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					              Winter 2009/2010

Wounded Warrior Care
Tragedy in Texas
Recover y Act Spending
Testing Disaster Readiness
                                                  Tragedy in Texas                                                          6
                                                  VA offers support and mourns its own losses at Fort Hood
                                                  Recovery Act Spending                                                     11
                                                  Stimulating more than the economy
6                                                 Building a Better Arm                                                     14
                                                  Amputee veteran is on a mission to revolutionize prosthetics
                                                  Charting a Course Towards Readjustment                                    16
                                                  Outward Bound partners with VA to offer expeditions for veterans
                                                  Testing Disaster Readiness                                                18
                                                  National exercise evaluates new equipment and technology
                                                  Better Care for Wounded Warriors                                          20
                                                  VA polytrauma team’s overseas visit furthers collaboration with DoD
                                                  The Unbreakable Code                                                      23
11                                                Navajo warriors are seeking support for a Code Talkers museum
                                                  Veterans Day 2009                                                         25
                                                  A photo tour of observances around the Department

                                                  3        Feedback                             31       Medical Advances
                                                  4        Outlook                              33       Have You Heard
                                                  5        News You Can Use                     36       Honors
25                                                26       Around Headquarters                  39       Heroes
                                                  30       Introducing                          40       Pearl Harbor

                  VA’s Employee Magazine                                             On the cover
                  Winter 2009/2010                                                   Wounded troops from Afghanistan and
                  Vol. LV, No. 6                                                     Iraq arrive at Scott Air Force Base in
Printed on 50% recycled paper                                                        Illinois, one leg of their long journey to
                                                                                     various military and VA medical facilities
Editor: Lisa Gaegler                                                                 across the country. Their trip back to the
Assistant Editor/Senior Writer: Gary Hicks                                           states began at Landstuhl Regional Medical
Photo Editor: Robert Turtil                                                          Center in Germany. A VA polytrauma
Staff Writer: Amanda Hester                                                          team recently visited Landstuhl to gain
                                                                                     valuable insights into wounded warrior
Published by the Office of Public Affairs (80D)                                      transport and care transition from DoD
                                                                                     to VA. photo by Senior Airman Teresa M.
U.S. Department of Veterans Affairs                                                  Jennings/U.S. Air Force
810 Vermont Ave., N.W.
Washington, D.C. 20420
(202) 461-7427
E-mail: vanguard@va.gov                             To Our Readers: A Change for the Better
www.va.gov/opa/publications/vanguard.asp            You may have noticed that we’re calling this the Winter 2009/2010 issue. That’s
                                                    not because we’re changing VAnguard from a bi-monthly to a quarterly. It’s to
                                                    allow us to adjust our production schedule and bring the magazine to you in a
                                                    more timely manner. Look for the next issue, March/April, in early March.

2                                                      VAnguard • Winter 2009/2010
Where are the OEF/OIF             eration Iraqi Freedom.              August 2008, the VA volun-         working there, volunteering
Women Veterans?                         With my family’s help, I      teer office suggested that I       80 to 90 hours each month in
I always look forward to read­    wanted to give something back       transfer my volunteer services     conjunction with VA. It keeps
ing each issue of VAnguard        to the VA volunteers and those      to the Hawaii State Veterans       me mentally alert!
as I find many of the articles    who work so hard at our VA          Cemetery, which is now do-                   D. Zane Schlemmer
informative, educational, or      hospital to help us recover. So     ing veteran burials since the          D-Day Veteran/Volunteer
just plain inspiring. When I      I started a T-shirt company         National Memorial Cemetery              State Veterans Cemetery
saw on the cover that the Sep­    that gives its profits to VA vol­   of the Pacific is full. So I’m                           Hawaii
tember/October issue included     unteers and disabled veterans.
an article on “The Nation’s             I was honored that James      A New Look for the Web Site
Newest Veterans,” I eagerly       Leahy, VA Canteen Service
flipped to the article, only to   supervisor, and Craig Fishbein,     Same name, new face! On Veterans Day, VA rolled out the first
be disappointed.                  Oklahoma City VA Medical            phase of a large-scale Web renovation.
      This was a great op­        Center canteen supervisor,               This is the first and most visible step in changing VA’s Web
portunity to focus attention      took a chance and allowed me        domain to better serve veterans and their families by making it
on women veterans as a sig­       (showed me, encouraged me)          easier for them to find the information they need about benefits
nificant portion of our newest    to become a VA vendor. Craig        and programs. Long term, VA’s goals for its Web presence are
veteran population. While         has ordered from my company         to make it easier and more inviting for veterans by focusing
the article did make mention      twice. I used the profits to buy    on topics and tasks rather than office functions, improving the
of women in a few places, it      Wii Fit games, TVs and more                                                              navigational
disappointingly did not in­       for Richard Maxey, VA volun­                                                             structure, and
clude any photos of Operation     teer supervisor in Oklahoma                                                              making it
Enduring Freedom/Operation        City.                                                                                    more visually
Iraqi Freedom women veter­              I hope my company                                                                  appealing.
ans.                              grows to do more to give back                                                                 The
      As women are in combat      to the finest hospital and its                                                           new Web site
zones, experiencing combat,       staff, who really do care for                                                            design will
though not assigned to infan­     its veterans. Not only getting                                                           cover more
try or battery combat units,      us well, but wanting us to be                                                            than 500 VA
they very much are the face       successful. My company Web                                                               Web sites and
of our newest veteran. It is      site is www.sittinprettyusa.com.                                                         about 80,000
often not VA staff but other      Thank you for helping our                                                                pages. Ma­
older veterans and the public     veterans.                                                                                jor changes
that don’t see the faces of                  Larry Van Schuyver                                                            include
our newest combat veterans.                                 Patient                                                        improve­
This article would have been              Oklahoma City VAMC                                                               ments to the
a great format to assure that                                                                                              navigational
we all see women as not only      65th Anniversary                                                                         structure that
veterans but OEF/OIF combat       of D-Day                                                                                 ensure consis­
veterans.                         You can imagine my surprise         tency among all sites and consolidate major topics; a slideshow
      Thank you for your          when I received and read the        section that showcases current VA events or hot topics; and bot­
continued work and great          July/August issue and found         tom columns that feature news items, highlights and a “Quick
magazine.                         my picture on pages 28 and          List” with links to important applications such as Veterans On
             Kathy Zima-Sauer     30 with the article, “65th An­      Line Applications (VONAPP) and MyHealtheVet. Check out
    Women Veterans Program        niversary of D-Day: France          VA’s new Web face at www.va.gov.
                        Manager   Remembers.”
    VA Eastern Kansas Health           Never in my wildest
                    Care System   dreams did I ever expect to be
                                  awarded the French Legion of          We Want to Hear from You
Canteen Service Giving            Honor medal by the French             Have a comment on something you’ve seen in VAnguard?
Back to Veterans                  President Nicolas Sarkozy and         We invite reader feedback. Send your comments to van­
I wanted to write and tell you    to meet our President Barack          guard@va.gov. You can also write to us at: VAnguard, Office
how your Canteen Service is       Obama, who mentioned me in            of Public Affairs (80D), Department of Veterans Affairs, 810
giving back to veterans. I am     his address there. Quite above        Vermont Ave., N.W., Washington, D.C., 20420. Include
a retired Navy Reserve master     and beyond!                           your name, title and VA facility. We won’t be able to pub­
chief. I am 100 percent dis­           I also wanted you to             lish every letter, but we’ll use representative ones. We may
abled due to injuries received    know that I’ve been a VA              need to edit your letter for length or clarity.
during my two tours in Op­        volunteer for many years. In
                                                     VAnguard • Winter 2009/2010                                                       3

                   National Cemeteries: Transforming for the 21st Century
                   Steve L. Muro
                   Acting Under Secretary for Memorial Affairs

As VA Secretary Eric K.                  Virtually all NCA direc­      choose either the new medal­         ing of Washington Crossing
Shinseki leads the department      tors, foremen and other man­        lion, or a traditional govern­       National Cemetery in Bucks
in fundamental and compre­         agers have attended superviso­      ment headstone or marker,            County, Pa., in early 2010. In
hensive change to become a         ry and leadership training, and     to memorialize veterans who          late summer 2010, VA plans
21st-century organization, the     front-line employees regularly      died on or after Nov. 1, 1990,       to conduct first burials at a
National Cemetery Adminis­         attend courses related to their     and are interred in privately-       cemetery expansion to be con­
tration is striving to improve     job functions, such as heavy        marked graves in private cem­        structed on land leased from
the access and quality of ser­     equipment operations, safety,       eteries. We anticipate that the      the Department of the Navy
vices available at VA national     landscape maintenance, cus­         medallion will be available in       at Marine Corps Air Station
cemeteries.                        tomer service or other topics       early 2010.                          Miramar, Calif. Administered
      Already a national leader    associated with the operational           NCA’s newest responsi­         by Fort Rosecrans National
in veteran-client service, NCA     requirements of NCA.                bility is to process first notices   Cemetery, this expansion will
earned the highest overall rat­          VA has streamlined the        of death for veterans. In fiscal     resume the option for the
ing in customer satisfaction of    process of burial eligibility       year 2009, NCA captured and          interment of casketed remains
any federal agency or private      determinations and interment        entered data into VA informa­        for thousands of veterans in
corporation participating in       scheduling with establishment       tion systems that ensured the        the San Diego area.
the American Customer Satis­       of the National Scheduling          necessary discontinuance of                Gravesite expansion
faction Index survey, achieving    Office, also located in St. Lou­    approximately $17.4 million          projects are now underway to
a score of 95 out of 100 in        is. By January 2010, this office    in monthly compensation pay­         ensure uninterrupted service at
2007. Our goal is to further
improve the caring and com­        Our goal is to further improve the caring and
passionate service that veterans
receive at national cemeteries.    compassionate service that veterans receive at national
      According to NCA’s           cemeteries.
internal 2009 Survey of Cus­
tomer Satisfaction:                will handle interment requests      ments for deceased veterans,         43 existing national cemeter­
n 95 percent of respondents        for all VA national cemeter­        thereby contributing to the          ies across the United States.
rated the quality of service re­   ies, except those located in        proper stewardship of funds.         Seven new state veterans cem­
ceived from VA cemetery staff      Puerto Rico and Hawaii. As          We are now coordinating              eteries—established through
as excellent;                      a one-stop scheduling center,       procedures to fulfill other VA       the State Cemetery Grants
n 98 percent rated the appear­     the National Scheduling Of­         responsibilities following the       Program—are also under con­
ance of VA national cemeteries     fice ensures timely, consistent     death of a veteran, such as the      struction. With the opening of
as excellent; and                  eligibility determinations and      cancellation of medical ap­          these new cemeteries, 90 per­
n 98 percent would recom­          is available for families and       pointments and shipments of          cent of veterans will have rea­
mend a national cemetery to        funeral homes to schedule           prescription medications.            sonable access to burial space
veterans’ families during their    burials seven days a week. This           Five new national cem­         in a national or state veterans
time of need.                      innovation has freed cemetery       eteries opened in 2009 to serve      cemetery by the end of fiscal
      These results are a testa­   staff to devote more time to        the areas of Columbia, S.C.;         year 2011.
ment to the dedication and         their primary mission of serv­      Sarasota and Jacksonville,                 Nearly 20 percent of
hard work of NCA employees         ing veterans and their families.    Fla.; Birmingham, Ala.; and          NCA permanent hires in fis­
as they serve veterans and their         VA is expanding the           Bakersfield, Calif. As a result,     cal year 2009 were veterans of
families during difficult and      government headstone and            668,000 previously unserved          Operation Enduring Freedom/
emotional times. Our pro­          marker program to include           veterans now have access to          Operation Iraqi Freedom.
grams for employee develop­        a new medallion option to           a burial option in a national        With more than 70 percent of
ment—which are centered at         acknowledge and honor the           cemetery within a reasonable         our permanent employees be­
our National Training Center       service of eligible veterans bur­   distance (75 miles) of their         ing veterans, all NCA employ­
in St. Louis—are crucial to        ied in private cemeteries. This     residence.                           ees understand the meaning of
maintaining VA cemeteries as       new product will be affixed to            In the Philadelphia re­        service. They are committed
national shrines, and to pro­      existing privately purchased        gion, more than 580,000              to making VA an organization
viding outstanding service at      headstones and markers. Fam­        veterans will have access to a       that is people-centric, results-
every national cemetery.           ily members will be able to         burial option with the open­         driven and forward-looking.
4                                                      VAnguard • Winter 2009/2010
                                                                                                       NEWS YOU CAN USE

First Lady Visits VACO to Thank Employees for Their Dedication

First Lady Michelle Obama
made the 12th stop on her
tour of federal agencies and
departments when she visited
VA Central Office on Oct. 20
to thank employees for their
hard work and dedication to
serving veterans.
      Speaking in the second-
floor conference center to a
gathering of employees who
got randomly distributed
tickets to the event, Obama
joked about having to be
driven the two blocks from the
White House to VACO in­                                                                                               First Lady
stead of simply walking across                                                                                        Michelle Obama
Lafayette Park. She also drew                                                                                         and Secretary
                                                                                                                      Shinseki greet
laughter from the crowd when                                                                                          VACO employees
she said that she was supposed                                                                                        gathered in a
to come earlier in the year,                                                                                          basement confer -
but got “bumped” by her          robert turtil                                                                        ence room.
husband—the President came
in March for the celebration     Taylor; Marilyn Twombly;           realizes his efforts are only as   ing, Obama shook hands and
of VA’s 20th anniversary as a    and Al Zanella.                    strong as the people on his        posed for photos with employ­
Cabinet-level department.              “One of the reasons why I    team, the First Lady added         ees; earlier, she greeted a larger
      Obama was introduced       do this is because so often fed-   that “it’s just important for      group of employees who had
by VA Secretary Eric K. Shin­    eral employees feel underap­       you to know that the President     gathered in a basement confer­
seki, and joined onstage by      preciated,” Obama said. “You       and I are proud of you, just       ence room to watch the event,
several long-serving depart-     often get a lot of the blame       as proud as we are of the men      which was broadcast live on
ment employees: William R.       but sometimes none of the          and women who serve this           VA’s television network. It was
Bremby; Patricia J. Covington;   thanks. And my simple job is       country, the people that you       also live-streamed, and avail­
Dorothy Dillard; James S. Mc­    to say thank you, because the      serve. And we just urge you to     able to employees around the
Cain; David P. McLaughlin;       job that you do is a big one.”     keep it up.”                       nation via satellite and closed
Loretta R. Rocko; Ralph L.             Noting that the President          After she finished speak-    captioning capabilities.

Under Secretary for Benefits Dunne to Step Down in Early 2010
                                 VA Under Secretary for Benefits Patrick W. Dunne announced his resignation on Nov. 20, effec­
                                 tive early next year. Dunne, who attained the rank of rear admiral in the Navy, has been with VA
                                 since 2006.
                                       As Under Secretary for Benefits since October 2008, Dunne has directed the administration
                                 of VA’s disability compensation, pension, education, home loan guaranty, vocational rehabilitation
                                 and employment, and life insurance programs through a nationwide network of 57 regional of­
                                 fices, other special processing centers, and Veterans Benefits Administration headquarters.
                                       “I’ve appreciated the wonderful opportunity VA has given me to serve our nation’s veterans
                                 and their families,” said Dunne. “We have an obligation to care for our heroes and their depen­
                                 dents, and I will fully support the transition of my successor to meet that moral responsibility.”
                                       “Pat Dunne has guided the Veterans Benefits Administration through a number of challenges
                                 during his tenure as Under Secretary. I applaud his service and loyalty to our team and thank him
                                 for his unfailing commitment to our nation’s veterans,” said VA Secretary Eric K. Shinseki.
                                       Born in Washington, D.C., and raised in Troy, N.Y., Dunne earned his undergraduate de­
                                 gree in mathematics from the U.S. Naval Academy, and a master’s in mathematics from the Naval
Patrick W. Dunne                 Postgraduate School. He is also a graduate of the Navy’s nuclear power training program.
                                                    VAnguard • Winter 2009/2010                                                           5
                                                                                                                 First respond-
                                                                                                                 ers transport
                                                                                                                 a wounded
                                                                                                                 soldier to an
                                                                                                                 at Fort Hood,
                                                                                                                 Texas, where a
                                                                                                                 gunman’s attack
                                                                                                                 on Nov. 5 left 13
                                                                                                                 dead and doz-
                                                                                                                 ens injured.

                                                                                                     u.s. army

            Tragedy in Texas
    In the midst of providing mental health services and other support to 

     the Fort Hood community following the tragic shootings, VA mourned 

                      its own losses from the violence.

‘I need to do this’                       Fort Hood, Texas, after Maj. Nidal          need to help them.”
Russell G. Seager, 51                     Hasan allegedly went on a shooting               Seager told his friends he was
He didn’t have to do what he did. But     spree.                                      inspired to join the military after 9/11.
then again, talk to people who knew            Seager arrived at the post hours       While teaching at Bryant and Strat­
him best, and they’ll tell you that for   earlier en route to Afghanistan, where      ton College, he interviewed for a new
Russell G. Seager, there was no other     he would be on the front lines to help      position at the VA medical center
way. And that’s what made him such        soldiers with mental health issues im­      that would incorporate mental health
a special person, and made his death      mediately, instead of waiting until         treatment into the primary care clinic.
that much harder to take. It was also     they got back home. He had joined                Some veterans “are afraid to go to
a stark reminder of the dangers troops    the Army Reserve only four years            mental health because of the stigma,
face on a daily basis in the current      earlier and pushed hard to get the de­      so we wanted to have a total approach
wars.                                     ployment.                                   to help them,” explained Jim Bode,
     Seager, 51, a nurse practitioner          “Russ, why do you need to go?”         the primary care program manager
who specialized in mental health          Jennifer Hauger, his friend and col­        who interviewed and hired Seager.
treatment at the Clement J. Zablocki      league in the primary care clinic, re­           “I think he just loved to take care
VA Medical Center in Milwaukee,           called asking him.                          of vets. It was a passion of his. That’s
was one of 13 people killed Nov. 5 at          “I need to do this,” he told her. “I   why he joined the Army in his mid-
6                                                VAnguard • Winter 2009/2010
40s. He wanted to do this. He needed             Sue Lemcke, a nurse who worked             Everyone’s Best Friend
to do this,” Bode said. “We could tell     in the office next to Seager, said he            Juanita L. Warman, 55
when we interviewed him that he was        took each case personally. “I remem­             More than 1,200 miles separate Fort
really compassionate and really cared.     ber he was treating a young man, and             Hood, Texas, from Perry Point, Md.,
He called on his patients, scheduled       I could tell by the tone of his voice            but the tragedy that took place there
his patients. He didn’t like just giving   when he said ‘goodbye’ that he was               Nov. 5 sent shock waves through the
that to other people to do. He really      really affected. He told me it was be­           Perry Point VA Medical Center and
built a relationship with them. It’s go­   cause the man was close to his son’s             the rest of the VA Maryland Health
ing to take a long time to find some­      age, and he felt that connection.”               Care System. Counted among the 13
one like him.”                                   In the primary care clinic, there          lives lost in the shootings was Juanita
     Although he believed he could         are still little things to remind his co­        L. Warman, a 55-year-old nurse prac­
best serve the soldiers on the front       workers of his presence. They wear red           titioner and Army reservist who
lines, it was tough for him to leave.      ribbons with gold stars on their lapels,         worked at the Perry Point VAMC.
“He was very worried about his pa­         in honor of his service.
tients here and wanted to make sure              Lemcke, along with fellow nurse
they were taken care of, and he want­      Laurie Lange, can’t help but smile as
ed to make sure his position would be      they talk about the last gift Seager
here when he came back,” Bode said.        gave them before he left—a peace lily
     Rev. Norm Oswald, chief chap­         plant in a glass that reads: “HOOAH!
lain at the medical center, said his       It’s an Army thing.”

                                                                                                                             u.s. army

                                                                                            Juanita L. Warman
                                                                                                 Warman had been an integral
                                                                                            and valued member of the Trauma
                                                                                            Recovery Program team at the medi­
                                                                                            cal center since October 2005. Her
                                                                                            colleagues said she took great pride in
                                                                                            her work serving veterans as part of
                                                                                            the VA Maryland Health Care Sys­
                                                                                            tem’s Returning Veterans Outreach
                                                                courtesy of seager family   Education and Care Program.
Russell G. Seager                                                                                “I always thought of Juanita as
patients also knew they had someone             “He made us promise that we                 ageless. She was everyone’s best friend
special in Seager. “One of his patients    would take care of it while he was               because she got along with every­
told me that Russ wasn’t afraid to         gone,” Lange said, blinking back tears.          body,” said Dr. Christina Watlington,
come into the darkness with him, and            “Even though it was in pretty bad           a staff psychologist who worked daily
he stayed there until there was light.     shape,” Lemcke added. “So we pulled              with Warman. “She was a courageous
To Russ, these were not patients.          off the dead leaves and we fertilized it,        woman who was truly dedicated to
They were human beings with needs.         and brought it back. New leaves are              helping veterans.”
They were not customers. He rebelled       budding on it right now. We want to                   Warman, a lieutenant colonel
against that word. They were fellow        give it to his family because, for us,           in the reserves who was about to em­
humans and he wanted to help them.         that symbolizes that Russ is still here.”        bark on her fourth deployment with
It was really a gift that he could con­                                                     her Kansas-based unit, the 1908th
nect on their level.”                      By Gary J. Kunich                                Medical Detachment Combat Stress
                                                  VAnguard • Winter 2009/2010                                                         7
Control, was highly respected by her         men and women as they reintegrated        ferral services in the aftermath of the
colleagues for her knowledge of the          into their local communities. She will    tragedy.
military and the psychological needs         be greatly missed by her co-workers            The 39-foot vehicles, outfitted
of returning combat veterans. She ac­        and patients alike.”                      with two confidential counseling
tively participated in outreach events             Warman earned both bachelor’s       rooms and state-of-the-art satellite
for returning veterans and assisted          and master’s degrees in nursing from      communications, came from Fay­
the National Guard with the design           the University of Pittsburgh. Born        etteville, Ark., New Orleans, San
and implementation of the Beyond             into a military family, she “loved the    Antonio and Midland, Tex. With 50
the Yellow Ribbon Reintegration              Army and her family,” said her half-      of these vehicles nationwide, the vet
Program. Warman considered the               sister, Kristina Rightweiser. Instru­     center program had the perfect tool
military her family, which she demon­        mental in creating a Cognitive Pro­       for a quick VA response to this emer­
strated through her dedication to her        cessing Group for veterans, Warman        gency.
work, particularly with returning and        always found time to deliver profes­           Within hours of the shootings,
women veterans.                              sional presentations to social workers    Readjustment Counseling Service de­
     “Ms. Warman was a brave Ameri­          and other health care professionals       veloped an integrated plan and began
can who voluntarily served in the            who work with returning veterans and      mobilizing the vehicles and bringing
U.S. Army Reserve to protect and             military families.                        staff to the area to provide counsel­
defend the freedom and liberties we                “She was especially interested      ing services to people impacted by
cherish in this great nation,” said          in helping women veterans,” said Lt.      the tragic event. While the mobile
Dennis H. Smith, director of the VA          Col. Michael Gafney, who runs the         vet centers were en route, the Killeen
Maryland Health Care System. “Her            reintegration program for the Mary­       Heights Vet Center was in full gear,
selfless sense of commitment extended        land National Guard. “That topic was      staying open late and working over­
to her career here, where she gave           dear to her heart. She loved meeting      time to ensure that every client had
generously to support returning service      with and helping women soldiers           been contacted to see how they were
                                             through the long and, many times          doing.
                                             lonely, path they faced after returning        Arriving with the mobile vet cen­
    More VA Connections                      from war.”                                ters were more than 30 vet center staff
    Dorothy carskadon, 47, a social                A resident of Havre de Grace,       members from across the country. Lo­
    worker and team leader at the Va         Md., Warman helped establish the          cated on-base at the PX and off-base
    vet center in madison, Wis., was         post-traumatic stress disorder instruc­   at community centers, the four mobile
    wounded in the fort Hood attack.         tion portion of the Yellow Ribbon         vet centers, equipped with counselors
    a captain in the army reserve, she       Reintegration Program for Maryland,       and outreach workers, began seeing
    was preparing to deploy to afghani­      and she assisted Guard members and        people immediately.
    stan with the madison-based 467th        reservists returning from Afghanistan           “The vet center staff who re­
    medical Detachment.                      and Iraq with acclimating to civilian     sponded to the Fort Hood tragedy
          carskadon has been team lead­      life.                                     went above and beyond in assisting
    er at the madison Vet center since             “We mourn the loss of someone       the local community,” said Dr. Al­
    2006. she was released from Darnall      who gave so much for others,” said        fonso Batres, chief officer of Readjust­
    army medical center at fort Hood to      Brig. Gen. James Adkins, adjutant         ment Counseling Service.
    continue her recuperation at home.       general of Maryland.                           The Killeen Heights Vet Cen­
          a former Va employee, michael                                                ter and mobile vet centers saw more
    g. cahill, 62, was among the 13 killed   By Rosalia Scalia                         than 8,200 veterans, soldiers, family
    at fort Hood. Working as a civilian                                                members and civilians at Fort Hood
    contractor at the army base at the       Counseling a Shaken                       and the surrounding area who were
    time of the shootings, the physician     Community                                 in need of counseling and emotional
    assistant previously worked at Va        They made their debut earlier this        support.
    facilities in montana, oregon and        year. They’ve been on Capitol Hill,            Since this was the first time the
    texas.                                   on the grounds of VA medical cen­         mobile vet centers were deployed dur­
          on an average day, more than       ters, at post-deployment events and at    ing a crisis of this magnitude, there
    850 Va employees don uniforms            stand downs. On Nov. 5, four of these     were a lot of lessons learned, one of
    to serve military commitments in         mobile vet centers were deployed          which was location. “We learned
    reserve and National guard units         to the Fort Hood area and put into        quickly that our initial locations were
    across the country and overseas.         action providing counseling, crisis       not reaching the amount of people
                                             intervention, and information and re­     we expected,” said Robert Gombeski,
8                                                   VAnguard • Winter 2009/2010
                                                                                                                            joel cHaVerri

                                                          joel cHaVerri

 Above: Anthony Seamster, mobile vet center counselor, provides
 information to a family outside Wal-Mart at one of the four mobile
 vet centers deployed to Killeen, Texas, to offer counseling services
                                                                                                                            joel cHaVerri
 in response to the shootings at Fort Hood; top right: Michelle
 Milonas, team leader at the New Orleans Vet Center, and Kevin
 Mickens, mobile vet center counselor, greet military members
 and local residents outside the mobile vet center at Wal-Mart; bot-
 tom right: Chuck Edens, veteran outreach specialist at the Killeen       “We spent a lot of time speaking
 Heights Vet Center, talks with a soldier outside the mobile vet cen-
 ter deployed to the Warrior Way PX on Fort Hood.                         with both military and civilian
Killeen Heights Vet Center team leader. “To connect with
                                                                          workers who were feeling anxiety as
the community, we had to be creative and go where they                    a result of the events.”
were—a place that was sure to have people visiting every
day.”                                                                          The incident hit close to home for many mental
     The solution: Wal-Mart. No sooner had the idea been                  health and hospital workers. “The staff at the hospital on
brought up than staff members were talking with local                     base worked very hard to provide care for the victims and
Wal-Mart management to request permission to set up the                   their families, but often they are the last to receive any
mobile vet centers in their parking lot. Soon, the vehicles               care themselves,” said Jacquelyn Cusick, a counselor with
were set up outside two different Wal-Marts, where they                   the Killeen Heights Vet Center and on-site mobile vet
were capable of seeing a large number of people each day,                 center counselor.
many of whom knew someone involved in the shootings.                           The mobile vet center, with its ease of access and neu­
     “We spent a lot of time speaking with both military                  tral location, was able to provide that care. Anyone need­
and civilian workers who were feeling anxiety as a result                 ing assistance could simply walk in and talk to a counselor
of the events,” said Michelle Milonas, team leader at the                 without having to actually visit a clinic or hospital. This
New Orleans Vet Center and on-site mobile vet center                      proved to be a vital aspect of the mission, since many sol­
counselor. “We’ve been able to answer questions and pro­                  diers were initially fearful of returning to the base.
vide therapy in this time of need.”                                            “With some veterans, these shootings have re-trig-
                                                        VAnguard • Winter 2009/2010                                                     9
     ‘You are not going to die on me’
     ana maldonado, a registered nurse at the audie l. murphy              there and they will take you to the hospital.”
     memorial Veterans Hospital in san antonio, part of the                     maldonado helped assess the condition of the victims.
     south texas Veterans Health care system, was at fort Hood she also directed some fellow nurses and others who were
     on Nov. 5 attending her husband’s graduation ceremony.                at the scene.
     maldonado, who was inside the auditorium, saw the band                     “i was asking people if they knew how to do cPr, take
     and the graduates suddenly rush in through the main doors. the pulses of those wounded and put pressure to help stop
          “i thought, this is not right,” maldonado said. then, she the bleeding.”
     heard gunshots.                                                            When the ambulances arrived, maldonado informed
          a soldier came in through the back entrance asking for the paramedics who needed to be taken first and who
     volunteers with com­                                                                                          needed help. she
     bat experience, or                                                                                            stayed until all the
     any nurses, doctors                                                                                           wounded had been
     or emergency per­                                                                                             taken to the hospital.
     sonnel. she started                                                                                           maldonado, who
     to respond, but her                                                                                           has two decades
     husband held her                                                                                              of experience as
     hand tightly.                                                                                                 a combat nurse,
          “i looked at him                                                                                         said that being a
     and said, ‘i have to                                                                                          nurse and a veteran
     do this,’” maldonado                                                                                          helped her during
     recalled.                                                                                                     the incident.
          from the audito­                                                                                               after making
     rium, she and some                                                                                            a statement to the
     other volunteers ran                                                                                          fbi, maldonado re­
     to the soldier and                                                                                            joined her husband.
     family readiness                                                                                              they returned to
     center, where the                                                                                             san antonio that
     shootings took place.                                                                                         night. When they got
     When she walked                                                                                               home, she wept. “i
     in, she saw blood                                                                                             was there for a rea­
     everywhere. the             luPe HerNaNDez                                                                    son,” she said.
     people on her left,         Registered nurse Ana Maldonado, who was at Fort Hood on Nov. 5 attending her            about a week
     she soon realized,          husband’s graduation ceremony, raced to the scene of the shootings to help the    later, maldonado
     were already dead.                                                                                            went back to fort
          “i asked someone to get me some gloves. i took off my            Hood for the memorial service. “the people i worked with
     boots and rolled up my pants and started looking at the vic­          that day recognized me,” she said. “they came over and
     tims,” maldonado said.                                                said that they were looking for me. they said i must have
          “a soldier had his hand up, and he was the first one i           been an angel because they could not find me.”
     went to,” she said. “He was still alive. i asked someone to                in addition to her 20 years as an army nurse, mal­
     give me their shirt; i rolled it up and used it to help stop the      donado has 22 years of civil service—four at brooke army
     bleeding.”                                                            medical center and 18 at the south texas Veterans Health
          maldonado looked at the soldier and said, “you are not care system. she currently works in gastroenterology ser­
     going to die on me. you are a soldier. the ambulance is out           vice. - Genevieve T. Joson

gered past events of combat,” said               considerable impact on the soldiers,           service to the Fort Hood community,”
Vaughn DeCoster, team leader at the              families and civilians who live on or          said Louann Engle, RCS regional
Fayetteville Vet Center and on-site              around the base. Many are grateful for         manager. “Their hard work reflects a
mobile vet center counselor. “Most               the timely support provided to them            tremendous dedication that has really
people think that something like this            by the mobile vet center staff.                paid off for those who needed care.”
is not supposed to happen here.”                      “I’m proud of all the RCS staff
     The Fort Hood shootings made a              for their commitment and sustained             By Joel Chaverri
10                                                       VAnguard • Winter 2009/2010
                                                                                                                                  robert turtil

VA Central Office ARRA team members (left to right): Ruth Jane Peterson, senior policy advisor (Recovery); Allan Millington, systems accoun­
tant-team lead; Jonathan Lambert, deputy director, Financial Business Operations; Edward J. Murray, deputy assistant secretary for finance;
Jill N. Cottine, administrative officer; and Jacqueline Hillian-Craig, Recovery support.

  Recovery Act Spending: Stimulating
           More Than the Economy
                                A talented and creative team was assembled to oversee
                                              the spending of VA’s share of the funds.

   n a previous article, VAnguard                      And find the right people they               Spending it “properly” means

   asked, “How hard is it to spend              did.                                            meeting VA’s contracting perfor­
   nearly one and a half billion dol-                From top-level managers at VA              mance goals. Projects have to be

lars?”                                          Central Office to field contracting of-         “properly solicited, competitively bid

     VA Deputy Assistant Secretary              ficers, Murray and his team assembled           and the work … done to satisfaction
for Finance Ed Murray admitted it               a talented and creative staff commit-           before the contractor can be paid,”
was easier said than done, noting, “It’s        ted not only to spending VA’s share             Murray said. VA is also holding to its
definitely a lot of work and … we had           of the American Recovery and Rein-              goals for awarding contracts to small,
to … find the right people that could           vestment Act funds within the given             minority, veteran and disabled veter­
contribute.”                                    time frame, but to spend it properly.           an-owned businesses.
                                                         VAnguard • Winter 2009/2010                                                        11
                                                                                                                       robert kummer

                                                                                                As a result, the White House rec­
                                                                           Nicole fiscus   ognized VA for far exceeding goals in
                                                                                           the areas of competition (more than
                                             Clockwise from left: Field-based ARRA         99 percent), obligations to small busi­
                                             team members, including John Lombard,         nesses (approximately 38 percent),
                                             Scott Fiscus and Tami Diaz have used
                                             a number of new tools and resources to
                                                                                           and on-time completion. Further, the
                                             successfully manage and monitor Recov-        changes instituted by Buck and his
                                             ery Act spending.                             team have established an infrastruc­
                                                                                           ture that can be used to improve the
                                            and energy,” Murray said.                      quality, timeliness and performance of
                                                 One employee cited for helping            all future VA procurements.
                                            reach these goals is Kenneth J. Buck,               The impact of those changes
                                            Ph.D., director of acquisition policy,         within the Veterans Health Admin­
                                            who oversees a complex process in­             istration has been direct, immediate
                                            volving more than 1,300 individual             and noticeable.
                                            contract actions totaling more than                 “We have incorporated a number
                                            $1.2 billion.                                  of new tools and resources that have
                                                 As the senior acquisition official,       greatly enhanced our ability to man­
                                            Buck deftly coordinates activities be­         age and monitor our performance, and
                                            tween experts in finance, legal, infor­        are able to provide an unparalleled
                                            mation technology, and the Office of           amount of data that support our …
russell lambert
                                            the Secretary.                                 desire for a higher level of transparen­
     And there’s a time limit—they               In addition to drafting and               cy and accountability in our business
have 24 months to spend the money           implementing acquisition policy and            practices,” said Scott Fiscus, director
without adding staff, while providing       procedures, he designed significant en­        of VHA’s Recovery Act Acquisition
an unprecedented level of transpar­         hancements to the electronic contract          Program, Office of Procurement and
ency not seen before in the federal         management system (eCMS) so that               Logistics.
government.                                 all contracts include provisions unique             One new management tool,
     They also must meet VA Secre­          to ARRA acquisitions. He also devel­           eCMS, was still in its infancy when
tary Eric K. Shinseki’s priority targets.   oped performance indicators to track           the Recovery Act was initiated. The
“We were looking for projects that fell     procurement milestones and put in              Act, according to Fiscus, has propelled
into one of three categories of patient     place a quality assurance process that         the system forward and forced con­
safety, security of the environment         predicts and corrects problems.                tracting officers to take advantage of
12                                                 VAnguard • Winter 2009/2010
all its capabilities.                     tracting officers for their diligence and   maintain the final resting places
      “The system provides the most       commitment to meeting established           for millions of veterans as national
effective means we have of generating     ARRA spending goals.                        shrines, the National Cemetery Ad­
recurring reports, and tracking any            “Contracting officers working on       ministration was provided $50 million
individual project remotely,” Fiscus      ARRA projects really stepped up to          in ARRA funds. The funding allows
said. “More importantly ... the system    the plate and did an exceptional job        NCA to immediately address a back­
offers acquisition planning functions     meeting the expectations,” said Tami        log of maintenance needs at VA cem­
that allow staff to adhere to a more      Diaz, eCMS coordinator for the VA           eteries.
organized, structured, and risk-averse    Healthcare System of Ohio (VISN                  “NCA is using these funds to raise
acquisition process.”                     10).                                        and realign headstones and mark­
      Similar sentiments were expressed        The improvements in contract           ers, renovate gravesites, and make
at the field level, too.                  management, combined with the               road repairs and other improve­
      “Our contracting officers are us­   focus on competitive bidding and the        ments to cemetery grounds and
ing eCMS to document every step of        efforts of the contracting officers, have   facilities,” said Acting Deputy Un­
the procurement process,” reported        provided an additional benefit. Most        der Secretary for Memorial Affairs
John Lombard, a contract specialist       contracts have been awarded under           Ron Walters. “NCA will also pur­
and eCMS application coordinator for      the planned amounts.                        chase new equipment for cemetery
the VA Northwest Health Network                “These cost savings provided ad­       operations and conserve and repair
(VISN 20). “We are able to create re­     ditional funding for projects that may      49 historic monuments at national
ports … that offer a true reflection of   not have been awarded this fiscal year      cemeteries and soldiers’ lots across the
where each procurement stands. This       without the efforts of the contracting      United States.”
has created efficiencies in our Con­      officers,” noted Diaz. “These efforts            Additionally, the funding will al­
struction Branch, and now we can just     translate into meeting more needs for       low NCA to finance projects that use
look at eCMS to answer questions,         the veterans.”                              wind turbines, solar power and other
rather than spend time calling con­            While maintaining and upgrading        measures to conserve energy and wa­
tracting officers to get the status.”     152 VA medical centers easily takes         ter. So far, NCA has obligated more
      An important element of ARRA        the lion’s share of VHA’s Recovery          than $29 million for projects at 85
spending is increased transparency of     Act funds, a sizeable portion, $399         national cemeteries.
the process.                              million, has been designated for a               In just nine months, VA has
      “All of our plans, projects and     substantial number of energy initia­        obligated more than 54 percent of its
weekly financial and program accom­       tives—projects incorporating energy         Recovery Act funds, including more
plishments are fully transparent to       efficiency and renewable energy.            than $465 million directly to more
the American people on the ARRA-               In an effort to put Recovery Act       than 1.8 million veterans through the
specific Web site that VA developed       money directly into the hands of            individual $250 checks they received
within the first week after passage of    veterans, the Veterans Benefits Ad­         in June.
the Recovery Act,” said Murray.           ministration began making $9,000                 The American Recovery and Re­
      This transparency is not just for   and $15,000 payments required by the        investment Act of 2009 was designed
the public to better see how their        Act to eligible Filipino veterans in        to jumpstart America’s economy, cre­
government is conducting its busi­        April, and $250 payments to eligible        ate or save millions of jobs, and put
ness, but also for federal managers to    veterans with disabilities in June. Ad­     a down payment on addressing long-
be able to monitor the process and        ditionally, VBA hired the first of          neglected challenges so our country
provide direction as needed to stay on    2,293 temporary employees to assist in      can thrive in the 21st century.
track.                                    processing compensation and educa­               “VA is on its glide path to fully
      “I have not been involved in any­   tion claims in April.                       obligate all of its Recovery Act funds
thing with as much scrutiny at such a          “These actions required the de­        by September 2010,” Murray said.
high level,” admitted Randy Harvel,       velopment of business processes, ac­             VA is obligating the funds to
the eCMS coordinator with the South       quisition of workspace and equipment,       improve benefits and services to veter­
Central VA Health Care Network            training, and multiple changes to           ans, while at the same time stimulat­
(VISN 16). “Requiring the contract­       VA’s automated systems,” said Jimmy         ing the economy in and around the
ing officers to work with and update      Norris, VBA’s chief financial officer.      communities that are home to hun­
milestones regularly helped to identify   “A rapid, coordinated response was          dreds of VA facilities and millions of
and rectify problems early on.”           delivered by multiple VA elements to        the nation’s veterans.
      Across the board, eCMS coordi­      ensure this timely action.”
nators complimented their field con­           Keeping its commitment to              By Jim Benson
                                                 VAnguard • Winter 2009/2010                                                13

 a Better

       Amputee veteran
  Jonathan Kuniholm is
 on a mission to bring
 upper limb prosthetics
 into the 21st century.

    n many ways, Jonathan Kuniholm
    is like a lot of young veterans
    across the country. After serving
three and a half years in the Marines,
he went back to school and began his
pursuit of a graduate degree in me­
chanical engineering at North Caro­
lina State University.
      Kuniholm enjoyed his studies, but
he missed the camaraderie of his days
in the military. So after starting a doc­
toral program in biomedical engineer­
ing at Duke University, he decided to
join the Marine Corps Reserve’s 4th
Combat Engineer Battalion. It was a
                                             Jonathan Kuniholm, left, has worked on a DARPA-funded
compromise that would have allowed           project to develop a prosthetic arm that looks, feels, per -
him to continue to serve his country         forms and is controlled like a natural limb. He tested a
while studying nanotechnology at one         modified version of Guitar Hero III developed by project en-
                                             gineers. Stuart Harshbarger, right, formerly led the project. mike mcgregor/coNtour by getty images
of the country’s finest schools.
      “Part of the reason I joined a unit   squarely in the blast zone.                        arm below the elbow. “But I was just
was seeing the Marines stepping up               The explosion was so severe that              psyched to be alive.”
and doing what we had all trained           it snapped his rifle like a twig, nearly                One of his fellow Marines wasn’t
to do. I was prepared to deploy, but        cut his right arm off and slammed his              as fortunate, dying of internal injuries.
didn’t think I’d get the warning order      body hard to the ground. Severely                  Four more would not live to see Feb­
48 hours after swearing in,” said Kuni­     wounded and under fire, he scrambled               ruary. Kuniholm was headed back to
holm.                                       out of harm’s way, where a medic ap­               the states—facing rehab and life with­
      Within a month, the unit was          plied a tourniquet, saving his life. It            out a right hand—but he was alive
called to active duty, and the captain      was New Year’s Day 2005.                           and thankful for it.
was training to deploy to Iraq with              “One of the medical officers                       For the next five months, Kuni­
his new platoon. Seven months later,        told me that if it had been Vietnam,               holm was in rehab learning how to
Kuniholm was on foot patrol not far         I would have died from the loss of                 use an array of prostheses, from the
from the Euphrates River when Iraqi         blood,” recalled Kuniholm, who                     most advanced electric hand to a
insurgents detonated a bomb with him        awoke in a hospital missing his right              prosthetic hook that hadn’t changed
14                                                  VAnguard • Winter 2009/2010
much in nearly 100 years.                      terpret these impulses and turn them               said.
     “David Dorrance’s name is on              into motion. The goal is to have a                      The reason for that, in spite of
the 1912 patent, and is stamped on             prosthesis that is controlled the same             the need, is the size of the market.
the titanium hook that I like to use,”         way as your natural arm.”                          While just about every human be­
Kuniholm said.                                       Compared to other inventions                 ing on the planet has a use for a car
     Kuniholm switched his studies             and devices, prosthetics have been                 or cell phone, there are only a small
at Duke from nanotech to prosthetic            dramatically outpaced. The telephone,              percentage of amputees, and most
arms. He was now on a mission to               the automobile and the split-hook ar­              can’t afford much. In the developed
bring prosthetics into the 21st cen­           tificial arm were all in production dur­           world, there are probably fewer than
tury. Since then he has worked on              ing the early 1900s. By 1955, the car              200,000, with less than half of those
numerous projects, including the               featured power steering, a radio, and              living in the United States.
Defense Advanced Research Projects             could be started with a key instead of                  The biggest hurdle for Kuniholm
Agency (DARPA) Revolutionizing                 turning an engine crank mounted in                 and other amputees is getting the
Prosthetics program, which has goals           the grill. The rotary-dial telephone               technology into production and af­
that recall the “Six Million Dol­              was in countless homes and one could               fordable for the user. “While the ac­
lar Man,” or Luke Skywalker’s hand             place a call from New York to Cali­                complishments of the research teams
replacement in “The Empire Strikes             fornia without a second thought. The               have been impressive, in many ways
Back.”                                         prosthetic arm, meanwhile, remained                the real challenge is figuring out how
     “When people think about pros­            basically the same.                                to get this stuff to the clinic and actu­
thetic arms, their impressions are                   Fast-forward to 2009. The tele­              ally on patients,” he said.
often guided by science fiction,” said         phone is now a “cell” that can go any­                  He has some ideas about how to
Kuniholm. “But what is actually avail­         where, make calculations, store hun­               make it happen. His plan involves
able is a lot different.”                      dreds of songs, take photos and surf               borrowing existing technology from
     Kuniholm’s participation in the           the World Wide Web. Most cars are                  bigger industries, such as robotics
project has been focused on using              available with everything but autopi­              technology employed by the defense
pattern-recognition software that              lot, and a few models even automati­               industry. Where there’s been no de­
interprets thoughts into motions. In­          cally apply the brakes when needed,                velopment of a useful technology, like
stead of an amputee having to learn            and sound an alarm if the driver starts            the myoelectric pattern recognition
how to use an artificial arm, the arm          to doze off. The prosthetic arm? Basi­             Kuniholm wants to use to control
will learn from the wearer.                    cally the same.                                    arms, he hopes to find uses in bigger
     “When I imagine moving my                       “Despite what’s possible in other            markets, such as electronic games and
right hand, muscles produce electrical         industries, and what science fiction               entertainment. Finally, he plans to
impulses that can be detected with             makes us think ought to be possible,               design the parts and software in the
electrodes,” he explained. “We are             prosthetic arms have simply been a                 open to increase innovation.
teaching the arm’s ‘computer’ to in-           wasteland for innovation,” Kuniholm                     “I could capture about a thou­
                                                                                                  sandth of the video game market and
                                                                                                  exceed the entire prosthetic arm mar­
                                                                                                  ket,” Kuniholm said. “That’s the kind
                                                                                                  of buying power I want solving my
                                                                                                  problem. And who wouldn’t want to
                                                                                                  be able to pull the trigger by moving
                                                                                                  their finger instead of pressing a but­
                                                                                                  ton in Unreal Tournament 3?”
                                                                                                       While some have been skepti­
                                                                                                  cal of his open strategy, Kuniholm
                                                                                                  has an answer. “I don’t know if this
                                                                                                  will work,” he said, “but I know that
                                                                                                  what we’ve done for the last 100 years
                                                                                                  hasn’t worked. And you wouldn’t
                                                                                                  believe the offers of help that I’ve
Using myoelectric pattern recognition to
                                                                                                  gotten. I feel like Tom Sawyer white­
control the hand and wrist of his prosthetic                                                      washing his fence.”
arm, Jonathan Kuniholm is able to crush a
soda bottle.                                              mike mcgregor/coNtour by getty images   By Gary Hicks
                                                      VAnguard • Winter 2009/2010                                                        15
    ix months ago, Sgt. Neal Brace was
    trudging across the scorching desert
    of Ramadi, Iraq. This past October,
Brace found himself hiking in the
mountains of Appalachia.
      On both occasions, the packs
were heavy, but the nature of this mis­
sion was much different. Instead of
listening for enemy fire or searching
for an IED, this small company of vet­
erans was hiking through the fall foli­
age of western North Carolina. Crows
called, and silence welcomed them on
top of a peak as they took a moment
to reflect on their ascent.
      These six Afghanistan and Iraq
veterans seized the opportunity to
attend an Outward Bound course
aimed at helping them reintegrate
into civilian life. The goals of the
Outward Bound veterans program are
to physically, mentally and emotion­
ally challenge veterans, and to build
the self-confidence, pride, trust and
communication skills they need to
successfully return to their families
and communities following wartime
      The program is funded by a grant
from the Sierra Club and Disabled
Veterans of America. The grant al­
                                                                                     Outward Bound
lows Afghanistan and Iraq veterans                                                   partners with VA to
to sign up for a free Outward Bound
course nationwide.                                                                   offer returning
      Outward Bound has its roots in
wartime. It was created in 1941 during                                               veterans a free
World War II out of a need to instill
spiritual tenacity and the will to sur-    Veteran Rhonda Burleson                   wilderness expedition.
                                           prepares for descent.                             courtesy of NortH caroliNa outWarD bouND

 Charting a Course Toward Readjustment
vive in young British seamen.              participants.                             hear their stories and tell mine,” said
     In the early 1980s, Col. Bob               The recent partnership between       participant Rhonda Burleson.
Rheault ran Outward Bound trips for        the Charles George VA Medical Cen­             Outward Bound is working to
Vietnam veterans out of a VA inpa­         ter in Asheville, N.C., and Outward       reinvigorate its connection to VA
tient post-traumatic stress disorder       Bound marks the first time in decades     facilities. The organization is currently
treatment program in Northampton,          that a custom course has served veter­    in dialogue with facilities across the
Mass. Over the last 20 years, Outward      ans enrolled in a specific VA facility.   nation to schedule custom courses for
Bound has run wilderness expeditions       “It helped so much to know that there     Afghanistan and Iraq veterans.
specifically designed for war veterans     are other people locally that have             The recent five-day wilderness
and service members at no cost to          been in Iraq and Afghanistan, and to      expedition in the Asheville area was
16                                                VAnguard • Winter 2009/2010
led by two seasoned instructors, Dave          tion, as conflicts arose between par­              ers, this course was their first exposure
Genova and Diana Belknap, with                 ticipants during challenging activities.           to the wide array of services offered by
the North Carolina Outward Bound                     On the course, veterans told each            VA for Afghanistan and Iraq veterans.
School. Outward Bound veterans pro­            other of their military experience and                  As the participants departed from
gram course instructors include many           adjustment to civilian life. “Coming               the Charles George VAMC to begin
who served in the military themselves,         home from war is so very hard and                  their course, staff met with the group,
and all instructors go through custom­         lonely,” participant Stacie Tindle said.           providing them benefits information
ized veterans training. The Asheville­         “It’s easy to hide from the rest of the            and various program materials, as well
area expedition included backpacking,          world. On this course I have been                  as suicide prevention information.
rock climbing and a high ropes course.         able to share my experiences, my pain,             Medical center leaders paved the way
     “Diversity played a role in this          with other veterans.”                              for this partnership to occur, including
being a successful course,” explained                Connecting with fellow veterans              Acting Director Dr. Mary Ann Curl,
Genova, a Vietnam-era veteran and              in the beauty of the country for which             Associate Director Walter Hitch,
30-year instructor for Outward Bound.          they served can be a meaningful expe­              Chief of Mental Health Service Dr.
“Some veterans were struggling with            rience for participants. “My transition            Carole Rivers, and Chief of Social
adjustment, others not so much. The            from military to civilian life has been            Work Service Richard Adams.
age of participants ranged from 22 to          a huge struggle,” said participant Mi­                  Trevor Ridge said participating
47, and included two women. Some               chael Seng. “This course has given me              in the course was an important part
participants returned home from Iraq           an opportunity to meet up with others              of his journey toward readjustment to
as recently as two months ago, while           on the same path.”                                 civilian life. “As a veteran returning
others have been home several years.”                This contracted Outward Bound                from an unpopular war, I have found
     Genova said they purposely cre­           course was not intended to be therapy,             it difficult to adjust to life outside of
ated a flexible course to empower              but rather an adjunct to other VA                  the military,” he explained. “This
the group to choose aspects of their           services provided. VA social work staff            course offered the best opportunity for
trip, unlike the structure of military         helped veterans enroll in the course,              us to gain a sense of belonging in this
expeditions. “We told the group, you           and provided follow-up with veterans               beautiful world.”
can decide as a group to hike the trail        post-course to assist with linkages to                  In the end, it may be on this
around to camp or bushwhack up and             VA services as needed.                             course that a veteran feels the first
over the ridge.”                                     For those already engaged in                 sprouting of insight or change. It may
     Instructors also encouraged par­          therapy, the course provided a rich ex­            be many months later, after a seed is
ticipants to practice open communica-          perience to debrief in session. For oth­           planted, that the impact is evident.
                                                                                                       “Over the period of this course,
                                                                                                  I changed in ways I didn’t think pos­
                                                                                                  sible,” said Seng.
                                                                                                       “This experience will help me get
                                                                                                  back to my pre-war self,” said Ridge.
                                                                                                  “One thing I can say about the course:
                                                                                                  It uplifted me confidence-wise. I con­
                                                                                                  quered many of my fears. More vets
                                                                                                  need to get into this.”
                                                                                                       Afghanistan and Iraq veterans
                                                                                                  interested in an Outward Bound
                                                                                                  open-enrollment course can contact
                                                                                                  admissions at (866) 820-9577 and
                                                                                                  speak to an admissions advisor. For
                                                                                                  custom contract courses like the one
                                                                                                  described here, contact Meg Ryan
                                                                                                  at Outward Bound, (866) 669-2362,
                                                                                                  extension 2374. For more information
                                                                                                  on Outward Bound programming for
                                                                                                  veterans, visit www.outwardbound.org/
Michael Seng belays a fellow veteran on a                                                         index.cfm/do/cp.veterans.
rock face while Stacie Tindle provides back-
up belay; rock site instructors stand by.              courtesy of NortH caroliNa outWarD bouND   By Hillary Bolter
                                                      VAnguard • Winter 2009/2010                                                       17
        he threat of hurricanes is a fact   Medical Center and the community-         step-by-step framework for planning,
        of life for coastal towns along     based outpatient clinics located in       developing, executing and evaluating
        the Atlantic Seaboard. All VA       Virginia Beach, Va., Morehead City,       exercises. It also provides after-action
hospitals located in high-threat areas      N.C., Jacksonville, N.C., and Wilm­       reports and improvement plans in a
are required to conduct evacuation          ington, N.C., are all close enough to     Department of Homeland Security
exercises at least annually. While          the water’s edge to make the threat of    standardized format.
some of those efforts are accomplished      hurricanes a real concern. Likewise for        On Sept.14, the fictional Hur­
in the form of table-top exercises,         the VA facilities in VISN 8 located       ricane Zulu intensified into a Category
the Veterans Health Administration          along the Florida coast.                  4 storm and was expected to impact
recently added an extra measure of re­           “Exercises like this one are vital   the coast in the coming days close to
ality to challenge its readiness by host­   to the success of our mission,” said      the border between North Carolina
ing the National Patient Movement           Daniel F. Hoffmann, VISN 6 director.      and Virginia. Simultaneously, an­
Exercise Sept 16-17.                        “Having had to evacuate the Hamp­         other hurricane was headed directly
     The purpose of the exercise was        ton VAMC during Hurricane Isabel,         toward South Florida. The leadership
to evaluate the operational readiness       we know the threat is real. This exer­    in VISNs 6 and 8 made the decision
of personnel and equipment, and the         cise allowed us to review and evaluate    to evacuate the Hampton and West
logistics required to support patient       our processes, procedures and new         Palm Beach medical centers.
movement from one VA medical                technology. Anything we can do to              Successful patient evacuation
center to others not affected by the        better our readiness and response ac­     begins with the planning efforts of
disaster. The foundation for this exer-     tions goes a long way toward ensuring     the emergency management team.

                                                                                              Exercise participants tested new
                                                                                              ambulance buses used to evacuate
                                                                                              patients during an emergency.


         National exercise
            evaluates new
           equipment and
     technology to ensure
        continuity of care
      during emergencies.                                                                                            sHeila bailey

cise was data derived from the VHA          we can and will provide continuity of     For this exercise, Boucher was lead
Emergency Management Strategic              care regardless of the challenge.”        planner for VISN 6 participation, and
Health Care Group’s analysis of Hur­             According to Mike Boucher,           Victor Ramos, VISN 8’s area emer­
ricane Katrina. This exercise looked at     emergency management director             gency manager, led the Florida team.
equipment needs for coastal evacua­         at the Durham (N.C.) VA Medi­             Both VISN exercise-planning teams
tion and became a technology test bed       cal Center, planners used the VHA         were in constant contact with Mick
for VHA.                                    Exercise Builder-Hospital product         Feeser, lead planner for VHA, during
     Participating in this exercise were    to plan the exercise. This product is     exercise development and planning.
the VA Mid-Atlantic Health Care             a VHA-sponsored, Department of            Their seven-month effort focused on
Network (VISN 6) and the VA Sun­            Energy-developed database applica­        developing a comprehensive plan
shine Healthcare Network (VISN 8).          tion that assists emergency managers      that would test every aspect of how to
For VISN 6, the Hampton (Va.) VA            and exercise planners by providing a      safely prepare, load, transport, track
18                                                 VAnguard • Winter 2009/2010
and deliver patients to VA medi­          Center and representatives from the         tem Interconnect. This fully portable,
cal centers in Richmond, Va., and         Air Force’s Air Mobility Command,           lightweight network system sets up
Durham. “EMSHG area emergency             who were evaluating these ambulance         in less than 15 minutes and provides
managers provided valuable support        buses against what the Air Force is         phone service and secure Internet
throughout the exercise development       using to shuttle patients from war          access where service has been inter­
and planning,” said Boucher. “With­       zone to medevac locations, and from         rupted, or in remote areas where there
out EMSHG, this exercise would not        aircraft to hospitals when they land in     is no infrastructure or communica­
have happened.”                           the United States.                          tions are non-existent. Iridium satel­
     According to Boucher, the scope           Successful patient transportation      lite phones were also tested.
of this exercise reached far beyond the   requires more than just getting them              “VHA will use the results of the
current emergency response capabili­      from point A to point B. Because            VISN 6 and VISN 8 evaluations to
ties by incorporating new technology      the inpatients being evacuated may          decide how to outfit the rest of the
that deals with the many shortcom­        require critical care, accurate informa­    country,” Boucher said.
ings that surfaced during Hurricane       tion must flow between the medical                The patient tracking software
Katrina. Along with the common            center being evacuated and the one          tested is a program that was developed
issue of transportation, the exercise     receiving the patient before departure      in VISN 6. This software, known as
tested a variety of communications        as well as en route.                        the VISN 6 Emergency Evacuation
gear and a software program designed           The difficulties of establishing       Application, provides continuity of
for evacuation.                           and maintaining communication links         care by letting the evacuating hospital
     Both VISNs 6 and 8 tested and        were brought to the forefront by Hur­       enter patient data and allowing the
evaluated three new ambulance buses.      ricane Katrina. “It’s typical that land     receiving hospital to have the entire
These prototype vehicles, made by         lines will be lost, and while cell towers   record of care. The Hampton VAMC
Farber Specialty Vehicles of Colum­       may survive, they can quickly become        loaded patient data into the system,
bus, Ohio, are designed to fill a dual-   overloaded,” said Boucher. “What we         keeping the Richmond and Durham
purpose role to ensure maximum cost       need is a system that will work any­        medical centers apprised of the status
benefit to VHA. When not being            time, and in any weather. That’s why        of the patients headed their way.
used as emergency evacuation tools,       we are testing a variety of systems dur­          Throughout the week, from the
safely transporting patients with the     ing this exercise.”                         first warning of the impending hur­
latest technology, the buses can be            According to Boucher, the De­          ricane exercise until the threat passed,
used for daily transportation, such as    partment of Homeland Security has           a team of VISN 6 employees stood
shuttling patients from parking areas     mandated interoperable communica­           watch in the command center, assist­
to the medical centers.                   tions, and is working with agencies         ing and monitoring the progress of the
     The buses come in three sizes—       around the country to build a nation­       evacuation through situation reports,
28, 30 and 34 feet long—and each          wide system that will allow interface       and managing the availability of beds
is designed to quickly and easily be      by local, state and federal responders.     throughout network medical facilities.
transformed from ordinary bus to          One such system used in this exercise             “It’s our job to activate the VISN
state-of-the-art patient mover. The       is North Carolina’s statewide Voice         6 Emergency Operations Plan, make
buses carry from nine to 15 litters,      Interoperability Plan for Emergency         the decision to evacuate a facility, and
and each bus has a hydraulic lift for     Responders, commonly referred to as         maintain consistent communications
wheelchairs, along with ramps that        VIPER.                                      between all of our medical facilities
allow loading and unloading from the           The Durham VAMC was the first          and VA Central Office,” said Joseph
rear. The water-cooled generator un­      VA medical center in North Carolina         Jenkins, VISN 6 command center di­
der the bus powers the redundant air      to get the system. And according to         rector for this exercise.
conditioning units and provides 120­      Boucher, it lets him speak with virtu­            “This exercise went extremely
and 240-volt power along the interior     ally all state and local responders and     well,” said Rick Rhodes, VISN 6 area
walls of the bus, which allows provid­    has a range that allows communica­          emergency manager. “We had the op­
ers to use many of the monitors and       tion anywhere within the state. Dur­        portunity to evaluate a good deal of
cardiac care response tools used by Air   ing the exercise, he used a hand-held       technology, which should help VHA
Force evacuation squadrons.               VIPER radio to communicate directly         decide how they want to equip medi­
     More than 35 volunteers from         with the Durham VAMC from be­               cal centers nationwide. We’re glad to
around VISN 6 participated as “pa­        yond the Virginia border, more than         have had the opportunity to partici­
tients” and evaluators. Also evaluating   70 miles away.                              pate.”
the equipment were emergency re­               Another communication system
sponse coordinators for Duke Trauma       being tested is the F4W Portable Sys­       By Bruce Sprecher
                                                 VAnguard • Winter 2009/2010                                                19
                                                                               VA polytrauma team’s
                                                                               overseas visit furthers
                                                                               collaboration with
                                                                               Department of Defense
                                                                               medical system.

                                                                                    The Army’s Landstuhl Regional Medical
                                                                                    Center is the first stop for severely wounded
                                                                                    troops from Afghanistan and Iraq before be-
                                                                                    ing sent stateside for further medical care.
                                                                                                                       u.s. air force

             Better Care for
            Wounded Warriors
           hen troops are severely wounded on the battlefield in Afghanistan or Iraq,
           they are taken to Landstuhl Regional Medical Center in Germany, where
           the Army’s medical treatment teams perform emergency operations for a
wide range of acute wounds, including severely damaged or severed limbs, traumatic
brain injuries, paralysis, major burns, or combinations of these severe injuries.
     The acutely wounded service          Landstuhl, the medical team there         experienced before arriving at VA.
members are usually at Landstuhl for      rarely hears what happens to their             Until now.
less than a week before they are trans-   former patient. And medical and re-            A four-day visit to Landstuhl in
ferred to the United States, where        habilitation teams at VA receive little   October by a team of two doctors and
they will be sent to another military     information about wounded warrior         two nurses from VA’s polytrauma
treatment facility or to one of VA’s      transport, the full extent of the acute   system of care has led to a regular
polytrauma rehabilitation centers.        care process the service member has       exhange of information between
     Once a service member leaves         undergone, or stress the patient has      medical teams in the military and
20                                               VAnguard • Winter 2009/2010
VA. These exchanges provide a better      of severely wounded service members        communication and research between
understanding of what service mem­        onto a bus for the 15-minute trip to       the military and VA. Finally, VA staff
bers experience from the time they are    Landstuhl.                                 visited the aerovac staging area at
wounded on the battlefield to being            “I was really impressed with the      Ramstein, where service members are
sent through a series of patient hand­    quality of care being provided in a        prepared for their flight back to the
offs from medical teams in the field to   very hectic, chaotic environment,”         United States.
Landstuhl and then to VA.                 said Nina Pagel, R.N., polytrauma               “I was particularly impressed
     Following the team’s visit, vid­     nurse manager at the Minneapolis VA        with the bravery and resilience of
eoconferences began taking place be­      Medical Center. “Every branch of the       the service members, as well as the
tween Landstuhl and VA polytrauma         military meets their patients curbside     professionalism and dedication of the
staff, including Joint Theatre Trauma     (at Ramstein), triaging them right         doctors, nurses and therapists who are
Surgeon colleagues, and Webinars          there.”                                    caring for the severely wounded,” said
have been held on “Spinal Cord                 While at Landstuhl, each VA           Brenda Stidham, R.N., who serves as
Injuries in Combat Casualties” and        team member met and shared infor­          VA’s polytrauma nurse liaison at Wal­
“Severe Traumatic Brain Injuries in       mation with a broad segment of mili­       ter Reed Army Medical Center.
Combat Casualties.” These videocon­       tary medical staff, including the base          At the conclusion of their trip,
ferences and Webinars will now occur      commander, trauma surgeons, pulmo­         the VA team went back to Ramstein
on a more frequent basis.                 nary physicians, neurologists, trauma      for transport to the United States,
     In addition, the Landstuhl Clini­    nursing directors, psychologists, thera­   where they observed the transfer of
cal Informatics Department is explor­     pists, intensive care unit attendants,     patients and then flew with the pa­
ing use of a tool developed by DoD        medical professionals and professionals    tients and their families on the same
and VA nurses for Walter Reed Army        in charge of data collection. The VA       return flight.
Medical Center, National Naval            team visited the program that houses            “It helps to observe in person the
Medical Center and VA polytrauma
rehabilitation centers. This tool will    “Now, I can pick up the phone and exchange 

standardize the nursing handoff of
patients along the continuum of care.     critical information about the patient with the

If implemented at Landstuhl, it will      providers at Landstuhl.”
provide clinical data for DoD-VA per­
formance improvement initiatives.         ambulatory patients, and shared in­        clinical and patient exchange taking
     “The teams communicated and          formation about the trauma process,        place and to understand the physical
collaborated on the continuum of care     clinical data and rehabilitation inter­    environment the patient has been in
from the point of stabilizing severely    vention.                                   before he reaches us,” said Dr. Ted
wounded service members through                “This enables us to develop ways      Scott, staff physiatrist for the polytrau­
the acute rehabilitation provided by      to track patients from the beginning       ma rehabilitation center at the Palo
VA’s polytrauma system of care,” said     and identify complications, with the       Alto VA Medical Center. “It is good
Dr. Lucille Beck, chief consultant for    idea of performance improvement,”          for us to be able to observe the inten­
the Department’s Office of Rehabili­      said Dr. Steven Scott, who serves as       sive care unit to see what specialists
tation Services, which oversees the       chief of Physical Medicine and Reha-       they have, and be able to exchange
polytrauma system of care. “The visit     bilitation/Polytrauma at the James A.      ideas with them.”
was important in enabling VA and          Haley Veterans’ Hospital in Tampa.              On the flight back to Andrews
Landstuhl medical staff to exchange       “This will establish a continuum of        Air Force Base in Washington, D.C.,
information regarding wounded war­        care that is not solely DoD or VA,         members of the VA team interacted
rior transport and care transition, and   and will help us develop one system of     with some patients and family mem­
to develop a better understanding of      care that benefits our patients.”          bers, gaining valuable insights into
the acute care process.”                       The team delivered a grand            what they have been through before
     Each member of the VA team           rounds presentation on the VA poly-        they are sent to a polytrauma rehabili­
represented a different role in the       trauma system of care for Landstuhl        tation center.
continuum of care and came from           staff. They visited the facility’s Medi­        “Patients often arrive exhausted,
different medical facilities in the       cal Transient Detachment and trau­         and after experiencing delays in
VA polytrauma system of care. They        matic brain injury programs, holding       travel,” said Dr. Ted Scott. “It is very
landed Oct. 12 at Ramstein Air Base,      discussions with staff about patient       helpful for us to be able to understand
where they observed military medical      data collection and the documenta­         what they have been through before
teams as they worked on the transfer      tion process, with a focus on efficient    they reach us.”
                                                 VAnguard • Winter 2009/2010                                                 21
                                                                                                       Left: Wounded troops arrive
                                                                                                       at Ramstein Air Base and are
                                                                                                       transferred onto a bus for the
                                                                                                       15-minute trip to Landstuhl;
                                                                                                       below: Members of the VA
                                                                                                       team who made the trip to
                                                                                                       Landstuhl were (left to right):
                                                                                                       Dr. Steven Scott; Dr. Ted Scott;
                                                                                                       Nina Pagel, R.N.; and Brenda
                                                                                                       Stidham, R.N.

                                                                                      u.s. air force

     “We’re still learning what the
stressors are for the families,” added
Dr. Steven Scott.
     The genesis for the VA team’s
trip to Landstuhl was an earlier visit
in April by Dr. Shane McNamee,
director of the polytrauma rehabilita­
tion center at the Hunter Holmes
McGuire VA Medical Center in
Richmond, Va. As the VA-DoD in­
tegration team examined transition
issues for service members from the
military to VA, they recognized that
exchanging information about trans­
port and care transition for severely
wounded service members would help
VA develop a better understanding of
the acute care process. The approach
was supported by then Under Secre­
                                                                                                                  courtesy of Dr. teD scott
tary for Health Dr. Michael Kussman,
and retired Gen. Ron Winter, former        critical care team for transport, to the   better communicate with each other
member of the VA-DoD integration           surgical team at the medical facilities    whenever they need to.
team, who helped get DoD support.          where they are sent.                            “The key is the relationships with
     Citing the significant potential           “There is a remarkable level of       the providers,” McNamee said. “Now,
for errors, McNamee noted that             coordination and communication tak­        I can pick up the phone and exchange
he was impressed with the efficient        ing place along the trauma continuum       critical information about the patient
transfer of severely wounded patients      of care,” McNamee said.                    with the providers at Landstuhl. It
from one area to another. A severely            Across both VA staff visits to        will help us provide better care for the
wounded service member will be             Landstuhl, all team members agreed         recovery of the patient—and that’s
transferred from a field medical team      that the most important aspect of          the most important thing about the
to the acute surgical team in the field,   the trips was the personal connec­         exchange of information.”
to the critical care air transport team,   tions that were made between DoD
to the Landstuhl medical team, to the      and VA specialists to enable them to       By Bill Outlaw
22                                                VAnguard • Winter 2009/2010
The Unbreakable Code
                                                                                                                       Keith Little is
                                                                                                                       president of
                                                                                                                       the Navajo
                                                                                                                       Code Talkers

                                                                         courtesy of NaVajo coDe talkers associatioN

                       Navajo warriors are seeking support for a museum
                       that would preserve their legacy and recognize their
                       unique contribution to the nation.

                                ommunicating. Sending and receiving messages. It’s something we do every day. It’s
                                part of being human. It’s also at the heart of military operations and essential to suc­
                                cess in combat. Protecting these messages is equally important.
                            Enter the use of codes. Encrypting, or using codes to hide or protect messages, has been
                       around since the Egyptian pharaohs in 1900 B.C. One of the most effective codes ever used
                       and the only military code never broken was developed by young Navajo warriors using
                       their ancient tribal language.
                            Considered “hidden” because it had no alphabet or written form, the Navajo language
                       was well-suited to meet the security requirements of military communications. At least, that
                       was the belief of Philip Johnston, the son of a missionary to the Navajo.
                            Johnston suggested the use of the Navajo language for military voice and wire commu­
                       nications to Marine Corps Maj. Gen. Clayton B. Vogel, commanding general of the Am­
                       phibious Corps for the Pacific fleet.
                            With the help of four Navajos living in nearby Los Angeles and another on active duty
                       in San Diego, Johnston set up a test that demonstrated the speed and accuracy of using the
                       Navajo language for coded messages. In later tests under combat conditions, Navajo Code
                       Talkers proved their ability to translate a classified message into Navajo, transmit, receive
                       and decode the message back into English faster than the conventional cryptographic facili­
                       ties and techniques.
                                           VAnguard • Winter 2009/2010                                                               23
     Navajo Code Talker Bill To­           were learning the code with the com­       Talkers were on hand for the unveil­
ledo, who saw action at Iwo Jima and       puter we were born with,” explained        ing and dedication of a special exhibit
Bougainville, recalled being asked to      Code Talker Frank Willetto.                of photographs, equipment and the
retrieve a classified message that had           Initial skepticism about their       original code, which were put on per­
frustrated the radioman for two hours.     value by field commanders quickly          manent display. The exhibit is a regu­
Toledo called a fellow Code Talker at      evaporated as time and again the Na­       lar stop on the Pentagon tour.
the source and “translated the message     vajo Code Talkers assigned to their             Now that their story can be told,
in five minutes.”                          units proved instrumental in success­      a new effort to share their military his­
     The Marine Corps’ Navajo Code         fully executing their missions.            tory and cultural values of service with
Talker program began in September                Navajo Code Talkers, who num­        future generations is underway.
1942 with the recruitment of 200           bered more than 400 by war’s end,               With an understandable sense
Navajos to be trained and assigned         took part in every marine assault from     of urgency, four of approximately 40
as Code Talkers to Marine units            1942 to 1945, including Guadalcanal,       remaining Navajo Code Talkers came
throughout the Pacific theater.            Tarawa, Peleliu and Iwo Jima.              to Washington, D.C., in October to
     Like other Marines, Navajo                  At Iwo Jima, Maj. Howard Con­        meet with administration and con­
recruits completed basic boot camp         ner, signal officer for the 5th Marine     gressional representatives to obtain
training at Marine Corps Recruit           Division, gave his unequivocal en­         support for a Navajo Code Talkers
Depot San Diego before receiving           dorsement, reporting, “Were it not         Museum and Veterans Resource Cen­
their specialized training at Camp         for the Navajos, the Marines would         ter being planned near their reserva­
Elliott, Calif. They were also taught      never have taken Iwo Jima.” Six Na­        tion outside Gallup, N.M.
basic communications procedures and        vajo Code Talkers worked around the             They also visited the National
equipment at Camp Pendleton, Calif.        clock for the first two days of the bat­   Museum of the Marine Corps in
     The first 29 Navajo Code Talkers      tle, sending and receiving more than       Quantico, Va., not only as Marine
had the added responsibility of assign­    800 messages—all without error.            Corps veterans, but to get ideas on
ing words from their language to stand           Although their primary mission       how best to tell their own story in a
for certain military terms and equip­      was to “talk,” transmitting vital op­      museum setting. The Marine Corps
ment for which there was no Navajo         erational information from command         museum has its own Code Talker ex­
equivalent. Some examples: “besh-lo”       elements to the field and back, the        hibit.
(iron fish) meant “submarine”; “dah­       men in their units found the Navajos            Keith Little, president of the
he-tih-hi” (hummingbird) meant             were also good Marines and could do        Navajo Code Talkers Association,
“fighter plane”; and “chay-da-gahi”        their share of fighting and other Ma­      explained his motivation to serve: “I
(tortoise) meant “tank.”                   rine duties.                               wanted to protect my people, my land
     Many terms and names simply                 Concern that the darker-skinned      and my country.”
had to be spelled out, and for that        Navajos might be mistaken for Japa­             Once punished for speaking their
they devised a system whereby a Code       nese soldiers was borne out in more        native language, the Navajos have
Talker would translate a Navajo word       than a few instances; several Code         witnessed an evolution of perceptions
into its English equivalent, and then      Talkers were taken “prisoner” by           and attitudes toward their unique cul­
use only the first letter of the English   their own forces, only to be released      ture, preserved by that same language.
word to spell out the message. To add      upon validated identification from         Their experience provides clear evi­
another layer of security and confound     their commander. Thereafter, some          dence of the individual, community
the enemy, several Navajo alterna­         commanders assigned bodyguards to          and national enrichment possible
tives were used for each of the most       accompany the Navajos during the           when diversity is embraced from a
commonly used letters in English.          remainder of their assignment.             sense of awareness, acceptance and
Thus, the Navajo words for “ant,”                The continued value placed upon      appreciation.
“apple” and “axe” all represented the      the effectiveness of the Navajo-based           It’s all about communicating.
letter “a.”                                code by the military kept acknowl­
     To compound the difficulty for        edgement of and recognition for the        By Jim Benson
the Japanese, who had a well-earned        Code Talkers as hidden as their lan­
reputation for their code-breaking         guage.                                      Want to Know More?
skills, the Code Talkers had to memo­            Finally, in a Pentagon ceremony       to learn more about the Navajo 

rize the entire code with all its vari­    held on Sept. 17, 1992, the Navajo          code talkers and their quest for

ables, as no printed documents about       Code Talkers were honored for their         a museum, visit their Web site at 

the code were sent into combat.            contributions during World War II.          www.navajocodetalkers.org.
     “We had no pads or pencils. We        Thirty-five of the remaining Code
24                                                VAnguard • Winter 2009/2010
Veterans Day 2009

                                                                                          bryaN HoPkiNs

           cHarles brosHous

                                                                                         micHelle coVert

              aNgela taylor

                                                                                        berNt e. joHNsoN

                               Clockwise from bottom left: Joe Lacey said he’d never forget his
                               visit with Miss America 2009 Katie Stam at the Baltimore VA Medi-
                               cal Center; Indianapolis Colts players (left to right) Taj Smith, Eric
                               Foster and Hank Baskett visited patients, including Nathan Florey,
                               at the Richard L. Roudebush VA Medical Center; Rifle salute at the
                               Fort Logan (Colo.) National Cemetery Veterans Day ceremony;
                               California Gov. Arnold Schwarzenegger joined American Legion
                               Commander John Johansen, of Palisades Post 283, to lay a wreath
                               at Los Angeles National Cemetery; The Chalmers P. Wylie VA Am-
                               bulatory Care Center joined city, county and state offices to bring
                               the annual Veterans Day Parade to the city of Columbus, Ohio; The
                               Booker T. Washington High School Marching Band participated in
                               the 60th annual Veterans Day parade on the Tuskegee campus of
                               the Central Alabama Veterans Health Care System.
               keNya griffiN

            VAnguard • Winter 2009/2010                                                              25

Bay Pines, Louisville Facilities Take Trophy in 2009 Carey Awards 

The Bay Pines (Fla.) VA             tional Cemetery, VA Sunshine          position was created to work       Albuquerque, N.M.;

Healthcare System and the           Healthcare Network Office             closely with returning soldiers    n Minneapolis VA Medical 

Louisville (Ky.) VA Medi­           (VISN 8), and other VA and            through the Warrior Transi­        Center; and 

cal Center were awarded the         non-VA tenant organizations.          tion Unit at Fort Knox. The        n White River Junction (Vt.) 

prestigious 2009 Robert W.                 The health care system         Louisville VAMC has progres­       VA Medical Center.

Carey Performance Excellence        also includes a large outpatient      sively moved up the Carey          Performance Excellence
Awards Trophy during a cer­         clinic in Fort Myers and seven        awards ladder, earning the Per­    Winners
emony in Washington, D.C.,          community-based outpatient            formance Achievement Award         n Central Arkansas Veterans
on Oct. 30.                         clinics. Bay Pines provides a         in 2007 and the Performance        Healthcare System, Little
      The Carey awards are pre­     full continuum of veteran-cen­        Excellence Award in 2008.          Rock;
sented annually to recognize        tered care, and has sustained               The Carey program fol­       n James A. Haley Veterans’
VA organizations that have          the highest performance levels        lows the Malcolm Baldrige          Hospital and Clinics, Tampa;
demonstrated noteworthy lev­        among complex VA medical              National Quality Award crite­      and
els of performance excellence       centers while caring for more         ria. It provides a model against   n South Texas Veterans
in seven areas: leadership; stra­   than 93,000 patients with             which organizations can assess     Health Care System, San An­
tegic planning; customer and        more than 1.1 million outpa­          their quality transformation       tonio.
market focus; measurement,          tient visits annually.                efforts, organizational effec­
analysis and knowledge man­               Bay Pines received the          tiveness and performance in
agement; workforce resource         Carey Performance Excellence          delivering service and satisfy­
focus; process management;          Award in 2008.                        ing customers.
and results. The Trophy is the            The Louisville VA Medi­               There are four catego­
highest award given.                cal Center provides care to           ries of awards: Performance
      “We know that the Carey       41,000 veterans in a 35-county        Achievement awards are
program is not about winning        area in north central Kentucky        given to applicants that score
a trophy. It’s about striving to    and southern Indiana. Louis­          340-429 points; Performance
continuously improve service        ville VAMC is a tertiary care         Excellence awards are given
to veterans by giving your­         facility classified as Clinical Re­   to applicants that score more
selves an honest assessment,        ferral Level 2, and operates six      than 430 points; Trophy
understanding your strengths        CBOCs in Kentucky and two             awards are selected by the
and pursuing opportunities for      in Indiana.                           Secretary from applicants
improvement,” said VA Dep­                Through its 54 affiliations     meeting Performance Excel­
uty Secretary W. Scott Gould        with colleges and universities,       lence requirements; Circle of
during the awards ceremony.         including the University of           Excellence awards are given to
“It’s about being the best at       Louisville School of Medicine,        recent Trophy winners that are
providing veterans with the         the Louisville VAMC trains            not yet eligible to compete due
highest-quality products and        more than 750 university resi­        to a five-year waiting period
services that meet their needs      dents and students annually.          after winning the Trophy.
and expectations.”                  Training opportunities include        Thresholds for Circle of Excel­
                                                                                                             emersoN saNDers
      Bay Pines is a unique         nursing, dentistry, pharmacy,         lence are higher than Trophy.
health care system with a 76­       social work, psychology, radiol­      For 2009, the minimum re­          The Bay Pines VA Healthcare System re­
year history of serving veterans.   ogy, audiology, pastoral care         quirements were 450 overall        ceived top honors in the Carey awards, along
                                                                                                             with the Louisville (Ky.) VA Medical Center.
The historic 330-acre campus        and health care administration.       score with all item scores at 30
includes a top-level acute care           The medical center also         percent or higher.                 Performance Achievement
hospital offering a full range      provides support to the Soldier             The awards program is        Winners
of medical, surgical and acute      Readiness clinic located at Fort      dedicated to the memory of         n Camp Nelson National
psychiatric inpatient and out­      Knox. This clinic is respon­          the late director of the Phila­    Cemetery, Nicholasville, Ky.;
patient care, community living      sible for the mobilization and        delphia VA Regional Office         n Central Texas Veterans
center, domiciliary, and resi­      demobilization of active duty         and Insurance Center, who          Health Care System, Temple;
dential rehabilitation treatment    troops for Operation Endur­           was known as a quality leader      n VA Maryland Health Care
programs such as military sexu­     ing Freedom/Operation Iraqi           and champion for excellence        System, Baltimore;
al trauma and stress treatment,     Freedom and serves as the             in the federal government.         n Veterans Health Care Sys­
with a total of 414 operating       primary care site for all medi­       Circle of Excellence Winners       tem of the Ozarks, Fayette­
beds. In addition, the campus       cal hold soldiers at Fort Knox.       n Cooperative Studies Pro­         ville, Ark.; and
includes the St. Petersburg VA      To ensure seamless transition         gram, Clinical Research Phar­      n Washington (D.C.) VA
Regional Office, Bay Pines Na­      in 2009, a military liaison           macy Coordinating Center,          Medical Center.
26                                                      VAnguard • Winter 2009/2010
                                                                                                    AROUND HEADQUARTERS

Government-wide Veterans Employment Initiative Launched

On Nov. 9, President Obama            nel Management to share les­       and OPM on establishing a           up their own programs.
signed an executive order             sons learned and best practices coordinated government-wide                  “The Veterans Employ­
launching the government-             to help set the tone for the       effort to increase the number       ment Initiative in a sense re­
wide Veterans Employment              new initiative and help other      of veterans employed by the         quires other federal agencies to
Initiative, designed to increase federal agencies hire more              federal government; serving         follow the VECS model,” said
the number of veterans in the         veterans.                          as a national forum for pro­        May. “They are now required
federal workforce. The initia­             “It’s great to be at the      moting veterans employment          to have a Veterans Employ­
tive stresses the importance of       front of this initiative, and      opportunities in the executive      ment Program office with peo­
recruiting and training veter­        we’ve understood the impor­        branch; and establishing per­       ple dedicated to hiring veter­
ans and helping them adjust           tance for a long time,” said       formance measures to assess         ans and helping them navigate
to government service as a            VECS Director Dennis May.          the effectiveness of the Veter­     the application process, just
civilian.                             “President Obama’s initiative      ans Employment Initiative and like we have been doing.”
      “Honoring our sacred            highlights the importance and submit an annual report to the                 In addition to May,
trust with America’s veterans         significance of what we’ve         President.                          VECS employs nine regional
means doing all we can to help been doing and serves to rein­                  “The federal government       veterans employment coor­
them find work when they              force our commitment to our        has collected veteran hiring        dinators strategically located
come home so they never feel          nation’s veterans.”                data for a very long time,” said across the country who work
as if the American                                                                                                    collaboratively with
Dream they fought to                                                                                                  warrior transition
defend is out of reach                                                                                                units, transition cen­
for them and their                                                                                                    ters, veterans service
families,” said Obama.                                                                                                organizations, VA’s
      “But this initia­                                                                                               Vocational Rehabilita­
tive is about more                                                                                                    tion and Employment
than repaying our debt                                                                                                Service, and other
for their courageous                                                                                                  veteran stakeholders
service and selfless                                                                                                  to promote VA career
sacrifice. It’s also about                                                                                            opportunities in the
continuing to fill the                                                                                                veteran community.
ranks of federal em­                                                                                                        Human resource
ployees with men and                                                                                                  offices VA-wide were
women who possess                                                                                                     also asked to designate
the skills, dedication                                                                                                an HR specialist as
and sense of duty that                                                                                                their local veterans
Americans deserve                                                                                                     employment coordina­
from their public           robert turtil                                                                             tor to help guide local
servants. And few           VA Deputy Secretary W. Scott Gould discusses the Department’s initiative to hire more     efforts to attract and
embody those quali­         veterans, now serving as a model for other federal agencies.                              recruit veteran appli­
ties like our nation’s                                                                                                cants for employment
veterans.”                                 VA Secretary Eric K.          May. “The difference now is         in VA’s workforce.
      It’s no secret that VA is       Shinseki recently released         that data will be submitted                “VA believes that all
dedicated to hiring veterans— a memo highlighting VA’s                   to the President and agen­          veterans deserve an opportu­
no other federal agency outside obligation to set the standard           cies will be scored on their        nity to successfully enter the
of the Department of Defense for all federal agencies when               performance. That kind of vis­      workforce and lead produc­
employs more veterans than            it comes to hiring veterans.       ibility and attention will have     tive lives after service to our
VA. As a matter of fact, VA           The Veterans Employment            a dramatic impact on hiring         nation,” said May. “Through
has a long history of commit­         Initiative establishes an inter­   veterans.”                          the VECS initiative and by
ting to hire veterans and in          agency Council on Veterans               Since the signing of the      helping to ensure that manag­
2008 created the Veterans Em­ Employment that is co-chaired Veterans Employment Initia­                      ers and supervisors throughout
ployment Coordination Ser­            by the secretaries of Labor and tive, VECS has received a great VA are better aware of special
vice with the goal of increasing Veterans Affairs. The OPM               deal of attention while serving hiring authorities that help
its veteran employee popula­          director serves as vice chair of   as the benchmark for the pro­       bring veterans into our work­
tion from 30 to 33 percent.           the council.                       gram. According to May, four force, VA will continue to
      In June, VECS was con­               The council is charged        other federal agencies have         open the doors of opportunity
tacted by the Office of Person­       with: advising the President       asked for VA’s help in setting      for veterans.”
                                                        VAnguard • Winter 2009/2010                                                        27

Defense Finance and Accounting Service Now VA’s Payroll Provider

                                     secretary for Financial Busi­      board as the execution and          two could communicate and
                                     ness Operations, who oversaw       implementation phase of the         transfer the records. The trans­
                                     the migration. “In our Site        $37 million project was rap­        fers were made in five separate
                                     5 migration, which involved        idly approaching. “He was           groups. The first was made up
                                     70,000 records, we only had        able to get everyone working        of three VISNs and 32,700
                                     17 rejected transactions. That     together with a clear focus and     people. After that first success­
                                     is amazing.”                       realistic goals in a short period   ful migration, the following
                                           As the federal govern­       of time,” said Peña.                four increased in number with
                                     ment’s second-largest agency             Coles immediately fo­         each migration, ending with
                                     behind the Department of De­       cused on the technical work         Site 5’s 70,000 payroll records.
                                     fense, VA’s massive migration      to transfer the nearly 300,000            In the end, it took the co­
                                     of records from one system to      pay records from VA to DFAS         ordination and cooperation of
                                     another makes for a notewor­       and between two different sys­      VA Central Office, the three
                                     thy accomplishment. The fact       tems that couldn’t even com­        administrations, IT developers,
                     robert turtil   that very few employees even       municate.                           the Financial Services Center,
Linda Peña oversaw the payroll       saw a hiccup in their pay is at­         To bring it all together,     Quality Assurance, DFAS,
migration project.                   tributable to the superb project   VA first had to clean up the        payroll staff in the field, Hu­
                                     management practices VA fol­       data in PAID to make sure all       man Resources offices and
For most of the nearly               lowed in this effort.              of the records were correct,        contractors to implement and
300,000 people employed                    “The successful comple­      and then define specific pay        complete one of VA’s major
by VA, Sept. 15 was just             tion of an initiative of this      requirements to DFAS. Unlike        IT initiatives.
another day, but for VA’s Fi­        magnitude does not just hap­       most federal agencies, VA em­             “The whole project ended
nancial Business Operations,         pen,” said Peña. “It required a    ploys a large number of Title       up being as seamless as pos­
it marked the completion of          tremendous amount of plan­         38 workers, such as doctors         sible,” said Peña. “And amaz­
a major project that affected        ning, defining accurate systems    and nurses. Title 38 employees      ingly enough, nothing made
every single person that earns       requirements, and flawless         do not have linear pay scales       it to the senior level no matter
a paycheck from the Depart­          systems modifications to make      like those of general schedule      how complex the problem.
ment.                                it happen.                         employees, and have some of         That is a direct reflection of
     On that third Tuesday                 “The real key to the suc­    the most complex time and at­       how well Roy and the staff
in September, the last of VA’s       cess of this project was Roy       tendance rules and regulations      performed—tackling issues
employees were transferred           Coles, who pulled the whole        in the federal government.          before they became problems
from the 40-year-old legacy          project together and kept us all         “The staff’s ability to de­   and never losing sight of the
system PAID to the Defense           on track,” she continued. “Roy     velop and define crystal-clear      goals.”
Finance and Accounting Ser­          is the ‘Great Collaborator.’ He    requirements, and especially              In 2003, VA was directed
vice (DFAS) payroll system.          kept everyone informed and         those of Title 38 employees,        by the Office of Management
     “This is one of the first       totally involved in the project.   was critical and paved the way      and Budget to move payroll
major IT initiatives to be           If we had questions, we could      for DFAS to accurately modify       processing to DFAS, which
successfully completed in a          go to anyone on the staff and      its system to ensure employees      uses the Defense Civilian Pay
long time, and to have these         get an answer. He kept every­      received their proper pay,” said    System to process and execute
conversions from one payroll         one focused on the goals.”         Peña.                               pay transactions. The system
system to another occur with               Coles, who assumed du­             Once the requirements         has received numerous awards
very few problems is really          ties as director of HR/Systems     were laid out, both VA and          and certifications, and remains
incredible,” said Linda Peña,        and ePayroll for the office in     DFAS had to modify their            a state-of-the-art example of
VA’s associate deputy assistant      November 2007, came on­            respective IT systems so the        pay technology.

Senior Executives Meet to Lay the Groundwork for Transformation

More than 100 of VA’s senior         but also to lay the ground         rate Senior Executive Manage­       rounded senior executives.
executives met in Washington,        work for Secretary Eric K.         ment Office, covers traditional          Secretary Shinseki opened
D.C., Nov. 4-6 for the first of      Shinseki’s plan to transform       leadership topics such as per­      the forum with an hour-long
four training sessions designed      VA into a 21st-century orga­       sonnel management, strategic        “Dialogue on Leadership,” in
to not only bring newly ap­          nization.                          planning, public relations,         which he shared a number of
pointed senior executives up to           The four-part program,        ethical leadership and other        personal lessons learned dur­
speed and promote leadership,        organized through the Corpo­       skills necessary to develop well-   ing his 38 years of military
28                                                      VAnguard • Winter 2009/2010
                                                                                                       AROUND HEADQUARTERS

service, as well as his views on    tion on the transformation of       objectives for the Department           and retaining great people.”
the leadership qualities needed VA was just a small portion of that are the collective respon­                       Gould also outlined 13
in an organization. He empha­       the SES training, the topics he sibility of the Department as a major initiatives that represent
sized qualities that make up a      covered formed an outline ex­       whole.”                                 the areas of utmost importance
“competent organization”:           plaining the Secretary’s vision           The three integrated ob­          to VA: eliminating veteran
n People operate outside their and priorities for VA:                   jectives are what VA will do            homelessness; eliminating
narrow lanes for the benefit of n Improve the quality and               to accomplish the goals: make           claims backlogs; automating
the entire organization and the accessibility of health care,           it easier for veterans and their        GI Bill claims benefits; imple­
mission;                            benefits and memorial services families to receive the right                menting a Virtual Lifetime
n There is trust and confi­         while optimizing value;             benefits and meet their expec­          Electronic Record; improving
dence;                              n Increase veteran client satis­    tations for quality, timeliness         mental health services; devel­
n Teamwork is valued; and           faction with health, education, and responsiveness; educate                 oping seamless communication
n People are provided the           training, counseling, financial     and empower veterans and                with veterans; designing a vet­
proper training to ensure suc­      and burial benefits and ser­        their families through proac­           eran-centric health care model;
cess.                               vices;                              tive outreach and effective ad­         expanding health care access
      While Secretary Shinseki      n Raise readiness to provide        vocacy; and build VA’s inter­           to women and rural veterans;
focused on leadership, Deputy services and protect people               nal capacity to serve veterans,         ensuring readiness in cases of
Secretary W. Scott Gould laid and assets continuously and in their families, employees and                      national emergency; measuring
out much of VA’s strate­                                                                                              performance to ensure
gic plan and some of the                                                                                              consistent improvement
challenges of transform­                                                                                              and efficiency; establish­
ing VA.                                                                                                               ing strong management
      “Our mission is to                                                                                              infrastructure; developing
serve veterans, but today,                                                                                            and improving employees
we face new challenges,                                                                                               with mission-essential
and to meet them we                                                                                                   skills; and conducting
must be ready and willing                                                                                             research and development
to collaborate with one                                                                                               to enhance the long-term
another in new and dif­                                                                                               health and well-being of
ferent ways,” said Gould.                                                                                             veterans.
“People at VA speak one                                                                                                     “These initiatives
of three languages: the                                                                                               represent the priorities of
language of medicine; the                                                                                             the entire organization in
language of business; and                                                                                             creating better outcomes
the language of govern­                                                                                               for veterans immediately
ment. As leaders here at                                                                                              and into the future,” said
VA, most of you speak                                                                               Priscilla kates
                                                                                                                      Gould. “Although they
one of those languages                                                                                                may in some cases be led
very well. President           VA Deputy Secretary W. Scott Gould talks with Wanda Mims, director of the VA 
         by a specific organiza­
Obama and Secretary            Caribbean Healthcare System, at the SES Orientation and Leadership Forum. 
            tion, they all will require
Shinseki have charged us with       times of crisis; and                other stakeholders efficiently          the collaboration and support
transforming the Department         n Improve internal customer         and effectively.                        of the entire Department to
to capture opportunities and        satisfaction with management              Promoting an increased            achieve success.”
to meet the emerging chal­          systems and support services to understanding of VA’s stra­                      Three more SES training
lenges of the 21st century.         achieve mission performance         tegic goals, objectives, strate­        sessions are planned for the
      “This transformation will and make VA an employer of              gies and guiding principles to          coming year. They will include
require learning the other VA       choice by investing in human        senior executives helps prepare traditional leadership training
languages you don’t speak and capital.                                  the organization by ensuring            as well as further guidance
adapting to new realities, lever­         “Our plan for achieving       everyone is on the same sheet           on transforming VA into a
aging new technologies, and         these goals calls for a Depart-     of music.                               more veteran-centric, results-
proactively serving a diverse       ment-wide effort, harnessing              “We must commit our­              oriented and forward-looking
range of veteran needs. We          all of our talent to focus on       selves to investing in the re­          organization better equipped
must do so in a manner that         the needs, expectations and ex­ newal of our internal capabili­             to adapt and serve the veterans
is consistent with our guiding      periences of veterans and their ties and building a foundation of today and those of tomor­
principles of being people-         families, while maximizing          for future innovation,” Gould           row. For more information
centric, results-driven and         efficiency and value,” Gould        said. “Together, we will build          about the SES Orientation and
forward-looking.”                   said. “To do this, we have          a first-rate Department, com­           Leadership Forums, contact
      While Gould’s presenta­       committed to three integrated mitted to attracting, deploying Valman.Cummins@va.gov.
                                                         VAnguard • Winter 2009/2010                                                          29

Sharon Batala
To the Hopi Indians, the           Navajo veterans, Batala often
Grand Canyon is a sacred spot      finds “they know they have
believed to be the source of       benefits, but they don’t know
their origins. For VA Read­        how to start the process. I
justment Counseling Service’s      help them with their paper­
Sharon Batala, a Hopi her­         work, the follow-up, and so
self, the Canyon is not only       forth. I’m different from other
sacred—it’s also a unique place    counselors. Since I speak the
where she delivers assistance to   language, I can act as the go-
the area’s veterans.               between for them and the
      Every other month, Bata­     VA.”
la, who works on the Hopi                One of the difficulties
Nation reservation, is flown       Batala faces in such a rural
in by helicopter to reach the      area is distance. She spends
elderly and disabled veterans      much of her time on the road,                                                                  art batala
who live deep in the Canyon.       frequently logging more than
Unable to walk up the steep        100 miles a day. Often, she         Although natural beauty abounds, reaching the remote reservations
                                                                       she serves are a challenge for Sharon Batala; she often logs more
trail, with horses, mules or       has to plan her trips around        than 100 miles a day.
helicopters as their only other    the weather, which creates
means of transportation, the       road hazards, wintry condi­         acter. According to Batala, her     “During the summer months,
Supai veterans living in this      tions, and no cell reception in     large extended family connec­       because we are an agricultural
remote location had been           most areas. Her schedule also       tions help the veterans relate to   tribe, the veterans here suffer
isolated until Batala arrived in   revolves around the cultural        her since they may be part of       from PTSD less due to the
2001. Although only a handful      calendar of the native tribes.      the same clan or were raised in     outside physical activities they
of military veterans live there,   “I know when things are busy,       the same area.                      are doing,” Batala said. “When
Batala helps resolve their pend­   quiet, or they’re in preparation          Part of Batala’s job is       they see things grow, it makes
ing claims issues, providing       for a ceremony,” said Batala.       coordinating benefits between       them happy. It can be thera­
much-needed support in an                Her long commutes may         VA, Indian Health Service, the      peutic to take care of other
area mostly forgotten by the       seem extreme, but Batala            state benefits counselor, and       things.”
rest of the world.                 stresses the importance of the      the Hopi Tribe veterans office,           For Batala, by helping
      On remote Native Ameri­      face-to-face conversations she      where she began her career.         veterans, she is also helping
can reservations such as the       has with veterans. “As Hopi,        An Air Force veteran herself,       their families. “I’ve learned
                                                                       she spent eight years in the        so much from the veterans,”
“As Hopi, we want to talk to you in                                    military.                           she said. “Sometimes, I’m the
                                                                             “I’ve been through basic      only person, the only witness,
person, to see your eyes. Phone                                        training,” Batala said. “I can      they are willing to share their
conversations don’t work.”                                             relate to them on that level.       story with. Most don’t even
                                                                       My experience was not that          tell their families. I inform
Hopi Nation in northern Ari­       we want to talk to you in           different from theirs. I know       them they’re not crazy. There
zona, there is no public trans­    person, to see your eyes,” she      how the military system works.      is a diagnosis for what they
portation. With most people        said. “Phone conversations          I know what it’s like to be         are feeling. I work with the
living on the lower end of the     don’t work. For us, it’s not the    away from your family.”             families, explain why grandpa
income scale, many veterans        amount of time you spend—                 The Hopi culture itself       is angry all the time and wants
encounter difficulties reach­      it’s the quality. It may take me    can often be instrumental in        to be alone. I get them talking
ing their nearest VA facilities.   half a day to get there, but it’s   healing war trauma, especially      about it on a regular basis.
Almost all of the veterans live    worth it.”                          post-traumatic stress disorder.           “Sometimes, I look at
more than an hour from town.             By tradition, Batala,         “PTSD makes you so iso­             those who were angry, whose
And at four hours away, the        whose name means “reflection        lated,” said Batala. “As Hopis,     mood has changed, and I
Prescott VA Medical Center         off any body of water,” always      it’s built into our culture that    think ‘wow, I helped do that.’
is the closest VA medical cam­     introduces herself and her fam­     you rarely do things alone.         Their quality of life changes.
pus.                               ily background to the veterans      You always do things together       Now they can pay their bills,
     For the past 17 years, this   she is helping. In Hopi tribes,     and socialize.”                     buy a car, help put food on
is where Batala has stepped in     family lineage defines people             Because of things the tribe   the table. It changes their
to help. Servicing anywhere        and can give the veteran an         does routinely, Hopi veterans       whole life.”
from 300 to 500 Hopi and           indication of the person’s char­    actually have fewer symptoms.       By Amanda Hester
30                                                     VAnguard • Winter 2009/2010
                                                                                                           MEDICAL ADVANCES

Older Heart
Bypass Method is
Best, Study Shows
The topic has been hotly de­
bated among surgeons and car­
diologists: Is it safer and more
effective to do bypass surgery
with or without a heart-lung
pump that allows doctors to
stop the heart while they oper­
     A clinical trial at 18 VA
medical centers has found
that while both methods are
generally safe and effective,
the more traditional on-pump
method yields better outcomes
after one year. The findings
appear in the Nov. 5 New
England Journal of Medicine.
     “There was good survival
in both groups at one year,                                                                                             amaNDa Domaszek urrea
but the conventional method
                                   A clinical trial at 18 VA medical centers looked at whether it was safer and more effective to perform
proved safer and somewhat          heart bypass surgery with or without a heart-lung pump that allows surgeons to stop the heart while they
more effective than the newer      operate.
off-pump method,” said study
co-leader Frederick Grover,        the off-pump procedure, in­         a cardiopulmonary bypass            method as enabling a quick re­
M.D., a heart surgeon with         cluding quicker recovery and        pump, or heart-lung machine.        covery, with lower health care
VA and the University of           less impact on cognitive func­      During an “on-pump” proce­          costs and less risk of cognitive
Colorado.                          tion. This study indicated a        dure, the heart is stopped with     decline.
     After a year, patients in     consistent trend toward better      medication and the machine                Recent studies, though,
the on-pump group fared bet­       outcomes in patients who had        takes over blood circulation.       have raised concerns about the
ter on a composite measure         undergone the conventional          This allows doctors to work on      newer procedure as well: Is it
that included death, repeat        on-pump technique.”                 a still heart.                      too technically difficult? Are
cardiac procedures, or nonfatal          The 2,203 veterans in               An alternative, “off­         surgeons sometimes unable to
heart attacks. Their vein grafts   the study all had clogged or        pump” method that has               complete multiple grafts on a
were also more likely to re­       narrowed coronary arteries,         gained some popularity in the       patient? Are the grafts more
main open. The study includ­       resulting in less blood flow to     past decade is also known as        likely to fail? And as a result,
ed follow-up angiograms per­       the heart. This can cause chest     “beating heart” surgery. As the     are patients more prone to
formed by cardiologists who        pain and increase the risk of       name implies, the heart keeps       heart attacks or repeat proce­
were “blinded” as to which         heart attack. In bypass surgery,    beating during the procedure        dures?
type of bypass the patients had    also known as coronary artery       and no heart-lung machine is              No studies to date have
undergone.                         bypass grafting (CABG), doc­        used. Doctors use special de­       been conclusive, but the new
     In particular, Grover         tors take a healthy piece of        vices to stabilize only the small   VA trial results should greatly
pointed to the fact that both      vein from elsewhere in the          section of heart where they are     inform the debate. Grover
groups scored equally well a       body and sew it in place as a       stitching in the graft.             said he thinks the results may
year after surgery on neuro-       “detour” between the heart                Controversy has existed as    influence cardiology referrals
psychology tests. Some experts     and a point in the problem          to which method is safer and        and cardiac surgery practice,
have believed the on-pump          artery below the blockage.          more effective. Some studies        but he stresses that individual
method is riskier for cognitive    As long as the graft remains        suggested that using the pump       patient differences still need to
health.                            open—“patent,” in medi­             could weaken heart function         be taken into account. Patients
     According to first author     cal terms—and doesn’t close         after surgery, harm the lungs       with certain risk profiles and
A. Laurie Shroyer, Ph.D., the      down over time, the heart           and kidneys, result in more         patterns of coronary damage,
findings of the large, multisite   enjoys a renewed flow of blood      blood use during surgery and        he said, may still be strong
VA study contradict find­          and oxygen.                         longer hospital stays, and bring    candidates for the off-pump
ings from earlier studies that           For more than 30 years,       on problems with memory             method, notwithstanding the
showed “some advantages of         most bypass procedures have         and thinking. Many experts          general results seen in the trial.
[heart bypass] surgery using       been done with the use of           came to see the off-pump            -VA Research Currents
                                                      VAnguard • Winter 2009/2010                                                          31

Comprehensive Study                  nam-deployed women were
of Vietnam-Era Women                 studied in the 1980s. Then, it
Veterans Gets Underway               was about 8.5 percent.
Understanding the experi­                  “There are cases of remis­
ences of women who served            sion, as well as new onset and
in Vietnam and the long-term         delayed onset. There could be
health effects of their service is   new traumas totally unrelated
the goal of a new VA study. As       to military service,” noted
many as 10,000 women, most           Magruder. “Also, we’re using
now in their 60s, are expected       different instruments now—
to take part. The sample will        there’s a whole new diagnostic
include women who served in          system. So we don’t know
Vietnam and, for comparison,         what we’re going to find.”
those who served stateside or              Chairing the study
elsewhere in Asia, such as in        with Magruder are Dr. Amy
Japan, Korea, Guam or the            Kilbourne, a mental health
Philippines.                         researcher with the Ann Arbor
       “We’re going to be look­      (Mich.) VA Medical Center,
ing at current and lifetime          and Dr. Han Kang, who
prevalence of a range of             directs VA’s Environmental
physical and mental health           Epidemiology Service and the
outcomes,” said study co-chair       War-Related Illness and Injury
Dr. Kathy Magruder, an epi­          Study Center in Washington,
demiologist at the Charleston        D.C.
(S.C.) VA Medical Center.                  About 8,000 of the wom­
She noted that the study is the      en VA expects to enroll in the      NatioNal arcHiVes

largest and most comprehen­          new study were part of earlier      A U.S. Air Force flight nurse tends to American wounded aboard a
sive effort to date to look at       research by Kang on birth out­      C-141 prior to an aeromedical evacuation from Vietnam back to the
this population.                     comes. That study, published        United States in 1967.
       Among the key questions       in 2000, found higher rates of      the course of 40 years—will be     pre-existing health conditions,
the researchers hope to answer:      birth defects in the children       a challenge for the researchers.   childhood traumas, wartime
How many of the women de­            of women who had served in          Most of the prospective re­        exposures or injuries, home­
veloped post-traumatic stress        Vietnam compared with those         spondents are nurses and have      coming, social support, and
disorder or depression after         who had served elsewhere. The       experience reporting health        health behaviors, such as ciga­
their service, and how many          causes for the increased risk re­   conditions.                        rette smoking or alcohol use.
still cope with these conditions     main unknown, but research­              In terms of mental condi­          Most of the women
today? Are these conditions          ers believe they may include        tions, the researchers will ask    expected to take part in the
more prevalent among those           exposure to herbicides such as      mainly about PTSD, depres­         study have not been regu­
who served in Vietnam, and           Agent Orange.                       sion, anxiety and substance        lar users of VA health care.
to what extent have they led to            The new study will in­        abuse. The physical conditions     Nonetheless, VA—which
physical health problems?            clude mail surveys, phone in­       they’ll focus on include car­      has ramped up programs for
       Magruder said it’s dif­       terviews and reviews of medi­       diovascular disease, diabetes,     women in recent years—will
ficult to predict whether the        cal records. Teasing out the        multiple sclerosis, Parkinson’s    use the results to improve care
prevalence of PTSD will be           complex links between Viet­         disease, brain cancer, breast      and services for this Vietnam-
similar to what was found            nam deployment and various          cancer and gynecological           era population.
when smaller groups of Viet­         health factors—especially over      cancers. Some of the condi­             “These women, for the
                                                                         tions have been linked in past     most part, are in their early
                                                                         research to exposure to trauma     60s,” noted Magruder. “They
 Women in Vietnam                                                        or environmental toxins; oth­      may have a lot more years. It’s
                                                                         ers don’t have a particular        important for us to know what
 n about 8,000 women served in Vietnam during the war,                   military tie-in but are common     they’re dealing with.”
 some 85 percent as nurses. in total, some 250,000 women                 among aging women.                      The findings may also
 served in the u.s. military during the Vietnam era.                          Along with probing the        shed light on what the newest
 n the new Va study will include mail surveys, phone                     prevalence of various condi­       generation of women—those
 interviews and medical chart reviews for 10,000 women                   tions, the researchers will ask    returning from Afghanistan
 who served in or near Vietnam or in the u.s. during the                 about demographics and life        and Iraq—may face in the
 Vietnam War.                                                            and military factors such as       years ahead.
                                                                         years of nursing experience,       - VA Research Currents
32                                                      VAnguard • Winter 2009/2010
                                                                                                             HAVE YOU HEARD
First Lady Visits Bronx
VA Medical Center                                                                                            San Francico VA
First Lady Michelle                                                                                          Medical Center
Obama visited patients                                                                                       Celebrates 75
and staff at the James J.                                                                                    Years of Service
Peters VA Medical Cen­                                                                                       on sept. 14, the san
ter in the Bronx before                                                                                      francisco Va medi-
attending Game 1 of the                                                                                      cal center celebrated
World Series between                                                                                         its 75th anniversary of
the New York Yankees                                                                                         providing care to vet-
and the Philadelphia                                                                                         erans.
Phillies on Oct. 28. Ac­                                                                                           a ceremony was
companied by Jill Biden,
                                                                                                             held for patients and
wife of Vice President
Joe Biden, the First Lady                                                                                    staff with marvin
was at the medical center                                                                                    sleisenger, m.D., dis-
to take part in Major                                                                         jim blue       tinguished physician
League Baseball’s Wel­       First Lady Michelle Obama greets veterans at the James J. Peters VA             and former chief of
                             Medical Center on Oct. 28.
come Back Veterans ini­                                                                                      medicine at the cen-
tiative, which helps connect returning Afghanistan and Iraq veterans with mental health                      ter, and lloyd “Holly”
services and job opportunities.                                                                              smith, professor emeri-
     Major League Baseball dedicated Game 1 of the World Series to veterans and their                        tus, university of cali-
families. “I’m happy with every minute that I spend with our men and women in uni­                           fornia, san francisco,
form and our veterans,” Obama said. “Each and every day, they selflessly and coura­                          providing remarks.
geously serve this nation.” She called on all Americans to “take the time to be more aware                   both are responsible
of these heroes in our midst, and honor them by doing more service not just for them,
                                                                                                             for the establishment
but for all our communities.” After speaking to a crowd of patients and staff gathered in a
hospital conference room, Obama visited patients in the spinal cord injury unit, handing                     of the affiliation be-
out Yankee paraphernalia, including teddy bears and caps.                                                    tween the Vamc and
                                                                                                             ucsf, one of the most
                                                                                                             successful affiliations
‘Heroes at Heinz Field’                                                                                      in the country.
On Sept. 28, a unique
partnership between VA
                                                                                                                   the original plans
Healthcare–VISN 4 and                                                                                        called for 21 buildings
the Pittsburgh Steelers gave                                                                                 and a 500-bed hospital,
76 veterans a once-in-a­                                                                                     but today the medical
lifetime opportunity. The                                                                                    center serves more
“Heroes at Heinz Field”                                                                                      than 50,000 veterans
event—now in its second
year—teamed local Op­                                                                                        and had more than
eration Enduring Freedom                                                                                     400,000 outpatient vis-
and Operation Iraqi Free­                                                                                    its in fiscal year 2008.
dom veterans with Steelers                                                                                   more than 700 ucsf
players.                                                                                                     trainees from 34 pro-
      To start the evening,
veterans and their guests                                                        justiN guiDo/butler eagle   grams rotate through
caught passes, kicked field    Pittsburgh Steelers linebacker Lawrence Timmons signs an autograph for
                                                                                                             the medical center
goals and tossed footballs     veteran Daniel Maguire and family.                                            each year. it also has
as 10 Steelers players stood                                                                                 the number one Va re-
by, offering encouragement and expert tips. When the skills session ended one hour later, the pros           search program in the
posed for photos and broke out their Sharpies to autograph souvenir “Super Bowl Champions”                   nation, with more than
caps for the former soldiers. The veterans and their guests then moved to the stadium’s North
Club Lounge to enjoy a complimentary dinner overlooking the field. The event “lets veterans                  $77 million in expendi-
know that we will go anywhere to make sure that they get an opportunity to be recognized and to              tures in 2008.
connect with us,” said VA’s VISN 4 Director Michael Moreland.
                                                        VAnguard • Winter 2009/2010                                                 33
Little Rock’s Welcome
Home Event Draws 4,500                                                                                  Veteran Volunteer
The Central Arkansas Veter­                                                                             Leaves His Entire
ans Healthcare System hosted                                                                            Estate to VA
a Welcome Home event to                                                                                 VA Illiana Health Care
honor Operation Enduring                                                                                System recently had a re-
Freedom/Operation Iraqi                                                                                 membrance program in
Freedom veterans and their                                                                              honor of Army veteran
families in September. The                                                                              John P. Wright. Wright
event, which featured food,                                                                             served as a VA volun-
local live entertainment, games                                                                         teer for nearly 40 years,
and activities for adults and
                                                                                                        amassing a total of nearly
children alike, included a rock
wall, dunking booth and cake­                                                                           50,000 hours of service.
                                                                                           jeff boWeN
walk. In addition, a four-hour                                                                          Assigned to Recreation
                                   The Central Arkansas Veterans Healthcare System Welcome Home         Therapy, Wright did
golf tournament, which at­         event’s job fair drew more than 80 vendors.
tracted 74 golfers, was held at                                                                         most of his volunteering
the local War Memorial golf course, and a job fair featuring more than 80 vendors took place on         in the Recreation Hall.
the west side of the stadium.                                                                           He did not have family,
     The event attracted 4,500 veterans and family members and about 400 volunteers. It was             but his extended family
more than fun and games. The Emergency Medical Response Team administered 161 flu shots to              was the Recreation/Vol-
those in attendance that wanted the vaccination. Central Arkansas partnered with area businesses,       untary Service staff.
the Veterans of Foreign Wars, the American Legion, the American Legion Auxiliary, Disabled                   Michael E. Ham-
American Veterans, the Salvation Army, AMVETS, Arkansas Army National Guard, Little Rock
                                                                                                        ilton, director, and
Air Force Base, the City of Little Rock, Clear Channel Communications, and Channel 4 News.
                                                                                                        Jan Filicsky, acting
                                                                                                        chief of Voluntary Ser-
‘Scrubs’ Group Performs                                                                                 vice, unveiled a large
at Dallas VA Medical                                                                                    check in the amount
Center                                                                                                  of $1,559,227.66 that
What a treat when The Blanks                                                                            Wright’s estate left to
stopped by the Dallas VA                                                                                VA Illiana to be used
Medical Center to perform
                                                                                                        in Recreation Therapy.
for patients. VAnguard read­
ers may recognize them from                                                                             “What a wonderful gift
guest appearances on the TV                                                                             for Wright to give back
series “Scrubs.”                                                                                        to his fellow veteran
     The Blanks were a delight                                                                          with this donation. Out
to hear and watch and made                                                                              of Wright’s generosity,
a special effort to visit with                                                                          for many years to come
patients on the units and sing                                                                          veterans will be receiving
for those who couldn’t come         NaNcy gray                                                          this gift,” said Hamilton.
to the show. Veteran Kent Bell                                                                               Staff at VA Illiana,
                                   Veteran Kent Bell enjoys a bedside performance by The Blanks (left
was among those who received to right): George Miserlis, Paul Perry, Sam Lloyd and Philip McNiven.      veterans and retired staff
a private concert in their room.
                                                                                                        attended the program for
The Dallas VAMC was the first VA performance for The Blanks. But as they visited with the vet­
erans and learned about their life and experiences in the military, it surely won’t be their last.      Wright.

Houston VA Medical Center Opens New Post-Deployment Clinic for Returning Veterans
Houston’s michael e. Debakey Va medical center recently opened a new Post-Deployment clinic to serve as a “Welcome cen­
ter” for veterans who served in operation enduring freedom and operation iraqi freedom. the Post-Deployment clinic is a “one-
stop” center performing multi-disciplinary evaluations tailored to the individual’s physical, mental and social needs. assistance
and information regarding non-medical Va benefits and community resources are also available. if the veteran cannot stay for
the 90-minute comprehensive screening, the staff schedules more convenient appointments.
     in response to the unique physical and mental health needs of returning combat veterans, the medical center assembled
a team of specialists to ensure smooth transition to Va medical care. the oef/oif support team meets with local reserve and
National guard units before and after deployments to brief about available Va benefits.
34                                                   VAnguard • Winter 2009/2010
                                                                                                               HAVE YOU HEARD
Group Burial Conducted at Dallas-Fort Worth
National Cemetery
More than 500 people turned out in the pouring rain on Sept.
13 for a group burial ceremony at Dallas-Fort Worth National
Cemetery honoring seven military helicopter crash victims who
perished in Iraq on Sept. 17, 2008. The deceased were National
Guardsmen, members of Bravo Company, 2nd Battalion, 149th
Aviation Regiment. They were aboard a CH-47 Chinook he­
licopter en route from Kuwait to Balad, Iraq, when the crash
     Most of the remains of the men had been identified and in­
terred elsewhere months ago, but after long analysis of the crash
scene, further remains were found which could not be separated
or identified. Those remains were interred in a single casket and
marked with a monument located in Section 76 of the cemetery.                                            roN eNNis/fort WortH star-telegram
Four of the men were buried earlier in individual graves at na­      A National Guard member places a hand on the casket of his fallen
tional cemeteries, including two at Dallas-Fort Worth, one at        comrades.
Fort Sam Houston National Cemetery in San Antonio, and one
at Fort Sill National Cemetery in Elgin, Okla. It is highly unusual in VA cemeteries to inter and mark a veteran’s remains in more
than one location.

                                                   North Chicago VA Medical Center Honors Former POWs
                                                   Former POWs from U.S. conflicts gathered at the North Chicago VA Medical
                                                   Center in September to honor and remember fallen comrades during their annual
                                                   POW/MIA ceremony, which included their first-hand accounts as prisoners. “This
                                                   event was different from previous POW/MIA ceremonies,” said John Stoffle, for-
                                                   mer POW and event speaker. “Most depict the difficulties and suffering of these
                                                   wars, but the events I described depicted the differences between Pacific-area and
                                                   European POWs.” Stoffle was captured southwest of Berlin. “I think of death
                                                   marches and poor camp conditions when I think of the war in the Pacific,” he
                                                   said. “My experience was much different, in that my captors were more concerned
                                                   with the war’s end and possible retribution.”
                                                   Left: Former POWs (left to right) Don McCormick, John Stoffle, Chester Pestrak and Al
                                   mary WatermaN   Fehrman salute the flag during the POW/MIA ceremony at the North Chicago VAMC.

VA Palo Alto Hosts Exhibit Honoring Hispanic Military Service to the Nation
The VA Palo Alto Health Care System hosted the Hispanic Medal of Honor Society’s Legacy of Valor exhibit Oct. 8 and 9 in
celebration of Hispanic Heritage Month. The exhibit honors Hispanic military service to the nation. It includes displays honoring
Hispanic Medal of Honor recipients, Latino heroes such as Presi­
dential Medal of Freedom award winner Dr. Hector P. Garcia
and former POW Everett Alvarez Jr., and the Aztec Eagles, an
elite unit of pilots that flew combat missions during World War
II, among others.
      Rick Leal, president of the Hispanic Medal of Honor So­
ciety, was on hand to give a presentation on the exhibit for staff
and veterans in the facility’s auditorium. The exhibit’s two-day
visit to VA Palo Alto was arranged by Thomas M. Turréy III,
the facility’s Hispanic Heritage Program manager, who saw it on
display at the National Council of La Raza’s annual conference
last summer and contacted Leal about bringing it to VA Palo
Alto. After leaving VA Palo Alto, the exhibit was displayed at San
Francisco City Hall.

Right: The Legacy of Valor exhibit was displayed at VA Palo Alto Oct.
8 and 9 in celebration of Hispanic Heritage Month.                                                                              curt camPbell

                                                        VAnguard • Winter 2009/2010                                                        35
Like Father, Like Son                                                                                    VA’s O’Leary to Serve
The proverbial apple didn’t fall too far from                                                            as Journal Editor
the tree in the case of Det. Mike Grieco, of                                                             Timothy J. O’Leary, M.D.,
the VA New York Harbor Healthcare Sys­                                                                   Ph.D., acting VA deputy
tem, and his son, Mike Grieco Jr. The senior                                                             chief research and devel-
Grieco is a career civil servant who spent 20                                                            opment officer, has been
years with New York City Corrections be-
                                                                                                         named editor-in-chief of the
fore coming to VA. His son has served with
the city’s fire department for four and a half                                                           Journal of Molecular Diag­
years.                                                                                                   nostics. His term begins in
      Besides civil service, father and son also                                                         January 2010.
share a passion for weightlifting, and recently                                                                Along with his leader-
won gold medals at the World Police and Fire                                                             ship role in VA research,
Games in Vancouver, Canada. Dad took the                                                                 O’Leary is well known for
gold in the age 50-55 class, and Junior gar-                                                             his work in molecular diag­
nered a gold medal in the 198-pound weight                                                               nostics. The field involves
class.                                                                                                   the study of genes and
      The World Police and Fire Games Fed-                                                               proteins within cells. Ad­
eration established the games in 1985 and                                    VA New York Harbor
                                                                             police detective Mike       vances in recent years have
they are now an international sporting event,
offering police officers, firefighters, customs
                                                                             Grieco and his son, Mike    boosted health profession-
                                                                             Grieco Jr., won gold        als’ ability to diagnose and
officials and corrections officers an opportu-                               medals at the World Po-
nity to showcase their athletic ability in more                              lice and Fire Games.
       monitor cancer and other
than 60 sporting events.                                                                raymoND aalbue   diseases. He has published 

                                                                                                         more than 130 scientific
                                                                                                         papers and numerous book
     2009 Environmental Services Department of the Year Winner Selected
                                                                                                               The Journal of Mo­
     Va’s tennessee Valley Healthcare system was recently selected for the 2009 environmen­
                                                                                                         lecular Diagnostics is the
     tal services Department of the year award by Health Facilities Management magazine and
                                                                                                         official publication of the
     the american society for Healthcare environmental services (asHes). the environmental
                                                                                                         Association for Molecular
     services Department of the year is designed to recognize the outstanding achievements
                                                                                                         Pathology, a not-for-profit
     of a leading-edge hospital environmental services/housekeeping team in maintaining the
                                                                                                         scientific society dedicated
     highest levels of performance in critical areas such as infection control and prevention,
                                                                                                         to advancing clinical mo­
     patient safety initiatives, customer service, waste reduction and recycling initiatives, staff
                                                                                                         lecular laboratory medicine
     education/training and patient satisfaction.
                                                                                                         and translational research
          a panel of four judges selected the tennessee Valley Healthcare system based on its
                                                                                                         based on genomics and
     innovative programs and commitment to helping reduce hospital-associated infections. in
                                                                                                         proteomics. Co-published
     their comments, the judges recognized the health care system for its teamwork, continual
                                                                                                         by the American Society for
     training programs, initiatives to reduce hospital-associated infections, efforts to reduce
                                                                                                         Investigative Pathology, it
     medical waste, improve recycling and more. Health Facilities Management and asHes are
                                                                                                         is the top-ranked journal in
     part of the american Hospital association.
                                                                                                         its field.

Bronx VA Medical Center Director Wins AMSUS Federal Healthcare Executive Award
Maryann Musumeci, director of the James J. Peters VA Medical Center in the Bronx, N.Y., was selected by the Association of Mili­
tary Surgeons of the United States as winner of the 2009 Outstanding Federal Healthcare Executive Award. The competitive award
is presented to an individual senior health care executive officer in the U.S. Public Health Service, Department of Defense or VA
who has made outstanding contributions to federal health care and has demonstrated superior leadership or executive management
      AMSUS, originally founded in 1891 as a society for surgeons and physicians, is currently comprised of more than 9,000 pro­
fessionals serving in the full spectrum of health care disciplines, including the U.S. Public Health Service, VA, and DoD’s active,
National Guard and reserve branches. Their official monthly journal, Military Medicine, features peer-reviewed scientific papers, case
reports and editorials, including international submissions. Each fall, AMSUS sponsors a major educational conference for members,
international delegates and others interested in the medical and health-related activities of the military and federal health agencies.
Past award recipients from VA include Dr. Jonathan Perlin (2005) and Dr. Michael Kussman (2006), both former Under Secretaries
for Health.
36                                                     VAnguard • Winter 2009/2010
VA Maryland Health Care System Named One of
Baltimore’s Best Places to Work
The Baltimore Business Journal has named the VA Mary­
land Health Care System one of Baltimore’s Best Places
to Work in 2009, the third such honor for VA Maryland.
Competing with other businesses, hospitals, universities
and financial institutions across the state, VA Maryland
ranked second in this year’s competition for an organiza­
tion with 500 or more employees, and earned the unique
distinction of being the only federal agency on the list.
     “As a federal agency, we don’t have the resources avail­
able in the private sector to enhance employee morale, but
our overall mission, competitive salaries, generous benefits,
employee recognition, strong leadership and cutting-edge
technology have enabled us to attract and retain some of
the most talented staff in the health care industry,” said
Dennis H. Smith, VA Maryland director.
     In an anonymous online survey conducted by the                                                               terry toDesco

Journal, employees were asked questions about job satisfac­ VA Maryland Health Care System Director Dennis H. Smith accepts
tion, management style and trustworthiness, and their own the Baltimore’s Best Places to Work award.
job performance. VA Maryland serves more than 52,000 veterans and employs approximately 3,000 clinical, technical,
administrative and support personnel, providing a broad spectrum of care from two medical centers, a rehabilitation and
extended care center and five outpatient clinics.

  VA Pharmacies Get High Customer Satisfaction Scores in J.D. Power Survey
  j.D. Power and associates, a firm specializing in consumer surveys, has given Va pharmacies some of the highest customer
  satisfaction scores in a national sampling of pharmacy customers. j.D. Power surveyed about 12,000 pharmacy customers
  who use pharmacy retailers, including independent and mail-out pharmacies, chain drug stores, mass merchandisers and
  supermarkets. Va received an “among the best” ranking for the mail order category, the same overall ranking as kaiser
  Permanente Pharmacy and Prescriptions solutions.
       among the factors examined in the 2009 National Pharmacy study were pharmacy environment, price and value of
  prescription drugs, experience with online ordering and mail delivery, and experience with pharmacist and non-pharmacist
  staff. every veteran enrolled in the Va health care system is eligible to receive prescription medications, over-the-counter
  medications, and medical and surgical supplies. Va operates seven mail-out pharmacies, known officially as consolidated
  mail outpatient pharmacies, in charleston, s.c., Dallas, Hines, ill., leavenworth, kan., murfreesboro, tenn., chelmsford,
  mass., and tucson, ariz. these facilities support Va’s health care mission through advanced automated production tech­
  nologies to dispense and mail prescriptions to eligible veterans. in 2008, Va provided approximately 126 million outpatient
  prescriptions to more than 4.4 million patients.

Four VA Facilities Make American Hospital Association’s List of 100 Most Wired Hospitals and
Health Systems
Four VA facilities made this year’s 100 Most Wired Hospitals and Health Systems listing in Hospitals & Health Networks
magazine, published by the American Hospital Association. VA’s Northeast Region 4 in Brooklyn, N.Y., with 8,000
staffed beds in 36 hospitals, has made the list for the last eight years, the most appearances of any VA facility. With two
years on the list, Fresno’s VA Central California Health Care System, with 114 beds, is a relative newcomer to the presti­
gious ranking. Both the 154-bed Richard L. Roudebush VA Medical Center in Indianapolis, and the 321-bed Washing­
ton, D.C., VA Medical Center have made the list for the past five years. The White River Junction VA Medical Center
in Vermont was one of 25 hospitals chosen for the Most Wired–Small and Rural list.
     In the annual Hospitals & Health Networks’ Most Wired Survey and Benchmarking Study, facilities are graded on
their use of information technology to achieve goals related to patient safety and quality, customer service, business pro­
cess improvement, workforce management and disaster readiness. This year, 556 hospitals and health systems nationwide
completed the study, representing 1,314 hospitals.
                                                  VAnguard   •   Winter 2009/2010                                                37
Omaha VA Medical Center Nurse                                                                           D.C. VAMC Wins
Honored for Exceptional Patient Care                                                                    Organizational
Dean Degner, an intensive care unit nurse at                                                            Achievement Award
the VA Nebraska-Western Iowa Health Care                                                                The Washington, D.C., VA
System’s Omaha medical center, is the first VA                                                          Medical Center is the 2009
recipient of The DAISY Award for Extraordinary                                                          winner of the Medallion of
Nurses. The award, presented in collaboration                                                           Excellence, the highest honor
with the American Organization of Nurse Execu­                                                          presented for organizational
tives, is part of the DAISY Foundation’s program                                                        achievement by the U.S. Sen­
to recognize the superhuman efforts nurses per­                                                         ate Productivity and Quality
form every day.                                                                                         Awards of Virginia.
      “We are proud to be among the hospi­                                                                    The SPQA uses the
tals participating in The DAISY Award pro­                                                              national Malcolm Baldrige
gram. Nurses like Dean are heroes every day,”                                                           Award criteria to rate orga­
said Eileen Kingston, Omaha VA nurse execu­                                                             nizations in all segments of
tive. “It’s important that our nurses know their                                                        enterprise reflecting “visionary
work is highly valued. The DAISY Foundation                                                             leadership, customer-driven
provides a way for us to do that.”                                                                      operations, value of employees
      A retired Air Force major with 17 years of                                        Will ackermaN
                                                                                                        and partners to the organiza­
military service, Degner has been a VA nurse                                                            tion, focus on results, and in­
                                                    Dean Degner receives The DAISY Award from
since 1999. The nonprofit DAISY Foundation          Bonnie Barnes, co-founder of the foundation that    novation.” Not since 2006 has
was established in 2000 in memory of J. Patrick     sponsors it.                                        the group’s judging committee
Barnes, who died at the age of 33 from compli­                                                          recognized an organization
cations of an autoimmune disease. As of July, more than 4,500 nurses have received The DAISY            with its highest achievement
Award nationwide. For more information, visit www.daisyfoundation.org.                                  award.
                                                                                                              The VAMC consistently
Dental Director Receives N.C. Governor’s Volunteer Service Award                                        scores high in patient satisfac­
Dr. Richard Chupkowski was named Cumberland County’s Outstanding Senior Citizen                         tion surveys, with nearly 85
Volunteer of the Year at the North Carolina Governor’s Volunteer Service Awards Ban­                    percent of patients describing
                                                                                                        access to hospital services as
quet recently. He also received a second-place award for the North Carolina Outstanding                 excellent. Its Patient Service
                                                Volunteer Medallion for Cumberland County.              Center ensures all incoming
                                                     Chupkowski began volunteering his profes­          calls are answered within 30
                                                sional services to perform free dental extractions      seconds.
                                                for The CARE Clinic patients in 1995. He soon                 The “paperless” hospital
                                                became the volunteer dental director and took over      uses technology to improve
                                                responsibility for all dental aspects of patient care   patient care. Its success is re­
                                                at the nonprofit facility.                              flected in its award-winning
                                                     Chupkowski is also an instructor for the Uni­      discharge summary program,
                                                versity of North Carolina School of Dentistry and       designation as a “Most Wired”
                                                supervises dental residents at the Fayetteville VA      hospital, and its telehealth
                                                Medical Center. As a way to provide additional                The D.C. VAMC was
                                                dental services to the clinic, Chupkowski began         the first in the nation to put
                                                bringing his dental residents with him twice a          EKGs on Blackberries, ensur­
                                                month. The extra volunteers allow the facility to       ing patients suffering chest
                   courtesy of tHe care cliNic	 provide services to an additional 288 people a year     pain get immediate, life-saving
Dr. Richard Chupkowski                          in the community.                                       treatment.

VA Mental Health Services Official Receives Top Award from American Psychological Association
Dr. Antonette Zeiss, deputy chief consultant for mental health services with the Office of Patient Care Services in VA headquarters,
has been named the recipient of the Retirement Research Fund Distinguished Contribution Award in Applied Gerontology from the
American Psychological Association. Zeiss received the award at the APA annual conference, held last summer in Toronto, Canada.
     APA is a scientific and professional organization that represents psychology in the United States. With more than 150,000
members, APA is the largest association of psychologists worldwide. Its mission is to advance the application of psychological knowl­
edge to benefit society and improve people’s lives. The award Zeiss received is presented in honor of M. Powell Lawton to recognize
those whose contributions include developing or implementing a program, practice, policy or treatment that has had or will have
great potential to improve the lives of older people.
38                                                   VAnguard • Winter 2009/2010
St. Louis VA Regional Office Helps
Domestic Violence Victim                                                                                Nurses Assist
The widow of a World War II veteran                                                                     With In-Flight
walked into the St. Louis VA Regional                                                                   Emergency
Office with her new husband and was                                                                     David mcgarry, a regis­
greeted by Public Interview Representa­                                                                 tered nurse at the West
tive Laura Thomas-Jones.                                                                                Palm beach (fla.) Va
     Thomas-Jones noticed that the                                                                      medical center, and his
elderly woman had bruises on her face                                                                   wife mari, also a regis­
and head. That, coupled with the wom­                                                                   tered nurse, were on a
an’s demeanor, led her to believe that                                                                  flight returning home from
the woman may have been the victim                                                                      a nursing conference
                                                                                    saNDra DaVeNPort
of domestic violence.                                                                                   when a call came from
                                             Left to right: Laura Thomas-Jones, Dawn Dixon, Angela      the crew asking any med­
     Going on instinct, Thomas-Jones         Clemoens and George Seper.
separated the woman from her hus­                                                                       ical personnel on board to
band and called Women Veterans Coordinator Angela Clemoens for assistance. The                          come forward. mcgarry
two learned that the woman’s husband was physically abusing her and he brought her to                   and his wife immediately
the VARO to change the address where her Dependency and Indemnity Compensation                          responded to the call for
checks were mailed. He forced her to deposit her DIC check into his checking account,                   help.
leaving her without any money. Thomas-Jones and Clemoens escorted the woman to the                            arriving at the front
office of Public Contact Coach Dawn Dixon, where they knew she would be safe and her                    of the plane, they met up
privacy would be protected.                                                                             with a doctor and flight
     Thomas-Jones called local police to report the incident and Clemoens began calling                 personnel who took them
local women’s shelters to find a safe place for the woman to stay. Dixon left messages at               to a man suffering from
the homes of the woman’s sons. Assistant Public Contact Coach George Seper distracted                   syncope, a brief loss
the husband by asking him to complete some paperwork. The husband was kept oc­                          of consciousness and
cupied long enough for the woman to be safely secured and the proper authorities con­                   posture caused by a tem­
tacted.                                                                                                 porary decrease in blood
     The woman didn’t need to visit the VARO, which is three hours from her home, to                    flow to the brain. “He was
change the address where her checks are mailed. She came to the VARO because it was                     unconscious, so we got
the safest place she could think of to get help.                                                        him into a wheelchair and
                                                                                                        into the galley of the air­
                                                                                                        plane, where we adminis­
VA Officers Break from                                                                                  tered oxygen and started
Competition to Provide                                                                                  an iV. He had been vomit­
First Aid                                                                                               ing and had low pulse and
Recently, several members                                                                               blood pressure,” mari
of the Salem (Va.) VA                                                                                   mcgarry said.
Medical Center police force                                                                                   in addition to their
were participating in an an­                                                                            traditional nursing train­
nual “Mud Run” competi­                                                                                 ing, the mcgarrys also
tion when they observed                                                                                 have in-air medical
a female participant in                                                                                 training. “in 2002, we at­
medical distress. The team                                                                              tended a conference for
stopped their run to aid the                                                                            in-flight emergencies,”
woman until medical per­                                                                                David mcgarry explained.
sonnel could arrive at the                                                                              the training paid off,
scene.                                                                                                  and eventually the man
     For disregarding the                                                                tamara malek
                                                                                                        regained consciousness.
competition to help a fellow Left to right: Detective Stanley Malek, Officer Russell Brockenbrough,     “i’m so thankful that my
                               Dispatcher Toney Clayton, Officer Brockenbrough’s son, and Officer
citizen, Detective Stanley     Benjamin Moody.                                                          training prepared me for
Malek, Officer Russell                                                                                  this kind of situation,”
(Carl) Brockenbrough, Officer Benjamin Moody and Dispatcher Paul (Toney) Clayton                        said mari mcgarry.
received certificates of commendation.
                                                     VAnguard   •   Winter 2009/2010                                              39
68th Anniversary
of Pearl Harbor
marines stationed at the marine
barracks in Washington, D.c., salute
during the national anthem at a ceremony at
the National World War ii memorial on the
National mall marking the 68th anniversary of
the japanese attack on Pearl Harbor. the
ceremony began at 7:53 a.m., the time in Hawaii
when the first bombs fell on Dec. 7, 1941.

                                             robert turtil

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