a day in the life of va a “fenway ambassador,” escorting a very special guest—the ... the...

VAnguard

November/December 2004 1

outlook

A Day in the Life of VAClose Call in Iraq

Salt Lake City’s Healing Garden

NCA’s New Training Center

November/December 2004

A Day in the Life of VAClose Call in Iraq

Salt Lake City’s Healing Garden

NCA’s New Training Center

VAnguard

2 November/December 2004

Features

A Close Call 6VA doctor survives suicide car bombing in BaghdadA Place for Healing and Connection 8Salt Lake City’s healing garden incorporates Native American therapiesTraining for a Unique Mission 10NCA’s new training center opensVeterans Day 2004 11activities in the nation’s capital honoring America’s heroesA Day in the Life of VA 12telling the VA story through photographs

Departments

3 Letters4 Management Matters5 Outlook24 Around Headquarters28 Introducing29 Medical Advances30 Have You Heard31 Honors and Awards32 Heroes

On the CoverThe Soldier’s Monument heralds the dawnof a new day at Dayton National Cem-etery in Ohio. The photographer, a visualinformation specialist at the Dayton VAMedical Center, was drawn to the sceneby the subtle shadows in the early morn-ing light. “It kind of made the statue lookalive,” she said. photo by Tessa Kalman

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VAnguardVA’s Employee MagazineNovember/December 2004Vol. L, No. 6

Printed on 50% recycled paper

Editor: Lisa RespessAssistant Editor: Matt BristolPhoto Editor: Robert TurtilPublished by the Office of Public Affairs (80D)

Department of Veterans Affairs810 Vermont Ave., N.W.Washington, D.C. 20420(202) 273-5746E-mail: [email protected]/opa/feature/vanguard/index.htm

http://www.va.gov/opa/feature/vanguard/index.htm

VAnguard


letters

Nobody forgets veterans on Veterans Day, and nobody can forgetthe Red Sox’s come-from-behind season this year that culminatedin the Boston team’s first World Series victory since 1918. The twoevents—Veterans Day and the World Series—came together Nov.11 at the Providence, R.I., VA Medical Center with a visit by BostonRed Sox senior advisor Jeremy Kapstein, above, third from right,with a “Fenway Ambassador,” escorting a very special guest—the2004 World Series Trophy. It was truly a memorable Veterans Dayfor patients and staff at the Providence VAMC.

World Series Trophy VisitJAMES W. BURROWS

Long Fingernails andHand HygieneIn the September/OctoberVAnguard, pages 6-8 havegreat information on handhygiene. Many thanks. How-ever, on page 8, the pictureof the person washing herhands shows long fingernails,which is prohibited in situa-tions where there is direct pa-tient care or food handling.This is because long finger-nails may compromise thegloves and may harbor infec-tious organisms.

Linda Adkins, R.N.Infection Control NurseOklahoma City VAMC

Editor’s Note: We received anumber of similar commentsabout the long fingernails inthe photo. VA’s NationalCenter for Patient Safety re-sponds: “The CDC Guide-line on Hand Hygiene rec-ommends that health careworkers keep natural nail tipsless than a quarter-inch long.

This is good practice, but theevidence is not as strong as itis for the other practices de-scribed in the story and it isnot required by the JointCommission on Accredita-tion of Healthcare Organiza-tions as part of the JCAHONational Patient Safety Goalto comply with the CDCGuideline.

VA facilities are free toestablish local standards thatgo beyond those of JCAHOrequirements, and this is onearea where they may considerdoing so. For the most part,however, the campaign hasused photos of hands withvery short nails and we ap-preciate readers’ comments.”

What About Patientsand Visitors?I read your article “Infection:Don’t Pass It On,” (Septem-ber/October issue) andthough informative, Ithought there was a some-what sensitive issue left out.

We Want to Hear from YouHave a comment on something you’ve seen in VAnguard?We invite reader feedback. Send your comments [email protected]. You can also write to us at:VAnguard, Office of Public Affairs (80D), Department ofVeterans Affairs, 810 Vermont Ave., N.W., Washington,D.C., 20420, or fax your letter to (202) 273-6702. In-clude your name, title and VA facility. We won’t be ableto publish every letter, but we’ll use representative ones.We may need to edit your letter for length or clarity.

What I think needs more at-tention is patient and visitorhand cleanliness.

There are many, manystaff-observed instances oftoilets flushing followed bythe patient/visitor openingthe bathroom door immedi-ately with no time for handwashing. These folks thenproceed on down the hallstouching handrails, door-knobs, etc. If signs are neces-sary to empower patients/

visitors to ask the staff if theyhave handwashed, then itshould not be a sensitive is-sue for staff to approachthose who have left the bath-room without washing, andVA should encourage staff todo this. Further, I have notobserved enough signs advo-cating cleanliness in patient/visitor bathrooms and stalls.

George L. Boccia, M.D.Physician

Togus, Maine, VAMC

VAnguardmanagement matters


Achieving an IT Program that Supports the MissionRobert N. McFarlandAssistant Secretary for Information and Technology

Information technology is the bedrock from whichwe deliver services to veterans safely, quickly andefficiently.

In this information age, tech-nology supports our troopsboth here and around theworld. And when thosetroops return home, it is thepower of technology that al-lows VA to touch their lives.

Information technologyis a critical factor in ourdepartment’s progress towardeach of its operating goals. Itis the bedrock from whichwe deliver services to veteranssafely, quickly and efficiently.

That is a huge responsi-bility. But VA has done anoutstanding job operation-ally, and I believe that IT en-ables this agency to provideexceptional service to veter-ans.

Of course, that cannothappen if our data systemsare not protected. VA-widewe are making excellentprogress on security. If youneed proof, look at the effectthe Blaster virus had on uslast year. It affected the entiredepartment. But VA is takingsecurity patches seriouslynow—and getting the jobdone. The more recentSASSER virus affected 1.32million PCs in the U.S.Within VA, it only affected192.

While we’re doing wellon the operational side, wehave not been as successfulwith systems developmentand execution. I believe ourproblems exist primarily be-cause we don’t take the timeto fully understand andevaluate the current state ofthe business environment weare about to change. Some-times we react too quickly toaddress a mandate or prob-

lem before we understandthe true nature and extent ofthe problem. We can’t attackthe problem until we’ve de-fined it and fully understandour current business environ-ment.

Once we understand theissue, it is imperative to moveahead forcefully to identifythe solution and implementaccordingly. To accomplishthis, we need to take a lookat our structure and begin touse our assets more wisely.Our IT operations may haveworked well in the 1980s,but in this new century we

must look carefully at ourcosts and make some organi-zational changes to updatethe way we do business. Wemust consider restructuringourselves organizationallymuch closer to current bestpractices in federal govern-ment and private industry.

Now let me tell youabout some of the areaswhere I am focused.

To ensure seamless com-munication within VA onthe e-mail system, the VAExchange ConsolidationWorkgroup plans to consoli-date more than 530 Ex-change servers at 270 sites toa much more manageablenumber of sites and a signifi-cantly smaller number ofservers. This will lower costs,improve performance and

availability, and provide moreefficient IT utility service toenhance our ability to serveveterans.

One of the most seriouschallenges veterans face indealing with VA is the manybusiness lines and locationswithin the department thatdo not share veteran identifi-cation and registration infor-mation. This is a direct resultof the limitations in technol-ogy capabilities at the timethese legacy systems were de-veloped.

We now have an excel-lent Enterprise Architecture

plan for systems, data andapplications, effectively end-ing the “stovepipe” systemsdesign and incompatible sys-tems of the past. One ex-ample is VA’s RegistrationEligibility and Contact Man-agement initiative, whichseeks to establish a single au-thoritative source for all vet-eran identification, servicehistory, demographics, familyhistory and location data, tobe shared by all VA businesslines.

Another IT strategicthrust is implementing aOne VA data network. InFebruary 2002, VA initiateda department-wide telecom-munications area networkmodernization and optimiza-tion project (TMP). The ob-jective of the TMP is to

structure a state-of-the-artOne VA wide-area networkthat is simple to administerand maintain.

We are also committedto establishing a One VA ap-proach to project manage-ment. Effective project man-agement is critical to the suc-cessful execution of our pro-grams. We have long recog-nized that standardization ofproject management guide-lines and procedures is cru-cial to achieving this goal.We are committed to projectmanagement certificationand professionalism, and

have instituted a seven-coursecurriculum to promote de-partment-wide project man-agement competencies.

My office has made acommitment to do all we canto help VA better serveAmerica’s heroes. We con-tinue to look for ways to im-prove performance, decreasecosts, and make better use ofour resources so we can re-turn those savings to the de-partment and provide thebest possible service to evenmore veterans. And we willdo this without negatively af-fecting performance.

Working together, wecan and will continue to im-prove and achieve an IT pro-gram that enables us to dowhat we are chartered todo—take care of veterans.

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outlook

VA’s Patient Safety Program Marks a MilestoneJames Bagian, M.D.Director, National Center for Patient Safety

In November 1999, the In-stitute of Medicine chal-lenged medical professionalsto break “the cycle of inac-tion” by developing a com-prehensive approach to pa-tient safety.

Their landmark reporton adverse medical events, ToErr is Human, called for allpatient safety programs to beevaluated after five years toassess whether they weremeeting their goals.

I take great pride inwhat we have accomplishedover these last five-plus years.I’m also very proud that VAaddressed the patient safetychallenge even before theIOM report was published.Because of our success, ourefforts became a model forthe Joint Commission onAccreditation of HealthcareOrganizations’ patient safetystandards, first published in2001.

We’ve consistently fo-cused on developing a cul-ture of safety at VA by takinga systems approach to prob-lem-solving.

Together, we’ve investi-gated how patient care sys-tems function, and that’s areal break from the past. Toomany in medicine once fo-cused on the “who,” ratherthan on the “how” or “why.”In the ineffectual “name andblame” culture, little atten-tion was paid to improvingpoorly functioning systems.Regardless of the caregiverinvolved, a poorly engineeredprocess can repeatedly gener-ate an unfortunate sequenceof events and jeopardize pa-tient safety.

Together, we’ve imple-mented a series of initiativesthat have positively affectedour patients’ lives:■ Patient safety trainingand courses. We’ve heldtraining seminars for morethan 1,000 VA health-careprofessionals at locationsaround the country and wel-comed participants fromaround the world.■ Tool kits and cognitiveaids for front-line profes-sionals. We’ve developed anumber of human factors-oriented cognitive aids andtoolkits that promote patientsafety while enhancing theuser’s awareness of the im-portance of developing a cul-ture of safety, such as ournew Falls Toolkit.

■ Medical team training.Studies continue to showthat a majority of adversemedical events involve team-work and communication-re-lated issues. We’ve developeda team training program toimprove communicationamong caregivers, particu-larly in high-risk environ-ments such as operatingrooms and intensive careunits.■ Patient safety curriculum.The place to begin learningabout patient safety is duringearly training. We’re workingwith professionals from VAand affiliated universities

who have volunteered to as-sist with the pilot testing andrefinement of this initiative.Our target population is resi-dents, medical students,nurses, pharmacists, andother allied health care work-ers.■ Healthcare Failure Modeand Effects Analysis(HFMEA). We developedHFMEA to proactively iden-tify and mitigate high-riskmedical processes. It hasserved as a model—both na-tionally and internation-ally—for developing proac-tive risk assessments and tak-ing action.■ Alerts, advisories andother publications. We pub-lish safety alerts or advisorieson a range of specific issues

that might cause harm to ourpatients; we also publish a bi-monthly newsletter, TIPS,that discusses a wide range ofpatient safety issues.■ Tailored Root CauseAnalysis (RCA) feedback forfacilities. RCAs submitted tous by facilities are reviewed.Critiques from a sampling ofRCAs are sent back to helpVA facilities conduct evenstronger RCAs.■ Ensuring correct surgerydirective. This pioneeringwork has served as a modelfor national and internationalguidelines. We’ve recently ex-panded our efforts to include

invasive procedures outsidethe operating room.■ Patient Safety Improve-ment Corps. The Depart-ment of Health and HumanServices’ Agency forHealthcare Research andQuality selected NCPS todevelop and implement amultifaceted patient safetytraining program for statehealth officials and selectedhospital partners to improvepatient safety nationwide.

As we mark the fifth an-niversary of To Err Is Hu-man, on behalf of myself andeach member of the NCPSstaff, I’d like to thank all ofyou who have done so muchto support our efforts. Wecouldn’t have accomplishedwhat we have without the

across-the-board support ofVHA employees at all levelsand VA leadership.

Patient safety starts atthe bedside. It starts withcaregivers like you who arecommitted to improving pa-tient care; caregivers whoknow that if we are to “firstdo no harm,” we must re-main committed to self-ex-amination that challenges theway we do things. Your in-volvement in patient safetyhas translated into outstand-ing care for our veterans.Thank you so much for thegreat work you continue todo.

In the ineffectual ‘name and blame’ culture, littleattention was paid to improving poorly functioningsystems.

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Athird VA employee has beenwounded in combat in Iraq.Dr. Kenneth Lee, 38, chief of

spinal cord injury service at theClement J. Zablocki VA MedicalCenter in Milwaukee, suffered se-vere shrapnel injuries in a Sept. 12suicide car bombing near the GreenZone in Baghdad.

Lee, a lieutenant colonel in theWisconsin National Guard, wascalled to active duty in November2003. His unit, Bravo Company ofthe 118th Medical Battalion,shipped out to Fort Drum, N.Y., inearly December for training in navi-gation, convoy procedures and otherskills tailored for duty in Iraq.

They departed for Kuwait inFebruary 2004 and crossed over intoIraq later that month. As com-mander of the 70-soldier BravoCompany, Lee’s mission was to es-tablish and oversee medical servicesat seven sites located in and aroundBaghdad. These included five battal-ion aid stations and two troop medi-cal clinics capable of providing morecomprehensive services such as X-ray, laboratory, dental and inpatientcare.

Lee soon found himself spend-ing a lot of time on the road as hetraveled back and forth betweenmedical missions. “I quickly realizedthat this was going to be pretty haz-ardous,” he said in an Oct. 21 inter-view from the Malogne House atWalter Reed Army Medical Center,where he is recovering.

In the spring of 2004, attacksagainst military convoys were occur-ring with increasing frequency and

ROBERT TURTIL

VA doctor survives suicide car bombing in Baghdad.

Dr. Lee in the lobby of Malogne House at Walter Reed, with a get-well card sent by col-leagues and friends at the Milwaukee VA Medical Center.

A Close CallA Close Call

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“I really want to go back, but the doctorswon’t clear me. It’s really frustrating.”

ROBERT TURTIL

sophistication. Convoy duty had be-come one of the deadliest missionsin Iraq. To reduce the likelihood ofbeing targeted in an attack, Lee as-sembled a nine-person convoy secu-rity team. They traveled in threehardtop “turtle-back” Humveesequipped with upper armor platesand turret-mounted squad automaticweapons. The lightweight machineguns are capable of firing 1,000rounds of 5.56 ammunition perminute.

The doctors and nurses of BravoCompany were now on the frontlines of a mounting guerrilla war.Lee said his team was extremelyvigilant. “Every mission, no matterhow routine, our weapons werelocked and loaded,” he said.

As time passed, Lee said enemyforces grew bolder. “There were a lotof close calls, a lot of quick decisions… should we engage or not. As aconvoy commander that drives younuts. When you make a run andcome back you are completelydrained, both physically and men-tally.”

On the morning of Sept. 12,Lee and his convoy team were tak-ing blood samples and X-rays to themain military hospital in the GreenZone when they encountered aroadblock set up by U.S. forces in-specting a suspicious vehicle. Rather

than return to base, they decided towait. They pulled their Humveesinto defensive positions near theroadblock, which had created a traf-fic jam as civilian vehicles mergedinto a single lane.

Lee hopped out of his Humveeand directed his troops to provide360-degree coverage of their perim-eter. He took up a position alongsideSgt. Chris Cook near the rear guard.

Suddenly a large sedan popped outof traffic and barreled straight forthem. It was about 50 feet away andclosing fast. Both men raised theirM-16 rifles. Cook got off two shotsbefore the vehicle detonated about25 feet from their position.

Lee remembers seeing a brightorange flash and feeling a wave ofheat pressing against his skin. Thenext thing he knows, he’s lying onthe ground about three Humvees’distance from where he had beenstanding, roughly 45 feet. His hel-met was gone, his pants were shred-ded. “I tried to move, but everythinghurt so bad. There was so muchblood,” he said.

He looked for Sgt. Cook andwondered if he was alive. “I thoughthe didn’t make it, because he wasstanding right next to me and Isurely should have been dead. Wewere completely exposed when thething went off.” The blast woundedeight members of the nine-personteam. Lee and two others weremedevaced to Walter Reed.

It’s easy to spot Lee at theMalogne House. He’s the only onewearing shorts in the cool autumntemperatures.

It hurts when he wears pants, heexplains, pointing to the 25 to 30shrapnel wounds on each of his legs.Some are dime or quarter-sized open

sores. Others have scabbed over.Jagged scars have formed where doc-tors removed the larger pieces. Thesmaller pieces are starting to pro-trude from beneath his skin. Theywill eventually work their way out,he explained.

Lee has spent the past fewweeks doing self-therapy: stretching,exercising and cleaning his wounds.He is expected to make a full recov-

ery. But his hopes of rejoining histroops in Iraq have been dashed.

“I really want to go back, butthe doctors won’t clear me. It’s reallyfrustrating,” he said. Instead, Lee isheading home for 30 days of conva-lescent leave before returning toWalter Reed to complete his active-duty tour as a staff physician work-ing with wounded soldiers.

The two other VA employeeswounded in combat in Iraq are Dr.Robert Frame, chief of VHA DentalService, who was wounded in April2003 in a Baghdad ambush, and Su-san Sonnheim, a nurse, also fromthe Milwaukee VAMC, who was in-jured in September 2003 by an im-provised explosive device.

Lee’s daily routine includes a stretching and exerciseregimen designed to speed his recovery. The chief ofspinal cord injury at the Milwaukee VA Medical Centeris expected to recover fully from his injuries.

By Matt Bristol

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What was once a patch of as-phalt is now a place of so-lace filled with native

plants, rock benches, sculpture andtrees dedicated to a deeper level ofhealing for veterans at the VA SaltLake City Health Care System.Purtkwahgahm (Burk-Wah-ga-me),dedicated last summer, is an outdoorgarden named after the native Uteword that translates to “HealingGround.”

The medical center providescare to veterans in the largest geo-graphic area in the VA system. “Wehave quite a challenge in meetingthe diverse needs of our patients,”said James R. Floyd, medical centerdirector. “They come from urban ar-eas and very remote rural areas, theycome from tribes, they come fromall races, and when they come toSalt Lake City, their needs need tobe met in a manner that fits them.”

VA health care facilities are increasingly offering alternatives toconventional Western medicine. The Salt Lake City VA Medical Center’shealing garden incorporates traditional Native American therapies.

For veterans who suffer fromchronic pain, drug addiction andmental illness, there is a need forconnection, inclusion and under-standing. The healing ground is atranquil, therapeutic space to medi-tate, reflect and enjoy a connectionwith nature.

In addition, the medical centerhas developed an Integrative HealthClinic offering a holistic mind, bodyand spirit approach to healing andwell-being. The clinic offers re-search-based complementary and al-ternative medicine therapies andself-empowerment classes to helpveterans with chronic pain and ill-ness. Currently, 14 different holistictherapies and self-empowermentclasses from acupuncture to yoga areavailable.

The idea to create a NativeAmerican healing ground originatedthrough the medical center’s resi-

dential treatment program called“Eagle’s Nest.” The program is de-signed to aid veterans living in re-mote areas and provide treatment tothose suffering from substance abuseand trauma. The healing ground wasseen as an opportunity to reach outto Native veterans who might feeldisconnected from the VA systemdue to lack of awareness or re-sources.

However, Purtkwahgahm is notjust for Native Americans. “This is aplace that honors all veterans andtheir families. It is inclusive of spiri-tual symbols, cultures and ethnicgroups,” said Dr. Stephen K.Harmon, director of patient educa-tion, during the dedication cer-emony.

Native American culture is veryinclusive, allowing those who par-ticipate to develop a deeper under-standing while retaining their own

A Place for Healingand Connection

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beliefs, according to social workerKym Couture.

Veterans can explore their spiri-tual self through a Sweat Lodge Pu-rification Ceremony; express emo-tions fully through song and musicduring drumming ceremonies; anduse smudging ceremonies to sym-bolically cleanse, purify and protectthe physical and spiritual body.They may also become more con-nected by pledging a sincere mindand heart as they bring awareness totheir intention with the sacredburning of tobacco.

Sandra Smeeding and SusanOsguthorpe founded the IntegrativeHealth Program as a holistic ap-proach to healing. “We feel an inte-grative approach will become in-creasingly more common in tradi-

tional medical settings,” saidSmeeding, “with conventionalWestern medicine addressing theneeds of individuals for medicationand surgery, and a holistic, self-em-powerment, non-pharmacologicalapproach addressing core attitudesand beliefs to assist those copingwith chronic conditions.”

Veterans participating in theprogram have come to discover waysto manage and even excel despitetheir difficulties. They may still livewith a measure of chronic pain andillness, but they are no longer fo-cused on or controlled by their con-dition. They often experience apositive change in self-perception,relief from physical and emotionalstress and pain, an increased abilityto cope with their chronic condi-

tion, and new self-empowermentskills.

“Being in this space offers animmediate and everlasting resourcefor inward reflection and the experi-ence of connection we all desire inthe deepest parts of ourselves. Theexperience of connection holdswithin it the nature of spiritual heal-ing,” Smeeding said.

The hope is that those who usethe resources at Purtkwahgahm willexperience a transformation similarto that which occurred on thegrounds where the garden lies. Oncea vacant and abandoned asphalt lot,it has now turned into a park-likegarden of beauty and growth, withan optimistic future.

By Jacob Floyd and Susan Huff

James J. Lackey, an Army veteran of Desert Storm, enjoys the healing garden on the grounds of the Salt Lake City VA Medical Center.The garden, which offers veterans a place for quiet reflection and meditation, is part of a broader effort by the medical center to meetthe diverse needs of its patients.

TOD PETERSON

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The National Cemetery Admin-istration cut the ribbon on itsown training center in August.

Now fully up and running, the cen-ter is located in St. Louis, close toJefferson Barracks National Cem-etery and the St. Louis VA MedicalCenter.

“Because of NCA’s unique mis-sion, no federal training center pro-vides the specific training our em-ployees need to run a national cem-etery,” said Steve Muro, NCA’s di-rector of field operations. “Thetraining received at the center willbetter prepare our personnel to oper-ate national cemeteries.”

A state-of-the-art facility, thecenter encompasses 3,000 square

stone alignment in the training cen-ter; on the next they may be atJefferson Barracks National Cem-etery practicing what they learnedin the classroom.

“The training center allowsNCA to centralize instruction, en-suring uniform instruction for allemployees attending the same class,”said training center director PatriciaRikli.

The first class of 14 cemetery di-rector interns began their training inEmployee Education System class-rooms at the St. Louis VA MedicalCenter in June. They moved intothe new training center shortly afterit opened. When they graduate inMarch 2005, they’ll be assignedthroughout the country as assistantcemetery directors. There they willgain more skills before eventuallybecoming cemetery directors them-selves.

The center, which has a full-time staff of two, supplementsclasses with guest instructors. Theseinstructors are VA subject matterexperts from the three administra-tions and headquarters, as well asindependent contractors.

Currently the center only hasone yearlong course, the director in-tern program, in its curriculum. Inthe near future, NCA plans to ex-pand courses to instruct cemeteryforepersons, cemetery representa-tives, equipment operators,groundskeepers and other employ-ees.

feet of office and classroom space forstudents and staff. The classroomshave new computers with Internetaccess for each student and the lat-est audio-visual equipment for in-structors.

Students at the center learn inan environment that includes bothclassroom and field training atJefferson Barracks National Cem-etery. The course requires students’active involvement and includesteam projects with opportunities toapply theory in the field. Studentsgain hands-on experience in realday-to-day cemetery operations andissues.

On one day students may attenda class on gravesite layout and head-

Training for a Unique MissionNo existing federal training center could offer National CemeteryAdministration employees the specific training they needed to run anational cemetery, so NCA created its own.

Cemetery director interns get some hands-on experience during a headstone alignmentclass at Jefferson Barracks National Cemetery.

By Mike Nacincik

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Veterans Day 2004Veterans Day 2004

Above: Veterans Day activities in the nation’s capital kicked off onNov. 10 with the dedication of the final element of the Vietnam Veter-ans Memorial, the In Memory Plaque. It honors Vietnam veteranswhose postwar deaths have resulted from their service in that war, butwhose names are not eligible to be added to The Wall; top right: Secre-tary Principi talks with California businessman and philanthropist Ken-neth E. Behring at the Nov. 10 dedication of a new permanent exhibitfunded by Behring on U.S. military history at the Smithsonian’s Na-tional Museum of American History. The exhibit, “The Price of Free-dom: Americans at War,” examines 250 years of American militaryconflicts; center right: A special Veterans History Project bus was un-veiled on Nov. 12. It will travel to communities across the country torecord oral histories of veterans for preservation by the Library of Con-gress; bottom right: Pleasant weather drew a big crowd at the tradi-tional Veterans Day ceremony at Arlington National Cemetery.

MICHAEL L. MOORE

ROBERT TURTIL

ROBERT TURTIL

ROBERT TURTIL

Honoring AllWho Served ...

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The concept for a Day in the Life of VA photo fea-ture had been bouncing around VAnguard for sev-eral years. Everyone thought it was a great idea. Butno one had any idea whether readers would be in-terested. If they weren’t, the whole thing would bea flop.

As it turned out, employees submitted nearly500 photographs. Some showed the everyday tasksof people on the job: pulling records from a filecabinet at a VA regional office or dishing up chowat a medical facility. Others showed unusual excur-sions such as an airboat ride in the Everglades or asing-along with a mariachi band.

The quantity of photos posed a challenge forVAnguard photo editor Robert Turtil, who was re-sponsible for selecting the best shots for publica-tion. “There were so many images. We wantedthose that stood out from the others. But we alsolooked for those that showed the broad scope of theVA mission and the employees who fulfill it,” hesaid.

What Makes a Good Photo?Trying to select the best photographs from 500

submissions is somewhat of a subjective exercise. Itraised the question of what makes a good photo?

VAnguard posed the question to several amateurand professional photographers throughout the de-partment. Their responses included technical as-

pects such as proper exposure and composition,along with contemplative musings on the ability tocapture a precise moment in time.

“Life moves so fast … through photographswe’re given the opportunity to stop and study thehuman condition, often causing us to reflect uponan aspect of our own lives,” explained Laurel LeeSchreiner, a photo enthusiast and human resourcesmanager at the Seattle VA Regional Office.

A good photograph is a work of art, accordingto Jim Moore, a former Time magazine photojour-nalist who now writes speeches for SecretaryPrincipi. It’s one that combines the elements oftiming, composition and lighting, capturing whathe called “the decisive moment,” a phrase coinedby French photographer Henri Cartier-Bresson.

One could argue that Tessa Kalman captured adecisive moment when she snapped this image ofan employee walking toward the patient tower atthe Dayton, Ohio, VA Medical Center one autumnmorning.

The sun reflecting off the windows appears asthough it’s emanating from within, creating a light-house effect, while the lone walker drifts throughthe low-hanging fog. If she had waited, the walkerdisappears, the sun rises, and the moment is lost.

Selecting the PhotosSeveral of the photos in this collection capture

A Day in the Lifeof VA

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the decisive moment. But showing good photogra-phy wasn’t the primary objective of this exercise.The idea was to tell the story of a typical day in VAthrough pictures.

VAnguard staff considered four key elementswhen selecting photos to include in this series: con-nection, composition, context and quality. Connec-tion refers to whether viewers can connect with thesubject; composition is how the photograph is ar-ranged; context is the scene or location in whichthe shot was taken; and quality is whether the im-age was properly exposed, in focus, and with print-quality resolution.

Most submissions will be added to the VAphoto library, which can be accessed through

MediaNet, vaww.mam.lrn.va.gov/MediaNet04. Thisonline database has more than 13,000 photos, illus-trations, graphics, animation and other assets avail-able to VA employees. VHA’s Employee EducationSystem established MediaNet last year. More than2,000 VA employees have since registered with thesite. They include public affairs officers, media pro-ducers, educators, computer technicians and otherswho use graphics.

The photos on the following pages represent atypical day at VA facilities. They depict the work ofa versatile workforce united in their service to vet-erans. Thanks to all who participated in thisproject. Send comments about the project or any ofthe photos selected to [email protected].

Sunbeams reflect off the windows of the patient tower at the Dayton, Ohio, VA Medical Center on a foggy morning.TESSA KALMAN

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Patricia Thomas (front) and Antoinette E. Walker prepare pa-tient trays at the Wade Park division of the Louis StokesCleveland VA Medical Center.

REBECCA JEWEL

Orthopedic surgeon Gerald Dreher scrubs upbefore going to work at the Temple, Texas, VAMedical Center.

BOBBY POFF

STEVE JUDISH

Employees from the Denver VA RegionalOffice show their spirit during the city’sVeterans Day parade.

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Tom Edmundson, military services coordi-nator at the Waco VA Regional Office, dis-cusses VA benefits with a soldier at FortHood, Texas.

DEBORAH K. MEYER

Left: Drs. Santiago Figuereo (left) and Suresh Magee at work at the Phila-delphia VA Medical Center; above: The delicate work of operating roomsurgeons at the Tucson, Ariz., VA Medical Center.

JACK WIDMAIER

GARNET G. MORRIS

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Above: Volunteer Al Morris at the Fargo, N.D., VA Medical Center.Morris drives patients from the parking lot to the hospital’s mainentrance in this electric car; left: A combat veteran support groupfrom the Fort Myers, Fla., Vet Center on an airboat ride throughBig Cypress Seminole Reservation.

MARGARET WHEELDEN

WAYNE PLUMMER

The VA Advisory Committee on Cemeteries andMemorials meets in VA Central Office. Thegroup meets twice a year, once in headquartersand once in the field.

ROBERT TURTIL

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feature

Noel O’Brien, a counselor at the Oakland, Calif., Vet Cen-ter (back row wearing the green shirt), takes a group ofcombat veterans to the California Vietnam Veterans Me-morial in Sacramento.

Above: Bill Ames, laundry machine op-erator, folds pajamas at the New MexicoVA Health Care System in Albuquerque;right: Training a rat to run on the tread-mill in the research department of theDetroit VA Medical Center.

WILLIAM BROWNING

MICHAEL KLEIMAN

COURTESY OF NOEL O’BRIEN

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Employees show their support for members of the 118th Medical Battalion, Connecticut Na-tional Guard, as they deploy to Iraq in September. The unit is based at the Newington cam-pus of the VA Connecticut Healthcare System.

DAN SHOWALTER

Program support clerk Darrell White pulls a claimfolder at the Lincoln, Neb., VA Regional Office.

RICHARD THOMPSON

Respirator-dependent patients enjoy a day of fishing at the Perry Point, Md., VA Medical Center.JOHN RIZZO

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feature

Above: Seeing eye to eye during pet therapy in the daytreatment program at the Southern Oregon RehabilitationCenter and Clinics in White City, Ore.; right: Veteran HarryPulschen gets an eye exam in the Ophthalmology Clinic atthe Bronx, N.Y., VA Medical Center.

LYNNE KANTOR

SCOTT SARVER

Environmental Management Serviceemployees from the Atlanta VAMedical Center pose after receivingthe September 2004 Clean AtlantaAward.

ANN HAMILTON

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Above: Student art therapist Kristen Lambert withnursing home resident Robert Henry at the Detroit VAMedical Center; right: Decontamination proceduresduring a bio-weapons drill at the West Palm Beach,Fla., VA Medical Center.

Peter Lin, M.D., chief of vascular surgery, and Ruth Bush, M.D., a vascularphysician, examine veteran Clyde Wilson after his cryoplasty procedure atthe Michael E. DeBakey VA Medical Center in Houston.

CHANI J. DEVERS

BOBBI D. GRUNER

GARY DALE

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feature

Operating room technician Tiffany Goodwin-Liskey during a procedure at the Salt Lake City VA Medical Center.

Left: Speech pathologist Kathleen Bashista uses a computerizedcommunication device with a paraplegic veteran while his fatherlooks on at the Lebanon, Pa., VA Medical Center; above: QuincyWhitehead (right), director of Wood National Cemetery in Milwau-kee, Wis., called this photo “A Little Heavier Than I Thought” asshe, along with Ell Nealey (left) and Gary Verkuilen (center) com-plete headstone realignment training.

ROBERT MANNING

TOD PETERSON

ROGER SANDS

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Dr. Mary Neal conducts a rou-tine checkup with WWII vet-eran Phillip DaCosta at theSouthern Oregon Rehabilita-tion Center and Clinics inWhite City, Ore.

DALTON MAURIN

Left: Marie Bertram, hemodialysis technician at the Bronx VA Medical Center,with Pedro E. Segarra Sr.; above: Chief radiologist Dr. Ismael Dennenburg (inwhite coat) reviews X-rays at the Bronx VA Medical Center with radiologictechnicians Ruby Chacko and Sayam Youngsuwan. Working in the backgroundare Jun Kwang Kwon and Carla Dixon.

LYNNE KANTOR

LYNNE KANTOR

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feature

Left: A veteran gets his prosthetic leg adjusted at the Atlanta VA Medical Center; above:Christopher Danseglio, a cook at the VA Extended Care Center, St. Albans, N.Y., VA Medi-cal Center, whips up 80 gallons of corn chowder for the VISN 3 Commissary.

PETER GRATTAN

TARA VUONO

Adrienne Macias, a licensed vocationalnurse at the Michael E. DeBakey VA Medi-cal Center in Houston, uses a hand-heldscanner to read the wristband of veteranElton Nodier to ensure he receives thecorrect medication in the correct dose atthe correct time.

BOBBI D. GRUNER

VAnguardaround headquarters


The future of assistive tech-nologies for people with dis-abilities includes implantablemicrochips that interfacewith the central nervous sys-tem, electrical stimulation ofparalyzed muscles, and usingbrain signals to check e-mailand channel surf.

These were just a few ofthe emerging fields high-lighted during a joint VA/White House conferenceheld Oct. 13-14 in Washing-ton, D.C. Nearly 100 leadingscientists and disability rightsadvocates from public andprivate organizations at-tended the event, includingrepresentatives from theChristopher Reeve ParalysisFoundation, the NationalScience and TechnologyCouncil and VA’s Office ofResearch and Development.

Presenters included Dr.Joseph F. Rizzo III, directorof the Center for InnovativeVisual Rehabilitation at theBoston VA Medical Centerand Harvard Medical School.Rizzo discussed his work ondeveloping a retinal implantto restore vision to patientswith age-related macular de-generation, the leading causeof blindness in America.

His approach involveswearing a miniature cameramounted to a pair of glassesto capture a visual scene. Thescene is then transmitted vialaser signal to the retinal sur-face, where it stimulates theganglion cells connected tothe brain. It is currently be-ing tested on six patients.Check out the Retinal Im-plant Project Web page, atwww.bostonretinalimplant.org,for more information.

Also presenting was P.Hunter Peckham, Ph.D., di-rector of the Functional Elec-

Conference Highlights Emerging Technologies for Disabled

trical Stimulation Center atthe Cleveland VA MedicalCenter. Peckham discussedhis work on electrical stimu-lation of the peripheral ner-vous system, which uses im-plantable electrodes to stimu-late muscles. This approachcan be applied in a variety oftherapies, including as an aidin stepping or walking, im-proving circulation, boweland bladder control, andmanaging skin ulcers. ActorChristopher Reeve received afunctional electrical stimula-tion implant in March 2003,allowing him to breathewithout a ventilator. Formore information, visitfeswww.fes.cwru.edu.

Some of the presentersdescribed concepts thatseemed the stuff of sciencefiction. John P. Donoghue,Ph.D., professor of neuro-science at Brown University,discussed his lab’s work onneuroprosthetics, which in-volves connecting a person’sbrain to a type ofsupercomputer. It is currentlybeing tested on one quad-riplegic patient. The patienthas a sensor implanted in anarea of his brain’s primarycortex responsible for handmovement. The sensor sendsbrain signals to a portal onthe top of his head, wherethey are transferred to a cablethat runs to the computer. Sowhen he thinks about mov-ing the computer’s mouse,the cursor actually moves onthe computer monitor. Hecan use the computer to readand write e-mail and changethe channels on his televi-sion. Check out www.cyberkineticsinc.com/index.htmfor more information.

A key theme repeatedthroughout the conference

was the importance of build-ing partnerships betweengovernment agencies, privateorganizations and manufac-turers. “No single one of uscan do it alone. We mustwork together,” said speakerMargaret Giannini, M.D.,

former VA deputy assistantchief medical director for re-habilitation and prosthetics(1981 to 1992), who nowserves as director of the officeof disability at the Depart-ment of Health and HumanServices.

ROBERT TURTIL

Top: Ron Lew, M.D., a radiologist at the Cleveland VA Medical Cen-ter, volunteers for functional electrical stimulation testing at theCleveland FES Center of Excellence. He is assisted by Rudi Kobetic,a biomedical engineer; above: Drs. Joseph Rizzo, Mindy Aisen andHunter Peckham (left to right) at the joint VA/White House confer-ence on emerging technologies in Washington, D.C.

CLEVELAND FES CENTER PHOTO

http://www.bostonretinalimplant.org

http://www.cyberkineticsinc.com/index.htm

http://fescenter.case.edu/

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around headquarters

The power of the Internet isenabling veterans to gethealthier and stay healthierlonger. Veterans Day 2004marks the one-year anniver-sary of My HealtheVet, theVA eHealth portal designedfor veterans.

The first version linksveterans with the informa-tion they need to better un-derstand, maintain and man-age their health. It features“one-stop shopping” for VAbenefits and forms, health fa-cility locations and specialprograms, and news aboutVA and benefits legislation.My HealtheVet also providesa health education librarywith current informationabout medications and con-ditions, health measurementtools, a prescription checkerand health news updates.

This Veterans Day, VA isintroducing the Personal

Health Record to MyHealtheVet. It allows veteransto keep a personal healthjournal where they canrecord such information asemergency contacts, healthcare providers and insurance,health history, prescriptions,over-the-counter drugs andsupplements, tests and aller-gies.

Using the eHealth por-

tal, veterans can enter andtrack health readings forblood sugar, blood pressure,cholesterol, heart rate, bodytemperature, pain and bodyweight. My HealtheVet alsogenerates an emergency con-tact card for the veteran’swallet, automatically filledwith personal informationpreviously entered in thehealth journal. These features

The Power of the Internet Empowers Veterans’ Health

are private and secure, andprovided by VA as a serviceto all veterans.

My HealtheVet is an-other way to bring VA healthcare to veterans’ homes, edu-cate veterans about theirhealth, and help make themactive partners in their healthcare. In spring 2005, MyHealtheVet will provide vet-erans receiving VA healthcare with online services suchas prescription refill and theability to see their up-to-dateVA health care co-paymentbalance and clinic appoint-ments.

By the end of 2005, vet-erans receiving VA healthcare will be able to requestand download key portionsof their VA health recordsand share this informationwith VA and non-VA healthcare providers and other del-egates, as they choose.

My HealtheVet can beaccessed from any computerwith Internet access. To be-gin keeping their PersonalHealth Record, all currentusers will need to re-registerthrough the site’s new secureregistration procedure.

Veterans can access MyHealtheVet and register forits free services by logging onto www.myhealth.va.gov.

Significant improvements have been made to VA’s Web-based system for providing health care infor-mation to patients since it was launched on Veterans Day 2003.

ROBERT TURTIL

VA’s FY 2004 Annual Performance and Accountability Report, submitted to the Presidentand Congress on Nov. 15, documents the department’s performance improvements indelivering high-quality health care, benefits and memorial services to the nation’s vet-erans. The department achieved an unqualified “clean” audit opinion on its financialstatements for the sixth consecutive year. This is the best result an agency can receivefrom an independent auditor. VA’s FY 2004 Annual Performance and Accountability Re-port is available on the Internet at www.va.gov/budget/report.

2004 Performance Improvements

http://www.myhealth.va.gov

http://www.va.gov/budget/report

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Under new rules that tookeffect in October, formerprisoners of war who sufferstrokes or develop mostforms of heart disease will beautomatically eligible for dis-ability compensation forthese common ailments, andtheir spouses and dependentswill be eligible for service-connected survivors’ benefitsif these diseases contribute to

A newly renovated veteransconference center in VACentral Office was named inhonor of former MississippiCongressman G.V. “Sonny”Montgomery during an Oct.27 dedication ceremony.

“Chairman Montgom-ery is a great American,whose distinguished recordof public service, both in the

Auditorium Named in Honor of G.V. ‘Sonny’ Montgomery

hot winds of battle and inthe congressional arena, isthe quintessential hallmark ofservice to country and serviceto others,” said SecretaryPrincipi.

Montgomery served inWorld War II and the Ko-rean War before being electedto Congress in 1966. Hewent on to serve 28 years on

the House Veterans’ AffairsCommittee and as its chair-man from 1981 to 1994.While in Congress, heauthored legislation to re-vamp the original GI Bill, ex-tending education and enlist-ment benefits. Some creditthe success of America’s all-volunteer military force tohis “Montgomery” GI Bill.

He is also credited withhelping elevate VA to cabi-net-level status. “I’m veryproud to have had a hand inelevating this department tocabinet status,” he said dur-ing the ceremony. “It allowsus to go to the front door ofthe White House instead ofthe back door.”

Montgomery retiredfrom Congress in 1996. Thetwo-level veterans conferencecenter in VA headquartersbearing his name will be usedfor presentations and specialevents. One highlight of theroom is a glass display show-casing items fromMontgomery’s collection ofpersonal memorabilia. In-cluded are the gavel he usedas chairman of the HouseVeterans’ Affairs Committee,his military decorations, andthe original Montgomery GIBill signed by PresidentRonald Reagan.

It’s not the first timeMontgomery’s name hasbeen associated with a VAbuilding. The VA medicalcenter in Jackson, Miss.,about 90 miles from hishometown of Meridian, alsobears the formercongressman’s name.

A two-level conference center in VA headquarters now bears the name of the former Mississippi con-gressman, above at the dedication ceremony, a legend in veterans’ circles.

ROBERT TURTIL

the death of a former POW.“This is an issue that has

been studied and debated toolong,” said Secretary Principi,who announced the ex-panded benefits in a speechat the national convention ofthe American Ex-Prisoners ofWar on Oct. 2. “We have sci-entific studies supporting theassociation of these illnessesto the military service of our

former POWs.”In September 2003,

Principi launched a nation-wide outreach effort to iden-tify and provide benefits tothe estimated 11,000 formerPOWs who were not receiv-ing VA disability compensa-tion or other services. Thereare about 35,000 livingformer POWs.

The Secretary also has

urged Congress to changefederal law that requiresformer POWs to be detainedfor at least 30 days to qualifyfor the full range of POWbenefits.

This new decision willadd to the list of 16 medicalproblems that VA presumesto be linked to the militaryservice of former prisoners ofwar.

VA Expands Former POW Benefits for Stroke, Heart Disease

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around headquarters

September’s hurricane season inflicted unprecedented damageand destruction on the southeastern United States. Many VAemployees remained at their posts through five ferocious

Secretary Principi presented the 2004 Olin E. TeagueAward to the Chronic Pain and Rehabilitation Programat the James A. Haley Veterans Hospital in Tampa onOct. 6. It is the department’s highest honor for pro-grams assisting combat-injured veterans. The Secre-tary specifically cited the work of clinical director Dr.Michael E. Clark, program coordinator Susan J. Hagan,and psychologist Dr. Ronald J. Gironda. The award isnamed after the late Texas Rep. Olin Teague, a highlydecorated World War II veteran who served 32 yearsin Congress, including 18 years as chairman of theHouse Veterans’ Affairs Committee. Teague’s daughterJill Cochran joined the Secretary, above, in presentingthe award to Gironda, Hagan and Clark (left to right).

Michael Rabdau, of VA Canteen Service, accepts SecretaryPrincipi’s contribution toward hurricane relief for VA employees.Looking on are members of the Disbursement Committee (fromleft): John Oswalt, president of the Leadership VA Alumni Associa-tion; Peter Flynn, president of the VACO Employee Association,and Ann Patterson, of VHA Central Office. The committee decidedhow the money collected would be distributed.

VA Employees Open Hearts, Wallets for Hurricane Victims

ROBERT TURTIL

2004 Olin E. Teague Award

The Congress for Im-proving Chronic Carepresented Dr. JonathanB. Perlin, left, actingunder secretary forhealth, the 2004 VisionAward for pioneeringwork in providing careto the chronically ill.Perlin accepted theaward on behalf of VAduring the group’s an-nual conference Sept.22 in Seattle. VA’shealth care system setindustry standards in

2004 by meeting 18 of 18 clinical quality indicators indisease prevention and treatment.

Improving Chronic Illness Care

storms to ensure the safety and continuity of service to veter-ans, even as their homes and properties were being damaged.

To recognize their dedication, and to help them recoverfrom their losses, Secretary Principi asked that the week ofOct. 11-15 be set aside as a “week of giving,” during whichVA employees throughout the nation had the opportunity tohelp their fellow VA family members who suffered losses dur-ing the recent storm season. VA employee organizations andVA Canteen Service joined forces to make that possible.

VA employees nationwide reached into their hearts andwallets and contributed more than $45,000 to help others.Fifty-six employees were identified as having had sufficientlycatastrophic damage to merit a share of the funds. Shareswere divided equally among this group as a heartfelt demon-stration of support and thanks from the VA family, and prov-ing, once again, that VA takes care of its own.

EMERSON SANDERS

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Gene Finney

Some say Gene Finney is theright guy for the right job. Ascasualty assistance officer atthe Seattle VA Regional Of-fice, his job is to discuss VAbenefits with the next of kinof servicemembers killed inthe line of duty.

He’s “probably the bestperson” for the job, arguedRalph Osman, triage coach,who nominated Finney forthe position when it openedlast year. He cited Finney’smilitary background, his ex-tensive knowledge of VAbenefits, and his caring na-ture as qualities that makehim ideal for the position.

Osman was on to some-thing, as Finney has flour-ished since taking on his newrole. This year he receivedthe Veterans BenefitsAdministration’s OutstandingCustomer Service Award. Butit isn’t his military experienceor familiarity with VA ben-efits that make him so effec-tive. It’s his compassion,drawn from personal experi-ence in the loss of a lovedone.

His father died suddenlywhile serving in the AirForce. Finney was a youngArmy sergeant stationed atFort Benning, Ga., at thetime.

He remembers visiting acounty veterans office nearFort Benning shortly after hisfather’s death. “It was an aw-ful experience,” he recalled.“There was this cranky oldguy who made me feel like Iwas wasting his time. Whenhe found out my dad had aheart attack, he said, ‘Oh, hejust kicked off, huh?’ Youdon’t talk about a familymember that way.”

Today Finney makes ev-ery effort to ensure others

don’t experience the samecold indifference he did.“These are young peoplewho suffered terrible loss. It’svery difficult for them andvery emotional. I listen andshow them I care,” he said.Having a personal connec-tion to the mission makeswork seem less work-like.Finney calls his job “a privi-lege.”

Finney joined the Armyin 1958 after graduatingfrom high school. He didfour years of active duty fol-lowed by a stint in the re-serves, where he used the GIBill to get a degree in politi-cal science from the Univer-sity of Washington. By 1975,he returned to active dutyand came to work as a De-fense Department liaison atthe Seattle VA Regional Of-fice. He spent the next 17years on active duty, retiringin 1992 as a sergeant major.

He returned to Seattlewith plans to take it easy andenjoy retirement. One thingled to another and he woundup taking a job at the VA re-gional office as a public con-tact representative. “It wasjust like what I’d done on ac-tive duty,” said Finney, whoworked as a recruiter formuch of his military career.

Since becoming a casu-alty assistance officer, he hasassumed duties of militaryoutreach specialist and Op-eration Enduring Freedom/Iraqi Freedom outreach coor-dinator. As such, he spends alot of time at nearby FortLewis briefing soldiers re-turning from Afghanistanand Iraq or visiting thewounded at Madigan ArmyHospital.

Ken Whitehall, a man-agement analyst who wrote

Finney’s nomination forVBA’s customer serviceaward, estimated that Finneyhas touched “thousands uponthousands” of returning sol-diers. “From the veterans Ispoke with [when writingFinney’s nomination], heseems to have touched themon a deeper level. You couldhear it in their voices—theywere personally moved bywhat he’d done for them,”said Whitehall.

Whitehall cited the caseof a National Guard soldierwho suffered devastating in-juries when her vehicle hit aland mine in Iraq. Finneyfound out about her througha story in the local newspa-per. Though she had recentlymoved to a remote part ofthe county, he tracked herdown and drove out to herhouse on the weekend.

When he arrived, he dis-covered her wounds were sosevere she was unable to situp in bed. He spent the nextfew hours visiting with herand her mother and discuss-ing the range of benefits towhich she was entitled.

Months later, with herwounds partially healed, thesoldier came to the regionaloffice to thank Finney for be-ing there in her time of need.

Finney doesn’t considerhis job a 9-to-5 operation.Weekends, evenings, even themiddle of the night, he’savailable for families who lostloved ones and soldiers re-covering from combatwounds. “I have yet to meetanyone who puts in as manyhours as Gene,” saidWhitehall.

Finney’s award nomina-tion best summarizes his ap-proach to serving veterans.“He provides the personaltouch that injured soldiersneed, and lets them knowthat their country has keptits commitment to them,”wrote Whitehall. “Geneshows them that the VA ismore than just a bureaucracy;he shows them that the VA ismade up of people whogenuinely care about them.Gene personally affirms theyare the reason for our being,our common purpose.”By Matt Bristol

LAUREL LEE SCHREINER

Gene Finney briefs returning reservists and National Guard members demobi-lizing at Fort Lewis, Wash. Veterans he’s worked with and his colleagues at theSeattle VA Regional Office say he brings a personal touch to his work.

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medical advances

Study PinpointsSchizophrenia BrainGlitchScientists for the first timehave identified a fault in thebrain waves of schizophrenicsthat may explain their hallu-cinations and disturbedthinking. The study, by ateam at the Boston VAHealthcare System andHarvard Medical School, ap-pears in the Nov. 8 Proceed-ings of the National Academyof Sciences.

The researchers studiedthe brain waves of normaland schizophrenic patients asthey responded to images.Those with the disordershowed no electrical activityin a certain frequency—the“gamma” range, from 30 to100 brain waves per sec-ond—that healthy brain cellsuse to exchange informationabout the environment andform mental impressions.

“The schizophrenics didnot show this gamma-bandresponse at all. There was apretty dramatic difference,”said senior author Robert W.McCarley, M.D., deputychief of staff for mental

health services at the BostonVA Healthcare System andhead of the Harvard psychia-try department.

“What some of themdid show was a response at alower frequency, outside thegamma band, which may in-dicate less efficient commu-nication among neurons,”said McCarley. He addedthat the strongest non-gamma activity was shownby patients with the worstschizophrenia symptoms.

Schizophrenia affectsabout 2.2 million Americans.It is the most common psy-chotic illness, and accountsfor some 40 percent of VA’smental health costs.

Bringing MentalHealth Services toPrimary CareScientists in VISN 2 (Albany,N.Y.) will begin exploringways to integrate mentalhealth services into the pri-mary care setting with theaward of a $9 million re-search grant. The grant, $1.8million per year for fiveyears, will fund the new Cen-ter for Integrated Healthcare

based at the Syracuse VAMedical Center.

The concept of integrat-ing behavioral health into aprimary care setting justmakes sense, according toLarry Lantinga, Ph.D., a psy-chologist who is helping toget the new center up andrunning. “People with men-tal health issues often don’trecognize that they need helpand they certainly don’t wantto see a shrink,” he said. “Butwhen they are approached ina primary care setting, they’remuch more amenable totalking about their problemsand receiving treatment.”

Lantinga’s observationsmay well be true, but thereare few scientific studies out-lining the best approach tointegrating these services,something the new centerhopes to change. One oftheir first studies will exploremechanisms for providingprimary care therapeutic ser-vices for veterans who areabusing alcohol. The centeralso will initially focus ontreatment of dementia andpost-traumatic stress disorder.Future studies will includeweight management, smok-ing cessation, and the man-agement of hepatitis C anddiabetes.

“Our center will teststrategies and once they arescientifically validated fortheir efficacy, we will sharethe results with the rest ofthe VA and throughout themedical community,”Lantinga said.

Does Where You LiveAffect Your Health?Veterans living in rural areasare in poorer health thanthose who live in the city, ac-cording to a study by VA re-searchers who reviewed thehealth of 767,109 veterans.The findings were published

ROBERT TURTILA study found that veterans who live in urban areas are healthier than those inrural areas.

in the October issue of theAmerican Journal of PublicHealth.

Study leader William B.Weeks, M.D., a physician atthe White River Junction,Vt., VA Medical Center andDartmouth Medical School,said the findings validate VAefforts to expand health carefor rural veterans. “We needto think about veterans wholive in rural settings as a spe-cial population, and we needto carefully consider theirneeds when designing healthcare delivery systems,” hesaid.

For the study, research-ers distributed a question-naire to veterans who usedVA health care between 1996and 1999. It included ques-tions on physical and mentalhealth.

When comparing theanswers, they found ruralveterans reported an averagephysical health score of 33while their urban counter-parts averaged 37. The dis-crepancy remained even afterresearchers adjusted thescores for socioeconomic fac-tors such as race, educationand employment status.

The findings supportVA efforts to expand thedepartment’s network ofcommunity-based outpatientclinics. VA began establishingthese clinics in the 1990s tobring health care closer toveterans’ homes, a move thatbenefits veterans living in ru-ral areas. There are nownearly 700 VA outpatientclinics nationwide, and moremay be on the way. The re-cent review of VA’s nationalhealth system infrastructurecalled the Capital Asset Re-alignment for Enhanced Ser-vices, or CARES, recom-mended establishing an addi-tional 150 community-based outpatient clinics.

VAnguardhave you heard


When a storm knocked down a large tree on the groundsof the Knoxville campus of the VA Central Iowa HealthCare System, Maintenance Foreman Tom Johnson had anidea about what to do with the stump. Why not turn it intoa work of art? Angie Sage, a voluntary service specialist,identified donated funds to hire a woodcarver and Knox-ville Mayor Craig Kelley came up with the idea of carvinga soldier and a young boy standing before an Americanflag. The carving is “a wonderful addition” to the Knox-ville campus, said Donald C. Cooper, director of the Cen-tral Iowa VA system.

VA has designed a newidentity card for veterans tosafeguard confidential infor-mation. The card, formallyknown as the Veterans Iden-tification Card (VIC), willhave veterans’ photos on thefront and identify them asenrollees in the VA healthcare system. Encrypted on amagnetic tape on the back ofthe card will be the veteran’sSocial Security number, dateof birth and a control num-ber. Veterans should requestthe new VIC at their localmedical center. Processingwill take five to seven daysonce eligibility is verified.

For the fifth year in arow, the independent Ameri-can Customer SatisfactionIndex found veterans arehappier than most Americanswith the health care they re-ceive. On a 100-point scale,veterans gave VA health carea rating of 91. VA inpatienthospital services received arating of 84 and outpatientservices a rating of 83, com-pared to private-sector pa-tients giving their health careproviders ratings of 79 and81, respectively. VA alsorated highly—92—in veteranloyalty, meaning that nearlyall veterans under VA care in-tend to continue using VAand speak positively to othersabout their experiences.

The hospice unit at theLake City division of theNorth Florida/South Geor-gia Veterans Health Systemis being refurbished to offerall the comforts of home,thanks to a $10,000 dona-tion from the DisabledAmerican Veterans Chapter38 in Orange Park, Fla. It isthe largest one-time mon-etary donation in recentmemory, according to RonJoyner, who has spent 16years with the Lake City VAvoluntary service depart-

ment. The donation is a “tre-mendous boost” in helpingto create a home-like envi-ronment for veterans livingout their last remaining dayson the hospice unit, saidSharon Timmons, R.N., theunit’s head nurse.

Thirty-six years afterearning a Bronze Star for hisservice in Vietnam, Armyveteran Donald Lee Newlandfinally received the medalduring a Nov. 2 ceremony atthe Michael E. DeBakey VAMedical Center in Houston.The ceremony came aboutafter Kuno P. Zimmermann,Ph.D., a physician with theRehabilitation Care Line,learned Newman had beenawarded the Bronze Star in1968, but never received theactual medal. He brought itup with Henry J.Ostermann, Ph.D., from theDiagnostic & TherapeuticCare Line, who is a brigadiergeneral in the U.S. Army Re-serve. Armed with a copy ofthe veteran’s citation,Ostermann was able to ob-tain the Bronze Star medalset while on reserve duty.

Frank Montijo, a volun-teer at the Denver VA Medi-cal Center, received a “7 Ev-eryday Hero Award” fromthe local ABC affiliate,KMGH-TV. Montijo, a re-tired optician, has been vol-unteering at the VAMC since1999. He uses his profes-sional contacts to get do-nated frames, pads, screwsand other supplies and thenprovides free eyeglass repairservices to veterans there.

Staff at the Michael E.DeBakey VA Medical Cen-ter and Houston VA Re-gional Office came togetherto help a veteran whoshowed up for a compensa-tion and pension examina-tion so distraught he had dif-ficulty responding to ques-

tions. Staff psychiatristJocelyn Ulanday, M.D., dis-covered that he and his wifehad fallen on hard times andtheir home was scheduled forforeclosure the next day. Hiscompensation and Social Se-curity checks had beenstopped because he didn’t ar-range for a change of addressand he had gone more than aweek without his medication.Ulanday contacted MiltonAustin and P.C. Matthews atthe Houston VARO to verify

the veteran’s service-con-nected status and that he hadseveral months of undeliv-ered checks. Medical centersocial worker Ellen Flood de-layed the foreclosure by con-tacting the veteran’s mortgagecompany to let them knowthe veteran had funds owedto him. While all this tookplace, Ulanday helped get hismedication refilled. Thanksto this team effort, the vet-eran is back on track and se-cure in his home.

Left to right: Knoxville Mayor Craig Kelley with VA CentralIowa Health Care System Maintenance Foreman Tom Johnson,Voluntary Service Specialist Angie Sage, and Associate DirectorPaul Bockelman.

A new addition in Knoxville

MARGARET E. MARSHALL

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honors and awards

The Fayetteville, N.C.,VA Medical Center wasnamed Government Cus-tomer of the Year byServiceSource EmploymentServices, parent company ofEmployment Source for theNational Institute for Se-verely Handicapped. Themedical center was recog-nized for hiring 12 peoplewith disabilities who provideadministrative support ser-vices such as operating thetelephone switchboard, pre-paring patient identificationbadges, and copying medicalfiles. ServiceSourceNetwork’s contract with theFayetteville VAMC to hirepeople with disabilities was afirst for the organization inNorth Carolina.

Virginia Governor MarkWarner appointed Daniel E.Karnes, team leader at theRoanoke, Va., Vet Center, toa four-year term on the Vir-ginia Board of MentalHealth, Mental Retardationand Substance Abuse. Theboard sets policy for thestate’s mental health and re-tardation facilities. A Viet-nam veteran, Karnes has amaster’s degree in socialwork. He has been with VAfor 25 years.

The Association of Mili-tary Surgeons of the UnitedStates recognized seven VAexecutives for their contribu-tions to federal medicineduring the group’s annualmeeting Nov. 17 in Denver.They are: Michael J.

Kussman, M.D., actingdeputy under secretary forhealth; James Bagian, M.D.,director of the National Cen-ter for Patient Safety; RobertM. Kolodner, M.D., associ-ate chief information officer;Ralph Charlip, director ofthe Health AdministrationCenter; Ann Busch, R.N.,clinical coordinator for thePortland VA Liver Transplantprogram; Robert L. Jesse,M.D., Ph.D., national pro-gram director for cardiology;and D. Robert Dufour,M.D., chief of laboratoryservice at the Washington,D.C., VA Medical Center.

Steven M. Asch, M.D.,a health services investigatorwith the VA Greater Los An-geles Healthcare System,

and Albert Lo, M.D., Ph.D.,a rehabilitation researcherwith the VA ConnecticutHealthcare System, receivedthe Presidential Early CareerAward for Scientists and En-gineers during a WhiteHouse ceremony Sept. 9. Itis the highest honor pre-sented by the U.S. govern-ment to scientists and engi-neers beginning their careers.Asch studies quality of care.He is currently developingmethods to access two areasof HIV care: treatment withantiretroviral drugs andscreening and prevention ofopportunistic infection. Lo, aneurobiologist, conducts ani-mal studies on the processesinvolved in nerve injury andpain.

Bridging the generations

The American Society of Directors of Volunteer Services,part of the American Hospital Association, recognized theAugusta, Ga., VA Medical Center’s Musical Bridges pro-gram during their annual leadership conference in Sep-tember. The program, above, uses music-based activitieslike singing and dancing to create bridges betweenpreschoolers and veterans with Alzheimer’s or dementia.It was recognized as a creative way for volunteers to en-hance the health care environment and reduce patientanxiety.

Jack Ross, director of the Cleveland VA Regional Of-fice, was one of 19 veterans inducted into the Ohio Vet-erans Hall of Fame Nov. 3 for the class of 2004. “TheseexemplaryOhioans em-body serviceto countrywhile in uni-form and intheir dailylives as civil-ians,” saidOhio Gover-nor Bob Taftin announc-ing the 2004inductees.Picturedwith Ross,center, arefellow Ohio Veterans Hall of Fame members Vane S.Scott Jr., left, and Joseph Andry.

Ohio Veterans Hall of Fame

ALVIN BURZYNSKI

WILL TULLIS

VAnguardheroes


Nurses teaming up to help

New Orleans VA Medi-cal Center employees wereamong some 75 people at-tending an anniversary partyat a local restaurant whenBarbara Mayfield, nursemanager at the medical cen-ter, began choking. Co-worker Veronica Williams-Riggs, R.N., performed theHeimlich maneuver, dislodg-ing a carrot. Guests and res-taurant staff applauded Will-iams-Riggs for her efforts inthe emergency.

Marilyn Butler, a Balti-more VA Medical Centeremergency room nurse, re-ceived a call from a patientthreatening to commit sui-cide. When the veteran brokeoff the call, Butler quickly re-ported the incident to VApolice. Officer AntonioJohnson Sr. immediatelycalled the veteran but wasable only to leave a messagerequesting a return call.Within 10 minutes, the vet-eran returned the officer’s

call, telling Johnson that hewas going to put a gun in hismouth and pull the trigger.Johnson remained calm andencouraged the veteran totalk. After a careful line ofquestioning, Johnson locatedthe patient’s records, andshift commander Sgt. MarkMarmash relayed all perti-nent information to local po-lice. Johnson remained onthe line with the patient ascounty police sped to the

Three nurses from the Robert J. Dole VA Medical Cen-ter in Wichita, Kan., witnessed a collision between acar and a bicycle and immediately went to assist.Nancy Heeren, a licensed practical nurse, appliedpressure to a gash above the young bicyclist’s eye-brow. Rita Lewis, a registered nurse, notified the boy’sfamily, while Trina Young, also a registered nurse,shielded the victim and paramedics from a rainstorm.

patient’s home. As they ar-rived, Johnson calmly in-structed the patient to placethe phone on the table. Theveteran complied andJohnson listened as thecounty police officers enteredthe home and peacefully de-fused the situation. Theveteran’s father later wrote aletter to Thomas Blake, Bal-timore VAMC chief of po-lice, commending Johnsonfor his actions.

Richard Burke, a captain with the police department atthe Philadelphia VA Medical Center, saved his 4-year-old granddaughter’s life when she began choking on amint candy. Burke was leaving a Riversharks baseballgame in Camden, N.J., with his wife and their grandchil-dren when hiswife realizedtheir grand-daughterwasn’t breath-ing. After as-sessing thesituation,Burke per-formed theHeimlich ma-neuver anddislodged themint.

Burke iscertified inCPR andteaches basiccardiac lifesupport at themedical cen-ter. He creditshis training with helping him respond to this emergency.“I know the training is important and I encourage every-one to take it,” he said.

CURTIS TASSET

Left to right: Nurses Nancy Heeren, Rita Lewis and TrinaYoung came to the aid of a young bicyclist injured in a colli-sion with a car.

Philadelphia VAMC Police Officer RichardBurke credited his CPR training with help-ing him save granddaughter Carol’s life.

CPR training saves lives

a day in the life of va a “fenway ambassador,” escorting a very special guest—the ... the...

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