VAnguard May-June 2011

8/6/2019 VAnguard May-June 2011

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Ater the Storm

Military Cultural Awareness Training

Amputee Sotball Team

VA and Its Academic Partners

May/June 2011

Ater the Storm

Military Cultural Awareness Training

Amputee Sotball Team

VA and Its Academic Partners


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2 VAnguard May/June 2011

Features

One Woman Veterans Dont Quit Message 6

Paraplegic veteran and VA patient Kate Callahan is an elite athlete

Coaching Wounded Warriors to Gold 7

VA Palo Altos Rod Williams is an inspiration to everyone around himTo Know Them is to Serve Them Better 8Understanding military culture has never been more important

A Game o Their Own 11

The frst-ever all-amputee standing slow pitch sotball team orms

Preventing Patient Violence in VA Health Care 14

VA is taking a systematic approach to dealing with the issue

Helping Families Living With Brain Injury 16An inormal support group has grown into a national organization

From Iraq to Homeless to Homeless Advocate 18

A ormer homeless veteran now helps others get back on their eet

Ater the Storm 20In the atermath o a deadly tornado, the Tuscaloosa VA steps up to help

VA and Its Academic Partners 22United by a common commitment to veterans health

Departments

3 Feedback 33 Have You Heard

4 News You Can Use 36 Honors

26 Around Headquarters 39 Heroes

30 Introducing 40 Winter Clinic

31 Medical Advances

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26

VAnguardVAs Employee Magazine

May/June 2011

Vol. LVII, No. 3

Editor: Lisa Gaegler

Assistant Editor/Senior Writer: Gary Hicks

Photo Editor: Robert Turtil

Sta Writer: Amanda Hester

Published by the Ofce o Public Aairs (80D)

U.S. Department o Veterans Aairs

810 Vermont Ave., N.W.

Washington, D.C. 20420

(202) 461-7427

E-mail: [email protected]

www.va.gov/opa/publications/vanguard.asp

On the coverTuscaloosa VA Medical Center employees

and spouses Je and Cassie Munord stand

in the backyard o their home, which was

destroyed in the tornado that ripped

through the Alabama city on April 27. Their

neighbors cars can be seen piled on top o

each other in the background. Despite the

act that many Tuscaloosa VA employees,like the Munords, were personally aected

by the storm, they pitched in to help the

community recover rom the disaster.

photo by April Jones


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VAnguard May/June 2011 3

FEEDBACKOUTLOOKFEEDBACK

Keeper o VAs HistoryOur thanks or the News YouCan Use article in the March/

April issue, Youre a Keepero VAs History, which servesto remind us that VA is in-deed the caretaker o some o

Americas most historic (andendangered) properties relatedto the birth o this nationscommitment to the health careo its veterans.

Including an image oOld Main, the iconic sol-diers residence in the HistoricSoldiers Home District (soonto be Landmark) o the Mil-

waukee VA grounds, was espe-cially relevant, as it is the mostsubstantially intact o the three

original soldiers homes estab-lished at the conclusion o theCivil War. The Soldiers HomeFoundation is proud to part-ner with VA in the restorationand return to service o theentire district, beginning witha soon-to-be-accomplished en-hanced use lease to restore the1889 Home Chapel.

Jim DuffPresident

Mary PanzerVice President

Soldiers Home FoundationMilwaukee

Dea Awareness:Breaking Down Barriers

As the division chie o Sup-port Services at the AppealsManagement Center in Wash-ington, D.C., communicationis an essential element o mysuccessul interaction withthe sta. When I arrived, Ihad one hearing impairedemployee, Debbie Cannady.

Debbie has been with VA or28 years. A ew months later,David Bernard transerredin rom San Diego. I wouldsoon learn the term hearingimpaired is not an acceptablelabel in the dea community.

I told mysel I can workaround this. I communicated

with them via e-mail, notes,

gestures, and with the assis-tance o a vocational rehabili-tation and education ocer

who knows sign language andattended my team meetings.I convinced mysel that wasgood enough, but I alwaysknew something was missing.

I made an eort to ensurethat Debbie and David un-derstood me, but I knew they

were somewhat let out o theeveryday social interaction thathelps solidiy the team andbuild camaraderie. I knew myhearing employees includedthem in some o this socialinteraction, but I also knew wehad a long way to go in break-ing down communication bar-

riers in our team environment.When Ron Burke, di-rector o the Appeals Man-agement Center, oered toarrange or our team to partici-pate in a six-hour on-site semi-nar provided by the BirnbaumInterpreting Service, I waselated. BIS is a dea-ownedand operated company oer-ing sign language interpretingservices or government, healthcare, legal, religious, businessand entertainment environ-

ments. From this seminar, ourteam was educated on someinteresting acts about thedaily lives and struggles o deapeople.

We did not know thatpeople with hearing loss ormthe largest disability groupin the country. In additionto the 4,000 to 5,000 babies

who are born dea every year,many people suer injuries orillnesses that cause deaness.Dea people nd some terms

limiting because they ail todescribe the sociological im-plications o deaness. Labelslike hearing impaired, deaand dumb or dea mute areconsidered undesirable becausethey reer to a presumed dis-ability.

Ater David Birnbaum,ounder and CEO o BIS, gave

his presentation, we were ableto ask questions and learn ba-sic signs to communicate daily

with Debbie and David. Theywill soon have a P3 Netbook,urnished by the Computer/Electronic AccommodationsProgram, or CAP, installedat their workstations. The P3Netbook will allow them tocommunicate via videophoneon all phone call-related issuesor VA or notications to theiroce managers or work orpersonal issues 24 hours a day,seven days a week.

Debbie and David nowregularly show the sta andme dierent signs each day.Learning a new language has

been exciting and un or allo us. Our sta will soon beobserving a day o silence.Throughout the day, the sta

will communicate via sign lan-guage. This will be a challengeor all o us, but we are look-ing orward to the experience.

As we move orward, we arelearning to celebrate our dier-ences and break down any bar-riers that threaten the strengtho our team.

Teresa Martin

Division ChiefAppeals ManagementCenter

Washington, D.C.

Atomic VeteransI read with interest the articleabout atomic veterans (Atom-ic Veterans: Blasts rom thePast Still Reverberate, March/

April issue). A couple o re-lated notes on that article.

In 1978, I was a news

photographer or KUTV inSalt Lake City. Ater watchinga report on our news aboutemployees o Dugway Prov-ing Ground being accidentallyexposed to nerve agent duringtesting activities, a veteran,Paul Cooper, called the news-room with his story about

witnessing an atomic test(the test was called Smokey)

while in the Army. We tookthe inormation and the nextday, a reporter and I paid Mr.Cooper a visit at the Salt LakeCity VA. He was an inpatienton the oncology ward beingtreated or leukemia.

The story he told us letus stunned. They were sent

into the desert and witnessedthe blast rom trenches, andshortly aterward were putin ormation and marchedthrough the ground-zero area.

That Saturday evening,his story ran on NBC NightlyNews and was the start othe atomic veterans story. Wecontinued to report on Mr.Cooper until he lost his battle

with leukemia the next spring.I covered his uneral and stillhave one o the brass cartridges

that was red in salute or myriend Paul Cooper.Now, as a VA employee,

I take pride in the act thatI was there when this storybroke and also that it started ata VA hospital, the one in SaltLake City.

Scott JacksonChief, Support Services

George E. WahlenVA Medical Center

Salt Lake City

Have a comment on something youve seen in VAnguard?We invite reader eedback. Send your comments to [email protected]. You can also write to us at: VAnguard, Oceo Public Aairs (80D), Department o Veterans Aairs, 810Vermont Ave., N.W., Washington, D.C., 20420. Includeyour name, title and VA acility. We may need to edit yourletter or length or clarity.

We Want to Hear rom You


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NEWS YOU CAN USE

The James E. Van Zandt VAMedical Center in Altoona,Pa., was honored with a Part-ner Recognition award byPractice Greenhealth, a na-tional organization or healthcare acilities committed toenvironmentally responsibleoperations. The award is giveneach year to honor outstandingenvironmental achievements inthe health care sector.

This VA medical centerhas been singled out or theireorts to protect patient healthand preserve the environ-ment, said Anna Gilmore

Hall, executive director oPractice Greenhealth. Theirapproach to health care dem-onstrates a keen understandingo the impact our activitieshave on the environment anda commitment to build on theachievements they have madeso ar.

The Altoona VAs GreenEnvironmental ManagementSystem, or GEMS, includes:hazardous materials handlingand waste disposal; solid waste

disposal and reduction; stormwater management; pollutionprevention; energy eciency;and green construction,among other green programs.The medical center has activeprograms reducing naturalresource use, increasing the useo recycled products, and usingalternative energy.

Altoona currently recyclesmore than 55 percent o its

waste stream and was amongthe rst VA medical centers to

begin using biodiesel and E85ethanol in its feet, installingthe alternative uels station in2008. The Altoona VA GEMSprogram has been recognizedas the leading program in VAHealthcare VISN 4 by thenetwork director.

A signicant GEMSproject is the new stormwater

treatment system that reducesruno into the ChesapeakeBay Watershed. The GEMScoordinator conducted our

years o planning, research andanalysis, with the assistance ostudent interns rom two localuniversities, prior to construc-tion.

The VAMC constructedthe rst phase o a stormwatermanagement system that usesa series o wetlands ponds orstormwater treatment. Themain pond provides an aes-thetically pleasing view at theront o the medical center;it oers a serene and calming

environment or veterans andvisitors who visit the nearbyWall That Heals.

This project headlineda breakout session at EPAsChesapeake Bay-FocusedEnvironmental ManagementSystems Seminar held atNASAs Goddard Space FlightCenter in Greenbelt, Md.

Mike McNeil, deputy director,Environmental ManagementDivision, NASA headquarters,called it the most innovative

program that I have ever seen.The goal is protecting,preserving and restoring theareas ecological assets, in-cluding the Chesapeake Bay.Enhancing the mission othe medical center was alsoparamount in the decisionprocess. Restoration o wet-lands destroyed in the originalconstruction was incorporatedinto the goals, leading to astormwater management de-sign using wetlands ponds or

stormwater treatment and re-storing the wetlands character,while providing a recreationalresource or veterans, visitorsand amily members.

Improving environmen-tal perormance is essential orthe health care sector, saidTim Blackburn, GEMS coor-dinator or the medical center.

A Permanent Commitment to the Environment at Altoona VA

I we want a sustainable u-ture, every acility needs to be-come involved. VA has made apermanent commitment to the

environment.The Partner Recognitionaward is or health care acili-ties that have begun to workon environmental improve-ments, achieved some progress,and have at least a 5 percentrecycling rate or the total

waste stream. The Altoona VArecycled more than 50 percento its waste last year, includingconstruction waste.

In addition to the Prac-tice Greenhealth award, the

VAMC was nominated or theVA GEMS Coordinator o theYear Award and was amongthe ederal acilities consideredor highly competitive EPARegion IIIs EnvironmentalExcellence Award or the sec-ond straight year.

By Andrea Young

Tim Blackburn, GEMS coordinator at the James E. Van Zandt VA Medical Center in Altoona, Pa., releasesat-head minnows into a pond that is part o a new stormwater treatment system that reduces runointo the Chesapeake Bay Watershed. The minnows will consume mosquitoes and also serve as ood orthe larger sh that will be added to the pond.

andrea young


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OUTLOOKNEWS YOU CAN USE

Barrancas National Cemeteryin Pensacola, Fla., welcomedstudents and trainers or thepilot o the National Cemetery

Administrations CaretakerTraining program March 21-25.

Cemetery sta hosteda ceremony and luncheonMarch 24, during which theyalso dedicated a new burialsection. Acting Under Sec-retary or Memorial AairsSteve Muro, along with spe-cial guests Capt. ChristopherPlummer, commanding ocero Naval Air Station Pensacola,

and Col. Joseph Richards,commanding ocer o MarineAviation Training SupportGroup, were on hand to wel-come the caretakers and to cuta ribbon during the ceremony.

The NCA CaretakerTraining program is an initia-tive to bring consistency andeciency to the position ocemetery caretaker, an oc-cupation held by more than50 percent o all employees inNCA. Caretakers are respon-

sible or setting headstones andmarkers, preparing gravesites,interring caskets and urns,maintaining the grounds andmuch more. Caretakers atVA national cemeteries mustadhere to strict operationalstandards and measurementsthat set their cemeteries apartas national shrines.

Fourteen caretaker stu-dents came to Barrancas Na-tional Cemetery rom aroundthe country to participate in

the pilot o the training pro-gram. In addition, 11 trainersand subject matter experts

with a combined total o 218years o experience with NCAprovided instruction and ex-pertise to the group.

Knowledge is power onlyi you share the knowledge,Muro told the trainees during

the ceremony. We want youto take what youve learnedback to your cemeteries andto your co-workers. And tellthem that their turn is com-

ing.NCA plans to train everycaretaker over the next twoyears. Caretaker trainers willtravel to various cemeteriesand provide training to classes

Barrancas National Cemetery Hosts Caretaker Training Pilot

o about 15 participants romaround the region. Ater twoyears, new employees will berequired to take the course

within six months o their

employment. Through anagreement with the Army,caretakers at Arlington Na-tional Cemetery will be able toreceive the training as well.

With many o our most

The NCA Caretaker Training program is an initiative to bring consistency and eciency to the position ocemetery caretaker, an occupation held by more than 50 percent o NCA employees.

experienced caretakers reach-ing the age o retirement,said Muro, we needed a

way to bring along the nextgeneration o leaders who

will saeguard and impart theskills and knowledge neededto maintain our cemeteries asnational shrines.

By Chris Erbe

chris erbe

VA recently reached a major milestone in the number o veterans making up its workorce. TheDepartment now has more than 100,000 veterans in the workorce, representing 32 percent oVAs 315,000 employees.

Leading the eort to increase the number o veterans in VAs workorce is the Veterans Em-

ployment Coordination Service, located in the Oce o Human Resources Management. VECS,and its team o 13 regional veterans employment coordinators located throughout the country,work collaboratively with HR oces, managers and supervisors nationally to link qualied veteransto VA career opportunities.

As the agency entrusted with the care o our nations more than 23 million veterans, we takepride in knowing that many o our employees who provide services, benets and health care arerepresentative o the customers we serve, said VECS Director Dennis May. Having a workorcecomprised o over 100,000 veterans shows VA is not only committed to providing the best serviceto our veterans, but also to employing them. To learn more about VECS, visit www.va.gov/vecs,or contact a member o the VECS sta at 1-866-606-6206.

Marking a Major Milestone in Veteran Hiring


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Some people, when acedwith the prospect o beingin a wheelchair or the resto their lives, might all into

a deep depression and ocus on allthe things they think they cant doanymore. Kate Callahan is not one othose people.

In 2000, the 18-year Army andAir Force veteran was diagnosed withhydrocephalus (uid on the brain)and required multiple back surger-ies, which in turn caused thearachnoids in her back to pullher spinal cord apart, leavingher a paraplegic. Always anathlete, she thought thosedays might be over, and or atime they were.

Then in 2007, she metSouth Texas Veterans HealthCare System RecreationTherapist Jose Laguna, whointroduced her to wheelchairsports. Without his guidance,Callahan might still be angry,grieving the loss o her legs.

Meeting Laguna openedup a whole new world to me,she said. I just thought, therereally is stu I can do, and since thenI havent been able to stop. I do more

now than I did beore my injury.To prove that point, Callahan

was in Christchurch, New Zealand,and Australia this past January andFebruary or her frst trip to the Para-lympics World Championships, whereshe competed in the shot put, discusand javelin events. Representingjust one o 72 countries at the event,

Callahan won 9th place in shot put,7th place in javelin and 5th place indiscus. She is now in the running orthe next Paralympics, to be held inLondon in June 2012.

It was a whirlwind trip or herto get to the world games, beginningwith local competitions to qualiy ornationals. That was in June 2010;nationals were next, and fnding outshe was in the running or the Para-lympics was the icing on the cake

and more than she thought she wascapable o.

In act, it didnt even eel realuntil the World Anti-Doping Agencyknocked on her door one night. Un-til they had a drug testing agency atmy door, I didnt realize I was reallydoing this, she said, still amazed.

Classifed as an elite athlete, Cal-lahan spends a lot o time training orher events. I couldnt do it without

amily support, she said. I have a4-year-old who will say, go throwmomma, go throw, so that motivatesme to train.

With the help o her throwingcoach, Gabe Diaz de Leon, Callahanhas made it to that elite athlete sta-tus. Diaz de Leon, himsel a fve-timeparalympian and a veteran, has beentraining elite athletes in the sportsCallahan is competing in.

Diaz de Leon knows what hestalking abouthes won sixmedals over the course o fvegames, at one point winninggold and setting the worldrecord in the javelin event.Any sport thats out therecan be adapted or people sit-

ting, he said.Callahan is pleased withthe spinal cord injury careshe gets at the South TexasVeterans Health Care Systemin San Antonio, but shedlike to see more care oeredor women veterans. Womenveterans are pushing or it,she said, and the need isthere. The VA has to meet it

because, well, were here.She also encouraged women vet-

erans to meet others. Youll fnd thatyoure accepted and that youre part othe brotherhoodwomanhoodjustlike you were in the service. You stillhave that camaraderie available. Justmeet more women veterans and fndout that you are not alone.

By Robin Risemas

A decade after becoming a paraplegic,Air Force veteran and VA patient Kate Callahan isan elite athlete training for the Paralympics.

One Veterans Dont QuitMessage for Women Veterans

Kate Callahan, Paralympian and South Texas patient, trains orthe shotput event.

courtesy o kate callahan


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Becoming an athlete requiresstamina and endurance, butwhen youre in a wheel-chair, athletic challenges

can seem overwhelming. Meeting andovercoming physical obstacles is whatVA Palo Alto Health Care SystemsLaboratory Inormation ManagerRod Williams does bestand hes aninspiration to everyone around him,including recently injured Marines.

Williams lost his ability to walkwhen he contracted polio at just 9months old. Today, he is a San JoseState University graduate with degreesin chemistry and microbiology who

manages one o VAs busiest hospi-tal laboratories. For 38 years he hasplayed and coachedlocal and interna-tional wheelchairbasketball and evenwon the Paralym-pics Gold Medalhimsel in 1988.

It was becauseo his skills and at-titude that the Ma-rine Corps recently

asked him to cometo San Diego andcoach the wheel-chair basketballtrials or the 2011Wounded WarriorGames.

It was trulyamazing to me,

said Williams, not that they werewounded warriors playing sports, butthe act that they all, every single oneo these athletes, had such tremendousspiritesprit de corpsand gung-hoattitudes. It was contagious.

The Wounded Warrior trialswere designed to help wounded, illand injured athletes prepare or the2011 Wounded Warrior Games at theOlympic Training Center in ColoradoSprings in May. Other events, besidesbasketball, included swimming, trackand feld, archery, pistol, rie, cycling,pentathlon and volleyball. This is thesecond year or the games, but this

year the Marines decided to includeinternational Marines rom Australia,

Coaching WoundedWarriors to Gold

VA Palo Altos Rod Williams is an inspirationto everyone around him, including the recently

injured Marines he coached to gloryin wheelchair basketball.

Great Britain and the Netherlands.According to Williams, the com-

petition was intense. The basketballparticipants were divided into ourteams ater the frst week o train-ing. On the day o competition, theyheld a round robin tournament inthe morning and the games or themedals in the aternoon. Shouldntsurprise anyone that the team Wil-liams coached got the gold medal.

Ater the fnal event o the tour-nament, one o the oldest veterans,a 64-year-old Vietnam veteran, em-braced one o the younger warriors,said Williams. They held on to each

other, celebrating having completedsomething special. Although theywere generations apartin lie, they knewthey were bound bysomething muchlarger than their dis-abilities: the MarineCorps Band o Broth-erhood.

It transcends anddefnes them to neverbe a quitter, never

give up, to fnish themission and to lovethe way o lie theyall swore to deend.They are Marines. Forall my accomplish-ments in lie, this wasan event I will alwayscherish.

Rod Williams has played and coached wheelchair basketball or 38 years, even win-ning the Paralympics Gold Medal in 1988.

courtesy o rod williams


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It is said that the best way tounderstand someone is to walk amile in their shoes, or in the caseo veterans, a mile in boots while

wearing 50 pounds o body armor,a Kevlar helmet, ammunition andweapons.

Understanding what veteranshave experienced directly relates tomy ability to build a trusting rela-tionship, says Geralyn Mushinski,assistant Vocational Rehabilitationand Employment ofcer at the VARegional Ofce and Insurance Centerin Philadelphia. I I can make thatconnection, demonstrate that I get it,thats a big step in being able to help.

The very nature o war and itschanging eect on service membersand their amilies presents ongoingchallenges and opportunities or to-days VA employee, in both large andsmall ways, adds Karen Malebranche,acting chie ofcer or the Legislative,Regulatory and IntergovernmentalAairs Ofce in the Veterans HealthAdministration. The key is not onlyto understand that these changes willkeep coming, but also that in themidst o change, VA people workhard to appreciate the little things.

Just saying, thank you or your

service, or calling a veteran by his orher rank can make all the dierence,Malebranche, also a retired Army col-onel, suggests. To have their personalsacrifces, and the sacrifces o theiramilies, demonstrably appreciatedcannot be understated.

Just as her own feld experiencehelped her improve care in an Armyclinical environment, Malebranchebelieves that understanding what aveteran has endured can help VAemployees improve the services they

provide.The beneft o this kind o deep-

seated understanding o veterans iswhat brought about development othe VA Military Cultural AwarenessTraining. The interactive 90-min-ute e-learning course was launchedlast November by the VA LearningUniversity under the Ofce o Hu-

From following proper protocol to

treating complex injuries,understanding military culture

has never been more important toachieving our mission.

To Know Themis to Serve

Them Better

usmc

The military experience canseem like an entirely newworld to people who have not

personally served.


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ollow-on training or release thissummer.

Using stories that resonate withparticipants, the award-winning (seesidebar) MCA training provides real-world context or the acts presented,making it an especially eective and

engaging approach to training. Itprovides oundational knowledge ocommon military culture, customsand courtesies, explains dierencesbetween the branches o the armedorces, defnes roles and ranks withinthe military, and overviews some othe conicts in which veterans haveserved.

I was nearly brought to tearsitjust brought so much about our vet-erans to lie or me, says ArmindaGuerrero, a training technician at theVA Health Resource Center in Tope-ka, Kan., who completed the course.Guerrero recommends this training

man Resources and AdministrationsADVANCE initiative.

I sought out Karen and oth-ers like her across the Departmentater Mike Walco (Acting UnderSecretary or Benefts) asked or richcustomer service training to improve

employee understanding o the armedorces and service members, recallsAlice Muellerweiss, Army veteranand dean, VALU. The concept wasuniversally embraced, and promptedswit development o the innovativeprogram.

Already, 1,458 people have com-pleted the training, and the eedbackweve received about its content,impact on providing better service,and the ormat itsel, is excellent, shesays. More than 4,600 people have thecourse on their learning plans to date.Because o this success, Muellerweissand her team are busy developing

or every employee at VA, whether ornot they are directly interacing withveterans or processing benefts. Thetraining opened my perspective on ourmission at VA, as well as the needs othe veterans on the other end o thelines at our call center.

The act is, we have changedAmerica in these recent wars, Male-branche adds. The impact on amiliesdue to longer and more requent de-ployments is very dierent rom pastgenerations.

Malebranche speaks rom per-sonal experience. Beore coming toVA 10 years ago, she served 31 yearsin the Army as an active-duty soldier,nurse, senior health systems analystand program manager. She recalls acritical part o her own training thatgave her added compassion and in-sight into her role as nurse. Simplyby suiting up in ull gear, and spend-

Just saying, thank you or your service,or calling a veteran by his or her rank canmake all the dierence, says Karen Male-branche, veteran and VA employee..

robert turtil


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ing a day walking and working side-by-side with a combat soldier, I gaineda sharper understanding o the kindo toll such duty places on a personsbody, Malebranche explains.

Another MCA participant, LisaMattingly, a cemetery representativeat Lebanon National Cemetery inKentucky, says she was prooundlyaected by the training. I eel aneven deeper sense o respect and ap-preciation or our veterans, she says.When I heard the vets talk abouttheir experiences in the video, what

theyve sacrifced or our reedoms,it made everything very real or me.They deserve our thanks and ourutmost respect now I eel like I un-

What Youll Learn From Military CulturalAwareness Trainingn The dierences between the various branches o the military and theircore values.nThe common uniorms, uniorm markings, and some basics on militaryranks and titles.n The experiences a service member goes through.n Why they serve, what motivates them, and the kind o training theyreceive.nThe major military conicts, rom World War I through the Global Waron Terror (Operation Enduring Freedom/Operation Iraqi Freedom).n The role the military plays in times o national disaster.n The customs and courtesies common throughout the branches o themilitary, and the potential implications or VA employees who work withveterans and service members.

VA Military CulturalAwareness Training WinsPrestigious Gold Awardt mca

2011 b P d l P-

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derstand personally why that is.Ater serving veterans and their

amilies or 9-and-a-hal years, a jobMattingly fnds very rewarding, shesays she now eels even more honoredto do so. They dont need a shoul-der to cry on, they want respect andrecognitionthats what I can do orthem. She knows she has providedthe most proessional service possiblewhen a veteran or amily memberturns to her and says, You understandme. The MCA training has helpedher eel that much closer to the peo-

ple she works with every day.Working at VA is a labor olove, Malebranche agrees. We mayall come rom dierent backgrounds,

but everyone has their devotion toour mission in common. Most peopleyou talk to have a amily member orriend who served, so they have somepersonal reason or coming, even i itsnot direct military experience. Maybethats part o the passionthe per-

sonal connection.The military experience can seem

like an entirely new world to peoplewho have not personally served. Andeven among those who have, aware-ness beyond their own branch o ser-vice or personal experiences can seemlike a dierent world. Clearly, beingbetter able to understand the implica-tions o that kind o wear and tear ona veterans body and mind is essentialto everyone at VA as they work toimprove care.

The simple act is, Mattinglysays, all VA employees should under-stand the need o every veteran. Themore we are connected to their hearts,emotions and experiences, the deeperour respect or them will be.

To register and view the MCAcourse, go to VAs Talent Manage-ment System, course #1341520, or goto http://bit.ly/mcacourse. For inorma-tion about the topics included in thecourse, a list o resources is available

at vaww.va.gov/valu/mca.asp. To learnmore about this and other trainingopportunities oered by VALU, visithttp://www.valu.va.gov.

Let: Alice Muellerweiss, dean, VALU, accepts the awardrom USDLA President Dr. Denzil Edge.

gerry sonnenberg


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A Game of

Their OwnEvery member of the rst-ever all-amputeestanding slow pitch softball team lost a limbserving their country in the military.

robert t

Army veteran Saul Bosquez and his teammatestook on (and beat) an able-bodied team romthe FBI during an exhibition game at George

Mason University in Fairax, Va., on May 6.


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At age 18, high school grad-uates begin to choose thenext steps in their lives.These choices become re-

ections o the women and men theywill turn out to be over the courseo their lietimes. They ollow their

dreams, hoping or the best.But not all dreams lead to happyendings. The road they choose can berewarding, but many times also chal-lenging. The 20 young men on thefrst-ever all-amputee standing slowpitch sotball team selected a road totravel and have aced a number ostruggles on their journeys.

In March, these athletes rom allover the country got the opportunityto participate in an all-amputee sot-ball game. Veterans Integrated Service

Network 18 Prosthetics Program Man-ager David Van Sleet brought themtogether or a weeklong spring sotballtraining camp; the goal was to createunity among team members and sta.The environment at the camp soonbecame one o encouragement andsupport.

Van Sleet realized rom the be-

ginning that there is a new active andcompetitive generation o veterans.He saw the need to provide a dierenttype o rehabilitation or this genera-tion by combining prosthetics andsotball. The biggest obstacle he acedwas selecting and preparing qualifed

veteran amputees or the big game,especially since a number o them hadnot played since their amputation.

On Aug. 25, 2003, a rocket-pro-pelled grenade, used to disable combatvehicles, hit Army Combat EngineerMichael Meinens vehicle. The RPGdid the damage it was intended to do,as well as signifcantly injuring thoseonboard.

The weapon managed to hit andgo through all three men, includingMeinen. The men were required to

fght or another hour beore return-ing to saety. That ateul day, Meinenlost his right leg and became anabove-the-knee amputee.

Army Sta Sgt. Francisco JavierPinedo deployed once beore receivinghis injury in Iraq. During the tour, histeams primary objective was to pre-vent and halt all mortar installations.

As they were completing theirduties, the vehicle hit an improvisedexplosive device. I was happy to bealive and it didnt sink in right away,said Pinedo.

But he soon realized that they hadbeen ambushed and he was covered

with pieces o his own arm and skin.Pinedo spent the next ew days in afeld hospital as medical personnelworked on saving not only his lie, buthis arm as well. Unortunately, theloss o blood and bone made it impos-sible to save his arm.

These are just two o the stories ocourage and perseverance at the sot-ball training camp. These men wentrom losing a signifcant part o theirphysical and mental being to discover-ing and regaining talents they thought

theyd never have again.Family, riends and work are ma-

jor support systems or these veterans.And their participation in sotballgives them an opportunity to play anorganized sport, where teamwork andpositive group morale are key.

Its been six years since my injuryand I never once went on any trips,

robert turtil

The members o theWounded Warrior

Amputee SotballTeam nicknamedthemselves theBody Parts.

Pictured are (let

to right): MichaelMeinen; BrandonOlson; Timothy Hor-ton; Saul Bosquez;and Greg Reynolds.


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made an impression. He showedPinedo that he too suered rom hisown injuries o war and had gone onwith his lie. My initial impression othe VA was negative, said Pinedo.I thought the VA is where you go toretire or die.

Ater giving VA a chance, henow believes the Department trulysupports and provides valuable re-sources or veterans. Pinedo serves aschie o prosthetics or the Las VegasVA Medical Center.

But not all veterans express theireelings in the same way. Meinentook a dierent route in quickeninghis recovery, explaining that he re-ally was never a model patient. I wastired o being in a wheelchair and oncrutches. I put my leg on and told

them i you can take it o you canhave it back.

Soon Meinen began walkingaround on his new prosthetic legand he decided to start helping otherveterans. He said he became theirally and riend. I just wanted to take

them under my wing.Im no longer just a VApatientI now serve aschie o prosthetics at theAmarillo (Texas) VAHealth Care System.

By Agnes Koterba

said Pinedo. I was so ocused on get-ting a job and moving on with my lie.I fnally realized I was in a place to dosomething or mysel.

Prosthetists Kelly Brooks, o theAlbuquerque VA Medical Center,and Melissa Stockwell, a veteran am-

putee, were two o the many supportsta present during the practices andgames. You see how they adapt andchange and get back into what theywant to do, said Brooks. Everyonesdierent.

Stockwell explained that its allabout the camaraderie. Its aboutseeing how one player with the sameamputation as another player adaptsdierently to something like catchinga ball.

During the sotball camp, all o

the players participated in a wheel-chair basketball training session. Theyattended a ew o the University oArizona womens sotball games.

The veterans were later split intotwo teams, with Van Sleet assuringthey were split evenly by skill level.

The veterans team was ormally rec-ognized at the UA Wildcats game onFriday, March 11. They played theirfrst game that same night with thesupport o the UA and Baylor sotballteams.

VA provided care and assistance

to these veterans ater their injuries.For Marine Corps Inantry MortarmanRobert McCardle, the Departmenthelped him obtain his leg and set uphis prosthetics plan. I try not to be aneedy guy and dont like hospitals ingeneral, he said. Regardless, McCar-dles caseworker oered him supportin navigating the health care system.

Pinedos experience ater his se-vere injury involved emotions like an-ger and even sadness, as he dealt withthe act that he had become an am-

putee. His reusal to have guests in hishospital room went on or two weeks,until Fred Downs, Vietnam veteranamputee and chie prosthetics andclinical logistics ofcer in VA CentralOfce, stopped by to see Pinedo.

Downs no-nonsense attitude

robert turtil

Greg Reynolds, who lost hislet arm in a car accident aterreturning rom Iraq, warmsup with teammates beore a

game. Reynolds enlisted in the

Army the day beore 9/11, atthe age o 17.


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There is a science to managing violent behavior.Like any science, it builds on knowledge to un-derstand, explain and predict events. Will a vet-eran who angrily threw a magazine across a wait-

ing room today return and do something worse tomorrow?At VA health care acilities across the country, vio-

lence prevention requires a concerted eort. Cliniciansand VA police are putting their heads together and speak-ing the same language, says David Drummond, Ph.D.,director o the behavioral threat management program inthe Ofce o Public Health and Environmental Hazards.This eort translates into sharing inormation on best

practices to stop violence beore it escalates.The frst step ollowing a disruptive episode in a healthcare acility is to look careully at all risk and mitigat-ing actors or that patient, says Drummond. Risk actorsinclude drug and alcohol abuse, a history o violence, ora lowered ability to control impulses ater a serious headinjury.

Mitigating actors, such as strong amily relationships,dependents, deep religious belies, and plans or the utureare good news, says Drummond. Mitigating actors helpkeep people anchored in a peaceul mode.

But violence isnt just about the patient, he points out.Insensitive or disrespectul behavior on the part o employ-

ees, as well as acility policies or procedures, may rustratepatients.

The incident o the veteran who threw the magazinecould be evaluated in a couple o ways by the medicalcenters Disruptive Behavior Committee. The committee,chaired by a senior clinician, would weigh available inor-mation to decide whether the risk was signifcant or not.

The committee may conclude that it was a one-timeoutburst related to the veterans rustration. But i the

Preventing PatientViolence in

VA Health Care

Violence prevention in thehealth care sector isnta happy topic, but VA isdealing with it through a

systematic approach.

committee looks in the patients fle and sees behaviorlike prior assaults, selective targeting o women, abuse ostimulants, carrying weapons, or living on the street, the

incident would likely raise concerns.Depending on the pattern, the committee membersmight decide to implement specifc saety measures to as-sure everyones saety during uture visits. Those measurescan then be agged in a specifc note on the patient re-cord.

When that patient comes back or care, the ag mayrequire VA police to be present or to have someone meetwith the patient to discuss the oending behavior. Suchags are entered on the patients record to help clinicianscare or the veteran saely. No prejudicial or inammatorylanguage is used.

We must make it possible or veterans to get the care

they are entitled to, while protecting the saety o otherveterans and employees, says Drummond.

A new ederal regulation, 38 U.S.C. 501, issued onDec. 16, 2010, prohibits a prior practice o banning veter-ans rom care i they threatened or assaulted sta but stillrequires VA to continue to oer the ull range o medicalcare to which a patient is eligible.

It does authorize VA to modiy the time, place ormanner in which treatment is provided to a disruptive or

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threatening patient to ensure the saety o other patientsand sta at VA medical acilities, and to prevent anyintererence with medical care. Among the restrictionsVA may impose are: speciying the hours in which non-emergency outpatient care will be provided; arranging ormedical and other services to be provided in a particularpatient care area; requiring a police escort; and authorizing

VA providers to terminate an encounter immediately icertain behaviors occur.

Almost 60 percent o workplace violence incidents inthe United States occur in health care settings. Violenceis a common problem in health care, but people dontwant to acknowledge it, says Michael Hodgson, M.D.,chie consultant, occupational health, Ofce o PublicHealth and Environmental Hazards.

VA initially developed its core violence preven-tion program, Prevention and Management o DisruptiveBehaviors, in the 1970s. It is now under the direction oLynn Van Male, Ph.D., also in the behavioral threat man-agement program. The program teaches how to identiyand de-escalate potentially dangerous situations to keepemployees and their patients sae.

Van Male says there are two kinds o violence perpe-trators: predatory (stalkers who will wait as long as it takesto attack the target); and aective (people who use vio-lence to neutralize a perceived or external threat). With atrue predator, anyone is at risk. But the type primarily seen

vention is the key. Employees should be looking or signsand correlates.

The 12-hour, our-part training program includes:n General online training module (one hour-plus).n Face-to-ace class in which employees are taught howto identiy potentially violent situations and intervene topromote good outcomes. This can involve talking people

down rom escalating their behavior and using a customerservice approach, such as How can I help you?n Transition into limit setting and giving directions. Ex-amples: Put the knie down. Sit there. The employee isat higher risk; patient may be grabbing or choking the em-ployee or throwing punches. Use techniques that involveweight not strength.n Therapeutic containment, a three-person technique orcontaining violent behavior and getting the person to theground quickly.

Not every VA employee will receive or needs theull training. Each VA medical acility completes a work-place violence risk assessment based on its own disruptivebehavior data to determine the amount o training eachemployee will be provided. VA has a team o master train-ers certifed to go to acilities and teach employees how tobecome a trainer. Maximum enrollment is 24 in the train-the-trainer classes, which is a fve-day course.

Patients who assault sta are oten repeat perpetra-tors, according to many studies. Drummond describes astudy at the Portland VA Medical Center o 50 repeatedlythreatening patients. Once appropriate restrictions wereplaced, threats and violence in this group were virtuallyeliminated, and most o them made ewer emergency roomvisits and instead scheduled more doctor appointments.

Violence prevention in the health care sector is not ahappy topic, but VA is dealing with it systematically. TheDepartment undertook a national review in 2001, lead-ing to the implementation o the Patient Record FlaggingSystem. Drummond compares using the patient record agto a fre alarm. The fre alarm doesnt do anything on itsown, but or employees who are trained, its an alert andthey need to understand what theyre supposed to do.

All VA medical acilities are now required to oersome kind o behavioral threat training. The Preventionand Management o Disruptive Behavior Employee Train-ing Program is VAs program o choice.

A disturbance happens every day, in every medical

center in and out o VA. Patients may simply rightenothers with loud, disruptive behavior. Or they may throwpunches, threaten with knives or guns, or even use weap-ons. Thats why the work o VAs behavioral threat man-agement program is so vital. I like to think were savinglives and preventing injuries by the kind o work we do.We keep things rom happening, says Drummond.

By JoAnn Blake

Opposite: Therapeutic containment, a method o gaining some control overa violent person, is demonstrated on Denton the crash test dummy in a bio-mechanics laboratory at the Tampa VA Research Center o Excellence. Thisresearch veries that these techniques are sae to use. The humans here are(let to right) Tim Grant, Don Farris and Jerry Pruitt; above: Pruitt and Farris

practice therapeutic containment on Denton.

at VA is aective, she says. When these patients have agrievance, their behavior can escalate quickly. Here, pre-

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As one o the most progres-sive adaptive sports clinicsin the world, the NationalDisabled Veterans Winter

Sports Clinic has been on the lead-ing edge o rehabilitation or 25 years.Among the lesser known stories othe annual Clinic, the latest o whichwrapped up April 1, is one o cama-raderie and kinship that has occurredat the eventnot between veteranparticipants, but between their lovedones.

Veterans attending the Clinicthis year got a surprise visitor whenthe Vice President took the stage dur-ing the opening ceremony March 27.Few in the audience were as surprised

as Cheryl Lynch, who stood andwatched as Vice President Joe Bidenstrode into the room wearing a lapelpin or American Veterans with BrainInjuries Inc., a nonproft organizationshe set up in 2009.

To see him there, wearing ourpin, was overwhelming, Lynch said.Brain injury is in the newspapers allthe time, but nobody really knowswhat it is until youve lived it.

Living with brain injury is some-thing she knows very well. Her son,

Chris Lynch, ell rom a building dur-ing a training mission while servingwith the 82nd Airborne Division andsuered a severe brain injury.

In that instant, her lie changedorever. She quit her job and spentthe next year accompanying her sonas he received treatment at militaryand VA hospitals. Ater treatment,

What started as an informal support group at the2006 Winter Sports Clinic has grown into

a national nonprot organization.

Helping Families LivingWith Brain Injury

Army veteran Chris Lynch skis the mountain at the 25th Winter Sports Clinic.

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ing common brain injury symptomsand listing a point o contact oremergencies.

She also designed a medical alertdog tag that points medical or lawenorcement personnel to the tri-oldcard or inormation. I made thisoriginally or Chris, but I realized theycan beneft all veterans with brain in-juries, Lynch said.

Today, the AVBI website hasmore than 3,000 veterans registered.Lynch knows many o them by name.Through the site, they receive the dogtags, wallet cards, a subscription to

a Web-based cognitive exercise pro-gram, and grants to attend adaptivesporting events like the Winter SportsClinic. And she still holds the annualsupport group meetings at the Clinic,which now has about 50 attendees.

When her son gave a lapel pinto Vice President Biden, Lynch neverexpected him to wear it. So when hedid, she elt a strong sense o purpose.My lie changed orever when Chriswas injured, she said. Now I want togive others a reason or hope and the

possibility or a brighter uture.Sponsored by VA and the Dis-

abled American Veterans, the Clinicis hosted each year by the GrandJunction VA Medical Center. For in-ormation, visit www.wintersportsclinic.va.gov.

By Matt Bristol

her son was medically retired rom theArmy. The transition home to Pensa-cola, Fla., was particularly difcult.

It was during this time that shefrst learned o the Winter SportsClinic through a newspaper article.She called Clinic Director SandyTrombetta and registered to attendthe event in 2003.

That frst year was an eye-openingexperience or her and her son. Skiingthe mountain and sharing the mo-ment with his ellow veterans awak-

ened something in her son. But it alsolet him eeling somewhat isolated andalone. Chris elt like he was the onlyone with a brain injury. His symptomswerent readily visible and he otenelt like he was on the outside lookingin, she recalled.

In subsequent years, she noticedmore and more participants with braininjuries. One o them was Alan BabinJr., who, like her son, had served withthe 82nd Airborne Division. She im-mediately elt a kindred spirit with his

mother, Rosie.The amily members, we all

share a connection, said Lynch. Wecan relate our struggles, our hopes, ourears; there is an immediate connec-tion.

That year at the Clinic, 2006,Lynch put together an impromptusupport group meeting or veterans

with brain injuries, their amilies andcaregivers. About 15 people showedup. The ormat was simple: Veteransintroduced themselves and talkedbriey about their lives.

As one veteran began to speak,he abruptly broke down in tears. Itwas the frst time he had ever spokenabout his brain injury.

At that moment, I knew thiscould be very powerul, Lynch ex-plained.

Babin agreed. Peer-to-peer con-

nections are invaluable, he said. Forthe frst time, we realized that we arenot the only ones going through this,and that was huge.

When Lynch returned to Floridaollowing the Clinic, she startedAmerican Veterans with Brain Inju-ries Inc., as a peer support networkand resource website (www.avbi.org).One o the sites key eatures was achat room where veterans and theirloved ones could discuss issues theywere acing.

As her sons recovery progressed,he began venturing urther and ur-ther rom home. Sometimes, troublewould ollow. There were severalrun-ins with police, Lynch said.

Law enorcement ofcers mistookher sons brain injury symptoms orsigns o intoxication. In response, shecreated a tri-old wallet card describ-

Let: Chris Lynch (wearing camo backpack) greets VicePresident Joe Biden at the Winter Sports Clinic as his mother,Cheryl, looks on; above: Members o the brain injury support

group at the Clinic (let to right): Sunny Brogan, Rosie Babin,Valerie Wallace, Cheryl Lynch and Debbie Schulz.

courtesy o cheryl lynch

robert turtil


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John Dodson was fnally let gorom his job in February 2006.His job perormance had su-ered ever since he returned

rom the Middle East in September2004, where he worked as a privatecontractor or 18 months.

Dodson was unable to makehis mortgage payments, and severalmonths later he moved in with hisneighbors ater his home in Augusta,Ga., was repossessed.

His story is all too similar to thoseo some American troops who havereturned home rom war and struggledto reintegrate back into normal, ev-eryday civilian lie. Like some combatveterans, Dodson turned to alcohol asa coping mechanism, and his drink-ing led him down a destructive path

where he lost his wie and children,job, house, credit, truck and dignity.

His transormation rom an ac-complished veteran, a college gradu-ate with a double major in computerscience and journalism and a success-ul career, to alcoholic and homelessveteran was shocking or the people inhis lie who knew him best.

In 1998, Dodson transitioned outo the Army ater 13 years o serviceand accepted a job oer with a de-ense contractor, which paid doublehis Army salary. In the Army, Dodsonserved as an electronics warare sub-station repairer and systems adminis-

trator, and his extensive knowledgeo secret military communicationnetworks made him a valuable com-modity or private employers.

For years, Dodson lived theAmerican dream with a well-payingjob, amily and his own home.

But his lie changed completelywhen he accepted a new job to workas a private contractor in Kuwait andIraq, where he helped ensure that se-cret military communication networksremained operational 24/7. Motivated

partly by patriotism and a lucrativesix-fgure salary, Dodson let his nor-mal lie and amily behind.

Dodson went to the Middle Eastunder military orders; he ate, livedand worked with troops in Baghdad,and also traveled to orward operat-ing bases throughout Iraq to maintaincommunication networks.

Mortar, sniper fre and rocketattacks became part o the rhythmo lie or Dodson, and his deep con-nection with the troops he lived andworked alongside caused him anguishwhen daily casualty reports were an-nounced. Flights in and out o Iraq

brought increased anguish.It was terribly sobering to get ona cargo plane that was ying out othe country and fnd ag-draped co-fns anchored down the center aisleo the uselage, said Dodson. Thoseights were always very quiet and noone would say a word throughout theentire trip.

Dodson returned home a changedman.

When I came home rom Iraq,I didnt realize I was bringing all this

extra baggage with me, he said. Idont think many o us do, and i wehave an inkling o an idea that weare bringing it home, we tend to notwant to ace it, and not seek out helpor it.

Within a couple o weeks oreturning home, Dodson lost hisather to cancer. Two months ater

With VAs help, an Armyveteran overcomes alcoholismand homelessness and now

helps homeless veterans getback on their feet.

From Iraq to

Homeless toAdvocate forHomeless Veterans

John Dodson, a VA voca-tional rehabilitation spe-cialist, once lived hereat Bryce House, a transi-tional residence in Tulsa,Okla., where homelessveterans can live or 24months while recoveringrom substance abuse.

Dodson now works withhomeless veterans at

Bryce House to helpthem nd employment in

the local community.

nathan schaeer


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that, he got a call rom his uncle onNew Years Day, inorming him thathis mother had died in her sleep thenight beore.

His drinking and erratic behaviorbegan to increase and his relationshipsand perormance at work suered sig-

nifcantly. Six months later, Dodsonreturned home rom work to fnd thathis wie had taken their children andlet him.

Suddenly, I simply couldntfgure out what I was living or any-more, he said. Thats when I beganto spiral in, and there were fve orsix really ugly, black, dark years. Iproceeded to drink all the time, ormonths, hoping that I would just diein my sleep. I remember drinkingnight and day, hating it when I wouldwake up still alive.

His drinking led to alcoholismand he eventually lost his top-secretsecurity clearance and his career as aresult.

Ater losing his home, Dodsonlived o and on with his sister inHouston, sometimes washing cars orpocket money so he could buy beerand liquor. According to Dodson,drinking was the only way he couldfnd any temporary relie rom his de-

pression and anxiety.In August 2008, he moved toOklahoma to be with his ailing grand-ather, and he hoped it would oer anew start where he could get his lieand health back.

But watching my grandatherwaste away, eeling helpless in know-ing there was nothing I could do, putme right back in the place I was withall the other lossesmy mom anddad, the kids we lost in the war, mychildren, said Dodson. But somehow

this was worse. It was the last straw orme, and I simply gave up.

In December o that same year,Dodson fnally drank too much andended up in the emergency room andwas admitted as an inpatient at theJack C. Montgomery VA MedicalCenter in Muskogee.

As an inpatient at the Muskogee

VA, Dodsons recovery and restora-tion were set in motion. He receivedmental health and substance abusetreatment, and the homeless programsta secured him a placement at12&12 Inc., a residential substanceabuse treatment center in Tulsa,

where he lived or seven months.Ater completing the 12&12

treatment program, the homeless pro-gram sta got Dodson a room in BryceHouse, a transitional residence whereveterans can live or 24 months whilerecovering rom substance abuse.

Nothing less than God couldhave put together a better sta or pro-gram than these places oered me,said Dodson. They saved my lie andrestored me back to an even betterpotential than I ever had beore in mylie.

At Bryce House, veterans arerequired to work, volunteer in thecommunity or attend school. Dodsonvolunteered 40 hours a week at theErnest Childers VA Outpatient Clinicin Tulsa, helping veterans with orms,requests and eligibility questions.

In 2010, a door opened or Dod-son when VA announced a newinitiative to hire ormer homelessveterans to work as vocational reha-

bilitation specialists with the homelessprogram sta at each VA medicalcenter across the nation.

Dodson was one o seven ap-plicants or the new position inMuskogee, and his volunteer workat the Tulsa Outpatient Clinic andVA-sponsored homeless stand downin Tulsa impressed Melanie Goldman,the Muskogee VAs homeless programmanager.

John and I were talking with ahomeless veteran who Ive known or

at least 10 years, and the conversationbetween the homeless veteran andme was pretty standard, touching onsurace-type things, said Goldman.John, who has known this homelessveteran or mere months, was able toconnect with that person within thefrst two minutes o their conversa-tion. He has a natural empathy, a

natural ability to connect with otherpeople who are struggling with someo the same things that he once strug-gled with.

Goldman hired Dodson in Janu-ary, which gave him a new missionin lie to help homeless veterans fnd

employment in the local communityand regain their dignity.

Dodson is now an advocate orhomeless veterans and is contactingemployers to set up interviews, work-ing as a case manager and counselor,and assisting veterans with interviewand resume preparation.

Ive been one o these guys, saidDodson. I was homeless and in andout o places, living with relatives,and Ive been through rehabilitativeservices mysel. I have walked in theirshoes. So I do understand their aspira-tions and, as well, the obstacles in liethat they now have to overcome.

Thanks to the sta at the Musko-gee VA, especially the homelessprogram sta, Dodson has been soberor more than two years, made a ullrecovery rom his depression and nowlives on his own in an apartment.

Dodson expressed his gratitude tothe homeless program sta.

I sometimes have to pinch my-

sel to realize that I am working along-side them now, he said. I intend toearn and somehow pay back all o theproessional and compassionate careand understanding that was given tome. You want to witness modern-daymiracles? Spend a ew days with thisteam.

The uture looks bright or Dod-son. He has regained his relationshipwith his children, and the ormerjournalism major hopes to write abook about his experiences. He is

also working on a novel he promisedhis children years ago that he wouldwrite.

My ultimate dream was alwaysto be a novelist, said Dodson. I willfnish the novel, and then probablypursue some publishers. Well see.

By Nathan Schaeffer


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At 5:15 p.m. on Wednesday, April 27, the

community o Tuscaloosa, Ala., was struckby a tornado that let a mile-wide swaththrough the city, killing dozens and injuring

hundreds more.Almost instantly, the Tuscaloosa VA Medical

Center became a community shelter. It was also desig-nated by local authorities as the citys primary morgue.

When we became the primary morgue or thecrisis, our sta took up the challenge at once, saidAlan Tyler, the medical centers director. To be hon-est, some o our people were not prepared, psychologi-cally, to deal with the number and appearance o thebodiesespecially the children. But our sta did theirjobs and handled themselves like proessionals.

We unctioned as a hospital, a morgue, and ashelter. We ed people and clothed them, gave thema place to sleep. We tried to comort them. We didbereavement counseling with all the amilies who camein to identiy their loved ones.

Damon Stevenson, the Tuscaloosa VAs publicaairs ofcer, said one bereavement eort was particu-larly heart wrenching.

On April 28, we had two amilies here who weremeeting each other or the frst time, but under verytragic circumstances, he reported. Each amily had a

daughter attending the University o Alabama. Theywere roommates. Both died in the storm. The twoamilies came together here, at the Tuscaloosa VA, tocomort one another.

It was one o the most emotional events Ive everwitnessed, said Daniel Pettey, a patient advocate atthe medical center. The two mothers immediatelyembraced. They shared an instant, tragic bond. It waswitnessing moments like this that made me realize thereality o the situation we were acing.

Stevenson said that in addition to displaced amilies, many localveterans were brought to the medical center or shelter and care.

The proessionalism I witnessed rom the medical center sta

through this horrifc event was truly amazing, he said. We had em-ployees perorming duties that many o them had never been askedto perorm. They did so with a sense o duty I can only compare toa battle-tested military unit. One day beore the disaster, I saw anemployee rom Human Resources processing paperwork. A ew dayslater, I saw that same employee carrying a body bag.

Laura Balun, director o Voluntary Service at VA Central O-fce, said local volunteers began showing up at the Tuscaloosa VAwithin hours ater the tornado struck.

After the Storm

In the aftermath

of a deadly tornado,the Tuscaloosa VAsteps up to help the

community.

aPril jones


21/40


to prepare bodies or viewing byamilies. They wiped and cleaned andcovered bodies to make them morepresentable.

How do you comort a motherwho comes in to positively ID her

1-year-old child? she asked. Well,you dont. You cry with her. But youtell her, I hope it brings you somepeace to know that your beautiullittle girl has been handled with greatcare and love while here with us, andwe all truly are grieving with you.

By Tom Cramer

Im told that members o vet-erans service organizations who vol-unteer at the medical center begancollecting and delivering donationso clothing, personal care items andother things needed or citizens whowere seeking shelter at the VA, sheexplained. Apparently, baby diapersturned out to be a hot item.

At the VA weve never neededbaby diapers beore, Stevenson said.But our volunteers stepped up to theplate, as they always do, and had these

items to the medical center in recordtime.We are a community, he added.

We just did our part to assist ourcommunity in any way we could.

Connie Booth, a managementanalyst at the Tuscaloosa VA, said shesaw some beautiul stories emergein the midst o the carnage, loss andheartbreak.

On Thursday morning (April28), a amily arrived at the morgueviewing area to identiy their 21-year-

old daughter, she explained. Ater-wards, our staers hugged them, satwith them, held their hands.

On Friday, an elderly gentlemancame in to identiy his deceased wie,she continued. They had been mar-ried 50 years. The sta determinedthat his wie had sustained major trau-ma to her ace. In an eort to lessen

this painul process or the husband,our VA photographer took the timeto go into the morgue and take verydetailed photos o the lady rom theneck down. When the man saw thephotos o his wies shirt, her ring, a

small scar, he was easily able to iden-tiy her. Thanks to the extra eorts oour sta, an already traumatized indi-vidual did not have to suer throughanother shock when making a positiveidentifcation o his wies body.

Over and over, Booth con-tinued, VA staers who had neverworked in a morgue took the time

Opposite: Rochelle Walker, a registerednurse on the Valor Unit or Rehabilitation atthe Tuscaloosa VA Medical Center, placesclips in 4-year-old Jaeannas hair. Walkerspent hours volunteering in the Red Crossshelter, bonding with the children there andeven buying them toys out o her own pocketto replace the ones theyd lost in the tornado;

Let: VA employees at the Tuscaloosa VAMedical Center sort through donated clothingat the Red Cross shelter set up in the acilitys

Sports Atrium.

Below: VA Under Secretary or Health Dr.Robert Petzel greets Army veteran MarkBooth at the Tuscaloosa VA Medical Centeron May 4. Booth and other veterans wereinside a local Salvation Army building whenit was destroyed by the tornado.

aPril jones

michelle lePianka carter/tuscaloosa news


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Ater World War II, there was a shortage o VA physicians trained to meet theunprecedented health care needs o returning veterans. To address this need,Public Law 293 was introduced in 1946, allowing VA to recruit thousands onew physicians.

This measure was immediately ollowed by VA Policy Memorandum Number 2,which provided the legal basis or afliations between VA and the nations medicalschools and launched a long tradition o VA-academic partnerships or veteran-ocusedhealth research and care. The VA-academic collaborations continue to this day, equip-ping our nation to meet the 21st-century health care needs o veterans.

Over the last several decades, VAs medical research sophistication has become an

increasingly critical priority, as medical knowledge has blossomed exponentially andveterans health care needs have grown in complexity. These needs include conditionsparticularly common among veterans returning rom combat, such as post-traumatic stressdisorder, traumatic brain injury and spinal cord injury, and also chronic illnesses, suchas diabetes and hypertension, which are becoming more common as veterans and otherAmericans live longer.

Many Americans are surprised to learn the history o accomplishment in the VA re-search program, and o the unique pairing o VA medical centers with the nations medi-cal schools. This years Research Week, held May 2-6, with a ull schedule o compellingevents at VA Central Ofce on May 5, celebrated a dual-pronged theme: Discovery andCollaboration or Exceptional Health Care.

The week honored VAs thriving academic afliations that or 65 years since the his-toric memo have magnifed the VA research programs impact on the health o veterans

and others and helped keep VA at the leading edge o medical research and care. Theseenduring public-private partnerships have enriched the learning environment in VAacilities as well as university medical schools and teaching hospitals; spurred remarkableprogress in medical research; and achieved ar-reaching improvements in health care orveterans and all Americans.

Training the Next GenerationVAs partnership with academic institutions can take much o the credit or training

the next generation o educators, doctors and researchers so they can transorm health

VA and Its Academic

Partners:United by aCommon Commitmentto Veterans Health

By Joel Kupersmith, M.D.Chief Research

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care or veterans and others. Through its academic afliations, VA conducts the largesteducation and training eort or health proessionals in the United States, with morethan 115,000 clinicians-in-training receiving at least some o their health proessionaltraining in VA in 2010 alone.

By nurturing health proessionals and amiliarizing them with VAs vital mission, aca-demic afliations attract exceptionally skilled health proessionals to the agency.

An additional acet o the public-private collaborations is that most VA investigatorsalso teach at an afliated university medical school, and in many cases provide patientcare at the universitys hospital. Open the pages o any leading journal, such as theNew

England Journal of Medicine or theJournal of the American Medical Association, and youllsee studies by authors with dual afliationsthe VA Boston Healthcare System and Har-vard University Medical School, or example; or the VA Connecticut Healthcare Systemand Yale University School o Medicine.

A Model VA-University PartnershipAn additional legacy o Memorandum Number 2 is the many research Centers o Ex-

cellence nationwide that are under the joint auspices o VA and an afliated university.One example o a ruitul joint eort o this type is the Center or Restorative and

Above: VA and University oCaliornia, San Francisco urologyresearcher Dr. Rajvir Dahiya,right, with lab members (rom

let) Dr. Long-Cheng Li, Dr. EmilyNoonan, Dr. Robert Place andDeepa Pookot.

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Regenerative Medicine, a partnershipbetween the Providence (R.I.) VAMedical Center, Brown University,and the Massachusetts Institute oTechnology. One o the higher-profleprojects in the works at this site isBrainGate.

The system uses tiny electrodesimplanted into the brain to pick up

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brain signals. The brain impulses aredecoded by an external computerand translated into commands orelectronic or robotic devices, thusenabling users to move prostheticlimbs or communicate via computers.The technology promises to oer newindependence or veterans and otherswho are paralyzed as a result o condi-

tions such as brainstem stroke, spinalcord injury and ALS (Lou Gehrigsdisease).

Other work at the center is o-cused on creating biohybrid pros-thetic limbs that combine humantissue with synthetic, biocompatible

materials and mechanical elements.Another prime example o VA-

academic collaboration is the Cleve-land Functional Electrical Stimula-tion Center. The FES Centeracollaboration o the Louis Stokes VAMedical Center, Case Western Re-serve University and MetroHealthrepresents the game-changing healthdiscoveries that can be made by VAinvestigators with like-minded part-ners.

Specifcally, the FES Center o-cuses on improving the quality o lieor those with neurological or muscu-loskeletal impairments, including pa-ralysis, by applying electrical currentsto generate or suppress nervous systemactivity. FES can produce and controlthe movement o paralyzed limbs orhand grasp and standing; activatebodily unctions such as bladder con-trol or respiration; create perceptionssuch as skin sensibility; and stop unde-sired activity such as pain or spasms.

The Centers research promisesto translate into vast improvementsin the lives o those with spinal cordinjuries, stroke, and ultimately a widerange o additional health conditions.

Already, FES systems have helpedthose with paralysis to cup their handsto pick up a drinking glass or otherobject and to achieve a hand grasp oractivities such as writing and brushingtheir teeth. Researchers at the FESCenter are now working on a project,called the Networked Neuroprosthesis

System, or NNPS, that would helpsome people with paralysis to movetheir arms while simultaneously con-trolling bladder and cough unctions,or to control their legs and bladdersimultaneously.

More Exemplars of CollaborationMore groundbreaking research

Research Week cont.


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ans health and lives through scien-

tifc discovery. Particularly in todayseconomic climate, such partnershipsare invaluableenabling researchersto share and leverage resources, romequipment to expertise, in ways thatvastly improve efciency and produc-tivity.

VA has the unique potential,together with our academic partnersin health research and care, to makediscoveries in the laboratory and de-liver them as quickly as possible tothe patients bedside. Though each

generation o veterans presents a newset o health challenges, our essentialmission remains the same: discover-ing ways to enhance health care orthose who have so selessly servedthis country, and returning these cou-rageous veterans to their vital roleswithin the amily and larger commu-nity.

nFinding Genetically Engineered

AIDS Vaccines. Led by a researcherwith the VA New York HarborHealthcare System and New YorkUniversity, an international team oresearchers with expertise in immu-nology, virology and other specializedsciences is isolating powerul antibod-ies seen in patients who have HIV,identiying structures on the virussurace targeted by the antibodies,and integrating them into geneticallyengineered vaccines or testing inanimals.

The Center or Imaging o Neu-rodegenerative Disease and someother leading centers that involve VAresearchersamong them, the McK-night Brain Institute in Gainesville,Fla., under the auspices o the Uni-versity o Floridainvolve three-waycollaborations among VA, its univer-sity partners, and the Department o

Deense. In terms o unding the vitalwork o VA investigators and theirpartners in research, the National In-stitutes o Health has made a crucialcontribution.

Perpetual Commitment

We at VA look orward to con-tinuing the synergistic eorts with ourdedicated partners who, like us, cher-ish the opportunity to improve veter-

strides attributable to VA-academicafliations include:nZeroing in on Brain Disorders.The Center or Imaging o Neurode-generative Diseases, the only imagingcenter in VA devoted exclusively tomagnetic resonance imaging o thehuman brain, is homing in on cluesto conditions such as Alzheimersdisease, Parkinsons disease, and post-traumatic stress disorder. Located atthe VA medical center campus o theUniversity o Caliornia, San Francis-co, CIND is home to a diverse team oresearchers with expertise in clinicalcare, physics and computer science.nReaching Out to Alzheimers

Families. Researchers with VA andseveral universities conducted an

eort called REACH, short or Re-sources or Enhancing AlzheimersCaregiver Health, to teach amilycaregivers how to reduce stress, solveproblems, and manage difcult behav-iors o amily members with Alzheim-ers disease. In REACH studies, im-provements were shown across manyareas, including improved emotionalwell-being overall and an hour a daygained away rom caregiving duties, allat a relatively low cost.

Based on these positive results,

VA, led by a team at the MemphisVA Medical Center and Universityo Tennessee Health Science Center,is parlaying REACH into an ongoingprogram to help caregivers o veteranswith Alzheimers. Also, the program isbeing modifed to help the caregiverso those with spinal cord injury andtraumatic brain injury.

Above: The Portland-based Evidence Synthe-sis Program group o

Dr. Mark Heland (sec-ond rom let) includes(rom let) Dr. Devan

Kansagara, Dr. Steven

Dobscha and MicheleFreeman; right: Dr.Jeery Kocsis (let),Heather Mallozzi andDr. Masanori Sasaki,with the West Haven(Conn.) VA MedicalCenter and Yale Uni-versity, view in vivoimages o neural re-

pair that resulted romcell therapy.

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AROUND HEADQUARTERS

VA Partners With Easter Seals to Train Veteran Family Caregivers

VA and Easter Seals ormallyannounced a partnership toprovide comprehensive care-giver training to amily care-givers o eligible post-9/11veterans as authorized by theCaregivers and Veterans Om-nibus Health Services Act o2010.

We at VA are verypleased to partner with a re-nowned organization such asEaster Seals in developing thebest possible training programor amily caregivers, saidSecretary Eric K. Shinseki.Throughout its long history,Easter Seals has demonstratedits strong commitment tosupporting our nations activeduty military, veterans andtheir amilies.

Easter Seals is proudto share our expertise andknowledge with this importantgroup o amily caregivers,taking care o loved ones whoreturned home with seriousinjuries ater their post-9/11service to our nation, ex-plained James E. Williams Jr.,

president and chie executiveocer o Easter Seals. We arehonored to help these veteransand their amilies.

Beginning May 9, am-ily caregivers and veterans canapply or services authorizedunder a VA interim nal rulethat was published on May 5.Eligible amily caregivers o

eligible post-9/11 veterans willreceive comprehensive trainingdeveloped by Easter Seals incollaboration with VA clinicalexperts. It is part o a pack-age o new services that alsoincludes a monthly stipend,mental health services andaccess to medical care underthe Civilian Health and Medi-cal Program o the Depart-ment o Veterans Aairs, orCHAMPVA, i the primaryamily caregiver is not entitledto care or services under ahealth plan contract.

Easter Seals has beenhelping people with disabilitiesand special needs, and theiramilies, live better lives ormore than 90 years. Fromchild development centers tophysical rehabilitation and

job training or people withdisabilities, Easter Seals oersa variety o services to helppeople address lies challengesand achieve personal goals.

Family caregivers o eli-gible post-9/11 veterans willhave a choice o how to receive

their training. Options willinclude traditional classroomtraining, online learning or acorrespondence course.

All amily caregivers willbe expected to complete train-ing as part o the preparationto start receiving other servicesunder the new program. Therst training courses are ex-

pected to start in June, andmonthly stipends, which arebackdated to the day applica-

tions are ormally submitted,could begin as early as July.Veterans may download

a copy o the amily caregiverprogram application atwww.caregiver.va.gov. The ap-plication enables the veteranto designate a primary amilycaregiver and secondary amilycaregivers.

Caregiver support coordi-nators are stationed at 153 VAmedical centers and available

by phone at 1-877-222-VETS(8387) to assist veterans andamily caregivers with the ap-plication process. Caregivers oveterans rom all eras are alsoencouraged to use the websiteand support line to exploremore than two dozen otherservices VA provides caregiv-ers.

Training VAs Minority Veterans Program Coordinators

The Center or MinorityVeterans conducts its 11th bi-ennial Minority Veterans Pro-gram Coordinators NationalTraining Conerence June6-10 in Dallas. The conerencetargets individuals appointedby acility directors in the roleo MVPCs at VA medicalcenters, regional oces and

national cemeteries.The national coner-ence provides support ortraining and education to ap-proximately 200 MVPCs toincrease their eectiveness andoutreach eorts to minorityveterans, as well as support ac-tivities that educate and sensi-tize internal sta to the unique

needs o minority veterans.Presentations ocus on culturalcompetency, communication(consistent messaging), andoutreach.

In scal year 2010, theMVPCs conducted more than16,000 outreach activities withmore than 1 million veteransand amily members, o which

40 percent were minority vet-erans. The MVPCs also sup-ported the Secretarys goal toeliminate homelessness amongveterans by conducting morethan 1,000 homeless outreachactivities; they saw more than83,000 veterans, o which 50percent were minority veter-ans.

robert turtil

Family caregiver advocate Sarah Wade addresses the audience at the an-nouncement o the VA-Easter Seals partnership at the Easter Seals Harry a

Jeanette Weinberg Inter-Generational Center in Silver Spring, Md., on May Seated behind her are (rom let): Rep. Chris Van Hollen (D-Md.); VA UndeSecretary or Health Dr. Robert Petzel; Easter Seals President and CEO JamE. Williams Jr.; Easter Seals Greater Washington-Baltimore Region Chairmthe Board Phil Panzarella; and VA Chie Consultant or Care Management

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OUTLOOKAROUND HEADQUARTERS

Each year the Secretarys Award orExcellence in Nursing and Advance-ment o Nursing Programs is given toindividuals who have been nominatedby their colleagues or outstandingservice to veterans and VA. Chosenrom individual medical centers, thenominees go through a rigorous reviewprocess and are selected based on bestcharacteristics and the highest level odedication to their proession.

The 2011 Secretarys Awardor Excellence in Nursing and theSecretarys Award or Advancemento Nursing Programs winners are:Registered NurseLinda Hudson, VAMaryland Health Care System, PerryPoint; Registered Nurse (ExpandedRole)Christine Locke, Portland (Ore.)VA Medical Center; Licensed Practi-cal NurseFaith Andrulot, Harry S.Truman Memorial Veterans Hospital,Columbia, Mo.; Nursing AssistantKarie Drollinger, VA Illiana HealthCare System, Danville, Ill.; DirectorMichael Winn, Central Arkansas Vet-erans Healthcare System, Little Rock; and Nurse ExecutiveMary Walters, Southern Arizona VA Healthcare System, Tucson. The

winners were honored at the Secretarys Award ceremony on May 10 at VA Central Oce.

Six Honored With Secretarys Award or Excellence in Nursing

VA and the American Federation o Government Employeesreached nal agreement on a new national collective bargain-

VA and AFGE Sign New Collective Bargaining Agreement

VA Secretary Eric K. Shinseki, ar right, meets with the 2011 national nursing award winners inhis oce: (let to right) Christine Locke; Karie Drollinger; Faith Andrulot; Linda Hudson; MaryWalters; and Michael Winn.

VA Secretary Eric K. Shinseki signs the agreement with (let to right):Leslie Wiggins, VA deputy assistant secretary; Alma Lee, president oAFGEs national VA council; and John Gage, AFGE national president.

ing agreement, their rst since 1997. This contract will enhanceVAs partnership with the union, change the rules or telework-ing and expand the use o e-mail in labor-management relations.

This new agreement refects VAs commitment to col-laborate with an important labor partner, said Secretary Eric K.Shinseki. The outcome will be a more highly motivated, moreeective workorce serving our nations veterans.

About 204,000 o VAs 315,000 employees are eligible orAFGE membership, with another 23,000 employees eligible ormembership in our other unions.

Secretary Shinseki approved the contract on March 15.The complete labor agreement was signed March 28 by Shin-

seki, AFGE leadership and the VA and AFGE members o thebargaining teams at an internal event that was broadcast at VAacilities around the country.

Among the provisions o the contract are:n Enhanced collaboration with union ocials on work-relatedissues;n Expansion o teleworking among employees, including clari-cation o rules governing telework; andn Increased reliance upon e-mails and new technology in labor-management communications and processes.

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AROUND HEADQUARTERS

Answering the Call to Assist Survivors o Military Sexual Trauma

April is Sexual Assault Aware-ness Month, and as in previ-ous years, VA acilities acrossthe country capitalized on theopportunity to rearm theircommitment to assisting vet-erans who experienced sexualassault and harassment in themilitary. Facility militarysexual trauma coordinatorsengaged in a range o activi-ties throughout the month o

April to raise awareness aboutthe impact o MST, the reeMST-related care availablethrough VA, and the implica-tions that experiences o MST

can have or veterans healthcare.These eorts t well with

other recent VA initiatives toimprove veterans ability to ac-cess MST-related health care,most prominently Answerthe Call, an awareness-raisingcampaign rom the VA Oceo Mental Health Services thatis based on the premise that allVA sta have a role to play inensuring veterans have accessto MST-related care. As part

o this campaign, the Oce oMental Health Services MSTSupport Team has been dis-seminating strategies and toolsMST coordinators can use to

assist their key acility ront-line sta, such as telephoneoperators and clinic clerks, inresponding to requests or in-ormation about MST.

Dr. Amy Street, directoro Education and Trainingor the MST Support Team,explains, We wanted to os-ter dialogue between MSTcoordinators and rontlinesta throughout VA, to raiseawareness about the experi-ence veterans might have whentrying to reach out or help

Taking that frst step to speak up can be incredibly difcult and itsimportant or VA to respond positively when veterans ask or help.

related to their experiences oMST. Taking that rst stepto speak up can be incredibly

dicult and its important orVA to respond positively whenveteran

Documents

VAnguard May-June 2011