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outlook

Evolution of ProstheticsVET IT Program

Eye on VA News

Memorials Inventory Project

May/June 2005

Evolution of ProstheticsVET IT Program

Eye on VA News

Memorials Inventory Project

75 Years Serving Veterans

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Features

Hiring the Next Generation of Combat Vets 6a grassroots program in VA’s IT office is putting young vets to workEye on VA News 10weekly roundup of news is produced by employees for employeesTaking Inventory 13a small army of volunteers helps NCA catalog memorials‘The Solemn Pride’ 15Memorial Day has special meaning this year for one VA employeeSecretary Nicholson Overseas 17VA chief visits troops in IraqThe Evolution of Prosthetics 18a look at VA prosthetics: past, present and future

Departments

3 Letters4 Management Matters5 Outlook28 Around Headquarters32 Introducing33 Medical Advances34 Have You Heard35 Honors and Awards36 Heroes

On the coverVietnam veteran Bill Wagner undergoes gaitanalysis at the VA National Prosthetics GaitLab in Long Beach, Calif., under the watchfuleye of the lab’s founder and director EdAyyappa. The spheres attached to Wagner’sbody reflect infrared light beams used to as-sess joint motion, ambulatory forces and othergait characteristics. Founded in 1986, the labwas the first to offer full-service orthotic andprosthetic gait assessment. Today it is one of ahandful of VA gait labs across the country.photo by Walter Thill

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VAnguardVA’s Employee MagazineMay/June 2005Vol. LI, No. 3

Printed on 50% recycled paper

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

U.S. Department of Veterans Affairs810 Vermont Ave., N.W.Washington, D.C. 20420(202) 273-5746E-mail: vanguard@va.govwww.va.gov/opa/feature/vanguard/index.htm

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letters

Have a comment on something you’ve seen inVAnguard? We invite reader feedback. Send your com-ments to vanguard@va.gov. You can also write to us at:VAnguard, Office of Public Affairs (80D), Departmentof Veterans Affairs, 810 Vermont Ave., N.W., Wash-ington, D.C., 20420, or fax your letter to (202) 273-6702. Include your name, title and VA facility. Wewon’t be able to publish every letter, but we’ll use rep-resentative ones. We may need to edit your letter forlength or clarity.

We Want to Hear from You

More LabyrinthsI saw your photo/mention ofSeattle VAMC’s canvas laby-rinth (March/April issue).We in VISN 2 have two per-manent, outdoor labyrinths.Our first was built at theStratton VAMC in Albany,N.Y. The second is at theCanandaigua VAMC. Both

are listed on the NationalLabyrinth Web site.

They are used by chap-lains with patients, as in Se-attle, as well as by other staffand surrounding communitymembers. VISN 2 is the onlyVHA affiliate of thePlanetree National Organiza-tion, a forward-thinking, pa-

tient-centered, holistic orga-nization.

Labyrinths are only onetool Planetree advocates inthe search for ways to treatthe patient as a whole per-son—body, mind and soul.To learn more about VISN2’s involvement in Planetree,visit our Web site atwww.va.gov/visns/visn02/planetree.html, or visitPlanetree National’s Web siteat www.planetree.org.

Neal K. Relyea, R.N.Patient Education

CoordinatorAlbany, N.Y., VAMC

Battle of the Bulge6oth AnniversaryThanks to Dr. Lynn Hackettfor the wonderful article shewrote and the pictures shetook in Luxembourg andBelgium (March/April issue).Between my father and my-self, we have served duringevery war since WWII untilthe present one, which wehave left to younger men.

I could not hold backthe tears in reading about thegratefulness of the citizenryof these small countries andof the sacrifice of those whofought. Though I have neverbeen to Belgium, I havestood at the American Cem-etery in Luxembourg andlooked across the rows ofwhite crosses and Stars of

David that form a beautifulquilt-like design on thegrounds.

Keep up the good work!There are many out therewho truly appreciate suchthings.

William J. FretwellProgram Support AssistantMontgomery, Ala., VAMC

Back Issues Available?As a reader of VAnguard, Ihave to tell you I enjoy thecontent on the whole. I’mgoing to show my WWII vetfather the recent article onthe 60th anniversary of theBattle of the Bulge.

Two things. One, makeVAnguard accessible on theInternet. It is a product thatI would like to be able toread when I’m off duty.Make back issues archivedand accessible on theInternet, too.

Second, every othermonth to publish VAnguardis not enough. There aremore than enough topics andreader inputs to make it amonthly magazine.

Ron DankmyerFood Service Supervisor

Fargo, N.D., VAMC

Editor’s note: Current andback issues of VAnguard areavailable on the VA Web siteat www.va.gov/opa/feature/vanguard/index.htm.

July 21, 1930 – President Herbert Hoover signs Executive Order5398, “Consolidation and Coordination of Governmental Ac-tivities Affecting Veterans,” implementing legislation passed July 3by Congress placing under one “administration” federal pensionand other benefits programs and veterans’ medical facilities. Itconsolidated the U.S. Veterans’ Bureau, the National Homes forDisabled Soldiers, and the Interior Department’s Bureau of Pen-sions into the Veterans Administration (VA).

VA employees from all over the country will play amajor role in planning, coordinating and implementinganniversary observance programs and activities that will

begin with a July 21,2005, gala kick-off pro-gram in the nation’scapital and run throughVA’s diamond jubileeyear to July 20, 2006.

The kick-off pro-gram will be held at theD.A.R. Constitution

Hall near the White House. The President has been in-vited, and 3,000 VIPs, veterans and VA employees willbe in the audience. This event will be televised andavailable to all VA facilities via satellite transmission.

The VA 75th anniversary logo (above) will soon beissued with guidance on its use throughout the cominganniversary year. Additional support materials will alsobe distributed through the public affairs network, in-cluding a speech, a poster, background sheets andtimelines.

Facilities will be expected to incorporate observanceof the 75th anniversary into their community relationsand communications plans under policy and planningguidance issued by the Secretary through the Office ofPublic and Intergovernmental Affairs.

A special 75th anniversary Web site, which will notonly provide guidance and information, but also sharethe ideas, initiatives and achievements of facility obser-vances with the rest of VA, will soon be established.

Happy 75th Anniversary VA!

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Making Progress in the e-Business RevolutionBarbara C. MayerickDirector, Business Development, VHA Chief Business Office

VHA’s electronic business—or e-Business—revolutionhas been progressing thisyear, providing an improvedfinancial foundation for vet-erans’ health care. Six e-Busi-ness projects are underway,all relating to reimbursementfrom insurers for veterans’non service-connected care.These projects also bringVHA into the world of stan-dardized electronic transac-tions, as required by HIPAA,the Health Insurance Port-ability and AccountabilityAct:■ We are continuing touse—and improve—elec-tronic means of identifyingveterans’ insurance coverage.■ We have put in place twoinitiatives that enable us tosend electronic reimburse-ment claims to third-partypayers, for both primary cov-erage and coverage secondaryto Medicare. (VHA is notpermitted to bill Medicare,but can submit claims fornon service-connected carewhen veterans have Medigapor other secondary coverage.)■ We have begun testing thefirst real-time outpatientpharmacy billing transactionsat eight VA medical centers.■ We are also systematicallyexamining ways to improvecollections from third-partypayers.■ We continue to grow ournationally recognized e-Pay-ments System, which receivespayers’ Electronic RemittanceAdvices (providing claimpayment information). Be-ginning with little more thana dozen insurers in 2003, wenow have more than 150 dif-

ferent health insurance planssending us Electronic Remit-tance Advices.

We passed two impor-tant milestones since we lastreported in these pages—wesubmitted the 16 millionthelectronic third-party reim-bursement claim, and we re-ceived the 4 millionth Elec-tronic Remittance Advice.

What does this mean forVHA? It means that we areindeed making the transitionto more streamlined businessprocesses. We have reachedall-time highs in terms ofnumbers of electronic claims

submitted per month, andare increasing the percentageof electronic claims on ayear-over-year basis. Thanksto our Electronic RemittanceAdvices, we have also realizeda 64 percent overall time sav-ings on tasks related to re-ceipt of payments and close-out of accounts.

Nonetheless, there arestill many bumps in the roadas not only VHA but the en-tire health care industrystrives to comply withHIPAA rules and leveragetechnology in an alreadyelectronic world. For ex-ample, VHA can also realizesignificant time and produc-tivity savings if payers submitpayments electronically, us-ing Electronic Funds Transfer(EFT). Our e-Payments Sys-

tem was built to accept EFT;however, the use of EFT isnew to many payers. VHA istherefore proactively workingwith payers, financial institu-tions and industry associa-tions to promote the benefitsof EFT and to provide thetechnical know-how to helppayers move to electronicpayments.

Similarly, we are work-ing directly with payers andtheir pharmacy benefits man-agers to encourage changes inpharmacy plan administra-tion that will enable reim-bursement to VHA and si-

multaneously benefit thoseveterans who have third-party pharmacy benefits in-surance.

What makes all of thisprogress possible is enor-mous, often unheralded ef-forts by VA personnel—theenrollment and intake staff;the insurance staff; the codersand billers; the agent cashiersand accounts receivable staff;the medical facility adminis-trators, health care providersand technicians; the phar-macy office staff; the softwaredevelopers and quality assur-ance specialists; the manyspecialists who guide thesoftware into the medicalcenters, install it, and sup-port the front-line VA staff;the developers of technicaldocumentation and training;

the trainers; and all of thestaff who diligently test,evaluate, and learn new soft-ware, work through systemand payer issues, help trainand support staff throughoutour medical facilities, provideideas for functionality im-provements, and ultimatelybring to life VHA’s e-Busi-ness revolution.

From the vantage pointof our Business Developmentgroup, we see ourselves aspioneers, blazing a trail as wemake this paradigm shiftfrom the old ways of doingbusiness to our new innova-

tive practices. As we takestock of our progress to date,and the milestones we havepassed, we draw inspirationfrom what we have allachieved together and theconfidence to meet our nextchallenges.

Chief Business OfficerMark Loper puts it this way:“Moving VHA’s businessprocesses from paper to elec-tronic systems is an enor-mous undertaking. We arebeginning to see very positiveresults, but we have a longway to go. We keep movingforward because of the dedi-cation of VA’s talented staff,and because of our commit-ment to streamline VHA’sbusiness to provide a strongerfoundation for the healthcare of our veterans.”

VHA’s electronic business revolution has beenprogressing this year, providing an improved financialfoundation for veterans’ health care.

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and professional groups havesimilar goals. VA representa-tives have joined with theseorganizations to launchtransformational efforts tosignificantly improve clinicaloutcomes and quality of lifefor anyone needing nursinghome care.

For those organizationsthat have paved the way andbegun the transformationaljourney, the rewards havebeen significant. Improvedclinical outcomes have beenachieved in such areas as nu-trition, hydration, reducedmedication (including psy-chotropics), reduced falls,improved continence, andimproved staff, resident andfamily satisfaction.

The VA Nursing HomeSummit of April 2005 wasjust the beginning. Each

VISN selected a representa-tive to serve as a point ofcontact with the nationalsteering committee to keepthe energy of the summitalive and implement trans-formational policies and ini-tiatives. This core group rep-resents the various disciplinesthat support nursing homecare. These are the leaders ofthe transformation effort andwe now look to them for fur-ther guidance as we begin anew and exciting journey incaring for those who haveborne the battle.

Transforming the Culture of VA Nursing Home CareChrista HojlaChief, VA Nursing Home and Subacute Care

At the heart of this transformation is the challenge tomove away from a traditional medical model to carecentered on the veteran.

This spring, more than 250VA nursing home leaders, cli-nicians and front-line stafffrom across the country metin San Antonio for a nursinghome summit, the first of itskind in VA. Every VISN andat least 15 disciplines wererepresented and had a voicein shaping and launching thetransformation of the cultureof care in VA nursing homes.

The purpose of the sum-mit was to examine thepresent culture of care, ex-plore innovations in nursinghome care delivery, and for-mulate plans for transform-ing the delivery of that carethroughout the system.

At the heart of thistransformation is the chal-lenge to move away from atraditional medical model tocare centered on the veteranand their functional and hu-man needs. Admission to anursing home assumes a vet-eran is medically stable andno longer needs acute inter-ventions. However, the vet-eran still requires nonacutemedical or skilled nursingservices such as rehabilitationor intravenous therapy; hassuffered a functional impair-ment that precludes dis-charge to home or to a non-institutional setting; or needsa place of comfort, compas-sion and dignity to facedeath.

Veterans are admitted tonursing homes because theycan no longer care for them-selves or lack the social andeconomic resources to re-main at home. For some vet-erans, the nursing home is atemporary placement. These

veterans are cared for withthe intent of being dis-charged to a non-institu-tional setting. For others, it istheir final home where theywill live out their days.

The elements of thiscultural transformation in-clude, first and foremost, at-tending to the human needsof the veteran regardless ofmedical diagnosis. In acutecare, it is important to treatand manage an illness aggres-sively. Nursing home caremanages the impact of illnesson the bio-psycho-social-physical-spiritual well-beingof the patient. Therefore,transformation calls for achange from the institutionalapproach of meeting the ba-sic needs of life such as bath-ing, dressing and eating, to aperson-centered approach

that allows the veteran thefreedom and flexibility to re-cuperate, rehabilitate, or diewith dignity.

The structure and func-tion of the care environmentis as important as the rela-tionships between nursinghome residents and care pro-viders. Transformational de-sign changes nurse stations toliving rooms and lonely eat-ing spaces to dining roomsthat enhance personal choiceand well-being. Nursinghome pets, as well as creativeuse of art, music and dance,

lift broken spirits of the mostdebilitated residents.

Programs for meaningfuluse of time augment thestandard Bible, bingo andbirthday parties. Open kitch-ens that emit delectable fra-grances enhance appetites forthose needing strength for re-habilitation and provide hu-man interaction for thosesuffering from dementia orchronic mental illness. Car-peting, lighting and furniturethat reflect the comforts ofhome enhance the desire toget up, get dressed, and getactive rather than be de-pressed and reclusive.

Ward-like corridors, in-stitutional signage and sterilewalls are transformed by en-gaged staff, residents, volun-teers and families who createneighborhoods like the

Lodges at the Batavia, N.Y.,VA Medical Center nursinghome. Residents, staff, vol-unteers and families work to-gether in new ways to createa setting where the stay—short or long—speaks to theculture of the resident, sup-ports quality of life, and callsforth the best in both staffand residents.

VA is not alone in rec-ognizing the need to trans-form nursing home care.The federal Centers forMedicare and Medicaid Ser-vices and major consumer

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Jennifer Duncan was facing thesame challenge as managersthroughout the federal govern-ment—how to deal with the

graying workforce.“We looked at the age of our

workforce and only two out of about300 employees were under the age of40,” said Duncan, a management di-rector in the Office of InformationTechnology in VA Central Office.

To mitigate what some call theimpending “brain drain,” Duncanand her colleagues devised a two-year IT internship for recent collegegraduates.

It was an immediate success. In2003, the program’s first year, the of-fice hired 20 recent grads to fill va-cated positions. Yet somethingdidn’t seem right to Duncan andothers in her office.

“We found we weren’t attract-ing any veterans and that puzzledus,” she recalled.

A leader in hiring veteransVA has long been a leader in

hiring veterans. As of January,slightly more than 72,000 of thedepartment’s 235,000 employeeswere military veterans. Most servedin the Vietnam era. So from a suc-

cession planning perspective, itmade sense to try to recruit youngerveterans.

But staff in the IT office took ita step further by focusing their ef-forts on hiring wounded soldierswho were being medically separatedfrom the military. “These guys neednew careers and we’re sitting here

worrying about recruiting youngerveterans. Why not bring themonboard,” reasoned Edward F.Meagher, a Vietnam veteran whoserves as deputy assistant secretaryin the IT office.

In October 2004, they createdVET IT, a pilot program geared to-ward hiring wounded soldiers recov-

A grassroots program is helping VA’s IT office deal with a grayingworkforce, while giving wounded soldiers some valuable work experience.

Medically retired from the Army after losing a leg in Iraq, Tristan Wyatt was working in a butcher’sshop back home in Colorado when he heard about the VET IT program.

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of Combat VetsHiring the Next Generation

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ering at Walter Reed Army MedicalCenter in Washington, D.C. Almostimmediately they encountered ob-stacles. For starters, the soldiers werestill on active duty and couldn’t filla paid internship.

Thus began the first formal vol-unteer program in VA Central Of-fice, according to Laura Balun, ad-ministrative officer in VA VoluntaryService. The soldiers get the sameintroduction as every other VA vol-unteer—training in HIPPA, privacyand security, plus a meal token ifthey put in more than four hours aday. Their hours are tracked andcredited toward work experience,which they can use to enhance theirresumes.

Volunteers are assigned a posi-tion according to their skills and in-terests. They’re also paired with amentor, who helps them adjust totheir new environment and respon-sibilities. If the volunteer is a goodfit for the job, they can be hired fulltime once they separate from themilitary.

As of April, 27 soldiers had par-ticipated in the volunteer programand 10 had been hired. “What we’refinding is they are very disciplinedand eager to get on with their lives,”said Paunee Grupe, a workforceplanner in the IT office who is in-volved with the program.

The chance of a lifetimeSome were injured in training.

Others lost limbs in Iraq. All are go-ing through one of the toughesttimes of their lives.

Staff Sgt. Matthew I. Braiottaserved five years as an Army scoutwith the 3rd Armored Cavalry Regi-ment and planned to make a careerof the military. Those plans came toan end, however, when he was

wounded by a roadside bomb inFallujah, Iraq. “I loved my job. I waspractically married to the Army,” hejoked.

But the Army wanted a divorce.Braiotta was deemed unfit for duty.He was going to have to start over, aprospect he called “scary.” His fearssubsided, though, when he heardabout the VA volunteer opportunity.

“When you get out in the civil-ian world, it’s a real shock. The VETIT program made me feel comfort-able about my transition. I mean, it’sthe chance of a lifetime,” saidBraiotta, who began volunteering inthe IT budget office in February andwas officially hired in April.

His boss, Owen F. Dolan, ishelping him learn about the depart-ment, the budget, and being a fed-eral employee. He knows Braiottamay eventually move on to anotheroffice or even another agency. But

that’s okay. The way Dolan sees it,“if we can do something to helpthese soldiers right here, right now,let’s do it.”

Braiotta is hopeful the pilot pro-gram can help others like him. “Ifthis progresses the way I think itwill, you’re going to be able to helpa lot of kids who would otherwise begoing home and sulking in their sor-rows,” he said.

Tristan Wyatt may not havebeen sulking, but he sure wasn’thappy to be leaving the service afterlosing his right leg in Iraq. “As soonas I got to Iraq, I knew this is what Iwanted to do with my life,” saidWyatt, who served as a combat engi-neer in the 3rd Armored CavalryRegiment.

Then came Aug. 25, 2003. Itstarted out like any other day forPfc. Wyatt, whose engineer com-pany was responsible for clearing ahighway between Khaldiyah andFallujah.

Halfway through their patrol,their armored personnel carrier wasambushed by dozens of enemy fight-

“They may be starting over, but they justwant to be treated like everyone else.”

Tristan Wyatt shares a laugh with his boss, Pedro Cadenas Jr., a deputy assistant secretary in VA’sOffice of Cyber Security.

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ers. “They hit us with rockets andsmall arms fire—it was a mess,” hesaid.

The driver pulled off the roadand maneuvered into a flanking po-sition while the engineers preparedto dismount and engage the enemy.Just as they opened the hatch, anenemy rocket flew inside the cabin.Wyatt recalled the projectile’s path.“It went through my leg, into myteam leader’s hip and out his back,and then ripped through thegunner’s hamstring,” he said.

Unaware that he was hit, Wyattfired his weapon until “I just gotdizzy and fell back” inside the car-rier. He saw his severed leg in thecorner and used it to elevate hisstump while he applied a tourniquet.Meanwhile the fighting raged as thecarrier withdrew under cover of anM1 Abrams tank.

After more than a year of rehab,Wyatt was medically retired in Janu-ary 2005 and went home to LoneTree, Colo., where he started work-ing in a butcher’s shop. Then inMarch he got a call from a friend atWalter Reed who told him aboutthe VET IT program.

Two days later he boarded aplane to Washington D.C., for aninterview with Pedro Cadenas Jr., adeputy assistant secretary in VA’sOffice of Cyber Security. “Heshowed a desire to learn, and that’sthe main requirement for this posi-tion,” recalled Cadenas, a formerMarine who stressed that the job of-fer was not a handout. “I told himhe needs to work or he’s out of herejust like anyone else.”

That’s one of the keys to theprogram, noted Duncan, the ITmanager. “They may be startingover, but they just want to betreated like everyone else,” she said.

Desire to help comes fromthe heart

Much of the program’s successcan be traced to a handful of em-

ployees who put in countless volun-teer hours—at night and on theweekends—to help wounded sol-diers. They do this in addition totheir regular day jobs.

“You have to treat them indi-vidually, based on their circum-stances, and you can’t do that on agovernment time clock,” saidDuncan.

Matthew Braiotta, above in Iraq and with his boss in the IT budget office, Owen Dolan,had hoped to make a career of the military before he was wounded in a roadside bombattack.

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It takes a team effort to pull off something as bold as theVET IT program, considering most of the soldiers needhelp with the basics—housing, furniture, transportationand business clothing.

Once they developed the concept, the volunteer staffin the VA Office of Information Technology set out to gainsupport from within VA and the community.

In January 2005 they organized a fundraiser calledOperation Jump Start that raised more than $24,000 incash and checks, plus an assortment of high-end suitsand sport coats. Sponsoring the event were the FederalCIO Council, the Information Technology Association ofAmerica and the Industry Advisory Council, a subsidiaryof the American Council for Technology.

The Leadership VA Alumni Association establishedan Operation Iraqi/Enduring Freedom Service MembersSupport fund, tax-exempt number 52-1843131, to manage

Behind the Scenes of VET IT

donations. Interested in making a contribution? Donationscan be sent to: LVAAA OIF/OEF SMS, P.O. Box 27102,Washington, D.C. 20038-7102.

There is also talk of expanding the program to otherVA facilities. Duncan and others in her office recentlyworked with their IT colleagues in the Veterans HealthAdministration, the VHA network office, and staff at the St.Louis VA Medical Center to set up a volunteer opportunityfor a combat-wounded soldier who was leaving WalterReed and heading home to St. Louis.

Prior to leaving Walter Reed, the soldier expressedinterest in starting a new career helping veterans. Staff atthe St. Louis VAMC encouraged him to begin volunteeringuntil his discharge in July, when he could apply for a per-manent position. They also arranged a job interview forhis wife, who impressed interviewers and was offered aposition at the hospital.

Behind the Scenes of VET IT

Several Iraqi Freedom veteranshired under the program creditJeannie Lehowicz with getting themon the right track. She’s a contractcounselor with the Washington,D.C., VA Regional Office’s Voca-tional Rehabilitation and Employ-ment Service who has been assignedto Walter Reed Army Medical Cen-ter since 2001.

“I meet with the soldiers, Ma-rines and airmen who come into thehospital and we begin a dialogueabout what they’d like to do,” saidLehowicz, explaining that this mightinclude school, training, a new ca-reer opportunity or any combinationof the three.

But when the clock strikes 5,Lehowicz doesn’t call it a day. Shestays at the hospital as a volunteerand has logged 362 volunteer hourssince the program’s inception.Wyatt, who moved from Coloradoto Washington, D.C., to join theVA, said Lehowicz was available24/7. “I swear that woman neversleeps,” he said, smiling.

When he first heard about VET

IT, Wyatt called Lehowicz to see ifshe would set up an interview. Sureshe could. But she also bought hisairline ticket, helped coordinate aplace for him to stay, and lined upan escort to take him to the inter-view.

It’s not a big deal to Lehowicz.

“Everything I do comes from theheart and I feel uncomfortable shar-ing that with everyone,” she said. “Ijust love these kids and want to givethem whatever they need to getback on their feet.”

Jennifer Duncan, left, and Paunee Grupe are key members of the team in the IT office thatdeveloped and manage the VET IT program.

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By Matt Bristol

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“Coming to you in 5, 4, 3, 2, 1... ” Director Patrick Mont-gomery sets the tapes rolling

at the VA Central Office BroadcastCenter to begin another weekly pro-duction of the award-winning VANews.

Executive producer KenMcKinnon keeps his eye on thescript, while Tom Barritt and LauraEdwards, VA employees who volun-

teer as news anchors, take theirplaces on the set. They’ve studiedtheir scripts, put on makeup, and arewired for sound. Broadcast techni-cians Brad Fredericks and JudyHowell place the anchors and headfor the control room. Another showbegins.

VA News is a product of the Of-fice of Public Affairs (OPA) and theEmployee Education System (EES).EES is familiar to most employeesfor its production of worksite-basedlearning and professional develop-

ment products, including videos.The VACO Broadcast Center, a

small, state-of-the-art television stu-dio that is home to VA News, istucked into former cubicle space onthe eighth floor of VA Central Of-fice. It is surrounded by a cluster ofoffices for producers, directors andtechnicians.

The program’s mission is to pro-vide a comprehensive weeklyroundup of organizational news forVA’s 235,000 employees.

Kim Luoma, VACO Broadcast

Weekly roundup of organizational news is producedby employees for employees.

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Above: Anchor Tom Barritt prepares to dohis “reads.” He is one of a number of VAemployees who volunteer as news anchors.

Eye on VA NewsEye on VA News

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Center director, has been instru-mental in the growth and develop-ment of VA News. “Our goal is to bethe first and best source of informa-tion about VA for VA employees,”said Luoma. “With good informa-tion they can react and advocate,and know and understand the strate-gies and emerging issues facing VA.

“Good communication has thesame rigor as good education,” headded. “Ultimately our efforts musthelp accomplish the work of VA,and that is serving America’s veter-ans.”

Though EES’s focus is on educa-tion, in this era of integrated com-munications, that mission has ex-panded to informational and moti-vational programming aimed atbroader audiences. Luoma and hisstaff, along with OPA, recently be-gan producing The American Vet-eran, a half-hour video news maga-zine aimed at informing veteransand their families about benefits andprograms that serve them.

The first program in themonthly series began airing on thePentagon Channel in March, andreaches U.S. armed forces personnelaround the world. The PentagonChannel is also carried by many do-mestic cable outlets, and OPA is of-fering The American Veteran directlyto local community access cable andpublic broadcast stations.

VA News, however, aims at VAemployees. It is broadcast five timesa day on the VA Knowledge Net-work to cover all work shifts andtime zones.

The show must go onProducer McKinnon is respon-

sible for gathering the news, infor-mation, video and graphics that gointo each program.

“This is TV,” he said, “and we’reonly as good as the visuals we show.I rely heavily on public affairs offic-ers and other folks at our facilitiesand offices around the country to

Executive producer Ken McKinnon manages all facets of production and writes the scriptfor each week’s show.

Broadcast technician Brad Fredericks and other members of the VA News production teamat work in the control room.

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help generate that material.”Shows in recent months have

included a segment on Women Vet-erans Day in Alaska and a tribute to40 VA employees from Pennsylvaniato Puerto Rico who retired with atleast 25 years of service. McKinnonworked closely with facilities for the

visuals needed for those stories.McKinnon works with limited

resources at VA Central Office. Hisproduction team includes elementsborrowed from OPA, the VACOBroadcast Center (EES), and VACentral Office Media Services.

The Central Office team is

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Once the visuals are gathered,the script is written, edited and fedto a teleprompter for the anchors toread during taping. After the anchor“reads” are taped, with the com-puter-generated graphics and anima-tion in place, all the elements arecomputer-edited into a 15-minutefinished product. Editor JulieDavidson painstakingly matchesvideo segments from around thecountry with script and anchor readsto create a seamless newscast.

The finished VA News travelsover phone lines to a satellite “up-link” at the EES Center in St. Louisby 5 p.m. every Friday. Come Mon-day morning, the VA News for thatweek is on the air and McKinnonand his crew start the process allover for the next edition of VANews.

Plans are underway to standardize this procedure, but in the meantime, de-pending on your location, there several different avenues to access VANews.

VA News is live streamed, which means it’s a video on demand serviceto desktops at VA Central Office. This stream is called the Content Distribu-tion Network (CDN), currently available to 55 percent of VHA employees,with the goal of being universally available in the near future. For those withthis access, it’s the best way to view VA News and other communicationsand educational programs. If you have CDN at your location, you can find theWeb site at vaww.vakncdn.lrn.va.gov.

At some locations, VA News is put under Customer Relations, and if thisis the case at your location, log on to your computer, do a general searchand then type in “VA News.” This should bring you directly to the site. An-other resource at other locations is to find VA News through the VA LearningUniversity Catalog, at vaww.sites.lrn.va.gov/vacatalog.

Should the above methods not be available at your location, most VA fa-cilities have satellite coordinators who will schedule a viewing on request.Employees can also ask their satellite coordinators to tape a program if theyare unable to view it at the designated time and location. As an alternative,many VA facilities have closed circuit cable systems. On closed circuit sys-tems, VA News should be available throughout the facility and viewable onany connected television. Finally, VA News is available through VA’s Intranethome page.

How Can You Watch VA News?

complemented by a few field “regu-lars”—contributors such as MelodeeMercer, at the VA Insurance Centerin Philadelphia; William Browning,at the Detroit VA Medical Center;Stefan Greene, at the Temple,Texas, VA Medical Center; andDavid Irvine, at the Battle Creek,Mich., VA Medical Center. JimBenson, often referred to as “theTom Brokaw of VA,” is the host ofThe American Veteran, and regularlycontributes his on-air talents to VANews as an anchor and interviewer.

McKinnon, the only full-timemember of the VA News team, man-ages all facets of production andwrites each week’s script. He’s proudof his team, and like them, doeswhatever is necessary to ensure thatthe show goes on. “I like to say thatI beg, borrow and appropriate any-thing I can to make VA News as at-tractive and interesting as possible,”said McKinnon. “Getting the ele-ments needed to make sure it is vi-sually appealing is my greatest chal-lenge.”

The finished productWeek after week, McKinnon

and Chris Scheer, director of OPA’sMedia Products Service, gather ideasand material that might fit the VANews format. If it involves a facilityor a location outside Washington,D.C., they turn to local public affairsofficers for assistance.

McKinnon has built relation-ships with many facilities and workshard to support these partnerships.His advice to anyone in VA with astory to tell on VA News is to thinkvisually and plan the video first.

“You can make that VA Newsstory even better by going the extramile to plan video and still imageseven before you start writing,”McKinnon advised. “We want thebest visuals we can get to tell VAstories. You can make it your VANews by working with us on plan-ning the shoot!”

Though he sometimes uses pho-tographs, McKinnon first looks forquality video. In Washington andareas where they are available, a VAcameraman, or “shooter,” is assignedto cover the event. At VA CentralOffice, McKinnon often calls onvideographer Steve Hollingshead inMedia Services.

Hollingshead is an Army vet-eran with more than two decades ofprofessional experience. “Electronicjournalism is one of the most de-manding jobs in the media,” he says.“In the field, you have to controllighting and sound as well as pho-tography. You must communicatewith on-camera talent and be surethey’re well presented. My militarybackground taught me to be pre-pared for anything and to know myequipment. And as a veteran, I’mcommitted to giving my best to VANews.” By Pauletta Walsh

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feature

The National Cemetery Ad-ministration just completeda two-and-a-half year effort

to catalog every memorial on itsgrounds, and the project yieldedsome surprising results.

In 2002, NCA estimated therewere 300 monuments and memorialsin VA national cemeteries andsoldier’s lots. The final count re-vealed there are 872.

The Memorials InventoryProject, based on the national SaveOutdoor Sculpture inventoryproject, used volunteers to docu-ment, measure and photographmonuments and memorials on NCAproperty. More than 3,000 peoplefrom around the world contactedNCA to express interest in volun-teering to participate in the project.Calls and e-mails came in from NewZealand, the Philippines, Denmark,Western Europe, and even from ac-tive duty military personnel fightingin Iraq. In all, 372 volunteersworked on the project—including40 VA employees from across thecountry.

Volunteers documented 1,049different memorial objects found atVA national cemeteries. A numberof surveyed objects, such as Bivouacof the Dead plaques, Gettysburg Ad-dress tablets, carillons and artillery,were reclassified under separate cat-egories after the project ended.

The majority of project volun-teers were active duty military per-sonnel and working professionals,followed by retirees and then stu-dents. “The volunteers were very

dedicated,” said Randy Watkins, ofJefferson Barracks National Cem-etery in St. Louis.

Numerous volunteers requestedadditional survey assignments aftercompleting their first one. Onecouple documented memorials inWisconsin and Hawaii, while a mili-tary retiree documented three NorthCarolina sites and two in Arizona.Several groups of volunteers alsoparticipated, including a 4-H clubthat recorded memorials at Rock Is-land National Cemetery in Illinois.

“It was my pleasure to partici-pate and play a small role in the sur-vey of memorials honoring ourservicemembers who sacrificed forthe freedoms we enjoy,” said

Michael Tanigawa, a retired Armylieutenant colonel who volunteeredat the National Memorial Cemeteryof the Pacific in Honolulu.

Ongoing analysis of the Memo-rials Inventory Project has shownthat 27 national cemeteries andsoldier’s lots have been found tocontain no memorials.

Dates of installment show thatthe number of memorials erected innational cemeteries has skyrocketedsince 1980; nearly 600 have beeninstalled since 1990. The increase isdue, in part, to the creation of me-morial paths or walkways as com-memorative areas in national cem-eteries built since 1980. These find-ings will guide future funding re-

Taking InventoryWith the help of a small army of volunteers, NCA completes anambitious project to catalog every memorial on its grounds.

The James Lent cenotaph at Congressional Cemetery in Washington, D.C., is the oldestmemorial on NCA grounds. Lent was a congressman from New York who died in 1833.

WAYNE ELLIS

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14 May/June 2005

500 negatives of memorials col-lected.

NCA will share information onits sculpture monuments with thepublic later this year through theSmithsonian’s art inventory data-base, known as SIRIS. The NCAHistory Program will also work withNCA IT staff to create a searchableonline database of its own so thatinformation and photographs on allof its memorials will be available tothe public.

quests for preservation of monu-ments and memorials located in VAnational cemeteries and soldier’slots.

The project raised awarenessabout national cemeteries, their his-tory, and the soldiers and sailors in-terred in them. Many volunteersconducted thorough and intensiveresearch on the memorials that hasproven invaluable for the NCA His-tory Program.

Through the project, NCAidentified one particularly signifi-

which was being built at the sametime.

Another beneficial outcome ofthe project has been the centraliza-tion of memorial information. Al-though volunteers were unable tolocate information on many memo-rials, the project did reveal howmany memorials are in VA’s na-tional cemeteries and where theyare. It also produced a significantphotographic archive for the NCAHistory Program, with more than6,600 photographs and more than

Estimated memorials in 2002: 300Memorials as of March 31, 2005: 872

Volunteers: 372Volunteer hours: 3,404VA employees who volunteered: 40

Number of cemeteries or soldier’slots with no memorials: 27

Oldest memorial: Cenotaph (a tombor monument erected in honor of aperson or group whose remains areelsewhere) for New York Congress-man James Lent, who died Feb. 22,1833, Congressional Cemetery,Washington, D.C.

Newest memorial: USMC Tanker’sAssociation memorial, dedicatedJan. 15, 2005, National MemorialCemetery of the Pacific, Honolulu.

Largest memorial: Pennsylvania Vet-erans memorial, Indiantown Gap Na-tional Cemetery, Annville, at 85 feetwide, 360 feet long, 107 feet high.

Individuals who have both ceno-taphs and burial sites in NCA sys-tem: N.C. Rep. David Heaton (ceno-taph at Congressional Cemetery,Washington, D.C.; interred at NewBern, N.C., National Cemetery), andCol. Edward D. Baker (cenotaph atBall’s Bluff National Cemetery in Vir-ginia; interred at San Francisco Na-tional Cemetery).

Cemetery with the most memorials(as of March 31, 2005): Ohio WesternReserve National Cemetery, with 68.

Carillons: 37Artillery: 73Revolutionary War memorials: 4War of 1812 memorials: 1Civil War memorials: 119Spanish American War memorials: 5

Project Findings

Memorial walkway at Ohio Western Reserve National Cemetery.

cant monument at the Loudon ParkNational Cemetery in Baltimore.The Maryland Sons monument,originally dedicated as the UnionMonument on Memorial Day 1884,has a 3-foot terracotta frieze aroundit—similar to the frieze around theNational Building Museum (for-merly the Pension Building) inWashington, D.C. The MemorialsInventory Project volunteer submit-ted 1884 newspaper articles reveal-ing that the monument sculptor wasallowed to use the mold from thefrieze at the Pension Building,

TIMOTHY D. BEAN

By Darlene Richardson

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May/June 2005 15

feature

The letter to Anna Gray ofNew Orleans was dated “12November 1944.” It read in

part: “Since your husband, PrivateFirst Class Walter Gray Sr. … wasreported missing in action 11 No-vember 1943, the War Departmenthas entertained the hope that hesurvived and that information wouldbe revealed dispelling the uncer-tainty surrounding his absence.However … the conditions of war-fare deny us such information.

“The record concerning yourhusband shows that he was a passen-ger aboard a United States ArmyTransport which was hit by a tor-pedo from an enemy submarinesouth of the Fiji Islands. … While

the great majority of the militarypersonnel were rescued a very thor-ough search failed to reveal anytrace of your husband.

“… I regret the necessity for thismessage but trust that the ending ofa long period of uncertainty maygive some small measure of consola-tion. I hope you will find sustainingcomfort in the thought that the un-certainty with which war has sur-rounded the absence of your hus-band has enhanced the honor of hisservice to his country and of his sac-rifice.”

The letter was signed by Maj.Gen. J.A. Ulio, The Adjutant Gen-eral.

With that notice, Walter Gray

Jr., then 9 years old, learned that hisfather would never be returningfrom the war. Other than fleetingchildhood memories, old photo-graphs, and stories told at familygatherings, that letter was the lastcontact Walter would have with hisdad for more than half a century.

Now 71, Walter Jr. is the direc-tor of the Beaufort, S.C., NationalCemetery, one of the oldest nationalcemeteries in the country. He is re-sponsible for ensuring that the 33-

A long-lost father, a surprising discovery. Memorial Day has specialmeaning this year for one VA employee.

Above: Walter Gray Jr.’s son-in-law, Ken-neth Morgan, creates a shadow over thename of Gray’s father on a monument wallat the National Memorial Cemetery of thePacific. Gray and his family stumbled onthe name while vacationing in Hawaii.

‘The Solemn Pride’‘The Solemn Pride’

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16 May/June 2005

acre site and final resting place ofmore than 16,500 veterans andtheir beneficiaries is maintained in amanner befitting the national shrinethat it is.

Gray retired from the U.S. AirForce in 1982, after 26 years of ser-vice, and joined the National Cem-etery Administration in 1991. Withmore than 40 years of federal ser-vice, he has seen and experiencedmuch. But nothing prepared him forwhat happened while visiting, as atourist, one of the other nationalcemeteries administered by NCA—the National Memorial Cemetery ofthe Pacific, the “Punchbowl,” inHonolulu, Hawaii.

In March, Walter and his wife,Doris, visited their daughter Jorineand her husband, Air Force ChiefMaster Sgt. Kenneth Morgan, andtheir granddaughter, Isabeau, attheir home on Hickam Air ForceBase in Honolulu. After touring theisland, and paying their respects tothe men entombed in the U.S.S.Arizona Memorial, Gray and hisfamily went to visit the Punchbowl,and pay a professional courtesy visitto its longtime director, GeneCastagnetti, a retired Marine Corpscolonel.

After being provided “splendidhospitality,” as Gray described theirvisit with Castagnetti, the familymembers were escorted to thevisitor’s center, where they weregiven information on the manymonuments located in the cemetery,situated in the Pu’owaina Crater.

The crater, an extinct volcanoknown in ancient times as “The Hillof Sacrifice,” commands one of themost spectacular views in all of Ha-waii. Many of the scenes depicted inmovies, television shows, and vaca-tion literature are of memorials atthe national cemetery, or clearly vis-ible from the Punchbowl. Amongthem is the Honolulu Memorial de-piction of Lady Columbia, standingon a stylized prow of a U.S. Navy

carrier, representing all of the griev-ing mothers of those interred at thecemetery. Included are 23 Medal ofHonor recipients, and 13,000 otherservicemen and women who losttheir lives in World War II.

The Gray family then moved onto the Courts of the Missing sectionof the monument. Somberly, theyreviewed the names of nearly 29,000servicemen engraved on the Courts’10 tablets. These American heroesare classified as Missing in Action(MIA), or lost or buried at sea inthe Pacific Campaign of World WarII. There are also the names of thou-sands of MIAs from the Korean Warand Vietnam.

After passing before the Navysection, Gray, a native of New Or-

leans, and his son-in-law, at thelatter’s suggestion, moved on to theArmy section of the Courts. It wasthen that the two of them spottedthe name:

WALTER GRAY SR.PFC 855 ENGR BN ANN

LOUISIANAAs Gray later recalled, when he

first saw the name on the wall, hewasn’t quite sure how to react. Afterall of his years of service in the mili-tary and NCA, where he has seen tothe needs of thousands of mournersat the national cemeteries where hehas been assigned, he had no ideathat the name of his father, lost formore than 60 years, was inscribedon one of the nation’s most cher-ished monuments.

His son-in-law asked him, “Isthat your dad?” After seeing thename of the unit and the state en-graved just below the name, Grayresponded, “Yes, that is my dad.When I saw the state, Louisiana,there was no more doubt about that

being my dad’s name.”For those who have visited the

monument, or others with the in-scriptions of the names of America’ssons and daughters, seeing thenames of strangers evokes emotionsthat are often hard to describe. Find-ing the name of his father, missingin action for 62 years, when Graywas not even aware that the carvedname existed, was overwhelming.“When I saw my dad’s name on thewall,” he said, “I felt sad, I felthappy, I felt proud.” He later learnedthat his father had been posthu-mously awarded the Purple Heart.

Returning to South Carolina,Walter Gray and the staff prepare, asthey do every year, to conduct spe-cial services for Memorial Day at the

national cemetery in Beaufort.Thousands will attend. But for Grayand his family, “Memorial Day” thisyear will be that day in March,thousands of miles from home, whenhe discovered the name on that sa-cred wall.

At the base of Lady Columbia,above the names of the honoreddead, are inscribed the words ofAbraham Lincoln: “The SolemnPride that must be yours to have laidso costly a sacrifice upon the altar offreedom.”

This year, “The Solemn Pride”has special meaning for a man whohas devoted so much to ensuringthat the vision of NCA’s Atlanta-based Memorial Service Network IIis uncompromised: “We will [fulfillour Mission with] Compassion,Southern Hospitality, Dignity, andHonor befitting the men andwomen who wore their country’suniform with pride.”

“When I saw my dad’s name on the wall, I feltsad, I felt happy, I felt proud.”

By Butch Stier

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May/June 2005 17

feature

The seamless transition of Operation Iraqi Free-dom and Enduring Freedom wounded from De-partment of Defense to VA health care was on

Secretary Jim Nicholson’s mind in early May as he ac-companied Sen. Larry Craig (R-Idaho), chairman of theSenate Veterans’ Affairs Committee, and other mem-bers of Congress on a trip to Iraq. He spoke with U.S.troops, military leaders and heads of state and said hecame away feeling “proud and optimistic.”

“My purpose was to meet with our military com-manders and soldiers and Marines to really get an ideaof how we are doing on transition,” he said. “Are wereaching them with our information and how do wecontinue to access them when they return home?”

The Secretary said he was “pleasantly surprised” athow much the military personnel he talked to knewabout their rights and benefits and how to access themwhen they redeploy to the States.

“I was particularly interested in talking to reservepersonnel,” he said. “More knew about the two years offree VA medical care they are entitled to when they re-turn home than I expected, [but] not all, so we still havework to do.”

Secretary Nicholson OverseasSecretary Nicholson visited an Idaho National

Guard Army artillery brigade based near Kirkuk, northof Baghdad. He said he was impressed with their spiritand morale.

“It made me feel so proud of our forces there andbrought home how important VA is in maintaining oursoldiers’ morale and trust in an environment where no-body is safe.

“They know that they are supported by the bestmedical care while in themilitary and in the VA systemwhen they leave service,” hesaid. “That’s very importantfor a soldier and it’s very im-portant to his or her family.”

The Secretary visited anArmy field hospital inBaghdad and followed themilitary medical evacuationroute back to Landstuhl Mili-tary Medical Center in Ger-many, where casualties are sta-bilized before their trip backto military hospitals likeWalter Reed Army MedicalCenter in the U.S.

“The patients I talked tothere will all be in the VAhealth care system one day,”he noted. “Thanks to our ad-vanced battlefield medicineand body armor, many sur-vived traumatic injuries thatwould have killed soldiers

serving during the Vietnam War. They are aware of VA’sleadership in traumatic injury, PTSD, and rehabilita-tion, and that’s something we have to maintain.”

Secretary Nicholson finished his overseas trip ashead of the U.S. delegation invited to participate in theCzech Republic’s observances of the 6oth anniversary ofits liberation from Nazi occupation at the end of WorldWar II. He represented the President as grand marshalof a national liberation parade.

“The Czech people remember what the UnitedStates did for them during World War II,” he said.“They appreciate it and now, like other Eastern Euro-pean nations, are free to express that appreciation afterlong years of Soviet control.”

Secretary Nicholson visits members of the 116th Armored Calvary Brigade of the Idaho NationalGuard in Kirkuk, Iraq.

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18 May/June 2005

TheEvolutionof Prosthetics

War has historically been a catalyst for advances in am-putee care and prosthetic design that have ultimatelybenefited all Americans who have lost limbs due to in-jury or disease. The war in Iraq has already led to im-provements, and more are expected. In this three-partfeature, VAnguard takes a closer look at VA prosthetics:past, present and future.

JOSEPH MATTHEWS

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May/June 2005 19

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The science of prosthetics has comea long way since the debut of“Anglesey Leg” in England in theearly 1800s. This above-the-kneeprosthesis was revolutionary in itstime, with a steel knee joint and ar-ticulated foot controlled by catguttendons.

Today’s prosthetic legs are fittedwith electronic sensors measured 50times a second. A microprocessoruses the information to adjust move-ment for the terrain and walkingspeed. Many of the troops who lost

aids are no exception. “In fact, warshave been veritable watersheds forthe technical development ofassistive devices for surviving com-batants,” wrote Dudley Childress,Ph.D., a world-renowned prostheticsresearcher who serves at the VAChicago Health Care System andNorthwestern University, in theNovember/December 2002 issue ofThe Journal of Rehabilitative Medicine.

One of the more vivid examplesis the U.S. Civil War. Records showUnion surgeons performed up to30,000 amputations during the war.Many factors contributed to thehigh amputee rate, but one of theprime culprits was the soft, leadMinie Ball fired by Springfield mus-kets. With a kill range of 1,000yards, Minie Balls crushed bone andripped arteries and tissue beyond re-pair. Doctors often had little choicebut to amputate limbs hit by aMinie Ball.

The post-Civil War era wasmarked by a period of entrepreneur-ship in prosthetic design as ampu-tees sought to improve their mili-tary-issue limbs. Some had successand went on to found their ownmail-order companies. By the timeWorld War I broke out, there wereup to 200 artificial limb clinics and2,000 skilled craftsmen in America.But many were interested only inpadding their own wallets. As theAmputee Resource Foundation ofAmerica’s Web page notes, “Shystersand charlatans dot the history atthis time.”

Dissatisfied WWII veteransset stage for change

Prosthetic fabrication inAmerica remained largely un-changed from the Civil War

through World War II. However,the volume of amputees returningfrom combat in Europe would usher

in an era of change. The box belowshows World War II amputation sta-tistics for members of the Army andArmy Air Corps.

A typical amputee received a

History

War Spurs Major Developments

Single amputationOne leg: 10,620One arm: 3,224Total: 13,844

Double amputationBoth legs: 870Both arms: 57Total: 927

Triple amputationBoth legs, one arm: 8Both arms, one leg: 1Total: 9

Quadruple amputation: 2

Total: 14,782

This Confederate soldier was one of manyfrom both sides of the Civil War who lostlimbs.

legs in Iraq are receiving these state-of-the-art C-Legs.

Amputation common inbloody civil war

War has long spurred develop-ments in medicine, and mobility

Opposite: Tim Harrison, left, who lost a legto cancer, and Mike Ellis, a Vietnam ampu-tee, play basketball wearing C-Legs built atthe VA Puget Sound Health Care System.

World-renowned prosthetics researcher Dr.Dudley Childress.

WWII Amputations

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20 May/June 2005

temporary artificial limb when heleft the service and was referred toVA for a permanent limb. But whenhe went to VA, in many cases hegot a “prescription” for a prosthesissupplied through a contract with thelowest bidder, as was required undergovernment procurement regula-tions.

A VA history written in 1967characterized the World War II pe-riod as “chaotic” for amputees andoffered the following account: “Andthe newly discharged amputee, onlyrecently assured that he was a heroand perhaps used as a speaker at warbond rallies, was understandably fu-rious when told that he could nothave an artificial limb available tocivilians because under the prevail-ing lowest bid concept it was notthe cheapest available to him.”

Veterans stormed the U.S.Capitol, waving their artificial limbsin protest. Congress investigated. Inresponse, VA on Nov. 1, 1945, cen-tralized its fragmented prostheticsoperation under a new Prosthetic

ApplianceService. ByDecember1945, Con-gress gaveVA broadauthority toprovide pros-thetic appli-ances by“purchase,manufacture,contract, orin such othermanner asthe Admin-istrator maydetermine tobe proper.”

SurgeonGeneral ofthe ArmyNorman T.Kirk got theball rollingby organizinga meeting ofprosthetics

experts in January 1945 at ThorneHall, Northwestern University. Themeeting was pivotal for two reasons:it marked the birth of federal fund-ing for rehabilitation research, and itestablished the fields of science,medicine and engineering as integralto prosthesis development. Themeeting pushed prosthetics beyondcraft and into the realm of science.

Dr. Paul B. Magnuson, a promi-nent Chicago surgeon who went onto serve as VA’s chief medical direc-tor from 1948 to 1951, was amongthe meeting’s principal attendees.Magnuson was strongly committedto vocational rehabilitation. He

VA leaders of the post-World War II era, including former chiefmedical directors Dr. Paul Magnuson (left) and Gen. PaulHawley (right), along with former VA administrator Gen.Omar Bradley, were able to cut through red tape to get much-needed programs started for the 15 million veterans whoflooded back home after the war.

A World War II amputee learns to make artificial limbs under VA’s vocationalrehabilitation program.

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aligned VA hospitals with universitymedical schools and established VAresidency programs, moves thatwould have profound effects on thedepartment. Some call Magnusonthe father of rehabilitation research.

Congress gives VA a leadingrole in research

The National Academy of Sci-ences initially managed the federalstudies called for during the ThorneHall meeting. By June 1947, how-ever, VA had taken over researchcontracts, while the academy as-sumed an advisory capacity.

The department also establisheda testing and development lab inNew York in 1947. This VA Pros-thetics Center played a key role inlimb design and refinement. Amongits early achievements was encourag-ing manufacturers to use new plasticlaminates instead of wood.

By 1948, Congress authorizedannual appropriations of $1 millionto VA for prosthetic and rehabilita-

tion research.One of thestudies VAwould fund,initiated sev-eral years ear-lier at the Uni-versity of Cali-fornia, Berke-ley, was a fun-damental studyof human loco-motion. An-other, con-ducted atUCLA, exam-ined fabrica-tion and fittingtechniques forsuction-socketabove-kneeprostheses.

In 1949,VA assembled30 multi-disci-plinary ampu-

tee clinics at strategic locationsacross the country. Each clinic had ateam consisting of a surgeon, pros-thetist, physical therapist, occupa-tional therapist, and prosthetic rep-resentative. These teams began at-tending a six-week course in upperlimb prosthetics at UCLA estab-lished in 1952 with the help of VAfunding. The course was a success,and in 1956 VA began funding asimilar education program at NewYork University.

Over the next few decades, VAcontinued an active role in artificiallimb development. In the mid-1950s, the department established anetwork of prosthetic service unitsto evaluate devices developed byothers. Those that were beneficial topatients were then adopted by theVA system.

In the mid-1960s, Dr. ErnestBurgess, chief of the amputee clinicat the VA hospital in Seattle, led aclinical investigation into the prac-tice of fitting amputees with pros-

Amputees at Washington, D.C.’s Walter Reed Army Medical Center in 1950.

thetic devices immediately after sur-gery, a technique that was eventu-ally adopted nationwide. Burgessand colleagues redefined amputationas part of the rehabilitation process.His team later developed the SeattleFoot, a prosthetic device made ofenergy-absorbing spring-like mate-rial, and went on to pioneer com-puter-assisted design software used inprosthesis fitting.

The years following World WarII were marked by rapid advances inlimb design, fabrication and fitting.“The VA was definitely a leader …and others followed, because the VAwas so successful,” said Childress ina telephone interview from his labin Chicago. Childress knows fromexperience. In 1968, two years after

Dr. Ernest Burgess, developer of the revolu-tionary Seattle Foot.

By Matt Bristol

joining the VA-funded ProstheticsResearch Laboratory at the Reha-bilitation Institute of Chicago, heand colleagues fitted the first self-contained and self-suspended trans-radial myoelectric prosthesis.

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22 May/June 2005

Don’t let the name fool you. VA’sProsthetic and Sensory Aids Servicedoes more than dole out artificiallimbs and hearing aids. In fact, theservice provides all sorts of medicalequipment—from simple $2 foamshoe inserts to hi-tech $30,000iBOT wheelchairs—to allow veter-ans with service-connected disabili-ties to live independent, fulfillinglives.

“People don’t really understandwhat we do because there is noequivalent in any other health caresystem,” said Frederick Downs Jr.,who has led the service since 1980.“We are the VA’s pharmacy for du-rable medical goods and equip-ment.”

A quick look at the numbersconfirms the truth about VA’s Pros-thetic and Sensory Aids Service: ar-tificial limbs and sensory aids are asmall piece of the pie.

Last year, the service saw nearly1.4 million veterans and supplied$812 million in medical appliances.Of those patients, only about 26,000needed new artificial limbs or ad-justments to old ones, at a cost ofjust under $66 million. Another631,000 veterans sought eyeglasses,hearing and other neuro-sensoryaids, to the tune of about $52 mil-lion.

Maybe it’s time to change thename to something more reflectiveof the service’s scope. “Sure, wethought about it over the years,” ad-mitted Downs. But what do you calla service that provides crutches,braces, eyeglasses, hearing aids, arti-

ficial limbs, oxygen bottles, wheel-chairs, hospital beds, pacemakers,stents, dental implants, money forclothes, automobile modifications,home adap-tations andmore?

In theend, theydecided notto changethe namebecause themedicalequipmentthey providetechnicallyis consideredprosthetics,explainedDowns, whodefined theterm as“anythinginorganicused to re-place or sup-port a bodilyfunction oractivity.”

Troubledtimes leadtosweepingreform

VA’soverall pros-thetic opera-tion waschaotic dur-ing the

1960s and 1970s. One of the keyproblems was lack of organization.There was no national oversight.Funding and administration were

Current Operations

ROBERT TURTIL

The Truth About Prosthetic andSensory Aids Service

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May/June 2005 23

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decentralized to individual medicalfacilities. As the service’s director,Downs said he struggled to “bring asense of order to the program.” Theway he saw it, a veteran should getthe same amputee care whether theyvisited a VA facility in New York orCalifornia.

Pressure from Congress led tosweeping changes during the 1990s.The service, which had been in ex-istence since 1948 and aligned as aseparate VA service line since 1977,was finally able to standardize proce-dures as part of a comprehensive im-provement plan.

It was good news to John R.Milani, who started his career in1975 at the VA Prosthetics Centerin New York City, then a renowned

artificial limb testing and develop-ment site. “We’ve seen a lot ofchanges over the years, not just inthe VA but in the field in general,”said Milani, who now oversees VA’snational orthotic and prosthetic pro-gram.

The department has 63 labsstaffed by 182 employees calledprosthetists and orthotists. They’reresponsible for fabricating, fittingand repairing artificial limbs andbraces, or ordering them from com-mercial vendors.

According to Milani, they haveaccess to the latest technologies andcan provide any device deemed nec-essary by an examining physician.Last year, for example, they provided176 veterans with the latest comput-

erized C-Leg, whichthe service purchasedthrough national con-tracts for the modestaverage price of$36,000 each.

Over the last fewyears, the labs havemade a concerted ef-fort to get certificationfrom one of the twoaccrediting organiza-tions, the AmericanBoard for Certificationin Orthotics and Pros-thetics, and the Boardfor Orthotist/Prosthe-tist Certification.

In 2003, only fiveof the labs were ac-credited. Today, 34have earned that dis-tinction. Similarly, in2003, there were 70board-certifiedprothetists andorthotists. Today thereare 97. “Certificationbrings a certain pres-tige to our labs,” saidMilani. “It demon-strates that we havethe professional capa-

bilities to meet veterans’ needs.” Italso helps to attract recent gradu-ates, who want to learn from thebest in the field.

Several of the labs that earnedaccreditation went on to seek certi-fication for prosthetic residency pro-grams. So far, five labs—located atVA medical centers in Seattle, LongBeach, Houston, Oklahoma Cityand North Little Rock—haveearned residency accreditation.Milani said they represent thedepartment’s “first national pros-thetic residency program.”

He is hoping students who com-plete a VA residency will want tostick around, just as he did back inthe 1970s. “Once [the residents] seeour facilities and the training oppor-

Opposite: Frederick Downs Jr. has led Prosthetic and Sensory Aids Service since 1980; above: Christopher Fantini, aprosthetist with the VA New York Harbor Health Care System, prepares a prosthetic socket for the next step in the fab-rication process.

ANTHONY MORALES

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24 May/June 2005

tunities we offer, they’re going towant to start their careers with us,”Milani said.

A lifetime commitmentIn the past, the majority of VA

prosthetic patients lost limbs incombat. But this appears to bechanging. National trends showtoday’s typical patient is a middle-aged male who suffered an amputa-tion due to vascular disease.

Someone likeDave Lemak, whoserved with theMarines in Viet-nam from 1967 to1968. Lemak wasdiagnosed with dia-betes in 2001 andlost his right leg be-low the knee inFebruary 2004. Hereceived an artifi-cial limb from theprosthetic lab atthe Michael E.DeBakey VA Medi-cal Center in Hous-ton a few weekslater. “Those peopleare saints,” saidLemak. “They tookgood care of me.”

Richard H.Nelson, a certifiedorthotist, overseesthe lab in Houston.His lab sees about100 new patientslike Lemak eachyear. First theyevaluate theveteran’s lifestyleand medical condi-tion to determinewhich type of pros-thetic limb willmeet their needs.Then they fabricatea socket, order thevarious compo-nents, put it to-

gether in their workshop, and fit itto the veteran’s residual limb.

Fitting the prosthesis can be thetoughest part, according to MarkBenveniste, a certified prosthetistwho works in Nelson’s lab. “Thenumber one concern is getting acomfortable socket fitting,” he said.“Without the right fit, nothing elsematters.”

In addition to building and fit-ting a limb, prosthetists serve on

amputee clinic teams made up oftherapists, doctors, and sometimesrepresentatives from commercialvendors. They meet with veteransweekly to make sure their artificiallimbs are functioning properly andmeeting their needs.

Watching his patients take theirfirst steps is one of the rewards ofworking for VA, according toBenveniste. And he’s happy to seeveterans like Lemak when they re-turn for follow-up services. “Every-one should have someone likeMark,” said Lemak. “He’s always en-couraging me and he’s always avail-able. He really takes an interest inyou and that’s what’s so great aboutit.”

Providing individual care is justanother perk of the job forBenveniste. “My patients are gener-ally pretty pleased because I’m ableto give them the best care possible,and that includes giving my timeand attention. They deserve noless,” he said.

Downs, the service chief, agrees.“We have a lifetime commitment tothese veterans,” he said. “We’re go-ing to help them regain their mobil-ity and independence, help them re-gain their dignity as a human being.That’s why we’re here and that’swhy our work is so important.”

By Matt Bristol with contributions byLiz Kiley

Prosthetist Mark Benveniste assembles a prosthetic leg using a hydraulicMercury knee system at the Michael E. DeBakey VA Medical Center inHouston. The hydraulic knee allows users to ambulate at varying speedsand is frequently used as a back-up to the computerized C-Legs.

BOBBI GRUNER

Quick StatsThe number of “unique” patientsseeking VA prosthetic and sensoryaid services has increased byabout 30 percent in the last fouryears—rising from 958,000 in 2000to 1.4 million in 2004. As the patientload increased, so did the budget.Last year’s budget of $930 millionwas nearly double the 2000 budgetof $532 million. The 2005 budget ismore than $1 billion.

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cover story

Remember the 1970s TV show “TheSix Million Dollar Man?” It featureda test pilot who suffered horrific in-juries in a crash and was “rebuilt”with bionic parts. This made him asuperman who could lift cars andleap 40 feet in the air.

The actual science of prosthet-ics has a more down-to-earth goal:to restore independence and mobil-

ity to amputees and enable them todo everyday things most of us takefor granted—walking, running, en-joying hobbies, using a pen or fork,holding a child. But the technologyemerging in labs today, includingseveral VA sites, is no less dramaticthan that depicted in the old TVshow.

Take, for example, the work of

Dr. John Donoghue at Brown Uni-versity and VA’s Center of Excel-lence for Rebuilding, Regeneratingand Restoring Function after LimbLoss in Providence, R.I. Donoghuehas developed a system calledBrainGate that decodes brainwaves—thoughts—and translatesthem into computer commands.Early results show that a quadriple-

gic canswitch onlights andopen e-mailusing only hismind. Thesystem,which uses atiny sensorimplanted inthe part ofthe brainthat controlsmovement,has huge im-plications foramputees. Aperson couldsimply“think” aboutmoving hiscomputerizedartificial arm,and the

thought could trigger the device toact.

The system still relies on wireshooked to the brain, but Donoghue’sgroup and others pursuing similarwork around the country plan toeventually have a wireless system.Dr. Richard Normann, the Utahbioengineer who developed the chipused by Donoghue, is spearheading a

$6.7 million grant from the Na-tional Institutes of Health to refinethe chip and explore further uses forit. “To go from a bundle of wiressticking out of somebody’s head to atotally implantable system that is in-visible will be a major advance inthis technology,” he says.

‘Biohybrid limbs’This research in “neuroprosthe-

tics” is part of a larger trend in pros-thetics that aims to integrate body,mind and machine. Dr. Roy Aaron,an orthopedic surgeon who directsthe VA-Brown center, talks of“biohybrid limbs.”

“Some breakthroughs may blurthe distinction between biologicaland non-biological,” says Aaron. Hiscenter, established by VA last yearat the Providence VA Medical Cen-ter, is at the front edge of a move-ment to create prosthetic limbs thatfunction almost like natural ones.

Dr. Hugh Herr, director of the“Leg Lab” at MIT, is collaboratingwith the VA and Brown researchers.Herr was a champion rock climberwho lost both feet to frostbite andwent on to become a top prostheticsengineer. His lab studies the intrica-cies of human walking and designs“smart” knees and ankles that mimicreal joints.

“These systems have to knowhow to walk,” says Herr. His latestknee-ankle prototype has sensorsthat measure force, position andmovement and feed the data to anonboard microprocessor. The kneehas an electromagnet and a friction-modulating fluid that changes inmilliseconds from an oil to a near-

Research & Development

Prosthetics of the Future Will MeshBody, Mind, Machine

Dr. Roy Aaron directs a new limb-loss center at the Providence, R.I., VA MedicalCenter where scientists hope to create “biohybrid” limbs that will use regeneratedtissue, lengthened bone, titanium prosthetics and implantable sensors that allowamputees to use nerves and brain signals to move arms or legs.

BROWN UNIVERSITY

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26 May/June 2005

solid in response to a magnetic field.The ankle may use polymers thatturn electrical energy into mechani-cal force, thus acting as a sort of ar-tificial muscle.

Herr envisions that in the fu-ture, “Amputees will be able totraverse greater distances with lessfatigue. Artificial joints will be ableto move like a biological joint.”

Two-way talk between brain,artificial limb

Herr’s model also uses“BIONs™,” short for bionic neu-rons. These microchips will be in-jected into residual leg muscles topick up movement signals from the

brain and send them to the artificiallimb. Says Herr: “We need to havethe amputee’s brain control the arti-ficial knee, to tell the knee that theyintend to turn left or right, or thatthere are stairs up ahead.”

BION technology, developed bythe Alfred E. Mann Foundation,also figures in an artificial hand in-vented in the VA Chicago lab of Dr.Richard Weir. Sensors placed in ex-isting arm muscles will pick up brainsignals. An external controller willuse “fuzzy logic”—the algebraic deci-sion-making of artificial intelli-gence—to translate the signals intocommands for the hand.

“We expect that for the first

time in prosthetics history we willhave enough control sites to domore than just open and close ahand—we should be able to controla wrist, a thumb, and possibly evenindividual fingers on a hand,” saidWeir.

According to Dr. DanielleKerkovich of VA’s RehabilitationResearch and Development Service,artificial hands of the future will alsofeature sensory feedback to thebrain. “It won’t be just output—re-sidual limb telling prosthesis what todo—but also prosthesis reportingback to the chip [and in turn, to thebrain] what it did. So even if youweren’t looking at your hand, you

Roy Bloebaum, Ph.D., director of the Bone and Joint Research Laboratory at the VA Salt Lake City Health Care System and professor ofBioengineering, Orthopedics and Biology at the University of Utah, is investigating osseointegration, or ways to attach prosthetics to tita-nium implants placed in bone. Here he is holding a proximal femur implant; inset: Researchers at the bone and joint lab use a scanningelectron microscope to measure the impact of titanium implants on bone density. This image shows mineral content in the patella, about3 mm from a knee replacement implant. The light gray areas are high in mineral content, while the dark areas are low. Researchersfound bone adjacent to titanium implants has less mineral content, making it more flexible.

TOD PETERSON

KARYN KOLLER

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cover story

could sense that it reached downand grabbed a can of soda.”

In fact, artificial hands of thefuture will likely contain not onlysensors to monitor the force of agrip, but also hot and cold sensorsthat would even allow a user tosafely prepare a baby’s bath.

Tissue engineering tocomplement robotics

Along with advances in engi-neering and robotics, cutting-edgemedical techniques being exploredat the new VA-Brown center prom-ise to play a key role in 21st-centuryprosthetics:■ Surgical techniques to lengthenthe bone in the residual limb willmake it easier to fit artificial limbsand allow for greater control andmobility.■ Tissue engineering will help re-store torn-up joints. Techniquescould include the use of biodegrad-able polymer beads, smaller than apinhead, which would release pro-teins to trigger the production ofcartilage and possibly bone.■ Osseointegration—attachingprosthetic legs to a titanium boltplaced directly in the bone—mayavoid some of the problems of cur-rent anchoring methods, such asskin sores, sweating and pain. Re-

searchers in Providence, along withVA colleagues in Salt Lake City andSan Diego, are seeking ways to pre-vent the infections that often occurwith the new method.

Artificial eye on the horizonThe same chip being used as an

interface between brain and artifi-cial limb may also help blind peoplesee. Normann’s group in Utah hopesto eventually implant his electrodearray into the visual cortex, the partof the brain that processes visual in-formation. Video signals from a min-iature camera mounted in eyeglasseswill travel through the electrodesand excite specific neurons, result-ing in an image for the patient.

A different approach is beingtaken by Dr. Joseph Rizzo at the VACenter for Innovative Visual Reha-bilitation in Boston. His model is anartificial retina, designed to help pa-tients with macular degeneration orretinitis pigmentosa. The system by-passes damaged photoreceptors—rods and cones—and electricallystimulates the remaining healthycells of the retina. Like other pros-thetic prototypes, it relies on elec-trodes and a chip to bridge the gapbetween body and machine.

Many other groups around theUnited States and Europe are work-

ing on artificialeyes, with some ex-perts even predict-ing a product on themarket by 2010.

But as with allmedical technology,bringing a productfrom bench to bed-side is a chief mile-stone but not theend of the story. Re-searchers have tomake sure the de-vice works in thereal world.

Good examplesare studies by Dr. Jo-

seph Czerniecki at VA’s Center forLimb Loss Prevention and Pros-thetic Engineering in Seattle, andDr. Steven Gard at the VAChicago’s Motion Analysis and Re-search Laboratory. These researchersare conducting some of the first rig-orous trials of the C-Leg, the currentstate-of-the art computerized kneethat has been fitted on many Iraqveterans. The leg, which costs morethan $40,000, seems popular withamputees, but scant clinical evi-dence exists to back its claims ofeasier walking.

Amputee care: Lessonslearned from Iraq

No less important than newgadgetry is the care amputees re-ceive during rehabilitation. Heretoo, the model is changing fromwhat it was in previous eras.

“One of the biggest things we’relearning in the psychosocial arenafrom the men and women comingback from Iraq is that their goingthrough this together is helpingthem enormously,” says Kerkovich.She cites the unique support systemat Walter Reed Army Medical Cen-ter, where most new amputees arereceiving long-term therapy, andpoints out that VA is developingspecial video games for upper-limbamputees at the Army facility tohelp them learn to use their pros-thetic arms.

Recently at Walter Reed, VAinvestigator Dr. Robert Gailey and agroup of Paralympic athletes held aweeklong clinic to teach new artifi-cial leg users how to run. “Years ago,that wouldn’t have happened,” saysKerkovich. “Amputees were taughthow to walk, and that was it. Itshows how rehabilitation has ad-vanced—we’re getting better at fig-uring out that maybe patients canget better months, even years, afterthe injury, if we keep at it.”

Promising early results from the BrainGate system show that aquadriplegic can switch on lights using only his mind.

CYBERKINETICS NEUROTECHNOLOGY SYSTEMS INC.

By Mitchell Mirkin

VAnguardaround headquarters

28 May/June 2005

The Army kicked off itsFreedom Team Salute cam-paign May 2 at the Pentagonto a chorus of “Hooahs”from soldiers and veterans inattendance.

The campaign is in-tended to salute those whosupport soldiers and recog-nize Army veterans with a

special commendation pack-age consisting of a U.S.Army lapel pin, decal, and acertificate of appreciationsigned by the Secretary of theArmy and Army Chief ofStaff.

“As former soldiers, ourveterans will always be per-manent members of the

Army family,” Army Secre-tary Dr. Francis J. Harveysaid during the ceremony.

Organizers have distrib-uted brochures and otherpromotional items to veter-ans service organizations,state Veterans Affairs officesand VA hospitals. They alsosent 235,000 commendation

Army Campaign to Honor Veterans Coming to VA Hospitals

packages to Army veteranswith service-connected dis-abilities and are planning tovisit VA facilities in an effortto reach out to the estimated10 million Army veterans na-tionwide.

Representatives fromabout 20 veterans service or-ganizations attended the Pen-tagon kick-off ceremony,where Secretary Harvey pre-sented the first FreedomTeam Salute commendationto David Rodriguez, a deco-rated Vietnam veteran andnational commander of theAmerican G.I. Forum.

“Army veterans haveserved this nation with honorand dignity. Freedom TeamSalute is a way to recognizeour veterans and show themjust how much we appreciatethe legacy of loyal servicethat they have passed on tothis generation of soldiers,”said Army Chief of StaffGen. Peter J. Schoomaker ina prepared statement.

For more on the cam-paign or to register for acommendation package, visithttp://freedomteamsalute.army.mil.

Eighty Participate in Take Our Children to Work Day at VACO

Eighty children got a glimpseof what their parents do allday during VA CentralOffice’s Take Our Childrento Work Day on April 28.

“I knew my dad workedfor Veterans Affairs, but Ididn’t realize how many dif-ferent sections of VA therewere,” said Juliana Cheplick,13, a student at LongfellowMiddle School in McLean,Va., whose dad DavidCheplick is a service director

for telecommunications inthe Office of InformationTechnology. Her 14-year-oldsister, Marissa, agreed. “Yeah,we learned a lot about all thedifferent branches of the VAand how they help veterans,”she said.

That’s exactly the point,according to Dot Walker, amanagement analyst in theNational Cemetery Adminis-tration, who organized theevent. “We want to teach

these children why we’re hereand what we’re doing forAmerica’s veterans,” she said.

The event, sponsored bythe Federal Women’s Pro-gram, included a questionand answer session withBrian Thacker, a Vietnamveteran and Medal of Honorrecipient who retired fromVA in 2002. The questionscame in rapid succession:why did you go to war, whatkind of gun did you use, did

ROBERT TURTIL

Army Secretary Dr. Francis J. Harvey presents the first Freedom Team Salute commendation pack-age to David Rodriguez, national commander of the American G.I. Forum.

you have to work for VA be-cause you’re a veteran, didyou like your job? Smiling,Thacker did his best to an-swer all the questions beforethe children broke intosmaller groups and headedout for tours of various of-fices.

One of the first stopswas the Board of Veterans’Appeals, where Chief JudgeConstance Tobias organized amock hearing for the young

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May/June 2005 29

around headquarters

visitors. She said the Boardhas held nearly 1,200 hear-ings this fiscal year, so it wasa good way to demonstratewhat they do.

Staff lawyers played theroles of veteran and counseland presented evidence fortheir case. The children thengot to weigh in on how theythought the hearing shouldbe decided. “It was a lot offun, and I think the childrenreally honed in on credibilityissues and the power of ob-servation,” said Tobias.

The mock hearing madequite an impression on 14-year-old Lindsey Manard,whose aunt, Elizabeth Spaur,is an associate counsel at theBoard. “It’s kind of cool tobe an attorney here,” shesaid, after participating in thehearing.

Later, they toured theVACO library, fitness center,audio-visual control room inthe main conference center,and the broadcast studio.What did they enjoy themost?

“The studio was the bestpart,” answered 13-year-old

Chris Scribber, whose dadWilliam G. Scribber worksin the Office of InformationTechnology. Visitors to thebroadcast studio got to tourthe virtual set, try out the

teleprompter and operate theswitcher that controls thecameras and video decks.

It’s too early to tellwhether Chris will want topursue a career in broadcast

journalism, but at least heknows it’s an option. Andthat fits right in with thetheme of Take Our Childrento Work Day: “SharingPower and Possibilities.”

FERS and TSP: Planning for a Financially Secure Retirement

Retirement is a time for re-flection, rest and enjoyment.But a rewarding retirementdoesn’t just happen. It takescareful planning. Knowingwhen you can retire andwhere you will stand finan-cially are important parts ofthat planning process. The fi-nancial security you will havein the future depends, inpart, on the plan you maketoday.

Your participation in theFederal Employees Retire-ment System (FERS) givesyou an opportunity to re-ceive some important ben-

efits as a federal employee.FERS is a three-tiered

retirement plan. The compo-nents are:■ Social Security■ FERS Basic Annuity■ Thrift Savings Plan (TSP)

The three componentsof FERS work together togive you a strong financialfoundation for your retire-ment years. FERS was de-signed so that the money yousave and earn through yourTSP account will provide animportant source of retire-ment income, in addition toSocial Security and the FERS

Basic Annuity. This meansthat the size of your overall“retirement plan” depends onhow much you and youragency contribute to yourTSP account during yourworking years and the perfor-mance of the investmentfunds.

As a FERS employee,there are three types of TSPcontributions available toyou:■ agency automatic 1 per-cent contributions■ your own contributions■ agency matching contribu-tions

You automatically receive anagency contribution of 1 per-cent of your base paywhether or not you contrib-ute to your account. You cancontribute up to 15 percentof your base salary in 2005,up to the annual InternalRevenue Service limit($14,000 for 2005), with anagency match of up to 5 per-cent of your contributions. Ifyou do not contribute a por-tion of your base pay eachpay period, you will not re-ceive agency matching con-tributions, which is a keycomponent of the TSP and

ROBERT TURTILChildren of VA Central Office employees tour the library as part of Take Our Children to Work Day onApril 28.

VAnguardaround headquarters

30 May/June 2005

your total retirement plan.There are also two ma-

jor tax advantages to the TSP.First, you pay current federalincome taxes only on yoursalary after your contribu-tions have been deducted.Second, you do not have topay current federal incometaxes on the earnings you re-ceive on your TSP accountbalance. Thus you defer orpostpone paying taxes on the

Secretary Jim Nicholsonpraised the department’s topenvironmental stewards dur-ing an April 21 Earth Dayceremony in VA Central Of-fice.

“To each of you, let mesay I applaud your vision,initiative and dedication, andlook forward to presentingeach of you the recognitionyou so well deserve,” said theSecretary during the 2005VA Environmental Excel-lence Awards Program.

His comments followedremarks from Federal Envi-ronmental Executive EdwinPinero, who congratulatedthe honorees and spoke ofthe tremendous strides in en-vironmental protection sincethe first Earth Day obser-vance in 1970. “We shouldbe excited about what we’veaccomplished and where weare going,” he said, address-ing the awardees.

The VA Pacific IslandsHealth Care System tookfirst place in the SustainableDesign/Green Buildings cat-egory for installing energy-efficient components at theambulatory care clinic. Theclinic is VA’s first to achievean ENERGY STAR ® ratingfrom the Environmental Pro-tection Agency (EPA).

2005 Earth Day Ceremony Honors VA’s Environmental Stewards

money you contribute untilyou withdraw these fundsfrom the TSP. This usuallyoccurs when you retire andyour tax bracket may belower.

Although participationis voluntary, employees arestrongly encouraged to famil-iarize themselves with thenumerous attractive featuresof this successful program. Asa FERS employee, you may

choose to invest part of themoney in your TSP accountin one or all of the five in-vestment funds listed below:■ Government Securities In-vestment (G) Fund■ Common Stock Index In-vestment (C) Fund■ Fixed Income Index In-vestment (F) Fund■ Small Capitalization StockIndex Investment (S) Fund■ International Stock Index

Investment (I) FundTSP Open Season runs

from April 15 through June30, during which you mayenroll, change or terminateyour contributions. It is thelast open season for TSP. Asof July 1, you may make TSPcontribution elections at anytime. To find out more aboutthe TSP, visit www.tsp.gov orcontact your local HumanResources office.

Kenneth Haines, BarryWoodin and TimothyTrittschuhl were recognizedin the Recycling category fortheir composting efforts atFort Custer National Cem-etery in Augusta, Mich. Theybegan composting grass clip-pings, leaves, branches andother yard waste in 1996.

Since then, they’ve re-duced their annual wastestream by about 40 percentand processed 4,000 cubicyards of topsoil for use at thecemetery. They also madetheir jobs a lot easier andmore efficient, according toForeman Kenneth Haines.He said the decision to com-post yard waste allowed themto purchase a soil shredder,which reduces the amount ofmanual labor involved.

The William S.Middleton Memorial Veter-ans Hospital in Madison,Wis., and Gregory L. Win-ters, from the Office of Fa-cilities Management in VACentral Office, shared thetop award in the Waste/Pol-lution Prevention category.The VA hospital was recog-nized for significantly reduc-ing regulated medical waste,which saves money and re-duces the amount of toxinsreleased into the environ-

ment. Winters was honoredfor his work in developingVHA’s Waste Minimizationand Compliance Report.

The final award went tothe GEMS Professional Advi-sory Group, which includesrepresentatives from the Vet-erans Health Administration,the National Cemetery Ad-ministration, the Office of

Acquisition and MaterielManagement and EPA. Thegroup developed VHAguidebooks for environmen-tal compliance and imple-mented green environmentalmanagement systems at VAmedical centers. They wererecognized in the Environ-mental Management Systemscategory.

ROBERT TURTIL

Cindy Keidel, from Federal Prison Industries Inc. (UNICORE), was one of theexhibitors at the Green Purchasing Awareness Fair held as part of Earth Dayobservances in VA Central Office.

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May/June 2005 31

around headquarters

The Secretary’s 2005 Excel-lence in Nursing Awards cer-emony brought much-de-served recognition to a groupof employees some call theheart and soul of VA healthcare. Five nurses—chosenfrom among nearly 60,000

throughout the VA healthcare system—and one hospi-tal director were honoredduring the May 11 ceremonyfor their devotion to nursingand unwavering commit-ment to caring for America’sveterans.

Marthe Moseley, Ph.D.,R.N., an advanced practicenurse at the South Texas Vet-erans Health Care System,was recognized in the regis-tered nurse in an expandedrole category for her clinicalexpertise and sound leader-ship.

Kim Pyatt, R.N., a staffnurse at the Louis StokesCleveland VA Medical Cen-ter, was honored in the regis-tered nurse category for herefforts in implementing awound care managementprogram throughout thenursing home unit.

Ferris Jones, an Armyveteran and licensed practicalnurse at the VA Puget SoundHealth Care System inTacoma, Wash., was recog-nized for his work with veter-ans in the domiciliary careprogram, many of whom suf-fer from homelessness, sub-stance abuse or PTSD.

John Cheng, from the

Top Nurses Honored in VACO During National Nurses Week

Northport, N.Y., VA MedicalCenter, was named VA’s topnursing assistant for his ex-ceptional work ethic andstrong desire to serve. Hecompleted training requiredto become a licensed practi-cal nurse and is working onthe prerequisites for his regis-tered nurse degree.

Rebecca Newsom Will-iams, R.N., associate directorfor patient nursing services atthe VA Eastern ColoradoHealth Care System in Den-ver, was honored for advanc-ing nursing programsthrough her leadership at thelocal, regional and nationallevels.

Timothy B. Williams,director of the VA PugetSound Health Care System,also was honored for advanc-ing nursing programs byconsistently supporting nurs-ing initiatives at the medicalcenter, in the communityand across the nation.

Twenty-four VA executivesare among the recipients ofthe 2004 Presidential RankAwards. Each year, the Presi-dent honors an elite group ofcareer members of the SeniorExecutive Service (SES) whoare selected for their out-standing leadership accom-plishments and service overan extended period of time.

Lawrence A. Biro, direc-tor of VISN 19 (Denver),and Kenneth J. Clark, direc-tor of VISN 22 (Long Beach,Calif.), are among 55 mem-bers of the SES who receivedthe Distinguished ExecutiveAward. Another 22 VA ex-ecutives were among the 284

SES members who receivedthe Meritorious ExecutiveAward. They are: Jon Baker,director, Milwaukee VA Re-gional Office; Barry M.Barker, director, Manila VARegional Office; James W.Bohmbach, VBA chief finan-cial officer; GeraldineBreakfield, VBA associatedeputy under secretary formanagement; Julie A.Catellier, director, Biloxi,Miss., VA Medical Center;David S. Derr, formerdeputy assistant secretary foracquisitions and materielmanagement, now retired;Gary W. Devansky, director,Coatesville, Pa., VA Medical

Center; Frederick Downs Jr.,chief consultant, prostheticand sensory aids; Glen W.Grippen, director, Milwau-kee VA Medical Center;Daniel F. Hoffmann, direc-tor, VISN 6 (Durham,N.C.); Thomas J. Hogan,former director, VHA man-agement support office, nowdeputy assistant secretary forhuman resources; Stephen L.Lemons, director, Salem, Va.,VA Medical Center; DennisM. Lewis, assistant deputyunder secretary for health foroperations and management;

Carl E. Lowe, director,Waco, Texas, VA RegionalOffice; George M. Moore

Jr., former director,Martinsburg, W.Va., VAMedical Center, now direc-tor, Shreveport, La., VAMedical Center; Melinda L.Murphy, former director,Muskogee, Okla., VA Medi-cal Center, now retired;Catherine J. Rick, chiefnursing services officer;Catherine L. Smith, formerdirector, Denver VA RegionalOffice, now director, Oak-land, Calif., VA RegionalOffice; William D. Stinger,former deputy under secre-tary for benefits, now retired;Michael G. Sullivan, formerdeputy inspector general,

President Honors VA Executives for Leadership Accomplishments

This year’s Excellence in Nursing Awards recipients with DeputySecretary Gordon Mansfield, center, and VA Chief Nursing ServicesOfficer Cathy Rick, second from right. They are, from left: KimPyatt, John Cheng, Marthe Moseley, Ferris Jones, Timothy Williamsand Rebecca Newsom Williams.

(continued on page 32)

JAMES LUCAS

VAnguardintroducing

32 May/June 2005

and his victim can end upside by side on a gurney hashelped me to maintain mynonjudgmental perspective.

“What I think theAmerican people don’t realizeis how difficult it is to be asoldier fighting in Iraq whenthe rules of engagement areexpected to be followed de-spite an enemy who is from aland where basic humanrights have never been a pri-ority. I also try to imaginewhat it is like to be that Iraqicivilian who has to struggleevery day to stay alive letalone make decisions regard-ing his family’s future whenchaos is the one constant intheir lives.”

What will the futurehold for Perez? “I’m not sureyet,” she wrote, “but there isa good possibility that I willreturn to the VA.”

National Nurses Week (May6-12) is a time to recognizeand honor the service of allVA nurses who give life andmeaning to the words ofAbraham Lincoln: “To carefor him who shall have bornethe battle, and for his widowand his orphan.” Nurses up-hold this vow day and nightin their care of the men andwomen who fought in WorldWar II, Korea, Vietnam,Desert Storm and now Iraq.

Currently more than250 VA nurses are deployedas active duty members ofthe U.S. armed forces. Mostwere activated as part of thereserve or National Guardforces. But not Cecelia Perez,an operating room nurse atthe Baltimore VA MedicalCenter.

She put her civilian lifeon hold to serve her countryfull time. Here’s her accountof being called to serve, asposted on the DefendAmerica Web site atwww.defendamerica.mil/CallAction/CalltoAction.html.

“I joined the Army atthe age of 44. I was a civiliannurse with 16 years of experi-ence in the private sector. Ihad a comfortable home andgood paying job working atthe beautiful new VA hospi-tal in Baltimore, across fromthe University of Marylandhospital, where I had earnedmy nursing degree as well asexperience in the operatingand emergency rooms. I felt

very proud to be workingwith our veterans at the timeof the events of Sept. 11.

“Their stories, courageand pride in serving theircountry in their generation’stime of crisis inspired me toinvestigate the possibility ofjoining the ‘reserves.’ (To mysurprise, the cut-off age fornurses was 47.) In a state ofpatriotic fervor, I, along withthree of my friends, beganchecking into the military. Iended up being the only oneto join, and even ended upgoing active [duty].

“In June of 2002, I wasmaking my way to Fort SamHouston for Officer’s BasicCourse. I remember being onan old Army bus along withother medical personnelheading back from CampBullis fresh from our fieldtraining exercise on the firstanniversary of Sept. 11. Ilooked out at the sparseTexas landscape in themiddle of the summer heatand thought, ‘What did I getmyself into?’

“But my very nextthought, grinning to myself,was how proud of me my VApatients would be. I wouldbe able to say to them, whenI returned, that I too hadserved my country in its timeof need. Sitting here writingthis from the ER of the 67thCombat Support Hospital inTikrit, Iraq, I would also beable to tell them that I didn’tregret it for a minute.”

In a follow-up e-mailwith VAnguard, Perez de-scribed her work at the 67thCSH. “The kinds of injurieswe see involve wounds fromIEDs (Improvised ExplosiveDevices) that usually injurethose on convoy missions.The precarious nature of theattacks makes for a ‘Russianroulette’ mentality, which isvery stressful for everyone.We frequently must also treatIraqi locals and never know ifthe individual is an innocentbystander or the cause of in-jury to some of the same sol-diers we have treated. This isespecially hard for theyounger medics. I try to be arole model and maintain aprofessional attitude, treatingall patients alike.

“I think my past experi-ence in an inner city ERwhere an alleged criminal

Capt. Cecelia Perez

Capt. Perez in Iraq.

now retired; Edgar L.Tucker, director, HoustonVA Medical Center; and JonWooditch, former assistantinspector general for manage-

ment and administration,now deputy inspector gen-eral.

The rank of Distin-guished Executive is awarded

to 1 percent of the approxi-mately 7,800 career membersof the SES and includes acash award of 35 percent ofbase pay. The rank of Meri-

torious Executive is given to5 percent of the career SEScorps and includes a cashaward of 20 percent of basepay.

Rank awards continued from page 31

VAnguard

May/June 2005 33

medical advances

Assessing the Cost-Effectiveness ofHepatitis B TreatmentsAn influx of new, expensivedrugs is raising questionsabout how to best treat hepa-titis B, a chronic medicalcondition affecting 1.25 mil-lion Americans.

“We need to develop amore calculated approachand establish guidelines forthe most cost-effective treat-ment,” noted Dr. FasihaKanwal, a researcher with theVA Greater Los AngelesHealthcare System and Uni-versity of California, Los An-geles. To that end, Kanwaland colleagues conducted thelargest and most comprehen-sive cost-effectiveness studyof hepatitis B treatmentsever.

Their findings, pub-lished in the May 17 issue ofAnnals of Internal Medicine,show the newest drug,adefovir, is not cost-effectivewhen taken alone. It was,however, very cost-effectivewhen used as a second-linedefense for patients with viralresistance to another treat-ment, lamivudine.

Perhaps most interest-ing, the findings show theoldest drug therapy, inter-feron, may still be the pre-ferred treatment method forhealth systems with limitedresources, and is particularlycost-effective for e-antigennegative patients. “We foundthe newer, more ‘sexy’ drugsare too expensive and betterto use only after other first-line therapies have failed,”said study author Dr.Brennan M.R. Spiegel, of theLos Angeles VA and UCLA.

The study incorporatedthe cost-effectiveness stan-dard accepted by insurers fortreating a chronic conditionlike hepatitis B—roughly$50,000 or less per quality-

adjusted life year gained, orevery year of life adjusted forits quality or value.

Only two therapies fellwithin this standard—inter-feron, at slightly more than$6,300 per quality-adjustedlife year gained, and the hy-brid strategy of lamivudineand adefovir, which came inat just under $8,500 per year.By comparison, the studyshowed treatment withadefovir alone costs morethan $90,000 for each qual-ity-adjusted life year gained.

Why Don’t HispanicsParticipate in ResearchStudies?They may be the fastest-growing minority group inAmerica, making up nearly14 percent of the U.S. popu-lation, but Hispanics arewoefully underrepresented inclinical research studies. As aresult, say researchers, it’s dif-ficult to determine how par-ticular diseases affect them.

“There are differences inhow you treat differentpopulations. Unless you havethese populations participat-ing in studies, you can’t havea good understanding of howthe disease impacts them,”noted Carol Lee, M.D., withthe Geriatric Research, Edu-cation and Clinical Center atthe VA Ann Arbor Health-care System and assistantprofessor at the University ofMichigan Health System.

One of Lee’s students atU-M Medical School, JoelEscobedo, set out to discoverwhy Hispanics shy awayfrom clinical research. Hefound the main reason isthey simply don’t know whenstudies are taking place.“When they actually knowabout clinical research, manyHispanic people are willingto participate,” saidEscobedo, who conducted

his research in Chicago.Escobedo presented his

findings during the Ameri-can Geriatrics Society’s an-nual meeting, held May 11-15 in Orlando. His researchwas funded through a VAResearch Career Develop-ment Award and the Hart-ford/AFAR Medical StudentScholarship.

Southern Arizona VAOffers Carotid ArteryStentingFor years surgeons have usedtiny mesh cylinders, calledstents, to prop open bloodvessels blocked by plaque.But it wasn’t until last sum-mer that the Food and DrugAdministration approved theprocedure for the carotid ar-teries, which carry oxygen-rich blood from the heart tothe brain. Approximately 25

percent of strokes are causedby plaque build-up in the ca-rotid arteries.

In early February, theSouthern Arizona VA HealthCare System became the firstin VA to offer the new pro-cedure to prevent the risk ofstroke in patients with ca-rotid artery disease who areineligible for the traditionalmethod of care, which in-volves surgical removal ofplaque. These include pa-tients with poor heart or

lung function, or who haverecently had a heart attack.

“The minimally invasivenature of the procedure anduse of local rather than gen-eral anesthesia provide a vi-able treatment alternative to alarge group of high-risk pa-tients,” noted Dr. BulentArslan, an interventional ra-diologist, who has since per-formed about 20 carotidstenting procedures.

The new procedure usesa combination of balloonangioplasty, a stent implant,and an embolic protectionsystem to unblock and re-open the carotid artery. It wasshown to have a lower rate ofdeath, myocardial infarctionand stroke in high-risk pa-tients than traditional sur-gery.

Veterans SlightlyHeavier than OverallU.S. PopulationA study conducted by the VANational Center for HealthPromotion and Disease Pre-vention in Durham, N.C.,found military veterans areslightly heavier than the gen-eral U.S. population.

Researcher Dr. Linda S.Kinsinger led a team that re-viewed weight, height andother data from records of1.8 million veterans who re-ceived VA outpatient careduring 2000.

They found 73 percentof male veterans were over-weight and 32 percent wereobese. This was slightlyhigher than the general popu-lation, in which 67 percent ofmen are overweight and 27.5percent are obese.

The findings of thisstudy, which appeared in theApril issue of American Jour-nal of Preventive Medicine,show women veterans alsoare heavier than non-veter-ans.

Arslan

VAnguardhave you heard

34 May/June 2005

New Fisher House in Houston

VA participated in TOPOFF 3, the most comprehen-sive terrorism response exercise ever conducted inthe United States, April 4-8. Sponsored by the De-partment of Homeland Security, TOPOFF 3 was thethird in a series of exercises designed to strengthenthe nation’s capacity to prevent, protect against, re-spond to and recover from terrorist attacks involvingWeapons of Mass Destruction. The full-scale exer-cise involved participants from international, federal,state, local and private sector agencies and non-governmental organizations. In the United States,participants responded to simulated, simultaneousattacks taking place in Connecticut and New Jersey.Above, the VISN 3 Emergency Operations Center inaction during the exercise.

Sixty years after theirservice in combat, severalWorld War II veterans re-ceived military decorationsduring a special ceremony atthe White River Junction,Vt., VA Medical Center,thanks to the efforts of DanMoriarty, prisoner of war co-ordinator. Moriarty got in-volved when he discoveredveterans who earned theCombat Infantryman Badgeor Combat Medical Badgeduring World War II wereeligible to receive the BronzeStar. He spread the wordamong former POWs andcollected military recordsfrom those who wanted to

A 21-suite Fisher House opened April 5 at the Michael E.DeBakey VA Medical Center in Houston. The home providesfree housing for the families of veterans being treated forlong-term illness or rehabilitation. The Fisher House Founda-tion donated half of the $2.2 million to build the home. Thecommunity raised the rest. Houston is the seventh VA hospi-tal with a Fisher House. The others are located in Denver,Minneapolis, Cincinnati, Albany, Bay Pines and West PalmBeach. The foundation has identified several other VA sites itconsiders in need of a Fisher House: Seattle, West Los Ange-les, Dallas and Brooklyn. Planning is currently underway forFisher Houses in Palo Alto and Tampa, according to theirWeb site: www.fisherhouse.org/theHouses/future.shtml.Above, landscapers at work on the grounds in Houston.

apply. After submittingtheir applications, he wasinformed that six veteranswere eligible for theBronze Star and one forthe Purple Heart. Themedal presentation cer-emony was held duringthe National Salute toHospitalized Veterans.

With more than5,600 buildings, 1,000 op-erating leases, $1 billion inequipment and approxi-mately 32,000 acres ofland, VA has a vast capitalasset portfolio. VA’s firstAsset Management Plan,released last December, de-scribes it and how VA

plans to manage it. With re-lease of the plan, VA is nowonly the second federalagency to score above a “red”on the President’s scorecardfor “real property asset man-agement.” The Asset Man-agement Plan is the blueprintfor achieving VA’s objectiveto effectively manage assetsand provide a safe and appro-priate environment for thedelivery of health care, ben-efits and memorial services toAmerica’s veterans. To readthe plan, visit www.va.gov/oaem.

VA Central Office em-ployees celebrated NationalPublic Health Week, with itstheme “Empowering Ameri-

cans to Live Stronger,Longer,” by going for a 30-minute walk on April 4.More than 400 VACO staffparticipated in the walkingchallenge, and many were in-spired to begin livinghealthier lifestyles by con-tinuing with daily walks. TheOffice of Congressional andLegislative Affairs had thehighest participation rate,with 41 percent of their staffwalking. Five Operation IraqiFreedom veterans working inthe Office of InformationTechnology participated inthe “Walk and Talk” with aveteran portion of the event.They partnered and walkedwith VA leaders.

Testing disaster readiness

FRANCES M. BURKE

LYNNE KANTOR

VAnguard honors and awards

May/June 2005 35

Honoring volunteer excellence

and one private industry rep-resentative from among the100 honorees.

Jim Delgado, who di-rected VA Voluntary Servicefor more than 13 years beforeretiring in January, and LyleUsgaard, a volunteer at theFargo, N.D., VA MedicalCenter, received theAMVETS Silver HelmetAward during theorganization’s National Ex-ecutive Committee meetingin Washington, D.C., onApril 16. Delgado wasnamed Civil-Servant-of-the-Year for his accomplishmentsin volunteer recruitment, re-tention and solicitation ofprivate donations in supportof VAVS programs. Usgaardwas named AMVET-of-the-Year for his distinguishedrecord of volunteer and com-

munity service to veterans inMinnesota and North Da-kota.

The VA Healthcare Net-work Upstate New York re-ceived the Spirit of Excel-lence Quality Award fromSODEXHO, a leading foodand facilities managementservices company, on March2. The network was recog-nized for its efforts to helphomeless veterans. RobertVanKeuren, homeless pro-gram coordinator, acceptedthe award on behalf of morethan two dozen homelessprogram staff throughout thenetwork.

The American RedCross recognized two VA vol-unteers for their service toveterans. William J. Duncan,a volunteer at the Roseburg,Ore., VA Medical Center,was named Male Volunteerof the Year, and Barbara W.

Perry, from the Long Beach,Calif., VA Medical Center,was named Female Volunteerof the Year. Both serve as RedCross representatives on theirlocal VA Voluntary Servicecommittee.

For the past 25 years,Grace Sharp has reported tothe Hunter HolmesMcGuire VA Medical Centerin Richmond every weekdaymorning at 6 a.m. to delivercomfort items to patients onthe spinal cord injury unit.In the process, the 92-year-old has logged more than21,500 volunteer hours. Thissummer, the Paralyzed Veter-ans of America will honorSharp for her dedication toveterans during their annualconference in Omaha. Shewill receive PVA’s SpeedyAward, the organization’shighest honor for non-mem-bers.

Five VA employees werelisted among the top 100leaders who made a differ-ence in federal informationtechnology during 2004 andwere profiled in the March21 issue of Federal ComputerWeek. They are: Dr. Ruth E.Dayhoff, national projectmanager for VISTA Imaging;Scott F. Denniston, directorof the Office of Small andDisadvantaged Business Uti-lization; Dr. Robert M.Kolodner, acting deputychief information officer forhealth; Craig Luigart, associ-ate deputy assistant secretaryin the Office of InformationTechnology; and EdwardMeagher, deputy chief infor-mation officer in VA CentralOffice. Meagher also receivedthe prestigious Eagle award,presented to one government

Elmore Patterson, below, acting chief of fee basis atthe Central Alabama Veterans Health Care System, wasfeatured as one of 30 leaders of the future in the Aprilissue of Ebonymagazine.Patterson hasa graduate de-gree in healthservices ad-ministrationand is a sec-ond lieutenantin the U.S.Army Reserve.He was intro-duced to VAduring his graduate studies when he participated in aprogram run by the Institute for Diversity in HealthManagement. VA participates in the program, whichworks with educators and health systems to expandhealth care leadership opportunities for minorities.

The American Hospital Association presented its 2003Hospital Award for Volunteer Excellence to the New Or-leans VA Medical Center’s Voluntary Service (VAVS) pro-gram for their mini stand down for homeless veterans.Volunteer Stephen Lassere accepted the award on behalfof the medical center’s VAVS committee, which organizedthe stand down for Make A Difference Day (the 4th Satur-day of every October) in 2003. The event, above, was ahit, drawing 131 homeless vets, of which 54 sought mentalhealth screenings and 40 were admitted for treatment.

Leader of the future

DAMON A. STEVENSON

NEW ORLEANS VAMC

VAnguardheroes

36 May/June 2005

campus’ secondary entrance.He immediately responded tothe scene and was told by off-duty employee Alice Reichardthat a vehicle had gone overthe embankment and flippeda number of times, trappingan occupant. Whisler imme-diately radioed back to thecommand center, requestingthat local rescue personnel becontacted. Whisler ap-proached the vehicle andfound the driver conscious,but choking on a seatbelttangled around his neck. Us-ing the Gerber Multi-Toolpurchased for the entire forceby the chief of the depart-ment, Whisler cut the seatbeltand freed the driver. Hestayed with the victim untilfire and EMS personnel ar-rived.

A desperate call for help

Rescued in the nick of time

Chantal Andrew, a reg-istered nurse at the MalcomRandall VA Medical Centerin Gainesville, Fla., was fly-ing home from Englandwhen the flight crew asked ifanyone onboard had emer-gency medical experience.Andrew, a seasoned ER nurseand former flight attendant,responded and was led to afemale passenger experienc-

Vernon Hayes Sr., above, a nursing assistant with theMental Health Service Line at the Wm. Jennings BryanDorn VA Medical Center in Columbia, S.C., was drivingwith family members when they spotted a man lyingacross nearby railroad tracks. Keeping a safe distance,Hayes pulled over, and he and his son Vernon Jr. ran tothe man, who appeared to be suicidal. The man resistedhis rescuers, but they managed to pull him from thetracks 90 seconds before the train that likely wouldhave killed him passed by. Police and ambulance per-sonnel soon arrived and took over.

Telephone operator Leonette “Lynn” Hair, seated be-low, of the Ralph A. Johnson VA Medical Center inCharleston, S.C., had been on the job less than a month

when she took acall from a veteranreporting a bloodpressure of 200/160and a history of sei-zures. The veteran,who refused to givehis name or ad-dress, dismissedHair’s appeals to goto the emergencyroom. Over the nexthour, the veterancalled repeatedly,still refusing to goto the ER. Hairasked her fellowoperator, CrystalReed, standing left,for assistance.

When the veteran called again, Reed ascertained thathe was having a seizure at that moment. Hair calmlytalked with the veteran while searching for a name tomatch the number on her caller ID. Meanwhile, Reednotified the Berkeley County sheriff’s office of the situa-tion. For another 45 minutes, Hair stayed on the line,calling out to the veteran, who by then was unrespon-sive. In the meantime, the sheriff’s office dispatchedhelp to the address Reed had found through the medicalcenter’s computerized records system. Thanks to theirefforts, county rescue personnel were able to find andsave the veteran, who was having diabetic seizures.

ing chest pain. Andrew put amonitor on the strickenwoman and found she had avery fast heart rate, known as“SVT.” With no medicationsto regulate the woman’spulse, Andrew used biofeed-back and imaging to relaxher. Andrew’s treatment en-abled her “patient” to arrivepractically pain free at theNewark, N.J., airport.

Mary Ebert, a licensedpractical nurse at the LakeCity, Fla., VA Medical Cen-ter, was dining at a local res-taurant when she heard thecall for a doctor or nurse.Ebert, who has 32 years ofmedical experience, re-sponded and was led out tothe parking lot, where a manhad collapsed and stoppedbreathing. Ebert and anotherbystander performed CPRfor about 3 minutes until thevictim began to breathe onhis own. Paramedics soon ar-rived and transported thevictim to the hospital.

Lieut. Scott Whisler, ofthe Lebanon, Pa., VA Medi-cal Center police depart-ment, received a radio dis-patch about a motor vehicleaccident across from the

CHRIS BAROODY

ROBIN CRONSHAW