart, who was a teacher, and she came to work with him in the print shop.  I should mention that my father, too, had worked for a big corporation and then had gone into business for himself, a transition that was difficult for him as well). 

Both the Reluctant wife and I went to college when our parent’s finances were in pretty bad shape.  She went to the local state school and commuted from home.  Meanwhile, her brother went into the Army.  So, after going to going to graduate school, doing the internship at the VA, and then doing a little private practice (where, as I mentioned before, she met my first wife), she was ready and willing to return to the VA.  She believed in the mission of serving veterans.  And she was good at it.  That said, after fifteen years, or so, of working with one population, she felt that she was running a bit dry – she found herself re-using the same metaphors and feeling a bit like she was mailing it in rather than genuinely investing herself in her work.

At about that time, a former mentor, who had started a national organization development consulting firm within the VA, invited the Reluctant Wife to join the group of consultants.  She was at first reluctant to take this position – she was concerned that it would involve a lot of travel while our kids (we were, by this time, married) were in school, but, when the director assured her that she could minimize travel through the school years, she accepted a position within this office.  She took to this work like a duck to water, and she also enjoyed managing the consultants and, within a few years, she became the director of the organization.  This meant that she was in charge of 40 or 50 consultants, but also that she was now a member of the team of leaders that runs the VA Health System from Washington.  I warned her that Washington would soon recognize her gifts and hard work and invite her not to just come to Washington once a month or so, but that they would want her there in a more permanent position, but she just pooh-poohed me.

Her first turn at being a member of the deep state came in the fall of 2020.  As Jon Stewart pointed out on his show, Fox news decided to support the idea that Diversity, Equity and Inclusion (DEI) curricula should be villainized.  Critical Race theory – something very few to that point had heard about – was fingered as threatening the very fabric of the nation.  Fox called on the President to root Critical Race Theory out of the Federal Government.  Then they riled up his base to oppose the use of DEI curricula in schools.  Well, nineteen days later, Trump answered Fox’s call, stating in a speech that Critical Race theory should not be a part of any Federal Government activity and then quickly cobbled together a remarkably unclear executive order demanding that DEI efforts by offices reporting to the President should cease and desist until they were vetted by a yet to be seated group of overseers.

Now the VA serves a very diverse patient group and they do this with a very diverse staff.  The Reluctant Wife had been instrumental in overseeing the design and implementation of a DEI coaching pilot program for leaders to help them improve workplace interactions across racial, gender, religious and other potential barriers to providing high quality service and/or collaborative work relationships.  This program had already been well vetted within the organization, but now, with just a few months remaining in his tenure, Trump had issued this poorly worded edict that could have been interpreted to mean that she and the office she oversees should cease and desist in their efforts.

The VA reports to the President.  The Secretary of the VA sits on the President’s cabinet.  That said, the funding for the VA comes from Congress, so it also reports regularly to congressional committees.  The Reluctant Wife is a good soldier and works will within a highly structured hierarchical system (another difference between us – I am better suited to being a faculty member who has a private practice).  When given a set of directions, she is very good a carrying them out.  So, the President’s order created a dilemma for her.  She deeply believes in the importance of working to treat all individuals equally, but she is also aware of just how difficult it is to do this and how much support we need to have in order to do it effectively.  My father, for example, despite his good intentions behind supporting the United Negro College Fund, treated African Americans as a kind of exotic species and would often ask individuals that he met embarrassing questions clearly based on stereotypes. 

As much as my wife believes in following orders, she also believes – or primarily believes – in doing the right thing.  In this case, it was clear to her what the right thing to do was to continue to provide a well-vetted program with preliminary positive outcomes that supported the mission of the institution for which she worked.  She put mission over marching orders and very publicly told her office to continue doing what they had been doing.

The Reluctant Wife also informed her supervisor that she planned to ignore the executive order.  She continued that she fully understood that this might mean that she could face disciplinary action for doing this, including termination of employment, but she intended to support her team in offering the kind of education that they had deemed was essential to the optimal functioning of the agency.  Her supervisor agreed with her that this was the correct course of action and acknowledge that she, too, might face disciplinary action for not correcting the Reluctant Wife, but she was prepared to do that as well.  I think this went up the chain to the Deputy Undersecretary with all the bureaucrats signing off on it and acknowledging that there might be consequences for having done so.

Ultimately there were no consequences.   Shortly after this, Trump lost the election and enforcing executive orders from a lame duck president who was in total denial that he had lost the election was the last thing on anyone’s mind.  But this action, along with her general competence, was noticed by the leaders in the organization and, when there was a need to fill one of the top positions in the organization, she was tapped to be the acting Chief of Staff of the Veteran’s Health Administration.

This is a big deal.  It is the highest position that a non-physician can fill in the organization without a Presidential appointment.  One way of explaining this is to compare her position in the organization to mine in the University.  I report to the chair of my department who reports to the Dean who reports to the Provost who reports to the President of the University.  She reported to the Undersecretary who reported to the Secretary who reported to the President.  Another way of thinking about this is that she was a member of a three person leadership team that was responsible for the functioning of 172 hospitals and almost 1300 outpatient sites of care across the country with over 400,000 employees working to serve millions of veterans.

Shortly after she was installed as Chief of Staff, a new Undersecretary of the VHA was appointed.  Though this undersecretary had worked for the VA as a presidential fellow early in his career, he had spent most of his career working in Hospital Administration in the private sector.  He was tapped by the Secretary (a former Chief of Staff for President Obama), appointed by the President and approved by Congress to run the VHA system.  The VA actually has three branches – the Veterans Health Administration, the National Cemetery Administration, and the Veterans Benefits Administration, and each of these branches has an Undersecretary to run it – all of them under the oversight of the Secretary.

The new Undersecretary is an ambitious and highly competent man with big plans for the organization, but came in with a steep learning curve to understand the functioning of the VHA as an entity – and of the Federal Government in general.  Part of the Reluctant Wife’s task was to help support his acculturation – to help him learn the ropes of this new organization.  So, for instance, she walked him through the hiring process for senior executives with which he was unfamiliar.

One of the first big organizational agendas for the Undersecretary was an ambitious plan to re-organize the governance structure to align it with the priorities that he had in mind for the organization.  The governance structure had been recently – within the past few years – reorganized and was just beginning to figure out how to function in this new system.  The Reluctant Wife had been closely involved in this project as a consultant and she had seen the organizational chaos that ensued when new relationships between subgroups had been articulated.  She told the Undersecretary, who was very invested in his proposed changes, that she did not believe this was a good idea – that he should use the existing structures that were just becoming effective to support his agenda because changing the governance structure again would mean that there would be two more years of realignment work before the new structures could support his agenda and, by that time, a new administration could be in place and, as a political appointee, he could be replaced by another Undersecretary.  The Undersecretary responded that this wouldn’t matter because his priorities were good ones and they would be consistent with the priorities of whoever it was that would replace him.  The Reluctant Wife (who agreed that his priorities were good and that they made sense) responded, “That’s what they all think.” She proposed, instead, that he set up Tiger Teams to work quickly on his priorities and to connect that work to the existing structures.  This would be a more efficient and effective way to implement his priorities.

To his credit, the Undersecretary was able to hear this very blunt assessment of his plan, to not take offense at it and hear it as insubordination, and he avoided throwing the system into chaos and made use of the feedback, recognizing that it was based on institutional knowledge and concern for the wellbeing of the organization and its ability to carry out the virtues of his priorities.  I’m not sure I would have had the maturity to go along with her suggestion were I in his position (something that can cause friction in our marital relationship, by the way).

So, the Reluctant Wife is a member of the deep state.  She cares, deeply, about the mission of her organization: to serve veterans.  And she works to protect that mission against interlopers – the Presidents and their appointees who, whether well intentioned or not, would move her and the organization away from carrying out that mission.  Fortunately most Presidents, and most of their appointees, also have the health of the organization, and therefore the well-being of the country, in mind.  What they often don’t have is the institutional knowledge about how best to make use of the office to best serve the country. 

It is also the case that a large governmental office is more like an aircraft carrier than a jet ski; it cannot turn on a dime.  While my family, particularly my father’s family, was used to seeing problems be solved on a local level, some of our problems are bigger than that.  When we became a world power, we did this based on our military strength, and maintaining that strength means we need to care for those who have worked to maintain world order, such as it is.  And this is not a small group of people.  In place of the small town, the hospital unit became the place where a community of ex-soldiers came to be known by a caring community of treaters.  And this small group was part of a massive organization – and the members of that organization, over the course of their careers, move from direct treatment to managing the functioning of the organization, and they need to interact with those who come with a mandate from the people to provide better care and help them realize how best to achieve the goals they have given the conditions that exist.

The other piece of institutional knowledge that the Reluctant Wife, as a member of the deep state, carries is a realistic appraisal of the pieces and parts of the institution, but also an appraisal of the institution as a whole.  In this instance she knows that the organization is in much better health than Congress and the press would lead us to believe.  She knows that our veterans are, in fact, being well served by the VA.  Recently she let me know that over 70% of VA medical centers received 4 or 5 Stars in a national patient survey rating versus 42% of Private Hospitals being rated with 4 or 5 starts.  Are there problems? Sure.  There are problems with every health system I have been associated with as a provider and as a patient.  When you have an organization that is employing almost half a million people at hundreds of hospitals, there are problems every day.  And you need a firm hand at the tiller to manage these problems and to keep the ship moving forward.

Happily for me (and for her), the Reluctant Wife’s tour of duty has come to an end after a little more than a year as Acting Chief of Staff.  A permanent Chief of Staff has finally been hired.  She has returned to her regular position as the director of the VA’s Internal Organization Development Office.  This is a position that, like the acting chief of staff, would have been characterized in my family as a bureaucratic one.  It is one that would be characterized in current political speech as being a member of the “deep state”.  Living with a bureaucratic member of the deep state has allowed me to have a new and very different appreciation of what I otherwise would have taken these terms to mean. 

Perhaps not for all, but for my wife, being a bureaucratic member of the deep state meant that she worked very hard to insure that the obligation of a country to its members that have risked life and limb for its protection are cared for in the best manner possible.  It has meant being a servant leader – and in her case it has meant serving the mission of the VA which is, in many ways, the mission of the government and therefore of all of us because ours is a government of the people, by the people and for the people.

Staying in the hinterlands while she commuted to Washington, I did not get to know the other leaders of the organization except through her report, but her experience is that , by and large, the leaders of the organization – the bureaucratic members of the deep state, work incredibly hard and are incredibly talented people doing very difficult work to bring top quality health care to a segment of the population that would otherwise likely be underserved.  They do this not primarily because of the tangible compensation (they would actually be better paid in the private sector) but because of their commitment to the mission.

The VA has come a long way in my life time.  It is a modern health care system, a functional national health care system in a country that is ambivalent about such systems and reports to a body – the US Congress – that is often openly hostile to such systems – while it also lives up to its mission.  One of the subtle, but I think important shifts in the system is that each veteran who arrives for treatment is greeted by a staff member who thanks them for their service.  I think we also owe a debt of gratitude to the health care workers who serve those who have served. 

 

P.S.  This essay, which is overly long, was conceived out of a brief fantasy.  I imagined Joe Biden, in one of his State of the Union addresses pointing to my wife as she sat uncomfortably in the gallery of the House of Representatives.  “There she is,” he would say “an exemplary member of the Deep State.  Educated at our best state institutions, trained by the VA, she has risen through the ranks to become the Acting Chief of Staff.  Along the way, she has helped countless Veterans reclaim their lives, kept the house in order, and, as acting Chief of Staff, has helped my appointees figure out how to continue to improve the great organization that serves our veterans.”  Everyone would have applauded, and she would have been given a medal.  He would have gone on to talk about how dedicated our civil servants are to making our country better.  To really tell the story, I had to add a few words…

To access a narrative description of other posts on this site, link here.  For a subject based index, link here.

To subscribe to posts (which occur 2-3 times per month), just enter your email in the subscribe by email box to the right of the text.