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MELISSA BLOCK, host:

This is ALL THINGS CONSIDERED from NPR News. I'm Melissa Block.

ROBERT SIEGEL, host:

And I'm Robert Siegel.

We have more troubling news about the man accused in the Fort Hood shootings. NPR has obtained an Army memo. It shows that two years ago, a top psychiatrist at Walter Reed Army Medical Center was so concerned about Major Nidal Hasan that he put those concerns in writing. He described incompetence and reckless behavior. Officials at Walter Reed sent that memo to Fort Hood this year when Hasan was transferred there.

As NPR's Daniel Zwerdling reports, it is the first written evaluation to surface of Hasan's work.

DANIEL ZWERDLING: On May 17th, 2007, Nidal Hasan's supervisor at Walter Reed sent this troubling document to Hasan's official file. It's more than a page, single-spaced and it says, quote, �The faculty has serious concerns about Captain Hasan's professionalism and work ethic. He demonstrates a pattern of poor judgment and a lack of professionalism,� unquote.

The memo was signed by the chief of psychiatric residence at Walter Reed. His name is Major Scott Moran. I showed this document to two leading psychiatrists, and they say this memo is so damning that it might have sunk Hasan's career if he had applied for a job outside the Army.

Dr. STEVEN SHARFSTEIN (President and CEO, Sheppard Pratt's Psychiatric Medical Center): Even if we were desperate for a psychiatrist, we would not even get him to the point where we would invite him for an interview.

ZWERDLING: Dr. Steven Sharfstein runs the Sheppard Pratt's psychiatric medical center. It's near Baltimore, Maryland. He says it's a little hard to read this evaluation now and pretend that he doesn't know that Hasan allegedly shot dozens of people. But, Sharfstein says, if he had seen a memo like this about an applicant, he'd avoid him like the plague.

The memo ticks off a striking list of problems over the course of Hasan's training. For instance, Hasan proselytized to his patients. He mistreated a homicidal patient and allowed her to escape from the emergency room. He blew off an important exam. The memo shows that Hasan hardly did any work. He saw only 30 patients in 38 weeks. And sources at Walter Reed say most psychiatrists see at least 10 times that many. When Hasan was supposed to be on call for emergencies, he didn't even answer the phone. And Steven Sharfstein says the memo doesn't suggest that Hasan might shoot people, but it warns that this psychiatrist might hurt his patients with lousy therapy.

Dr. SHARFSTEIN: He might miss the signs and symptoms of somebody who is acutely suicidal, who might enact on their thoughts. You know, there are all kinds of warning signs, flashing red lights, that you would say, oh no, this is not somebody that we would take a chance on.

ZWERDLING: The memo does have a couple of qualifications that say something positive about Nidal Hasan. It says, quote, �He is able to self-correct with supervision,� unquote. And Moran writes: I am not able to say he is not competent to graduate. Officials at Walter Reed told us those statements were very carefully worded. They meant that when Hasan's supervisors read him the riot act, you better shape up or else. When they gave him intensive supervision, then he would improve just enough that they had to tell their commanders Hasan is capable of doing better. But psychiatrists say: Who has time to supervise a doctor like that?

Dr. JUDITH BRODER (Director, Soldiers Project): I would never, ever hire a physician with this kind of a record.

ZWERDLING: Judith Broder runs a private therapy program for troops in Southern California. It's called the Soldiers Project. She just won a national award for her work. She says picture a soldier finally going to therapy. He or she is falling apart. They need a psychiatrist they can trust. Instead, they get a therapist like Nidal Hasan, who sometimes didn't show up and abandoned his patients.

Dr. BRODER: This kind of behavior could in fact set off a stress reaction. It could be a trigger to a post-traumatic stress reaction.

ZWERDLING: In the patient - in the young soldier or Marine.

Dr. BRODER: Yeah, exactly.

ZWERDLING: We asked Scott Moran, spokesman of the Pentagon, for interviews. They declined. We also called officials at Fort Hood and they wouldn't comment either. But sources say when the Army sent Hasan to Fort Hood earlier this year, Walter Reed sent the damning evaluation there, too, so commanders at Fort Hood would know exactly what they were getting.

Daniel Zwerdling, NPR News.

SIEGEL: And you can read that evaluation of Hasan at NPR.org.

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