March/April 2008 Vol

VAnguard

Features

Warriors in Transition 6 VA, Defense, Army team up to improve veterans’ care Building for the Future 8 VA is in the midst of an historic surge in construction and leasing 8 One-Stop Service for Soldiers 10 Newly expanded Fort Bragg facility offers easier access to VA benefits Doctor, Teacher, Role Model 12 Tampa VA’s chief of medicine is one of the youngest in the country Turning No Veteran Away 14 Former homeless veteran now helps others get off the streets Return of the Native 16 Kenyan returns to his homeland to help eradicate disease 12 The Files Behind the Faces 18 VA’s massive Records Management Center stores veterans’ records The Problem of Pain 22 And what two VA researchers are doing about it A Day to Remember in South Florida 25 VA’s 125th national cemetery is dedicated near West Palm Beach National Cemetery Volunteers: A Vital Force 26 Dallas-Fort Worth National Cemetery has a dedicated group National Salute 2008 27 26 Honoring veterans hospitalized at VA facilities nationwide

VAnguard Departments VA’s Employee Magazine March/April 2008 Vol. LIV, No. 2 3 Feedback 32 Medical Advances Printed on 50% recycled paper 4 From the Secretary 33 Have You Heard 5 Outlook 34 Honors Editor: Lisa Respess Gaegler 28 Around Headquarters 35 Heroes Photo Editor: Robert Turtil 31 Introducing 36 Memorial Day Photographer: Art Gardiner Staff Writer: Amanda Hester

Published by the Office of Public Affairs (80D)

U.S. Department of Veterans Affairs On the cover 810 Vermont Ave., N.W. Deborah D. Berry, acting Support Services Washington, D.C. 20420 Division Chief at the VA Records (202) 461-7427 Management Center in St. Louis, inspects a E-mail: [email protected] claims file at the RMC’s main storage www.va.gov/opa/feature/vanguard complex. The stacks hold the records of 18 million veterans. The employee behind her is one of 20 on shift pulling 2,100 folders a day. photo by Robert Turtil

2 March/April 2008 VAnguard feedback

Oldest Survivor of the VAnguard (March/April 2007 some three years and five George as we were both survi- Bataan Death March issue) depicting the back- months’ imprisonment by the vors of the Death March and The former POW community ground and experiences of Japanese. POW camps during the pe- of northern Nevada is sad- George Small. He was consid- George was looking for- riod April 9, 1942, to Septem- dened by the death of its old- ered to be the oldest (at the ward to celebrating his 100th ber 10, 1945. est survivor of the Death time) known survivor of the birthday on Feb. 28. I was George had recently fin- March. An article appeared in Bataan Death March and personally involved with ished his personal story of his past experiences and it had SVAC Member Named Chairman of West Point Board of Visitors been submitted for inclusion Senator Kay Bailey Hutchison (R-Texas) has been elected chairman of the Board of Visitors in VA’s Oral History program. (BOV) at the U.S. Military Academy at West Point. “I am honored to serve as chairman of the We here at the Reno VA Board of Visitors at West Point,” said Hutchison. “For more than two centuries the Academy has Medical Center shall most cer- been one of our nation’s finest institutions, developing cadets for the challenge of national service. tainly miss George. I look forward to working with the Board’s members over the next year to continue their standard Ralph Levenberg of excellence at West Point.” POW Consultant/Coordinator Created by the Federal Advisory Act of 1972, the BOV meets quarterly to review and receive VA Sierra Nevada HCS updates on the academic, physical and military programs at the Academy. Specifically, the Board Reno has oversight of the Academy’s morale and discipline, curriculum, instructions, physical equip- Editor’s note: Levenberg spoke ment, fiscal affairs and academic methods. The board consists of presidential appointees and at a tree-planting ceremony members of Congress. Hutchison previously served as chairman of the BOV from 1998 to 2000. held at the Reno VA Re- She is a member of the Senate Committee on Veterans’ Affairs. gional Office on Feb. 28, which would have been George Small’s 100th birthday. Plans had been made to host a birthday party for him. The tree and plaque honor the struggles of Small and all former POWs.

We Want to Hear from You Have a comment on something you’ve seen in VAnguard? We invite reader feedback. Send your comments to [email protected]. You can also write to us at: VAnguard, Office of Public Affairs (80D), RAMONA PHILLIPS Department of Veterans Remembering a Fallen Hero Affairs, 810 Vermont Family, friends and community leaders gathered in Granite City, Ill., to dedicate a billboard Ave., N.W., Washing- that went up there a few days before Veterans Day in memory of Army Sgt. Steven P. ton, D.C., 20420. In- Mennemeyer. Mennemeyer, 26, was the son of Ramona L. Phillips, IT specialist at the St. clude your name, title Louis VA Medical Center. On his second tour of duty in Iraq as an Army flight medic, he and VA facility. We was killed when his helicopter crashed on Aug. 8, 2006. In an effort to pay tribute to her won’t be able to publish son, Phillips envisioned a memorial billboard that would remind the public of the ultimate every letter, but we’ll sacrifice made for freedom. The billboard, which was financed completely by donations, use representative ones. stands 24-by-10 feet tall. “[The billboard] has been very healing for me,” Phillips said. We may need to edit Mennemeyer, assigned to the 82nd Medical Company based at Fort Riley, Kan., was buried your letter for length or with full military honors at Jefferson Barracks National Cemetery in St. Louis. clarity.

March/April 2008 3 from the secretary VAnguard

Beyond the Beltway: Learning What the ‘Real’ VA is Doing James B. Peake, M.D. Secretary of Veterans Affairs

Since becoming Secretary of nership with the Department continued provision of world- leader in telehealth-based care Veterans Affairs, I’ve made a of Defense to provide a seam- class health care and benefits delivery, and that requires point of getting out of the of- less transition from military to VA and DoD beneficiaries, continued restructuring of ele- fice to find out what the “real” duty to civilian life. It means including the development of ments of our clinical, techni- VA is doing and what veterans embracing the recommenda- secure, interoperable electronic cal and administrative pro- expect of us. I’ve traveled tions of the Dole-Shalala com- medical record systems; cesses. thousands of miles, talked mission to ensure that service- Improve the timeliness and A major challenge in im- with veterans and talked with men and women injured dur- accuracy of claims processing; proving the delivery of com- VA staff and leadership. ing the Global War on Terror and pensation and pension ben- This is the message I am receive their health care ser- Ensure the burial needs of efits is the steady and sizeable leaving with them: I am proud vices and benefits and return veterans and their eligible increase in workload. The vol- to be a part of a system of ex- to full and productive lives as family members are met and ume of claims receipts is pro- cellence. Great men and quickly as possible. maintain veterans’ cemeteries jected to reach 872,000 in women serve veterans every VA care also means meet- as national shrines. 2009—a 51 percent increase day with dignity, compassion, ing the needs of our wounded The challenge is clear. since 2000. Disability com- respect and technical excel- warriors injured by improvised During 2009, we expect to pensation claims from veter- lence, whether in health, ben- explosive devices and suffering treat about 5,771,000 pa- ans who have previously filed efits delivery or in creating the from traumatic brain injuries, tients—90,000 above the a claim comprise 54 percent lasting tribute of our cemetery burns and loss of limbs. It 2008 estimate. Our highest of the disability claims re- system. That must be our means helping them and all priority patients will comprise ceived by the department each standard and we cannot rest Operation Enduring Free- 67 percent of the total patient year. upon our laurels! dom/Operation Iraqi Free- population in 2009, but they We are now working For our most senior vet- dom veterans reenter the ev- will account for 84 percent of closely with DoD to develop a erans, that means respecting eryday world of civilian life, our health care costs. pilot of a new Disability the reality of their advancing confident that VA will be In 2009, we expect to Evaluation System for years and providing geriatric there for them with the best treat about 333,000 OEF/OIF wounded, ill and injured war- care, long-term care, and, when they die, honored trib- Great men and women serve veterans every day with utes in our national cemeteries. It also means making cer- dignity, compassion, respect and technical excellence, tain we respond quickly and whether in health, benefits or our cemetery system. efficiently to their compensation and pension problems. health care and benefits they veterans, an increase of 40,000 riors being processed through For veterans at the higher have earned through selfless above this year’s number. the disability system. This has end of middle life, VA care service. That, in short, is our In April 2006 there were the potential to enable VA to means helping them address mission. more than 250,000 unique award benefits to service- diabetes, heart disease and There are four goals in ar- patients waiting more than 30 members on the day of separa- other mid-life health threats eas critical to the achievement days for their desired appoint- tion or retirement. that, if left untreated, reduce of our mission: ment date for health care. As In my many years in the quality of life and shorten life Provide timely, accessible of Jan. 1, we had reduced the military and now with VA, spans. VA must do a better and high-quality health care to waiting list to just over I’ve been privileged to know job of responding to compen- our highest priority patients, 69,000. Our goal is to virtu- and care for men and women sation and pension claims and veterans returning from ser- ally eliminate the waiting list whose lives were changed for- servicing our Vietnam-era vet- vice in Afghanistan and Iraq, by the end of next year. ever by an injury or illness erans without unnecessary veterans with service-con- Coordination of care in that affected their mobility, waits for their benefits. nected disabilities, those with VA will help achieve this goal. but never daunted their spir- For the young men and lower incomes, and veterans We must integrate telehealth, its. They are an incredible women returning from Af- with special health care needs; health informatics and disease cadre of heroes who we must ghanistan and Iraq, VA care Advance our collaborative management and improve ac- always keep in mind as we means strengthening our part- efforts with DoD to ensure cess to care. VHA is a world strive to fulfill our mission.

4 March/April 2008 VAnguard outlook

Celebrating 60 Years of Achievement in VA Research Joel Kupersmith, M.D. Chief Research and Development Officer

“VA Research: A Promise for a as a neurally-controlled arm deliver low-level, computer- ings into advancements in vet- Brighter Tomorrow” is the and hand prosthesis that will controlled electric currents to erans’ health care. theme for this year’s VA Re- feel, look and perform like a weakened or paralyzed Fosters dynamic collabora- search Week, May 11-17. My natural limb, and speak about muscles to allow people with tions. While realizing the full office, the VA Office of Re- cutting edge research such as incomplete spinal cord injury advantages of an intramural search and Development, and the project that caught a ride to once again walk and per- research program, such as an research offices at VA medical on the space shuttle Endeav- form other everyday func- investigator-initiated, merit- centers across the nation an- our when it was launched tions; gaining new knowledge driven portfolio independently nually observe Research Week. March 11. The research, of the biological roots of post- reviewed for quality without VA Research Week pro- which was transported to the traumatic stress disorder and an eye for profit potential, we vides the opportunity for VA International Space Station, developing and evaluating ef- embrace our close partnerships research investigators and ad- will be used to create a Salmo- fective PTSD treatments; with academic institutions, ministrators to highlight their nella disease model that may identifying genes associated and foster dynamic collabora- discoveries and innovations ultimately lead to the develop- with Alzheimer’s disease, dia- tions with federal agencies that have led to advancements ment of a robust Salmonella betes and other conditions; such as the Department of in veterans’ care and the vaccine with the potential to pioneering new home dialysis Defense and the National In- nation’s medical knowledge, save many lives and billions of techniques; and developing a stitutes of Health. and to recognize veterans for dollars. This is a landmark system that decodes brain In short, by spearheading their participation in research study as it is the first time a waves and translates them into research that directly advances studies that help make VA health care the high quality Join the VA Research Week activities in your area and care that it is. As best stated by VA Secretary James B. learn more about how VA research is improving veterans’ Peake, M.D., “The VA re- lives. search program is the foundation for advancements in vet- living organism has been in- computer commands to allow the medical care of veterans erans’ health care and repre- fected in space for the purpose quadriplegics to perform daily and the nation’s medical sents the promise of a better of study, and represents a new tasks like using e-mail. One knowledge and care practices, life.” approach to vaccine develop- veteran has said of the pro- the VA Research and Develop- During Research Week, ment. gram: “Sometimes it works ment program has become an activities and events will be For the past 60 years, the miracles.” acclaimed model for conduct- held throughout the nation, VA research program has been Attracts exceptional inves- ing superior bench-to-bedside including an event in VA Cen- improving veterans’ lives tigators. One program aspect research—a program that all tral Office on May 23 that I through innovation and dis- that I am most proud of is the employees can be proud to encourage all employees in the covery that have led to ad- VA investigators. The oppor- call VA, as I am. Join the VA area to attend. During the vances in health care for veter- tunity to conduct vital re- Research Week activities in event, which we are planning ans and all Americans. search in an integrated health your area and learn more in collaboration with veterans A promise for a brighter care system with a state-of- about how VA research is im- service organizations and tomorrow. The VA Research the-art electronic health record proving veterans’ lives. Infor- other key stakeholder groups, and Development program is draws the best and brightest mation regarding VA Research Secretary Peake and Under the only research program in research investigators to the Week and research advances Secretary for Health Dr. which discovery and innova- program. VA investigators can be found at: www. Michael J. Kussman will pro- tion are focused wholly on have won three Nobel prizes, research.va.gov. vide remarks and lead off a meeting the full continuum of six Lasker awards, and numer- panel of veterans that will veterans’ needs, from preven- ous other distinctions. Because speak about the impact VA re- tion to rehabilitation. VA re- many investigators also care Celebrate VA Research search has had on their lives. searchers are: exploring new for patients, the VA research Week May 11-17. Go to VA investigators will approaches to pain treatment program is able to work with www.research.va.gov demonstrate research advances that will help veterans with the VA health care system to for more information. that are being developed, such burn injuries; learning how to quickly translate research find-

March/April 2008 5 feature VAnguard Warriors in Transition VA, Defense and Army team up to improve veterans’ care.

eamwork is the order of the and made more consistent and trans- key advisors. This spring more VA day between VA, thh Depart- parent,” said Dr. Ward Casscells, assis- staff will be working with the Army. Tment of Defense, the Army tant secretary of defense (health af- Kristin Day, VA chief consultant and its 35 new military units dedi- fairs). for care management and social work, cated since February 2007 to helping A pilot program is underway at agreed. “While much work remains to wounded soldiers and their families three Washington, D.C., area military be completed,” she said, “meaningful get quality outpatient care. medical facilities and is chartered to progress has been made through im- In the last year, the Army trans- both simplify and accelerate the dis- proved processes and greater collabo- formed how it provides care and assis- ability process. “In the pilot, a single ration between the Department of tance to all wounded, ill and injured physical is conducted and accepted by Defense and VA.” soldiers through the Army Medical both DoD and VA, eliminating the She noted that the two depart- Action Plan. The Army completed a need for multiple medical evaluations ments are in the process of imple- nationwide review this February that and speeding up the receipt of ben- menting more than 400 recommenda- included dozens of leaders addressing efits that are due to warriors who are tions of five major studies, as well as everything from barracks implementing the upgrades for disability ac- Wounded Warrior and cess to regular town hall Veterans titles of the re- meetings for soldiers and cently enacted National their families. Defense Authorization The Army’s “full op- Act (Public Law No. 110- erational capability” re- 181). “We continue to view of the 35 new War- implement recommended rior Transition Units changes through the use found much has been ac- of policy and existing au- complished—with much thorities,” Day said. She help. It noted strong sup- added that in August port from Congress, VA, 2007, the secretaries of the Defense Department the military departments Soldiers in the Army’s Warrior Transition Units get the support they and the American public. need to return to a fulfilling, productive life, including participation were directed to use all The Army Medical existing authorities to re- in adaptive sports. DOD Action Plan created these cruit and retain military units as part of a profound nationwide separated from the military,” Casscells and civilian personnel who care for push focused on one mission: to help said. our seriously injured warriors. soldiers recover and aid their families. “Both departments are commit- “We have done more than just “I am a Warrior in Transition. My job ted to building better relationships change policies and processes,” said is to heal as I transition back to duty and systems for the benefit of our war- Col. Jimmie Keenan, chief of staff for or become a productive, responsible riors and veterans,” said Brig. Gen. the Army Office of Warrior Care and citizen in society,” the Wounded War- Michael Tucker, Army assistant sur- Transition. “Breaking down the bu- rior mission affirms. “This is not a sta- geon general for warrior care and reaucratic culture, changing attitudes tus but a mission. I will succeed in transition. In mid-February, the Army about behavioral health issues and this mission because I am a Warrior.” and VA signed a joint statement of dispelling perceptions about asking Nationwide changes go well be- mutual support, further showing their for help are just some of our key yond the fence lines of Army forts. mutual commitment to care for goals.” Changes in perception and “We found our Disability Evalua- wounded, ill and injured warriors. culture will take time, she said, but “it tion System should be streamlined The Army and VA also exchanged is very clear to our warriors and their

6 March/April 2008 VAnguard feature families that we are listening to them by tailoring our programs based on their needs.” “I am confident with VA’s con- “We ask our- tinued support and that of our other selves every stakeholders we are on the right glide day two basic questions: It is path,” Tucker said. “We ask ourselves right for sol- every day two basic questions: Is it diers? Is it right for soldiers? Is it right for fami- right for families?” said lies?” Brig. Gen. The Army took major steps over Michael the past year to improve the manage- Tucker, Army assistant sur- ment and care of warriors in transi- geon general tion and is committed to providing a for warrior level of care and support equal to the care and transition. quality of their service, Army officials say. These veterans undergo a healing process that uses comprehensive care DOD Kristin Day, VA chief consultant for care families can call the center’s around- management and social work, said VA and the-clock toll-free hotline, 1-800-984- DoD are in the process of implementing more than 400 recommendations of five 8523, to get help. Staff members con- major studies. tact each reservist who enters a War- rior Transition Unit to begin a partnership dialogue. As part of this highly personal- ized approach, each warrior in transition is provided a squad leader, nurse case manager and primary care manager. Soldiers with severe injuries and wounds are also helped by Army Wounded Warrior Program and Sol- dier Family Management specialists who work closely to coordinate benefits, services and other assistance programs, for as long as they need. Besides the chain of command, patient advocates and a toll-free ROBERT TURTIL hotline number, frequent town hall plans focused on mending body, Family Assistance Center. The cen- meetings and formal ombudsman pro- mind, heart and spirit. ters offer one-stop access to essential grams provide independent avenues As of Jan. 2, the Army’s 35 War- services such as pay, legal, health ben- for warriors and their families to ad- rior Transition Units reached full op- efits and housing. Nine community- dress concerns. erating capacity providing more than based health care organizations lo- Tucker said the Army focused on 9,500 wounded, ill and injured war- cated throughout the Army provide improving case management, facilities riors in transition the support they additional support to National Guard as well as pay and benefits, restructur- need to recover medically and handle members and reservists who may not ing the Disability Evaluation System, administrative needs. Staffing levels live near a military installation. increasing Army, DoD and VA data are now at 95 percent or higher. In Meanwhile, the Army Reserve, sharing, and developing consistent as- less than a year, the Army increased whose soldiers and families have sessments and treatment approaches its staff dedicated to warrior care from unique needs, has created its own for soldiers with traumatic brain in- a few hundred to more than 2,700. Warrior and Family Assistance Cen- jury and mental health issues. Each Warrior Transition Unit is ters to provide information to serving located near an Army Soldier and and retired members. Soldiers and By Paul Boyce, Army Public Affairs

March/April 2008 7 feature VAnguard Building for the Future

New 1,500-space parking garage at the VA Pittsburgh Health Care System’s University Drive Division. GLENN HANGARD VA is in the midst of an historic surge in construction and leasing.

s the first traces of light are leased), VA has one of the largest in- with emergency supplemental funds breaking over Frenchman’s ventories of real property in the fed- at Biloxi and New Orleans in re- AMountain, Office of Construc- eral government, and huge require- sponse to damage from Hurricane tion & Facilities Management (CFM) ments to maintain, renovate and re- Katrina. In total, these projects trans- Senior Resident Engineer Tom Kupris place these assets. late to nearly $5 billion of major is already astride his motorcycle for Begun in 2001, the Capital Asset projects currently in planning, design the 20-minute ride to North Las Ve- Realignment for Enhanced Services or construction, and include replace- gas. Despite the sunshine, it is cool in (CARES) process examined the need ment VA medical centers in Las Ve- the desert this morning, but perfect for health care services and projected gas, Orlando, Denver and New Or- weather for a large concrete pour at facility requirements in terms of loca- leans, and major campus consolida- the site of the new Las Vegas VA tion, size and function. CARES is tions in Cleveland and Pittsburgh. Medical Center—VA’s largest health now bearing its early fruits. In addition to the dramatic care project now under construction. To date, 37 major medical con- growth in health care construction, This scene is being repeated struction projects have been identi- VA cemetery construction is also oc- across the country as VA engages in fied and funded by Congress, in whole curring at a record pace. In fact, cem- its most ambitious health care con- or in part, through this process. Three etery construction is at the highest struction program since World War II. new construction starts were re- level since the Civil War. With more than 5,000 owned build- quested by VA for fiscal year 2009. VA’s 125th national cemetery— ings (with an average age of more Of these projects, one (North South Florida VA National Cem- than 55 years), 1,100 leases, 32,000 Chicago) is complete, 21 are in de- etery—opened in Palm Beach County acres of land and approximately 158 sign, and 18 are in construction. Two in April 2007. This marked the fifth million gross square feet (owned and additional major projects were funded new VA cemetery to open since 2005.

8 March/April 2008 VAnguard feature

Thirty-eight cemetery projects are construction, the department’s leasing (North East Central Bexar County, now in planning, design, or construc- program is also experiencing a dra- San Antonio, and Harlingen, Texas). tion, including five more national matic increase in workload. Accord- Two additional leases are pending cemeteries that are projected to open ing to Donald H. Orndoff, director of award later in fiscal year 2008 (Fort in December 2008 and January 2009. CFM, “leasing plays a critical role in Worth, Texas, and San Diego). The “VA has an ambitious but achiev- VA’s ability to provide state-of-the-art remaining 14 leases are in various able plan to serve greater numbers of health care facilities that serve veter- stages of procurement. VA’s fiscal year veterans at these new cemeteries as ans closer to where they live, and is a 2009 proposed budget requested fund- soon as possible,” explained William very good procurement option when ing and authorization for 12 addi- F. Tuerk, VA under secretary for me- construction dollars alone cannot ful- tional major leases. morial affairs. fill VA’s space needs in a timely and “VA is extraordinarily proud of its The new national cemeteries will cost-effective manner.” health care facilities, regional offices serve the areas of Bakersfield, Calif.; Since fiscal year 2005, 27 pro- and national cemeteries, and the Birmingham, Ala.; Columbia, S.C.; spectus-level leases, those requiring thousands of dedicated employees Jacksonville, Fla.; and Sarasota, Fla. congressional approval, have been au- who build, lease and maintain them,” A sixth new VA cemetery will begin thorized in VA’s budget. With a single said Orndoff. “Modernizing and main-

Senior Resident Engineer Tom Kupris (third from right) and other South Florida VA National Cemetery began burial operations in April members of the CFM resident engineer team on the site of the new 2007, serving nearly 400,000 veterans and their families who reside VA medical center in Las Vegas, now under construction. in the West Palm Beach area. CLARK CONSTRUCTION GARY DALE operations to serve veterans in the Philadelphia area later in 2009. VA also has an active program to establish, expand and improve state veterans cemeteries through its State Cemetery Grants Program. Ulti- mately, VA’s strategic goal is to serve 90 percent of veterans with a burial option at a national cemetery or a state veterans cemetery within 75 miles of their residence by 2010. “The current rate of expansion of national cemeteries and state veterans New VA/Navy Ambulatory Care Center in Pensacola, Fla. RUBEN ROMERO cemeteries is unprecedented,” said Tuerk. “By establishing these new exception, each of these leases was for taining these critical assets remains a cemeteries, and extending the life of outpatient clinics. top priority for Secretary Peake, and existing cemeteries, VA will meet the Of the 27 lease projects autho- under his leadership VA will continue need for convenient, close-to-home rized, four leases have been awarded, to make significant progress in ad- burial options for our older veterans, two are in design/construction (Knox- dressing these challenges.” and for all of America’s veterans.” ville, Tenn., and Summerfield, Fla.), Coupled with the surge in VA and two were completed/activated By R. Michael Bowen

March/April 2008 9 feature VAnguard

Veterans Service Representative Jim Watson and Newly expanded facility at Program Support Clerk Lakeysha Byrd outside the lobby of the new Fort Bragg VA benefits office, located in the base’s revamped Soldier Fort Bragg offers easier access Support Center, a building formerly occupied by to veterans benefits. Womack Army Medical Center.

One-Stop Service for Soldiers ART GARDINER f the Fort Bragg VA Benefits De- employment counseling. Veterans ser- efits office in 2005. As supervisory livery Office was listed on the vice organizations (VSOs) are co-lo- VSR, she receives a lot of feedback INew York Stock Exchange, its cated there, including the Disabled from soldiers, their spouses and family stock would be through the roof. American Veterans, Military Order of members, most of it positive. “Clients The recently expanded VA ben- the Purple Heart and the Veterans of feel that their counselors can walk on efits office is located in Fort Bragg’s Foreign Wars. water,” she said. revamped Soldier Support Center. Its Walk-in traffic at the office has Counselors often have to guide new location offers one-stop service increased by more than 50 percent and support soldiers through uncer- for soldiers assigned to the sprawling since the move from the old location, tain times, from anxiety over what 1.74 million-acre post. VA shares the said Nina Tann, supervisory veterans the future holds and their ability to center with a multitude of other ser- service representative at the office. provide for their families, to just tak- vices, including the Army Career and She attributes the increase to the new ing care of themselves. Tann said her Alumni Program (ACAP), Central location’s visibility. goal is for a veteran to always walk Issue Facility, ID Card Facility, and On any given day the office has away from their meetings with a the Military Welfare and Recreation 75 to 80 walk-ins, the majority of counselor knowing what the next step Office. which are retirees, followed by initial in the VA claims process will be and Now, the VA office’s veterans ser- term enlistees. “Soldiers attending feeling confident that they are pre- vice representatives (VSRs) can liter- other out-processing appointment ser- pared to take it. ally walk soldiers through the claims vices will often stop by to read litera- Tann’s most memorable story is process. They offer everything from ture, ask basic questions, or schedule working with a soldier who was part VA intake interviews to medical ex- an appointment with a benefits coun- of the Army’s Wounded Warrior pro- ams, as well as on-site rating special- selor,” said Tann. gram. The soldier, wounded in com- ists and vocational rehabilitation and Tann joined the Fort Bragg ben- bat, suffered from numerous injuries

10 March/April 2008 VAnguard feature resulting from gunshot wounds, in- Hancock, management analyst at the cluding the loss of use of one leg and Winston-Salem VA Regional Office. PTSD. The Fort Bragg benefits office “For nearly all the other Benefits De- facilitated his exam appointments, livery at Discharge sites (except decided his claim, and awarded ben- Camp Lejeune Marine Corps Base), efits, all within days of his retirement. the records are forwarded to one of Tann said that it was his gratitude two centralized Rating Activity Sites and positive outlook on life that in Winston-Salem or Salt Lake City.” made him stand out. “He felt like we With more VSO representatives were doing him the biggest favor,” she co-located at the Fort Bragg benefits said. office, more soldiers are opting to Fort Bragg VA benefits counse- speak with them as well as VA ben- lors work closely with the new efits counselors. Wounded Warrior Transition Battal- VA benefits services at Fort Bragg ion specifically created to replace the have come a long way. Prior to 1998, Medical Hold Companies from the soldiers out-processing had to submit various military units on the base. VA their VA claims packet through Army counselors are able to assist soldiers Transition Services. The packet was with special needs and go to those then forwarded to the VA regional of- unable to sit through a normal brief- fice nearest the servicemember’s ing. home, often left to be completed by The benefits office also arranges the receiving office. That changed in transportation to and from briefing 1998 when the Fort Bragg benefits of- locations, and arranges for spousal fice opened its doors. participation if the wounded soldier An old-style North Carolina needs assistance. farmhouse served as Fort Bragg’s first ART GARDINER Will the Fort Bragg/VA one-stop VA benefits office. But it was far from Program Support Clerk Lakeysha Byrd greets walk-ins service approach become the tem- ideal. The wood-sided building was looking for information on the VA claims process. Walk- plate for future such offices? Only small, barely large enough to house a in traffic has increased significantly at the new location. time will tell, but its parent facility, few VA employees and two VSO rep- send servicemembers from one city to the VA regional office in Winston- resentatives. They were confined to a another to complete the medical Salem, N.C., certainly hopes so. cubicle environment in a single room. exam portion of their claims. “One thing that will probably al- When privacy was needed, an VA’s new facility is built with a ways be unique about Fort Bragg, 8-by-10-foot room near the cubicles complete, seamless transition from ac- though, is that the rating specialists was available. This meant that staff tive duty to civilian life in mind. Fort who decide the claims are physically could only comfortably see one vet- Bragg soldiers and veterans praise ev- located at Fort Bragg,” said Vincent eran at any given time. Staff had to erything from the location’s ease of use, accessibility and privacy, to the one-stop service experience provided The New and by the new facility. Improved VA Combined with the VA/DoD Benefits Office Disability Evaluation System pilot program—part of the President’s 14 VA employees and 3 vet- Commission on Care for America’s erans organization representa- Returning Wounded Warriors, or tives, with a fourth located Dole-Shalala commission—the two downstairs with ACAP agencies are striving to act in concert, 4 benefits counselors establishing one medical examination ART GARDINER 3 rating specialists under one disability rating system, all The new benefits office offers everything from 1 claims assistant intake interviews to medical exams and vocational in an effort to simplify the rehabilita- 1 program support clerk rehabilitation and employment counseling. tion and transition of servicemembers 1 supervisory veterans service representative to civilian life. 4 vocational rehabilitation & employment counselors By Art Gardiner

March/April 2008 11 feature VAnguard

Dr. Jose Lezama (seated) visits with veteran Billy Stephens bedside as medical residents look on.

ART NELSON Doctor, Teacher, Role Model Tampa VA’s Dr. Jose Lezama, 36, is one of the youngest chiefs of medicine in the country. t age 36, Dr. Jose Lezama is University of South Florida, where he Medical Colleges. The award honors one of the youngest chiefs of has taught more than 1,200 students a medical school faculty physician Amedicine in the U.S. And at in various stages of their medical edu- who is a caring, compassionate men- the James A. Haley Veterans’ Hospi- cation. To date, he has prepared more tor practicing patient-centered care. tal in Tampa—the nation’s busiest than 200 residents for the Board of Only 24 physicians nationwide VA hospital—these responsibilities Internal Medicine exam, and nearly were nominated for the honor. While are far-reaching. He supervises nearly all have passed. When he has a spare Lezama was not selected for the na- 70 staff physicians, oversees the work moment, he answers e-mail from stu- tional award, he was USF’s winner of 60 respiratory therapists and other dents, many requesting letters of rec- and was presented the award by Dr. technicians, and keeps a watchful eye ommendation. Stephen K. Klasko, dean of the USF on medical students and residents Sound like a busy doctor? He is College of Medicine, on Feb. 8 at a when they rotate through Medical that, and much more. Lezama’s medi- luncheon held at the university. Service. And that’s not all. cal students respect him, admire him, Melika George is a fourth-year He also participates in various adore him. In fact, he is so well USF medical student who describes hospital committees, volunteers at the thought of by his students that they Lezama as a “wonderful” teacher. Hillsborough County Emergency Op- nominated him for the national 2007 Third-year medical student erations Center, and is associate pro- Humanism in Medicine Award spon- Whitney Lapolla agrees whole- fessor of internal medicine at the sored by the American Association of heartedly. “I remember on that very

12 March/April 2008 VAnguard feature first day, he sat us down and talked to ergy and enthusiasm. He rapid-fires multidisciplinary approach to patient us for over an hour, just to get to questions at his young apprentices, care, we all work together to care for know us,” Lapolla recalls. “We all who hang on his every word. When our patients, who, to me, are the best knew he was incredibly busy … the they appear stumped, he offers a clue. in the world.” phones were ringing off the hook just And then another. When one finally And then there’s the unwavering outside the door, but his attention gets the answer, he is quick with a support of his pharmacist wife, Amy, was totally focused on us. We were his smile and praise. “You’re the first stu- and his children, daughter Kaitlyn, 5, top priority at that moment and I dent to ever get that right! Good and son, Derek, 1. “I would not be think that’s the way his patients feel, job!” he tells the student, who nods able to do what I do without my too. Rather than standing above in approval, clearly grateful for the wife’s support,” says this dedicated fa- them, he sits down on the bed to talk acknowledgement. ther, who describes himself as a to them and to make them feel more How is this Cuban-American “hands on” dad. “I can change a dia- comfortable.” Third-year medical student Scott “The VA has given me incredible opportunities Hamlin says what impresses him about Lezama is his breadth of knowl- to develop my teaching skills, leadership skills, edge and how he relates to his stu- humanism skills.” dents. “When you talk to Dr. Lezama, you don’t feel like you’re talking to doctor able to wear so many different per in 3.5 seconds,” he says with the chief of medicine. He’s young, en- hats successfully and still have a per- pride. ergetic, and not far removed from sonal life? He credits his “absolutely Glancing around his office, it’s medical school himself. We connect outstanding” staff, led by Administra- apparent family is everything to this with him.” tive Officer Andrea Davis. “They bilingual doctor whose parents came All agree Lezama is a role model have me on a very tight schedule; not to America from Cuba in the early and “humanist” they want to emulate. a minute of my time is wasted,” 1960s at the start of Fidel Castro’s He has been on staff at the Tampa Lezama says, adding, “Working for the rule. Nicknamed “Joey” by his family, VA since 2000 after finishing internal VA provides the structure for a very he was extremely close to his mater- medicine training. “I was 28 years busy and productive career, but it also nal grandmother, who taught Spanish old—a USF resident one day and a offers plenty of time for family. at Catholic schools in Tampa for 25 VA physician the next,” he says. “The VA has given me incredible years and inspired him to teach. To watch Lezama in action dur- opportunities to develop my teaching Although they certainly could be, ing a test prep session with his stu- skills, leadership skills, humanism his walls are not covered with honors, dents is to observe a whirlwind of en- skills. And because of the VA’s awards and plaques. Rather, there are photos of his family everywhere. It’s Lezama with his family: wife Amy, a the first thing medical students like pharmacist; son Derek, 1; and daugh- Lapolla notice when they enter his ter Kaitlyn, 5. office. “It’s important for me to see a physician with a healthy balance between work and home life,” she says. “He is totally dedicated to his work and to his career, but his family is his top priority.” As for Lezama, he’s clearly thrilled about his award nomination. “Just being nominated for the award is the honor,” he says. “And to be honored for teaching is a tribute to my grandmother and my family roots. I tell my students, ‘Remember who you are, never lose sight of where you’ve come from.’”

UNIVERSITY OF SOUTH FLORIDA By Susan Wentzell

March/April 2008 13 feature VAnguard Turning No Veteran Away Former homeless veteran Irvin Goodwin now provides homes, jobs and counsel to other homeless veterans. or three years, Army veteran fiscal year 2006 were contacted the Compensated Work Therapy Irvin Goodwin slept on make- through the Health Care for Home- (CWT) program. CWT programs of- Fshift beds of sleeping bags and less Veterans (HCHV) program out- fer vocational rehabilitation through cardboard boxes behind apartment reach effort. Almost half (46.3 per- supervised work contracted from pri- buildings, in parks, even behind a cent) of the veterans contacted vate firms and public sector agencies, church before his life took a dramatic through outreach (17,902) had not including VA. turn for the better. used any VA mental health services In one year, Goodwin and his One day in 1995 while standing in the six months prior to outreach. outreach partner made contact with in a food line, Goodwin was ap- Goodwin completed the sub- 975 veterans in northern California. proached by the outreach team from stance abuse treatment program at In one month, they went to 38 differ- the VA Palo Alto Health Care the Menlo Park Division of VA Palo ent homeless sites where veterans System’s Menlo Park lived. Goodwin used domiciliary program, his success through who offered him sub- the program as an stance abuse treat- example when en- ment and shelter couraging other through the Domi- homeless veterans. ciliary Care for As a former Homeless Veterans homeless veteran (DCHV) program. himself, Goodwin After 25 years of understands the drug and alcohol uniqueness of the abuse and several situation for his fel- short stints in prison, low veterans. Goodwin was ready “To help home- for a change. But like less veterans you many homeless veter- have to have imme- ans, he was unaware diate services,” said of the services avail- Goodwin. “Veterans able to him through COURTESY OF IRVIN GOODWIN are in dire need right VA. Irvin Goodwin started a facility offering transitional housing and supportive services there. Most are ready “If it hadn’t been to homeless veterans in an underused building on the VA Palo Alto Health Care to make the decision for people seeking out System’s Menlo Park campus. to turn their life veterans, I would not be where I am Alto and was successfully discharged around, but most services don’t have today in life,” said Goodwin. from the DCHV program in 1996. He the capacity to take them immedi- VA’s homeless veterans program went on to obtain employment in the ately.” recently marked 20 years of service to warehousing field and continued to That inspired Goodwin, with the homeless veterans. After two decades attend substance abuse meetings and help of like-minded friends, to begin of evolving to meet the needs of this use VA services as a support system. opening homes (eight total) specifi- special population, outreach is still While at Menlo Park, Goodwin cally designed to help homeless veter- the cornerstone of treatment for told other veterans about the pro- ans return to the community. The homeless veterans. gram. He was so successful at reaching veterans pay low rent while residing In fact, the majority of the home- these veterans that in 1999 he joined in houses that were offered to less veterans who received services in the DCHV outreach team through Goodwin by a friend’s father—first

14 March/April 2008 VAnguard feature one, then three more. Once others Goodwin started in 2000 with a federal contractor who works with heard of Goodwin’s success with the 12,000 square feet of the building— VA’s National Cemetery Administra- veterans, they began donating houses enough space to house 60 veterans. tion to provide headstone engravings. to the cause. Today, the Homeless Veterans Emer- Once again, all of his employees are While still conducting outreach gency Housing Facility occupies previously homeless veterans who, through the DCHV program, 32,000 square feet of the building and through the homeless veterans ser- Goodwin noticed that he would offer has brought more than 500 homeless vices and Goodwin’s persistence, are the services to veterans and a short veterans off the streets of northern now productive members of society. time later he would see some of those California every year for the past Providing housing to homeless same veterans back on the streets. seven years. veterans is an integral part of assisting “I wished that I had a building to The program offers 35 beds for these veterans, said Goodwin. That’s take vets off the street and immedi- immediate drug and alcohol rehabili- why he believes the homeless grant ately put them in a safe environment tation and other mental health issues. program is so important. “A lot of to receive treatment,” recalled These veterans are linked with the programs wouldn’t be in existence Goodwin. “I could make referrals to HCHV program and other local VA without this funding,” he said. “Hous- shelters, but if they were full, then the treatment services. Twelve beds are ing is the key—you have to get the vet was still homeless.” for women veterans. One hundred veterans out of their homeless state. With the support of VA Palo twenty-one transitional housing beds Once we can take them out of the Alto Director Lisa Freeman, Chief of fall under the homeless grant pro- homeless situation, the sky’s the Domiciliary Tom Burling and Assis- gram. limit.” The HCHV program is in accord “If it hadn’t been for people seeking out veter- with community providers like ans, I would not be where I am today in life.” Goodwin that housing homeless veterans is the springboard to success. tant Domiciliary Chief Chris Condo, Through Goodwin’s program, VA’s homeless residential treatment Goodwin ended his employment with veterans can participate in drug and programs provide safe housing with VA, obtained nonprofit status, and alcohol relapse prevention classes, continuous staff supervision, are de- presented them with a proposal to use Bible study and life skills classes in signed to reinforce abstinence from an underused building on the campus one central location. Professional staff substances, and provide on-site psy- of the Menlo Park Division to pro- such as social workers and benefits chosocial counseling and ongoing vide transitional housing and support- counselors are on board. Veterans can case management. ive services for homeless veterans. As also receive financial and debt ser- Goodwin’s is not the only success with the houses in the community, vices and low-income housing assis- story to come out of VA’s homeless Goodwin’s idea caught fire and others tance. veterans program. Many other former donated their services to the cause. Wanting to leave no stone homeless veterans have successfully The Housing Industry Founda- unturned, Goodwin also conducts completed the homeless program with tion gave him $140,000 worth of fur- prison outreach. His policy is to turn job skills, health and financial ben- niture. VA Palo Alto supplied 14 no veteran away, so he even offers efits, permanent housing and life-cop- telephone and four fax lines, didn’t some veterans a spot on the sofa for ing skills. In fact, since 1987, more charge for utilities, and gave him all the night until a bed becomes avail- than 400,000 veterans have benefited the support he needed. Goodwin later able. His program is so well known in from the programs and services VA applied, through his nonprofit organi- the community that local police offic- and its community and faith-based zation, for funding under VA’s Home- ers will often bring a homeless vet- partners have provided. less Providers Grant and Per Diem eran to his program with the intent to “Irvin Goodwin’s story serves as program, and received $458,000 for help treat the veteran instead of tak- an inspiration to all of us who work two years. ing them into custody. The Homeless with homeless veterans,” said Pete Under this program, VA offers Veterans Emergency Housing Facility Dougherty, director of the Homeless grants to nonprofit organizations to has 16 staff members, 14 of whom are Programs Office in VA headquarters. help develop supportive housing pro- former homeless veterans who came “VA was able to provide resources grams and service centers. Since through the HCHV and DCHV pro- and help show the way. Goodwin de- 1994, VA has offered grants and per grams. serves all the credit in the world for diem-only support to help create Goodwin recently added employ- using his success to help others.” more than 11,000 new community- ment services to his continuum of based beds for homeless veterans. care for homeless veterans. He is now By Kenya Griffin

March/April 2008 15 feature VAnguard

Kenyan returns to help Alexander Lokeno has made three trips back to eradicate disease in Kenya in the last 10 years. the African nation.

Look at those kids, they’re wasting clean water!” “Alexander Lokeno was shocked. It was 1991 and Lokeno was watching a water balloon fight shortly after arriving in Oregon from Kenya. He could only shake his head in amazement as the kids threw bal- loons, laughing and chasing each other around, a scene unheard of in

Return of the NativeCOURTESY OF ALEXANDER LOKENO his native country, where fellow Born in the northwestern part of Hamiltons sponsored him to come to tribesmen walked up to 20 miles a day Kenya near the Ugandan border, the U.S. for college. He arrived in for water, often finding it contami- Lokeno was raised in the nomadic 1991 and enrolled in Southern Or- nated. Pokot tribe. His father and grandfa- egon University, where he earned a Today, Lokeno, a clinical phar- ther were both tribal chiefs. When bachelor’s degree in biochemistry and macist and HIV clinical case registry Kenya gained independence in the chemistry. After earning his doctorate coordinator at the VA Southern Or- 1960s, the government took over, the in pharmacy at Oregon State Univer- egon Rehabilitation Center and Clin- tribal chiefs lost their power, and the sity and Oregon Health & Science ics in White City, has not forgotten Pokot were pushed out to the border. University, he joined VA in 2004. the plight of the Kenyan people. He Asked if he would have become a Making time to participate in the is a part of the East Africa Christian tribal chief, Lokeno laughed. “No, I mission’s efforts was easy for Lokeno. Mission (EACM) volunteer well wa- have older brothers so they would “Growing up there, I saw the need ter project, an effort to help dig new have been the chiefs,” he said. “But I and I saw what AIDS was doing to wells for clean drinking water in Af- would have been some sort of leader.” Africa,” he said. “I wanted to help rica. Lokeno, who adopted Alexander and since I’ve been lucky enough to Founded by missionaries Richard as his first name when he came to the get the education, I wondered how do and Jane Hamilton, the EACM is run U.S., laughs when asked his age. I give back?” out of Medford, Ore. Called “Wells “Well,” he says, “I tell people I was Before the well project, the local Angels,” the EACM works with vol- born in 1972. But we call that my Pokot tribe often dug holes by hand unteer groups and individuals inter- ‘pseudo’ birthday since I really don’t in dry riverbeds during the long dry ested in humanitarian efforts. The know. I’ve been told I was born dur- season. These makeshift wells were up mission has been going to Kenya ing the reign of Idi Amin Dada to five women deep, with each since the 1980s and sends teams at (Uganda’s notorious president from woman handing a bucket of water up least twice a year. Consisting of five 1971-1979) but I’m not sure how old to the surface. As the dry season went to 10 people, the teams stay anywhere I really am. I think I’m 35 but I could on, the holes got deeper and deeper, from two to four weeks working on a be older.” causing cave-ins and falls, but for particular project. Lokeno began vol- After attending the primary many, this was the only source of wa- unteering with the mission in 1998 school founded by the Hamiltons, he ter. Often contaminated and causing and hopes to sponsor a VA team next was sent to a public school outside his diarrhea, the makeshift wells were year to set up a mobile medical unit. village. Once he got older, the also perfect mosquito breeding

16 March/April 2008 VAnguard feature

unteer team will repair almost 20 bro- ken wells. The mission hopes to start training locals to help operate the rigs and repair wells so the problems can be fixed as they occur. Fifty wells have been drilled and eventually the mission hopes to have a well within five miles of every village of 100 to 500 people. Married with three children and a busy career, Lokeno doesn’t get to go back to Kenya as much as he would like. Due to the instability of the region, the upcoming trip, which Lokeno will not be participating in, has been postponed. “With everything that is going on over there right Lokeno volunteers with a group called East Africa Christian Mission, which works to bring clean drinking water to Kenya. COURTESY OF ALEXANDER LOKENO grounds, allowing malaria to flourish. The project’s wells, aimed at de- creasing the transmission of diseases, are drilled with the assistance of local geologists. Using a drilling rig and a compressor, holes are drilled 100 to 200 feet below to underground water sources, called aquifers. These wells are meant to never dry out. With the majority of the wells already 20 to 30 years old, major repairs are now necessary. The hand-pump rods inside have begun to break, causing the people to turn back to hand- dug wells. On the next trip, the vol-

COURTESY OF ALEXANDER LOKENO

Left: Lokeno now, the team that was to leave in was born in February is now hoping to leave in the northwestern part of May.” Kenya near Lokeno hopes to make another the Ugandan trip in late summer 2009. He has border and raised in the made three trips in the last 10 years nomadic and each time sees progress. “[The Pokot tribe; people] are very thankful,” he said. above: Lokeno says “They need basic things to help them the people he in life. I’m able to make a difference. volunteers to I’m kind of the bridge that’s helping help in his native land to make a difference in someone else’s “need basic life.” things to help COURTESY OF ALEXANDER LOKENO them in life.” By Amanda Hester

March/April 2008 17 cover story VAnguard The Files Behind the Faces VA’s massive Records Management Center in St. Louis stores the military records of 18 million veterans, documents needed to establish their eligibility for VA benefits. he family of a World War II Army Air Corps veteran wants him buried in a national cemetery. A Vietnam veteran diagnosed with prostate cancer seeks treatment at a VA medical center. TAn Air Force veteran whose hearing was damaged on the flight line hopes to have his compensation check increased.

All are entitled to VA benefits, Most veterans and their depen- care may depend, let alone know but the law requires more than their dents have never seen the military where those files are stored. word to prove eligibility. records on which future benefits and Michael Picerno, director of New

File Clerks (left to right) John Daniels, Elgin Bailey and Zenobia Randolph sort and pitch folders in the bullpen to prepare for merging and interfiling incoming inactive claims folders that are received in the relocation shipments the RMC receives from VA regional offices nationwide.

ROBERT TURTIL

18 March/April 2008 VAnguard cover story

simply: “Our job is to store these Chandra (Sandy) Thomp- son, a supervisor in the records so the regional offices don’t Customer Service Division, have to. VBA is expanding, hiring uses microfilm records to new staff, and they need space for locate a World War I veteran’s records. claims processing decision makers, not filing systems.” The center’s organizational structure was established in 1995, streamlined into three divisions involved with receipt, storage and tracking, research and extract, and redistribution of records and data. Its $13.6 million fiscal year 2008 budget covers more than 300 staff positions in administrative, support service, customer service, and VA-National Archives liaison divisions. Almost half of RMC’s staff members are veterans. Support Services Division’s staff ROBERT TURTIL of nearly 124 is the engine that di- gests incoming folders and data from York’s Calverton National Cemetery, ists, those records can be found at the separation points and other sources. is familiar with veterans’ dependents VA Records Management Center Employees input, consolidate and lacking eligibility information at a (RMC), in St. Louis. store inactive folders until requests most difficult time. “Often we’re The RMC occupies a massive are made. Each morning they are met given nothing more than a person’s building in a three-acre complex, a with electronically generated lists for name, a partial service number, or ‘my former World War II small arms “B-prints,” “FNOD-prints” and claims Grandpa was on a ship during World manufacturing facility on the out- folder requests that have come in to War II’—fragmentary information at skirts of the city. Though it was estab- the RMC overnight. best,” he said. lished in 1992 when the first Army Deborah Berry, acting chief of Proof of service could be stored in records were transferred to VA, the Support Services Division, depends any number of government centers RMC’s predecessor, the Records Pro- on three shifts of employees working around the country, some run by a cessing Center, had existed on the round-the-clock, pulling more than military service, others by VA; all will site since 1966 as a VA-only storage 2,100 folders from the stacks for ship- eventually end up in a National Ar- facility. ment to regional offices. When claims chives facility. Today, it houses the STRs, ben- are complete, folders are routed back More often than not, a veteran’s efits claims folders, service data and to the RMC, where they are re-filed military health record, also known as discharge papers for 18 million veter- in its massive storage complex. a service treatment record (STR), re- ans separated from the military ser- Support Services Division’s sides in a Veterans Benefits Adminis- vices beginning in the early 1990s, mailroom has processed nearly 2.5 tration facility within reach of veter- along with VA records as old as the million pieces of mail so far in fiscal ans claims adjudicators and service oldest living veteran. year 2008, including incoming and representatives, veterans, their depen- The center’s staff receives and outgoing folders filled with STRs dents and others, providing eligibility tracks STRs and claims folders from (nearly half a million in any given confirmation and data for a wide service separation points. These year), claims folders and discharge pa- range of purposes. records are reviewed, processed, pers, supplemental medical records If a VA claim has been estab- stored and redistributed to requesting from various sources, and written re- lished before, during or after dis- VA regional offices to provide proof quests for records. charge, a veteran’s STR will usually of eligibility for VA benefits, generally “We receive about 800 claims be found in the VA regional office within 24 to 48 hours of the VARO folder requests, known as ‘COVERS’ nearest a veteran’s residence, or, for request. (Control of Veterans Records), every those still on active duty, at one of RMC Director Patrick Prieb, an day. Until recently, we had a monthly two processing centers in Utah or Army veteran who joined VA in average pending file of about 14,000 North Carolina. If no active claim ex- 1991, describes the center’s mission requests,” Berry said. “Now, for the

March/April 2008 19 cover story VAnguard

minimal wait times for families need- ing to bury veterans. Operation En- during Freedom and Operation Iraqi Freedom service confirmation, congressional inquiries and those involv- ing eligibility for homeless veteran programs also require immediate response. VHA requests are usually calls to verify service and rank, but nearly every request requires pulling a folder, unless similar information was requested previously and entered into the RMC’s Automatic Telephone Re- quest System (ATRS). ATRS is an internal system originally developed to track telephone inquiries. It proved so successful, it is now used to track and update all requests, particularly to ensure proper response to individual veterans. The VBA Corporate Data Base includes the Beneficiary Identifica- tion and Records Locator Subsystem (BIRLS), which is used to update and ROBERT TURTIL first time in our history, we’ve reduced our pending requests to ap- Above: Customer Ser- vice Division Program proximately 3,000. We are quite Support Clerk proud of that. We’ve seen a lot of im- Chrisantha provement.” McClendon transfers claims files to VA re- While Support Services Division gional offices using does the heavy lifting at the RMC, the electronic COV- muscling folders into and out of the ERS system; right: Customer Service Di- system and distributing them around vision Program Sup- the country, the Customer Service port Clerk John Moss Division provides the smile that copies service treatment records (STRs) meets the customer. in response to a Customer Service Division’s 67- veteran’s request. member team includes an analysis ROBERT TURTIL and inquiry unit and a direct service folks have to know a little bit about store veterans service data. All re- unit to deal one-on-one with request- all the benefits VA offers to send a gional offices can access BIRLS. ing offices. Staffers input and track caller in the right direction.” Regional offices generate the vast records, then respond to telephone In fiscal year 2007, Customer Ser- majority of requests for information. and written inquiries. vice Division responded to nearly “The number of files we request from “Inquiries come to our office by 109,000 telephone, fax and written the RMC ranges from 150 to 250 per phone through the Automatic Call requests, producing nearly 1.5 million day,” said Barry Barker, director of the Distributor system,” says Lattissua copies of STRs and claims folder in- VA regional office in St. Petersburg, Tyler, chief of Customer Service Divi- formation supporting eligibility re- Fla. “Most are routine requests needed sion. “Our customer service represen- quests. to adjudicate veterans compensation tatives answer calls, from a queue, in The most urgent eligibility re- and pension claims. But we’ve also re- three minutes or less. We get calls quests are telephone inquiries from ceived requests from congressional of- from VA and other government of- NCA offices, which are turned fices to deliver a claims file for a spe- fices, veterans and dependents, so my around within 24 hours, allowing cial project or case review based on

20 March/April 2008 VAnguard cover story pending legislation.” regional offices with the RMC and timely manner. Other federal government VALO. The RMC is not the final resting requesters include the military ser- VALO has processed nearly 2 place for veterans’ files. When a vet- vices, Social Security, IRS, State De- million requests since its inception. eran dies, his VA regional office of partment and government health and Turnaround time for requests averages record sends a Notice of Death form research centers. “The National Insti- just over 21 days, down from 84 days to the RMC. Twice a year, folders for tutes of Health and the Centers for for a typical verification of service re- deceased veterans (XC folders) are Disease Control have visited the quest. Such is the volume of requests pulled and sent to the Federal RMC to specifically review medical and the difficulties involved with re- Records Centers, under National Ar- information for research on PTSD, storing and searching through the re- chives jurisdiction, where they are Vietnam service, and other specific mains of folders subjected to flame held in perpetuity. categories,” said Customer Service Di- and firefighter’s water and ax, before While VA and the Department vision chief Tyler. being shoveled off the still smoldering of Defense work on developing a uni- The RMC’s records are limited to roof of the complex. form electronic medical records sys- STRs and claims files, not Official VALO Chief Yvonne Hamilton tem, the paper-based work of the Military Personnel Files (OMPF), has led the VA staff at the NPRC RMC continues. such as records of training, unit as- since 2003. “We get up to 1,500 re- “VBA will have to rely on DoD’s signments, conduct reports, disciplin- quests a day and we try to answer that paper folder for benefits for years to ary actions, and awards and decora- many, but it doesn’t always work out come, since the services still haven’t tions. When the RMC’s records don’t “Family members are in no condition to search suffice, extracts from OMPFs are often needed to prove eligibility. Those their attic for eligibility information, or deal records are stored at the National Per- with red tape, paperwork or lengthy delays. sonnel Records Center (NPRC), a What they need is a burial and closure.” National Archives facility located six miles from the RMC. Within this that way,” she said. “Some are more migrated to an electronic health sprawling five-acre complex rest 1.5 difficult than others, especially if they record,” said RMC director Prieb. million boxes of files and microfiche are ‘burn’ or ‘mold’ records, which are “And for years after that, we’ll be OMPFs documenting the military ser- not released to us because they are so here to take the calls from NCA, vice of more than 57 million damaged. NPRC has trained some of VHA and regional offices as older pa- servicemembers dating back to the my staff, volunteers who go into a per records still won’t translate, but 1890s. special review area to see if the docu- those veterans will still be in our sys- Minimal wait times are essential ments we need are in the folder that tem.” to the RMC’s mission of supporting remains.” Calverton cemetery director eligibility inquiries and claims adjudi- Not all files are stored equally. Picerno, who manages 6,000 burials a cation, yet VA has historically met There is a special celebrity vault, year, knows how important the with delays in obtaining documents which contains the records of presi- RMC’s work is. “Considering their from the NPRC. Adding to these dents, senators and members of Con- workload from across the country, challenges are the effects of a devas- gress, as well as actors and other fa- RMC works miracles,” he said. “They tating 1973 fire which damaged or de- mous people. Elvis’ records are there. allow us to provide the answers fami- stroyed the files of 16 to 18 million Special place, special requests and es- lies need in as little as two hours. Army and Air Force servicemembers, cort required, but not a special name, This is done for the families, not for the largest loss of archival material in just “Vault Records.” us at the cemetery. U.S. history. The RMC and the NPRC are “Family members are in no con- To expedite requests, the RMC two entirely different agencies with dition to search their attic for eligibil- and Archives officials signed a 1999 the same mission of serving veterans, ity information, or deal with red tape, agreement establishing a VA Liaison though people often confuse the two. paperwork or lengthy delays. What Office (VALO) of 76 VA employees The difference is the RMC’s primary they need is a burial and closure. at the NPRC. VALO and Archives mission is to serve VA entities (pri- That is what we turn to the RMC for. personnel respond to inquiries using marily VBA) by housing inactive VA They pull needles out of haystacks. the unique electronic Personnel Infor- claims folders, ensuring access to They are as good as gold.” mation Exchange System (PIES), a needed medical documentation and request/tracking system that links VA verification to adjudicate claims in a By Robert Turtil

March/April 2008 21 feature VAnguard The Problem of Pain And what two VA researchers are doing about it.

hronic pain. There are hun- “fifth vital sign” as early as 2001. been doing this right,” Krebs said. dreds of pills designed to tem- While this led to serious consider- “Before pain screening was mandated, Cporarily stop it, stretches, ex- ation of a patient’s pain in medical of- no one looked at how accurate the ercises and massages that are supposed fices across the nation, the fifth vital numeric scale is for this purpose or to alleviate it, and millions of gim- sign has proven to be a bit of a pain whether it provides important or use- micks that claim to cure it. But for for practitioners. ful information to providers. The key the dedicated research team at the Blood pressure, pulse, respiratory here is, if we are asking a question Richard L. Roudebush VA Medical rate and temperature are all measured that changes nothing in the way we Center’s Center of Excellence for in patients with sophisticated instru- treat a patient, maybe it is not the Implementation of Evidence-based ments displaying precise numbers that right question to ask.” Practices in Indianapolis, it’s a serious clearly fall in ranges from good to Typically in the field, nurses or issue that plagues many of the return- bad, or life-threatening to non-life- ing veterans they see each day and threatening. These vital signs are easy they intend to get to the bottom of it. to read and easy to comprehend. And Erin Krebs, M.D., is a VA re- though pain can also be measured nu- search scientist who is looking into merically, it is done subjectively by the way pain is currently diagnosed, the patient. specifically the reliability of the zero- Clearly, there can be a diagnosis to-10 pain screening test used to indi- discrepancy. At least, that is what cate the level of pain patients are ex- Krebs’ research shows—she recently periencing. Matthew J. Bair, M.D., concluded a study that found fault another VA research scientist, has led with the way we currently screen a team to develop a clinical trial pain. called Evaluation of Stepped CAre “We found that the pain screen- for Chronic Pain, or ESCAPE, to test ing test, as it is currently used, missed a novel combination of pain treat- a lot of pain that was important,” ments. With ESCAPE, they are Krebs said. “As a result, we’re not sure throwing a new weapon from the how accurate pain screening in the treatment arsenal at chronic pain to field really is, and we are not sure improve how VA treats pain, and ul- how doctors and nurses currently use timately, quality of life for patients. it to improve practice.” Krebs and her team analyzed The Subject and Subjectivity of Pain pain-screening scores of visits and in- For years in the medical field, terviewed patients to determine if the whenever a patient was seen at a current zero-to-10 scale was an accu- medical center for any reason, four vi- rate tool for physicians in the field. tal signs needed to be checked: blood “We have been required to screen TERRY MINTON pressure, pulse, respiratory rate and for pain with the numeric pain scale temperature. Recognizing pain as a se- for some time, but we are only now Above: “I study pain because it is frustrating that we often don’t know how best to assess and treat it,” says Dr. rious detriment to vitality, VA pushed doing the research. We are kind of Erin Krebs; right: Dr. Matthew Bair is working to find for pain level to be included as a playing catch-up to see if we have more effective treatments for patients with chronic pain.

22 March/April 2008 VAnguard feature

merely suggesting physicians can agree that pain is important, but shouldn’t trust the test completely. we have a lot of questions left about “Physicians should look at that how we should be measuring and pain screening number but they treating it. I think that alone makes it should also ask questions themselves,” worth exploring.” Krebs explained. “As it is currently used, I don’t think we can rely solely Looking for an ESCAPE from Pain on that pain screening number to tell In his four years as a primary care us whether someone does or does not physician in Indianapolis, Bair has have an important pain problem. We seen a lot of patients struggling with still need to talk to our patients and chronic pain. Patients frequently an- hear what they have to say about guish over not being able to play with what symptoms are most bothersome their children or perform simple tasks to them.” at home or work because of restric- Krebs has further studies planned tions secondary to their chronic pain in her quest to pinpoint important condition. While a myriad of treat- pain. She does hope to improve the ment options were always available to pain-screening process or create a Bair and his colleagues, there is sim- new model in the future that will ply no clear-cut roadmap in medicine more accurately measure pain. for treating pain. “The end goal is really to im- “When I see patients, I struggle prove pain assessment in VA and in myself with how to best help veterans clinical practice in general. This is an with chronic pain and I really feel my early study looking at what we are colleagues, especially in primary care,

TERRY MINTON currently doing and pointing out do as well,” Bair said. “When you re- problems with our practice,” Krebs ally look at the medical literature, clinic assistants ask patients coming explained. “Now come the harder there are major gaps in it for effective in to rate their pain on the scale questions. If this isn’t perfect, what pain management. I want to find where zero is no pain and 10 is the will be better? A number of VA re- more effective treatments for patients worst possible pain. Everyone is asked searchers are thinking about those with chronic pain as well as help my- this question when they visit a medi- questions right now. We are trying to self and my colleagues understand cal center, regardless of the reason define the next step to evaluate differ- how to manage pain better.” they are coming in or their history of ent options for pain screening and To do that, Bair and his col- pain. come up with evidence-based ways to leagues developed ESCAPE, a three- “As a result of our study, I would do it better.” year study funded by VA Rehabilita- say that as we are currently doing it, In the end, Krebs acknowledges tion Research and Development that pain screening isn’t perfect,” said that since pain is inherently subjec- is currently starting and looking for Krebs. “It probably misses a lot of im- tive, it is unlikely that any machine Afghanistan and Iraq veterans experi- portant pain and it doesn’t distinguish or scale can be invented that will per- encing chronic pain of the lower between patients who have very fectly reflect levels of pain in the hu- back, neck, hips, knees and shoulders bothersome pain and patients who are man body. But she does see improve- that is at least moderately disabling in doing okay with their pain. We need ment as being well within reach and terms of activities and functional to take current pain screening results precision pain measurement as a valu- limitations. with a grain of salt and continue to able tool for her and her fellow pri- The veterans in the study will be fully evaluate our patients so we can mary care physicians. randomly placed into one of two try to understand how pain is actually “I study pain because it is frustrat- groups: the intervention arm or the affecting them. If the pain score is ing that we often don’t know how standard care arm. The standard care low, we shouldn’t ignore the possibil- best to assess and treat it,” Krebs said. arm will provide patients typical pri- ity that the patient has important “When a patient has high blood pres- mary and specialty care currently pain. We should still ask our own sure or diabetes, I know exactly what practiced in VA and other health care questions.” to do. But when chronic pain is the settings. The intervention arm will For the record, Krebs is not sug- issue, no one can say for sure what test a stepped-care approach that es- gesting that VA physicians forgo the methods really work because the re- sentially tries less expensive, less in- current pain-screening test, she’s search simply isn’t there. Everyone vasive types of treatments first for pa-

March/April 2008 23 feature VAnguard tients. If those measures don’t work, While many of the patients in avenue to some of the veterans al- patients will be elevated to new levels the study will not be dealing with ready participating in the study. of care that introduce more expensive PTSD, Bair believes that CBT can be “It’s how I think about the pain,” and invasive procedures as patients useful in pain management well be- said one study patient. “If I am in the continue to experience pain. yond helping veterans cope with trau- frame of mind that it is bad, it’s bad. I The first step of the intervention matic experiences. don’t know what that is, but if I think cycle lasts three months and involves “It’s about changing certain be- it is not good … the level of that pain optimizing analgesics, or making the haviors that lead to pain as well,” Bair actually will go up in my mind.” best use of pain medicines. This, com- said. “For example, it has long been Though Bair is not entirely sure bined with self-management strategies believed that when you injure your what to expect from his trial and the such as exercise, relaxation tech- back, you are supposed to rest for five addition of mental health practices to niques, stress management and vari- to seven days. Now we know that is primary care pain management solu- ous other strategies, will treat the some of the worst advice you could tions, he is willing to speculate that physical effects of pain. possibly give a person. Through CBT ESCAPE will have at least a moder- Even the first step in the stepped we are trying to overcome that ate reduction in functional limita- care process is stepped. Bair described learned behavior to avoid activity and tions, physical disability and pain se- a complex algorithm in prescribing actually substitute it with increased verity for his patients. different pain medications, from activity through exercise.” “The end result of this study, I simple anti-inflammatory drugs one Of course, CBT’s recognized abil- hope, will be changed lives for the pa- might find in a grocery store, all the ity to help with serious mental health tients and the physicians involved,” way to opiates, with stops in between, issues such as PTSD, depression and Bair said. “Obviously, the patients will depending on the severity of pain. anxiety won’t be ignored either. Many benefit from reduced pain and a Different levels of pain management strategies such as relaxation and exer- “There are multiple dimensions to how chronic cise also continue on a scaled basis as patients respond positively or nega- pain affects a person. Just treating the physical tively to the process. aspects with pain medication is not enough.” If the patients do not respond to the basic pain medications and self- of the hypotheses behind ESCAPE’s greater quality of life, but hopefully management in the first tier of treat- approach to treatment are in recogni- my fellow physicians will be able to ment, step two involves psychological tion of the fact that mental health af- look at their patients with chronic therapy, specifically Cognitive Behav- fects physical health and vice versa. pain confidently and say, ‘We have a ioral Therapy (CBT), a well-estab- “The thing about chronic pain is plan.’” lished treatment for chronic pain. Pa- that it is complex. It affects the per- The Roudebush VA Medical tients in the study will receive six ses- son on multiple levels,” Bair said. Center in Indianapolis is the only site sions of CBT during the second tier, “There is a sensory component where for this study in VA, so patients who the idea being that stepped-care will you feel pain. It physically hurts, but want to volunteer for the study will be more effective than standard care it can also affect a person’s mood and have to use services there. The De- in reducing pain-related disability and that adds to a person’s pain. So there fense Department has partnered with pain severity. Bair also thinks the in- is a strong association with chronic VA and is conducting the study from tervention will improve quality of life pain and depression or anxiety disor- Walter Reed Army Medical Center in for his patients and reduce psycho- ders and that chronic pain can lead to Washington, D.C., as well. logical distress. either one, or either one can cause Ultimately, 300 patients will be “There are multiple dimensions chronic pain. Treating both may pro- enrolled in a nine-month study. Vet- to how chronic pain affects a person,” vide the best overall pain relief for erans are on step one for three he said. “Just treating the physical as- the patient.” months before they are moved to step pects with pain medication is not Adding the mental health com- two, which also lasts three months, enough. So we believe that for the ponent to the physical methods of followed by three months of follow-up most optimal treatment you do need pain management in step two is what with the patients. Veterans interested to affect the physical aspects through really sets the ESCAPE study apart in participating in the study should pain medication, but you also have to from others. While it is a departure call ESCAPE’s study coordinator, address the cognitive and behavioral from the straight, physical side of pain Kate Nyland, at (317) 988-4312. aspects with some self-management management currently practiced in strategies, coping strategies.” primary care clinics, it is a welcome By Ryan Steinbach

24 March/April 2008 VAnguard feature A Day to Remember in South Florida VA’s 125th national cemetery is dedicated near West Palm Beach.

he scenic landscape of the cemetery director. cal Center also provided vital support, cemetery grounds is hard to Rotar spoke about deepening the which included emergency medical Tforget—a grass-covered field partnership between the cemetery personnel, VA police, traffic control surrounded by a semitropical forest on and the local service organizations. and parking, video, photography and one side and a lake on the other on a “We expect this national cemetery to outreach. beautiful Florida day. It served as a become an important facet of the The ceremony opened with the gathering site for more than 2,000 community,” he said. Rotar also rec- band playing “Ruffles and Flourishes,” veterans, their families and others ognized the cemetery staff for their followed by the Florida Army Na- who came together to dedicate the hard work, and the active duty, Na- tional Guard firing two 105mm how- South Florida VA National Cemetery. tional Guard and reserve units for itzers in a 19-gun salute to welcome VA officially dedicated its 125th providing military honors during the official party. The joint service national cemetery near West Palm burial services on a daily basis. color guard and joint Junior ROTC Beach on March 9 in a vibrant, open- One of the most striking features color guard presented the colors. air ceremony. Senior VA officials, a of the event was the volunteerism of At one point in the ceremony, U.S. congressman and other dignitar- individuals and service organizations. the cemetery’s resident bald eagle ma- ies commended veterans jestically glided over the and praised the new 313- crowd prior to the sched- acre cemetery that serves uled flyover by a Coast more than 400,000 veter- Guard HU-25C surveil- ans in the Miami area. lance jet. VA Secretary Dr. Throughout the cer- James B. Peake delivered emony, guests were enter- a keynote address empha- tained by the Palm Beach sizing the importance of Central High School veterans cemeteries in Bronco Band, which pursuing the VA mission played the national an- and expressing his grati- them and a medley of tude to veterans for their military service songs, VA Secretary James B. Peake, M.D., second from right, unveils the dedi- service. Peake called the cation plaque for the South Florida VA National Cemetery. He is joined among other patriotic cemetery a “timeless field by (from left): VA Under Secretary for Memorial Affairs William F. tunes. of honor” and a shrine to Tuerk; Florida Department of Veterans Affairs Executive Director LeRoy The ceremony con- Collins Jr.; and South Florida VA National Cemetery Director Kurt Rotar. the memory of the GARY DALE cluded with the unveiling “people who have worn of the dedication plaque the cloth of their country, who really Prior to the ceremony, more than 100 by Secretary Peake, a rifle salute and laid the foundation for the freedoms Patriot Guard riders came roaring the traditional performance of taps by we have every day.” into the cemetery on motorcycles and Sgt. Keston Marin of the Florida “The opportunity to provide and proceeded to greet the guests by Army National Guard. maintain cemeteries and memorials to flanking the entryway with American The cemetery has become the fi- those who came before us is a sacred flags. nal resting place for more than 2,100 trust—a part of VA’s historic mission,” A group of Junior ROTC cadets veterans and their eligible dependents said VA Under Secretary for Memo- helped transport older veterans to the since it opened for burials in April rial Affairs William F. Tuerk, who in- ceremony from a remote parking area, 2007. Upon completion of the first troduced Secretary Peake. Girl Scouts passed out programs to ar- phase of construction in 2009, the Rep. Ron Klein (D-Fla.), who riving guests, and uniformed members cemetery will include 14,000 casket serves Florida’s 22nd District, made of American Legion Post 164 served sites, 3,000 columbarium niches and brief remarks and presented an refreshments before and after the 9,500 in-ground cremation sites. American flag that flew over the U.S. event. Capitol building to Kurt Rotar, the The West Palm Beach VA Medi- By Eugene Oleynikov

March/April 2008 25 feature VAnguard National Cemetery Volunteers: A Vital Force The dedicated group of volunteers at the Dallas-Fort Worth National Cemetery is one of the largest at any of VA’s 125 national cemeteries.

t’s a cold, damp Saturday and said that many of the 40 regular vol- spouses and loved ones interred here Mary Rogers is heading to her job unteers have been with the cemetery and they are truly a blessing to work Ion the outskirts of Dallas. She since before it opened in May 2000. with,” said Pemberton. “Their dedica- works at a place many have come to “Every Monday from 8 a.m. to tion is unparalleled by volunteer regard as a National Shrine. noon, I’m here,” said John Fisher, groups at VA’s other cemeteries.” A stickler for promptness, she who has been volunteering at the It’s a job they take seriously and wants to get there early because cemetery since 2000. “This is payback cherish. people are counting on her. She to the community for all it’s done for “As a volunteer I help visitors lo- knows it will be a busy afternoon. But me.” cate specific gravesites and provide that doesn’t deter her enthusiasm; she The 76-year-old Korean War vet- them with information on burial re- finds her job fulfilling and rewarding eran tells the story of a couple that quirements,” said Rogers. “Many even though it doesn’t pay her a cent. came to the information desk dis- lonely spouses come to the cemetery It also brings her close to her late traught because the veteran had lost to visit with their loved ones and husband, John, who is buried nearby. his DD-214 and wanted to be buried then stop by the information center Rogers is one of to talk. It’s a wonder- 180 volunteers who ful feeling to be able work at the Dallas- to help.” Fort Worth National “I have been vol- Cemetery. This dedi- unteering at the cem- cated group of volun- etery since the begin- teers is one of the larg- ning, even before the est at any of VA’s 125 dedication,” said John national cemeteries Moore, an 85-year-old nationwide. veteran who volun- While VA lauds teers every Wednes- its more than 140,000 day. “I like being per- volunteers who give sonally involved. I more than 13 million work at the informa- The Dallas-Fort Worth hours of their time to National Cemetery relies on tion center helping VA facilities through- faithful volunteers like (left to families and visitors out the country, it is right) John Fisher, John and also support the Moore and Mary Rogers. not widely known that NANCY GRAY grounds crew making many of these volun- sure everything is teers do not work at medical centers there. After Fisher helped him, the maintained as it should be.” but at national cemeteries. They are a tearful veteran hugged him in grati- Last year, VA national cemeteries vital force. tude for the help he had received. conducted more than 100,000 inter- “Of the 180 volunteers on the “That is what makes my job worth- ments. That number is likely to in- roster, we have a group of 40 regular while,” said Fisher. crease in 2008. volunteers that manage our public in- “Having volunteers who continu- And while VA is prepared to formation desk eight hours a day, ally give of their time to help us ac- meet the ever-increasing challenges of seven days a week,” said Mickie complish our mission is priceless,” its national cemetery system, volun- Prendergast, volunteer coordinator at said Cemetery Director Ron teers like Rogers, Fisher, Moore, the cemetery. “We actually have vol- Pemberton, who oversees a full-time Prendergast and their fellow volun- unteers on the roster waiting for an staff of 27 and whose cemetery con- teers at the Dallas-Fort Worth Na- open slot so they can begin volunteer- ducts more than 3,100 burials annu- tional Cemetery are ready to help. ing!” ally. Prendergast, herself a volunteer, “Some of these volunteers have By Jessica Jacobsen and Lana Shuman

26 March/April 2008 NationalVA nguardSalute 2008feature

PAM ENSOR ROBIN CRONSHAW

DEBRA RUSSELL

HARRY PULSCHEN

WALT CODY SCOTT KRUEGER Clockwise from bottom left: Actor Mike Vogel, chairman of this year’s National Salute to Hospitalized Veterans, meets patient Kimberly Breen during his visit to the Baltimore VA Medical Center; Legendary R&B group Little Anthony and the Imperials celebrated their 50th anniversary in show business at a special Valentines for Veterans Con- cert Feb. 14 in Prescott, Ariz., sponsored in part by the VA Voluntary Service Committee at the Northern Arizona VA Health Care System; A chorus from P.S. 14 in the Bronx performed at the nursing home care unit at the Bronx VA Medical Center and handed out valentine cards and gifts to residents, including Luis Tua Segarra; Four members of the Shaw Air Force Base Honor Guard visited Harry S. Younger and other patients receiving dialysis at the William Jennings Bryan Dorn VA Medical Center in Columbia, S.C.;

March/AprilMembers 2008 of the Shriners Jericho Highlanders bagpipers performed and 27 visited patients at the VA medical center in Mountain Home, Tenn.; “Pork Chop,” mascot for the University of Arkansas Razorbacks, visited patients at the Fayetteville VA Medical Center, including Richard RICK MILANICH King; University of Wisconsin Men’s Basketball Coach Bo Ryan, the UW Spirit Squad Dancers and Marines visited Russ Eilders and other patients at the VA medical center in Madison. around headquarters

FLITE: Offering Employees an Easier Way to Get the Job Done

When Kathryn Niederjohn, a development called FLITE, Medical Center this fall. The VA serving veterans. biomedical engineer at the the Financial and Logistics In- other component of FLITE, You can learn more about Milwaukee VA Medical Cen- tegrated Technology Enter- the Integrated Financial Ac- FLITE on the VA Internet at ter, looks ahead to the arrival prise. counting System (IFAS), is ex- www.va.gov/FLITE or on the of FLITE, she sees all of her For several years, financial pected to begin its pilot pro- VA Intranet at vaww.va.gov/ procedures available online performance audits have iden- gram in spring 2009. VA per- FLITE. You can also ask ques- with “everything at my finger- tified the lack of an integrated sonnel who work within the tions, offer comments and re- tips.” She sees her work orders financial management system business areas of financial quest status updates regarding organized and prioritized au- as a VA business weakness. management, asset manage- FLITE. Just submit a question tomatically. And when a piece The FLITE program will con- ment, logistics, accounting, or comment to the AskFLITE of biomedical equipment centrate on two of the most purchasing, budget, funds box on the FLITE Intranet needs to be updated, FLITE important VA business ele- control, real property, inven- site or directly through Out- will have been monitoring ments: financial systems and tory and financial systems will look at [email protected]. Or which parts are needed and asset management. Merging become more efficient and ef- you can contact the FLITE will place the order for her. As these systems in a streamlined fective through the capabilities program director, Leslie an Internet-accessed system, way will give VA management provided by FLITE. FLITE Abbott, at [email protected] FLITE will come with inter- access to department-wide will affect almost everyone in or at (202) 461-6161. faces that will make it a lot point-of-use expenditures cap- easier for Niederjohn to auto- tured in a single database. matically produce reports that The database will support today she must manually pull the roll-up of costs and statis- together. tical analysis of data through- Derry Bowling, of out VA and produce more ac- Jefferson Barracks National curate and timely reports. Cemetery in St. Louis, is also Niederjohn, Bowling, Flores looking forward to the reports and many other employees capability of FLITE. He now will be able to turn on their has to manually produce im- computers in the morning, be portant ad-hoc reports, like greeted by modern Web-based the yearly inventory of “green” systems and, for the most recycled products. With part, enter data only once into FLITE, these reports will be systems that will seamlessly produced for Bowling auto- transfer and track it. ART GARDINER matically. When Deputy Secretary Bob Dole, center, with Deputy Secretary Gordon Mansfield, left, and Luis Flores, of the Ac- Gordon H. Mansfield spoke Secretary James B. Peake, at VA Central Office. counting and Loan Adminis- recently about FLITE, he tration Center in Austin, stressed the importance of Bob Dole Shares ‘One Soldier’s Story’ works on quite a few different making sure VA’s business systems now and is looking practices and support systems Former Kansas Senator and World War II hero Bob Dole was at forward to seeing them inte- are as efficient and reliable as VA Central Office on Jan. 29 to talk about his bestselling mem- grated under FLITE. Flores possible. Mansfield said that oir One Soldier’s Story, in which he describes his experiences as a says that the Financial Man- the FLITE system will allow soldier on and off the battlefield. agement System, or FMS, is for better control of finances The book offers a message of hope and survival. During 15 years old. Having an up- and assets as well as a better World War II, Dole was a platoon leader with the 10th Moun- to-date Web-based system will reporting system. He charac- tain Division in Italy and is a recipient of two Purple Hearts mean that he can do more terized FLITE as a way to do and a Bronze Star with Oak Leaf Cluster. timely research and eliminate a better job of managing and With his characteristic candor and wit, Dole talked to the a lot of the manual transfers called on senior leaders to em- audience of headquarters employees about his early life, his he must currently make from brace the system. It “makes military service, his fight to return to normalcy after suffering a other systems. good business sense,” he said. debilitating injury in the war, his political career, and his long- For Niederjohn, Bowling, FLITE has two compo- time service to veterans, which continues today. Flores and thousands of other nents. The Strategic Asset Dole’s visit was the third offering in the VACO Book Fo- VA employees, work will be- Management (SAM) System is rum series, a collaborative effort of the VACO Library, VA come easier and more efficient expected to begin its pilot pro- Learning University and Canteen Service to bring authors to through an initiative now in gram at the Milwaukee VA Central Office to speak about their books.

28 March/April 2008 around headquarters

Oldest Known American Veteran of WWI Honored at Pentagon

Frank Woodruff Buckles, 107, the last known living Ameri- can-born World War I veteran, was honored at a Penta- gon ceremony on March 6. The ceremony included the unveiling of an exhibit of World War I veterans’ portraits by photographer David DeJonge. “I feel honored to be here as a representative of the veterans of WWI and I thank you,” said Buckles, who lives on his family’s cattle farm near Charles Town, W.Va., and was one of the eight men and one woman whose portraits are included in the exhibit. Family members joined him at the ceremony. DeJonge worked with VA to identify, contact and docu- DOD ment the nine World War I World War I veteran Frank Buckles’ portrait is unveiled during a Pentagon ceremony March 6. Looking on veterans. He began the project are (left to right): Defense Secretary Robert M. Gates, photographer David DeJonge and Army Secretary in 2006; seven of the nine Peter Geren. have since died. The other and his comrades in arms. We driver in France and Great the time he got to meet John surviving veteran, John F. will always be grateful for Britain during the war. J. “Black Jack” Pershing, the Babcock, of Spokane, Wash., what they did for their coun- Earlier in the day of the legendary WWI general. Late is a native of Canada who try 90 years ago.” Pentagon ceremony, Buckles in the day, Buckles also visited served in that country’s army Buckles lied about his age met with President Bush in the World War I memorial in during World War I, and later to join the Army in 1917 at the Oval Office. He shared Washington, D.C., which was served in the U.S. Army. He the age of 16. The Missouri some anecdotes with the Presi- built to honor local veterans became a U.S. citizen in 1946. native served as an ambulance dent, including the one about of the Great War. “History is fading away before the very eyes of America,” DeJonge said dur- VA Careers Web Site Launched ing the ceremony. He donated the exhibit for permanent dis- The new VA careers Web site—www.vacareers.va.gov—was launched on Feb. 14. Its theme is play at the Pentagon. “One Source – One Solution” and its enhanced features include the ability to do the follow- Defense Secretary Robert ing: M. Gates praised the portrait access streamlined search criteria that help you select career opportunities by project for raising public occupation, internal merit promotion, geographic location, series and grade; awareness of a war that “is not enjoy improved customer support to answer inquiries about job announce- well understood or remem- ments, qualifications, benefits and application requirements; bered in the United States,” learn about valuable scholarship programs, employee benefits and legislative noting there is no national issues pertaining to employment; and memorial on the Mall in create your profile, manage your resume, access required forms and get Washington, D.C. e-mail alerts in your career interests as jobs become available. “We cherish the chance The target audience for the new Web site includes: to say thank you in person to current VA employees looking for new and exciting career opportunities Cpl. Frank Buckles,” said throughout the entire VA system; Gates. “Whoever views this potential Executive Career Field or Senior Executive Service applicants; and display will, I am sure, feel a individuals looking to start a VA career. connection to Mr. Buckles

March/April 2008 29 around headquarters VAnguard

Job Shadow Day Gives Students an Inside Look at Federal IT

The Office of Information and Technology (OI&T) hosted the second annual In- formation Technology Job Shadow Day on Feb. 7 at VA Central Office in Washington, D.C. Seven high school students from Marshall Academy in Falls Church, Va., partici- pated in the daylong session, which included members of VA’s top management in the IT field. The program is an academic activity designed to give students the unique opportunity to observe the federal IT workforce up close. Through hands-on experience, students learn about OI&T and “shadow” IT professionals through their workday. The ROBERT TURTIL program encourages students Charles Ashley, center, and Socheath Eap, right, were among the students participating in IT Job Shadow to pursue federal careers in the Day at VA Central Office with Office of Information and Technology staffers like Dirk Barrineau, deputy IT workforce. director, Certification Program Service. After a brief welcome about how they can parlay an “That was really helpful.” of software programs. “I from VA’s Executive Employee internship into a career. Janine Charles Ashley, a 17-year- learned a lot of useful skills,” Recruitment Office, the stu- Lafayette, IT specialist, spoke old senior from George C. he said. “The people here have dents were assigned a mentor. to the students about motiva- Marshall High School in Falls a passion for what they do and Some mentors, like Arnaldo tion in the workplace. “Ex- Church, Va., was impressed they all seem to love their Claudio, executive director, plore! Find what part of IT with his mentor’s knowledge jobs.” Oversight and Compliance, you like. During your intern- offered more than just career ship, make mistakes. Find out Search Gets Underway for New advice. “You can set your goals what your passions are, focus, Under Secretary for Benefits at a slower pace because you’re learn, develop and grow. If very young, so you have time. you don’t like it, you can A 10-member commission has turning from Afghanistan and But time is of the essence,” he move around. Get a detail. been formed to recommend Iraq, the search commission warned. “Go through it with Take every opportunity, even candidates for the post of un- must ensure we fill the under passion. If you find something if it’s not in the IT field, to der secretary for benefits. secretary’s job with a person you are comfortable with, build your character.” VA’s under secretary for having the right skills, experi- stick with it.” Later in the afternoon, benefits directs nearly 15,000 ence, vision and commitment The students spent time the students received a tour of employees and administers a to our nation’s veterans.” with their mentors, got hands- the Section 508 Compliance budget of more than $45 bil- The new under secretary on experience, learned tips of Lab and the Omar Bradley lion, mostly for disability will replace retired Navy Vice the trade, and observed VA Conference Room. compensation and survivor Adm. Daniel L. Cooper, who systems and programs. At a Peter Kalis, a 17-year-old benefits. The under secretary resigned recently after six roundtable discussion, several senior from Langley High is also responsible for VA’s years on the job. Cooper had IT employees discussed how School in McLean, Va., is pre- educational assistance, insur- been the longest serving under they deal with Freedom of In- pared to jump right into the ance program and pensions. secretary for benefits in VA’s formation Act requests, VA IT field. Already a Microsoft “I have asked Deputy history. Patrick Dunne is the data theft incidents, and how Certified Professional, he is Secretary Gordon Mansfield acting under secretary. they got into the IT field. hoping to get an internship as to lead this important effort,” The under secretary for After lunch, former well. “We got to meet with said VA Secretary James B. benefits is a non-political ap- OI&T interns, now VA em- people who were in our shoes Peake. “With a new genera- pointee, subject to Senate con- ployees, spoke to the students not too long ago,” he said. tion of combat veterans re- firmation, who serves at the

30 March/April 2008 VAnguard introducing

Portray Woods

Portray Woods’ smile is as big Woods, 36, spends three days as his heart. Woods, a cus- a week at the front desk, an- tomer service greeter at the Ri- swering phones and personally chard L. Roudebush VA escorting incoming patients to Medical Center in Indianapo- their destination. He now be- lis, suffered a traumatic brain lieves it was the best decision injury (TBI) in April 2004 he’s ever made. “I love what from an improvised explosive I’m doing,” he said. “The best device blast in Iraq that killed part of my job is helping seven other soldiers. It’s re- people out. Now, I’m happy.” markable that he’s even alive. In his free time, Woods In a coma for two visits injured Operation En- months, Woods awoke to find during Freedom/Operation ANGELA TAYLOR himself in the Minneapolis VA Iraqi Freedom soldiers receiv- Portray Woods works the phones at the VA medical center in India- Polytrauma Rehabilitation ing TBI treatment at the napolis. Center. The first thing he saw: VAMC. By relating his own a real arm with veins, skin col- tell them, ‘you can do any- his then 4-year-old daughter story to them, he encourages oring and even hair, is so au- thing you want to do. Don’t singing “You Are My Sun- them to succeed. “I let them thentic that most people who be like me, be better than shine” to him. Unable to know, don’t give up, just keep meet him don’t even realize it’s me.’” Woods is optimistic speak or respond to com- your head up,” said Woods. fake. about the future, and that mands, Woods faced a long “They are going through the A promising high school shapes his outlook on life, too. road ahead. same thing I went through basketball player, Woods “I’m learning—I know I can’t In 2005, after a successful and I made it. So can they.” earned an athletic scholarship do what I used to do, but I surgical procedure to relieve What most people don’t to Southern Illinois University, can adapt.” pressure on his brain, Woods know is that Woods is also an receiving an associate degree Robin Paul, polytrauma entered outpatient therapy ser- amputee. He lost his right arm in science. One of Woods’ vocational rehabilitation spe- vices at the Roudebush and left thumb in the explo- dreams is to eventually play cialist, has worked with VAMC. Going three times a sion. A former right-handed basketball again, though left- Woods since October 2006. week to speech and occupa- person, Woods has discovered handed this time. He later “Portray exhibits the attitude tional therapy, Woods has a surprising side effect of us- completed a bachelor’s degree of a true American hero,” Paul reached many milestones ing his left hand: “I now have from Trinity University in said. “Despite his long and originally thought impossible. neater handwriting as a left- Germany while serving in the continual road to recovery, ev- In the fall of 2006, he began hander!” Army. In 2005, after 12 years ery day he says ‘it’s all good.’ working with the Polytrauma But trying to adjust to a of service, he was medically He is truly representative of Vocational Rehabilitation Ser- world made for two hands has discharged as a sergeant first veterans serving veterans, and vice to explore re-entry into proved challenging. In his class, earning both a Purple loves the opportunities he has the work force. therapy sessions, he has Heart and a Bronze Star. to help others. He has cer- Last January, at the sug- learned to tie his shoes, first A divorced father of two tainly helped me stay focused gestion of his multi- with just his left hand and small children, Woods is an on what’s really important, disciplinary treatment team, then by using his left hand encouraging figure in their and he is the heart of why I Woods began volunteering at and his prosthetic arm. The lives. “We talk all the time love working for the VA.” the medical center. Currently, prosthetic arm, which mirrors about their future,” he said. “I By Amanda Hester

VBA search panel (cont.) pleasure of the President. Can- dates to the Secretary of Veter- president of the Mortgage Townsend, acting executive di- didates must demonstrate abil- ans Affairs, who forwards the Bankers Association; Charles rector of Paralyzed Veterans of ity both in fiscal management list to the President along with Rowe, president of the Na- America; James Bombard, and in the administration of any recommendations. tional Association of State Ap- chairman of VA’s Veterans Ad- programs of the Veterans Ben- Members of the commis- proving Agencies; Fran visory Committee on efits Administration or of sion, in addition to Deputy Hackett, from the Office of Education; Tim S. McClain, similar content and scope. Secretary Mansfield, Servicemembers Group Life former VA General Counsel; Under federal law, the include Brian Chappelle, Insurance; John F. Sommer Guy McMichael, former VA search commission must rec- president of Potomac Partners Jr., executive director of the acting under secretary for ben- ommend at least three candi- and former executive vice American Legion; Homer efits; and Cooper.

March/April 2008 31 medical advances VAnguard

Study Shows Flat who were already scheduled to It definitely is, at both screen- to study. Researchers believe Growths on the Colon undergo standard colono- ing for and preventing the microgravity of space can Can Turn into Cancer scopy. The average age of the colorectal cancer, the second bring about key genetic While the majority of colon study participants was 64, and leading cause of cancer death changes in cells that affect the cancers were thought to de- 95 percent were male. And in the United States. ability of the organism to in- velop from polyps, a new VA most—79 percent—were “Colonoscopy is a very vade human tissue and cause study challenges that and white. good tool. It’s not perfect, but disease. points out that so-called non- The researchers found it’s a good tool,” Lieberman To induce these changes, polypoid (flat or depressed) le- that 764 people (42 percent) said. “This study emphasizes minute worms will be grown sions in the colon are also had at least one unusual the need for a high-quality ex- from eggs onboard the space likely to turn into cancer. colorectal growth. One hun- amination with a fully-trained shuttle. While in space, these Published in the March 5 dred and seventy (9.35 per- endoscopic technician,” he worms will be fed Salmonella. issue of the Journal of the cent) had non-polypoid added. The extent of damage will be American Medical Association, colorectal lesions. Eighty-one measured when the worms are the study reports that such le- of these people had both pol- VA Research Project returned to Earth, helping to sions were present in almost yps and non-polypoid lesions. Launched into Space identify which of the weak- 10 percent of people screened Soetikno said that in a Aboard the Shuttle ened strains is the best to use for the study, and that these general screening, the chance Endeavour in a vaccine. lesions were 10 times more of finding a polyp is about 30 “Salmonella in Space.” No, it’s “This represents a new likely to be cancerous than percent, and that doctors are not a sci-fi B movie. It’s a VA approach to vaccine develop- polyps were. about five times more likely to research project aboard the In- ment, as it is the first time a “Colorectal cancer is find polyps than non-polypoid ternational Space Station that living organism has been in- common, it is preventable, lesions. But non-polypoid le- may lead to a vaccine to pre- and it can be prevented even sions are far more likely to be vent Salmonella poisoning. A VA research project bound better,” said the study’s lead cancerous than polyps are. The space shuttle En- for the International Space Sta- author, Dr. Roy Soetikno, The new study found the deavour transported the tion was onboard the shuttle chief of gastroenterology at odds were 9.78 times higher project to the International Endeavour when it launched the VA Palo Alto Health Care that a non-polypoid lesion Space Station March 11. into space March 11. System in California. “Not all would be cancerous than a When the research package re- colon cancers are created polyp. turns to earth, VA investiga- equal, and doctors will now Generally, non-polypoid tors and other researchers will start looking for those that lesions can be removed at the use it to develop a Salmonella aren’t so obvious.” time of a colonoscopy. vaccine with the potential to The good news is that Soetikno said that if the lesion save many lives and billions of with current colonoscopy is completely flat, you’ll prob- dollars. technology, doctors can find ably need to go to a more ex- The project came about and remove these lesions. The perienced center to have it re- through the teaming of VA re- bad news is that virtual moved. searchers with investigators colonoscopy (CT colono- Dr. David Lieberman, from the National Space Bio- graphy) is not yet sensitive chief of the division of gastro- medical Research Institute, enough to pick up these dan- enterology at Oregon Health Duke University Medical gerous lesions. & Science University and the Center, the Baylor College of Previously, experts be- Portland VA Medical Center Medicine, the University of lieved that these non-polypoid and author of an accompany- Colorado at Boulder, lesions were mainly found in ing editorial in the journal, Germany’s Max Planck Insti- people of Japanese descent, said, “I think this study will tute, and a commercial indus- and U.S. doctors weren’t spe- be very enlightening for the try sponsor, SPACEHAB Inc. cially trained to look for them. [gastroenterology] community. Previous research has NASA Soetikno and his colleagues It points out that the non- identified several genes that underwent training with spe- polypoid lesions are found in weaken Salmonella when they fected in space to study its im- cialists from Japanese endos- the U.S., and that they can be are removed from the host. mune response,” said Timothy copy centers to learn to better somewhat ominous because One of these weakened strains Hammond, lead VA investiga- detect these potentially pre- they carry a reasonably high may be suitable to use in a tor on the project from the cancerous lesions. risk of cancer.” vaccine, but the Salmonella or- Durham VA Medical Center Using their new knowl- Both Soetikno and ganism quickly loses its infec- in North Carolina. edge, the VA researchers Lieberman stressed that this tious characteristics under Salmonella infection is searched for non-polypoid le- study’s findings don’t mean normal earth-bound test envi- the most common form of sions among 1,819 veterans that a colonoscopy isn’t useful. ronments, making it difficult food poisoning in the U.S.

32 March/April 2008 VAnguard have you heard

85th anniversary celebration at Tuskegee VAMC Cuddly comfort for patients On Feb. 12, national, state and local officials joined Tuskegee VA Medical Center staff, volunteers and patients to celebrate the historic Alabama facility’s 85th anniversary of service to veterans. The special program and reception featured the Tuskegee University Concert Band, ROTC Honor Guard and several veterans of the renowned Tuskegee Airmen. Shortly after World War I, Congress authorized building a hospital to care for the more than 300,000 black veterans in the region who were having difficulty receiving quality care. The Hospital for Sick and Injured Colored World War Veterans was constructed at a cost of $2.5 million on more than 450 acres of land adjoining the Tuskegee Normal and Industrial Institute campus. In a Feb. 12, 1923, ceremony officiated by then-Vice President Calvin Coolidge, management of what was the third largest of the 19 hospitals being erected by the government at that time, was transferred to the Veterans Bureau.

MARIAN MCCONNELL

Salem VA Medical Center patient Ernest C. Gibson Jr. and ICU Nurse Kris Bivens, R.N., with the Spinoza Bear.

The Restraint Reduction Team at the VA medical center in Salem, Va., was recently challenged with reducing restraint use within the medical and surgical units. The team re- searched evidence-based literature, explored options and al- ternatives, and came up with the use of the Spinoza Bear at the suggestion of Music Therapist Beth Woodward. The Spinoza Bear is a soft, cuddly teddy bear who loves to be hugged and will carry on a conversation in either English or Spanish. Ann Benois, chief of Voluntary Service, found a BARBARA CORBIN sponsor to purchase the bears. The Lions Club purchased Martinsburg VAMC staff celebrate with Frank Buckles and his two bears—named Yogi and Boo Boo—that are now used to caregiver, Linda Binder. comfort patients who are agitated, have cognitive memory disorders, or are on ventilators in the intensive care unit. In 107 ‘candles’ for Frank Buckles addition, family members can record their own tapes with stories and memories designed to comfort their relative. Frank W. Buckles, the oldest known U.S. World War I veteran, turned 107 on Feb. 1. To celebrate, the staff at the VA medical center in Martinsburg, W.Va., where 75 years of service at Canandaigua VAMC Buckles receives outpatient care, decided to throw him The Canandaigua VA Medical Center in New York recently an early birthday party. Held at the medical center’s Audi- celebrated its 75th anniversary in grand style. Almost 250 ology and Speech Pathology Service on Jan. 28, the cel- people showed up for the festivities, which included music, a ebration was a surprise for Buckles. Accompanied by his video history of the medical center, tours and dancing. On dis- caregiver, Buckles came in for a hearing aid adjustment play for the ceremony was a gingerbread replica of the medical and met with audiologist Rene Donley. After his appoint- center, an assortment of clocks made by veterans, and a perfor- ment, he was greeted by employees and volunteers and mance by the 98th Division Army Reserve Band featuring patri- taken to the small birthday party, which included a bal- otic tunes. In addition, Rep. Randy Kuhl (R-N.Y.), offered a loon bouquet, cake and punch. At the party, Ann R. House resolution to honor the VAMC for its 75 years of dedi- Brown, Martinsburg’s new director, met Buckles for the cated service to area veterans. Kuhl says the Canandaigua first time. During the celebration, Buckles, an Army vet- VAMC has “a long history of providing exceptional psychiatric treatment to our nation’s bravest heroes.” The medical center, eran, spoke excitedly of his upcoming birthday plans with which sits on 171 acres, broke ground in 1931 and officially family and friends. opened in 1933.

March/April 2008 33 honors VAnguard

the Erie VAMC, providing crucial guidance on the implementa- Cardiology leader in Houston tion of ethics strategies and policies. The award, given annually, recognizes VHA employees Blase A. Carabello, M.D., Medical Care Line executive at whose career exhibits the highest standards of excellence, dedi- the Michael E. DeBakey VA Medical Center in Hous- cation and accomplishment in the field of health care ethics. It ton, was recently selected as the new president of the honors Nelson, who retired in 2003 after 30 years of federal ser- Association of University Cardiologists (AUC). A chairper- vice during which he was instrumental in promoting ethical health care practices throughout VHA. son of the Program Committee of the Council on Clinical Cardiology, Bronze Star for Iron Mountain VAMC physician Carabello is the Moncrief Professor of An emergency medicine doctor from the VA medical cen- Medicine and vice chairman in the De- ter in Iron Mountain, Mich., has been honored by the U.S partment of Medicine at Baylor Col- Army. Lt. Col. Edward A. Perez-Conde, 47, was awarded the lege of Medicine and a founding mem- Bronze Star Medal for exceptionally meritorious service from ber and immediate past president of June 5, 2005, to Sept. 3, 2005, while serving as the Battalion the Society for Heart Valve Disease. Surgeon for Task Force, 3rd Battalion, 116th Brigade Combat Listed as one of the best doctors in the Team during Operation Iraqi Freedom. While serving in Kirkuk, Iraq, Perez-Conde volunteered to be on the Quick Re- nation in the field of cardiovascular Carabello action Force because of the critical shortage of combat medics, disease in 2007 by the medical knowl- participating in several rescue missions supporting combat op- edge company Best Doctors Inc., he is the author of erations. more than 200 peer-reviewed and invited journals and A native of Puerto Rico, Perez-Conde joined the U.S. publications. Founded in 1961, the AUC limits membership Army Reserve shortly after Sept. 11, 2001. Perez-Conde is to 125 academic American cardiologists, elected by their board-certified in emergency medicine and completed military peers, whose members try to shape the course of re- training as a flight surgeon in August 2007. The Bronze Star is search and training in cardiovascular disease. the 9th highest military award (including both combat and non-combat awards) in the order of precedence of U.S. military decorations. Taking top honors in health services research David A. Asch, M.D., is the recipient of the 2008 Under Secretary’s Award for Outstanding Achievement in Health Ser- vices Research. This award recognizes a VA researcher whose Prestigious award for researcher work has led to major improvements in the quality of veterans’ Scientific American magazine announced in its January health care, has made key contributions to the future of health services research through excellence in training and mentorship, issue that Dr. Robert Rohwer, a researcher at the Balti- and has enhanced the visibility and reputation of VA research more VA Medical Center, will receive the prestigious through national leadership. Scientific American 50 Award. Listed 31st of the 50 rec- Asch has nearly 20 years as a VA health services researcher ognized, Rohwer is honored for his and is the co-director of Health Service Research and groundbreaking research to develop Development’s Center for Health Equity Research and Promo- a protective “filter” that might be tion (Pittsburgh/Philadelphia). He practices internal medicine able to purge red blood cells of dis- at the Philadelphia VA Medical Center and teaches health ease-causing protein particles, policy at the Wharton School at the University of Pennsylvania. called prions. For the past 30 years, Asch received his bachelor’s degree from Harvard University, his Rohwer has conducted research on medical degree from Cornell University and his MBA in health the transmissible spongiform en- care management and decision sciences from the Wharton School. cephalopathy (TSE) diseases, including Creutzfeldt-Jakob disease (the Rohwer Excellence in health care ethics honored human form of mad cow disease) The 2007 William A. Nelson Award for Excellence in Health and scrapie, which infects sheep and goats. Rohwer con- Care Ethics was presented to Jessica Steckler, R.N., at the VHA sults on the management of TSE risks for the World National Leadership Board meeting on Jan. 15. Steckler is an Health Organization, the European Commission, Health education specialist and instructional systems specialist in the Canada, the U.S. Food and Drug Administration, the Employee Education System and Education Resource Center at American Red Cross, the U.S. Department of Agriculture, the VA medical center in Erie, Pa. Throughout her 26-year ca- and numerous commercial clients in biotechnology, phar- reer with VA, Steckler has provided outstanding leadership in clinical ethics education, consultation and policy development. maceuticals, agribusiness and related industries. Since 1988, she has served as chair of the Ethics Committee at

34 March/April 2008 VAnguard heroes

Coming to the aid of a crash victim in Connecticut En route to the VA Connecticut Healthcare System’s West Ha- Averting a tragedy on the line ven campus on Dec. 20, Penny Vasilas, R.N., surgical case coordinator, saw an overturned vehicle down a highway ramp em- The speech of the caller on the end of the line was bankment. The wrecked vehicle’s engine was smoking as Vasilas “groggy and slurred,” according to Deanna Kruk, medical pulled over to ask bystanders if there were any injuries. They support assistant at the VA Western New York Healthcare told her there was an unconscious man trapped inside the ve- System’s Primary Care hicle. Vasilas gained entry into the wreckage through the bro- Clinic in Buffalo. She asked ken rear windshield and saw the elderly driver suspended by his for his name and the last seatbelt. four digits of his social se- As the car filled with smoke, she checked the unresponsive victim and found a rapid pulse. Concerned that the smoldering curity number. He gave her engine might catch fire, Vasilas made the decision to move the two different sets of num- victim to safety. She managed to unlatch his seatbelt and lower bers and the name he spoke the man down. With the help of two other bystanders, she was was unintelligible. The able to break the front windshield, allowing fresh air into the caller mentioned a provider’s name and said, “I’m taking care of my pain myself. I just took all my Just in time to save a life pills.” Then he hung up. BARBARA SELLON A planned early morning trip to the gym on Feb. 15 led to Kruk quickly phoned clinical an unexpected workout for Alexandria, La., VA Medical Sargent (left) and Kruk psychologist Dr. Erica Center’s Chief of Pharmacy Paul Moreau. As he set out Sargent and relayed what had just transpired. After mul- from home, he spotted a car with an elderly woman be- tiple entries of letters and numbers and connecting all the hind the wheel driving on the sidewalk, heading towards details, the identity of the patient was determined. A call him against the flow of was made to the veteran’s house, but there was no an- traffic. He turned his truck swer. The police were then called and responded immedi- to follow her as she drove ately to the veteran’s house. He was taken to the hospital. erratically through yards, “This situation really shows us that suicide prevention is and called 911 on his cell everyone’s business,” said Joan Chipps, suicide preven- phone for help. Moreau tion coodinator at the Buffalo medical center. “We never stayed on the line with the know when or where a call like this will come in. Deanna’s dispatcher, flashing his quick thinking and teamwork approach saved this man’s lights at oncoming cars life.” endangered by the driver, who remained oblivious to all traffic patterns and car. After assessing the victim for blunt trauma and bleeding, signs. Vasilas loosened his clothing and the man regained conscious- She eventually ran up ness. Emergency personnel soon arrived on the scene and took on and was stopped by a GARY KELLY over care of the victim. After a call and visit with the victim at dirt mound. Moreau ran to Moreau the hospital, Vasilas learned that he did not suffer any major injuries. During the visit, Vasilas also learned that the victim is a her and urged her to stop driving, saying that help was volunteer at the West Haven campus. coming. He then headed back to his truck to move it out of traffic. The woman suddenly sped off again, running Helping a fellow employee in crisis in Atlanta down a mailbox and heading straight into the waters of a Responding to a call for help, Debra Markart, program support murky bayou. Moreau jumped into the cold, muddy water assistant in Biomedical Engineering at the Atlanta VA Medical and swam out to the car. With doors and windows Center, ran to find a fellow employee lying near the doorway of locked, water began seeping into the woman’s car. a maintenance shop. Markart checked to see if he was breathing Moreau tried unsuccessfully to bash in the rear window and had a pulse. She then ran to the Biomedical Engineering with a T-post from his truck. The woman finally hit the shop and told someone to call an emergency code, that some- window button, creating a crack just large enough for one was down with a possible heart attack. Returning to the victim, Markart tilted the man’s head back to assure a clear air- Moreau to reach in and lower it further. He was eventu- way and checked for a pulse. She shook him to keep him as really able to pull her out of the sinking car. sponsive as possible. A short time later the emergency response team arrived and took over resuscitation efforts.

March/April 2008 35