WASHINGTON -- Often teetering on failure during his medical training, Nidal Hasan hit a particularly rough patch in 2007 when his Army superior cited him for unprofessional behavior, inappropriately discussing religion and underperforming in his residency program.
Yet the same supervisor who meticulously cataloged Hasan's problems suddenly swept them under the rug when graduation arrived that year for the man now charged in the Nov. 5 massacre at Fort Hood, Texas, government documents show.
Hasan, then a captain, was rated "Outstanding Performance, Must Promote" by that supervisor, Maj. Scott Moran, and as "Best Qualified" by another, Col. John Bradley, shortly after he barely escaped the punishment of administrative probation.
Reached by telephone, Moran declined to comment. Calls to Bradley's office were not returned.
Defense Secretary Robert Gates last week released an internal Pentagon review 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.
Gates withheld details. But the disjointed picture emerges through information gathered during the internal review and obtained by The Associated Press.
The information reveals a pattern of sanitized performance appraisals - praise piled into the official record by officers who seemed determined to advance Hasan's career despite knowing he was chronically late for work, saw few patients, disappeared when he was on call and confronted those around him with his religious views.
Mental health worries
Nothing in the record points clearly to a risk that Hasan would turn violent.
But after Hasan moved to a fellowship from his residency at Walter Reed Army Medical Center, one instructor, Lt. Col. Donald Lundy, thought Hasan was at risk of developing a psychosis, according to the documents. No follow up mental-health evaluation was done. Lundy did not immediately respond to telephone calls seeking comment.
It wasn't the first time people around him thought the physician needed to heal himself. Nor was it the last.
In Hasan's second year at Walter Reed, a potentially homicidal patient of Hasan's walked out of the emergency room without authorization.
Minutes from a January 2005 meeting held by a policy committee that oversees Walter Reed's psychiatry program assert: "Dr. Hasan exhibits poor self-monitoring, judgment and cognitive abilities. He has shown a failure to progress."
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 several telephone calls to Waldrep's office in North Carolina, but he could not be reached.
Then on June 1, 2005, the committee knocked Hasan 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." Remediation or probation was considered.
Weeks later, he received a glowing review covering the same period.
List of complaints
Starting in March 2007, Hasan began going sharply downhill.
Maj. Scott Moran, who replaced Waldrep as director of the psychiatry residency program at Walter Reed, proposed a remediation plan because Hasan was seeing less than one patient a week and acting unprofessionally.
Moran leaned on him hard. From March to June, Moran:
Reprimanded Hasan for being out of reach when he was on call.
Cited concerns about Hasan's professionalism and work ethic and his inappropriate discussions of religious issues.
Criticized Hasan's scholarly research presentation for being unfocused and too loaded with verses from the Quran.
Moran went on to write a letter of reference saying Hasan had completed the residency program despite "documented evidence of unethical or unprofessional behavior" and serious concerns about his performance.
But less than two weeks later, Moran wrote to the American Board of Psychiatry and Neurology, a professional organization that certifies psychiatrists. This time he ignored the record and closed the letter saying Walter Reed's records contain "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."
Moran declined to comment.
