VAnguard

March/April 2003 1

outlook

Women in VAInvisible Wounds of War

CWT Programs

Employee Wellness

March/April 2003

Women in VAInvisible Wounds of War

CWT Programs

Employee Wellness

VAnguard

2 March/April 2003

Features

Treating the Invisible Wounds of War...................................................................6two new war-related illness centers openWorking for a Better Tomorrow........................................................................9CWT programs harness the therapeutic value of workPortland’s Healing Garden..............................................................................11memorial symbolizes journey veterans made to war in Southeast AsiaSanctuary in a Time of Need.........................................................................12Fisher Houses offer patients, families comfort and supportWomen in VA...........................................................................................................16honoring the contributions of women in the departmentGetting Healthy at Work..................................................................................22the Detroit VAMC’s employee wellness project helps workers get fitA Talk with Dr. Andrew Schally.............................................................................24VA’s only active Nobel Prize winner revealed

Departments

Letters.............................................................................................................................................3Management Matters.................................................................................................................4Outlook...........................................................................................................................................5Around Headquarters.............................................................................................................26Introducing..................................................................................................................................28Medical Advances.....................................................................................................................29Have You Heard........................................................................................................................30Honors and Awards..................................................................................................................31Heroes.........................................................................................................................................32

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VAnguardVA’s Employee MagazineMarch/April 2003Vol. XLIX, No. 2

Printed on 50% recycled paper

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

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

On the coverVA Central Office employee Vila (Vi) Hunter cel-ebrated 60 years of federal service on March 12.She left the family dairy farm in Wisconsin shortlyafter graduating from high school and soon foundherself working in wartime Washington, D.C. She’sone of the employees featured in this issue com-memorating Women’s History Month.

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March/April 2003 3

letters

We’re Here to ServeMANY TIMES I have heardco-workers complain aboutpatients, and I have oftenheard the expression, “It isnot in my job description.”Although there have to berules and patients need tounderstand, it is our job todo our best to serve that vet-eran. They deserve all thehelp we can give them, notonly as employees but also asindividuals who are part of anation that was defended bythese veterans.

I just got home fromsaying goodbye to my son,who was deployed. I don’tknow what his future will beor if I will ever see himagain. A wonderful kid, 20years old, he is on the Dean’sList at Miami-Dade Com-munity College and an E-4in the National Guard.

Everything is differentwhen it touches us person-ally. How often do we as em-ployees stop to think howthese veterans felt when theywere called to duty? Howmany were 20 years old oreven younger when they werepulled out of the comfort oftheir homes and the securityof their environment to gofight a war they didn’t evenunderstand?

How much anxiety, fear,sadness and loneliness theymust have felt. Nobodyknows but those who livedthrough it and their lovedones. I would like for my sonto be treated with the respectand honor that he deserves.

I have worked withsome wonderful people herebut for those who still havedoubt about what is in theirjob descriptions, please tellthem that the freedom wehave in our nation thanks toour veterans is what best de-scribes our jobs. Serving ourveterans because they deserve

it and we appreciate whatthey have done for us.

Mary E. SarazenMedical ClerkMiami VAMC

Editor’s Note: Sarazen’s com-ments originally appeared ina letter she sent to the direc-tor of the Miami VAMC.

InclusionJUST READ the January/February issue and havecomments on the loose term“minority.” I am a formerMarine, female, Asian de-scent. I’m a bit perturbedthat every article I read (e.g.,“Preparing for the LongRoad Ahead” and “A Youth-ful Approach to SuccessionPlanning”) uses the term“minority” from the angle ofblack versus white.

In case anyone hasn’tlooked, our country is a ka-leidoscope. There are thoseof us “other” minorities thatseldom receive inclusion.

I recall that as an under-graduate, upon checking intoa minority scholarship, I wassimply told, “You’re not theright kind of minority.”Those words still sting. Sohow about practicing theideas of fairness and oppor-tunity so many write aboutin the contents of yourpages? Please address all mi-norities—we’re here too.

June M. HelligrathChief, IRM

Lexington, Ky., VAMC

We devoted a significant por-tion of the content of that issueto African Americans becauseFebruary is Black HistoryMonth, but your points aboutother minority groups beingunderrepresented on our pagesare well taken.

Call to ServiceI WAS especially interested

in reading the article “An-swering the Call” in yourJanuary/February edition.

I noted in previous is-sues that VA members werelooking for ways they couldhelp during this critical timein our country. Many werecalling the National Guardand Reserves, but they wererunning into age limits. Ihave joined a national orga-nization where patriots mayjoin and serve where theylive. Veterans, civilians, re-tired military, husbands andwives, and there’s no agelimit: American VolunteerReserves.

This organization wasinitiated by the Secretary ofthe Army several years agoand covers the entire nation,and brigades coincide withFEMA regions. Its mission isto assist in homeland secu-rity, backing up the militaryservices when needed, emer-gencies when called upon tohelp by FEMA, and to pro-vide military funeral honorsto our veterans. Their Website is www.amervolres.org oranyone who is interested cane-mail me atJPotterCS@aol.com.

Col. Joseph V. Potter (ret.)Colorado Springs, Colo.

Priority Health CareIT IS HARD to comprehendthe comments of Mr.Michael Leary in the Janu-ary/February issue concern-ing the proper place of ser-vice-disabled veterans in theVA health care system. Mr.Leary is in dire need of edu-cation about why the VAmedical system was originallyestablished—to take care ofservice-disabled veterans.

It is shocking to hearthat a VA employee (albeit aveteran) does not understandwhy service-disabled veteranshave a higher priority to care

Have a comment onsomething you’ve seen inVAnguard? We invitereader feedback. Sendyour comments tovanguard@mail.va.gov.You can also write to usat: VAnguard, Depart-ment of Veterans Affairs,810 Vermont Ave., N.W.,Washington, D.C.,20420, or fax your letterto (202) 273-6702. In-clude your name, titleand VA facility. We won’tbe able to publish everyletter, but we’ll use repre-sentative ones. We mayneed to edit your letterfor length or clarity.

over nonservice-connectedveterans. I sincerely hopethat Mr. Leary’s lack of un-derstanding on this matter isnot widespread throughoutVA. If it is, VA must under-take a serious education pro-gram to all frontline employ-ees.

As a 50 percent service-disabled Vietnam veteran, Ialso wonder why I must goto the end of the line whenseeking a VA clinic appoint-ment. The VA system todayis fair to all veterans. Veteransdo comprise one group ofcitizens but within thatgroup exists a hierarchy forpriority VA health care. My-self, I would move aside for acombat-disabled veteran whohas spent over half his life ina wheelchair. It’s unfortunatethat Mr. Leary believes thathe has as much right to pri-ority care as seriously dis-abled veterans.

John VitikacsManagement Analyst

VA Central Office

We Want toHear from You

VAnguardmanagement matters

4 March/April 2003

Make Cyber Security Your BusinessBruce A. BrodyAssociate Deputy Assistant Secretary for Computer Security

Computer viruses and similar types of malicioussoftware are some of the biggest causes of businessdisruption in VA.

Computer security, nowknown as cyber security, ison the minds of a lot ofpeople in VA. I hope it’s onyour mind.

If you work with or haveaccess to a VA computer sys-tem, cyber security is part ofyour business responsibility.

Take a few moments toconsider how important VA’scomputers are in conductingour business. Almost every-thing we do depends on ourcomputers.

Unfortunately, the samecomputers that help us serveveterans can also be used fora wide range of illicit pur-poses, including theft andfraud. Viruses and other ma-licious software can attackour computers and causemassive disruptions to theservices we provide our veter-ans. Cyber criminals and in-formation warfare profession-als can penetrate our com-puter systems and causedamage to our critical infra-structure.

Virtually every mission,function and service that VAprovides to veterans and theirdependents is reliant oncomputers, and cyber secu-rity incidents that disrupt ordeny computing resourcescan prevent VA from per-forming its vital mission.

When you witness orbecome aware of a cyber se-curity incident, it is impor-tant that you let your super-visor and Information Secu-rity Officer (ISO) knowabout it immediately. YourISO will contact the VACentral Incident ResponseCapability in my office that

will provide guidance and as-sistance in dealing with theproblem. Reporting cyber se-curity incidents helps VA re-duce the negative impact ofthese events and improve theDepartment’s informationprocessing ability.

Computer viruses andsimilar types of malicioussoftware are some of the big-gest causes of business dis-ruption in VA. High-techvandals create ever more dan-gerous infectious programsthat sometimes overcomeVA’s sophisticated defenses.When that happens the com-

puting resources and data wedepend on to fulfill our mis-sion are compromised.

It takes time and moneyto defend against viruses.VA’s defenses have stoppedmore than 3 million virusesin the past year, but the fewthat have penetrated our de-fenses each cost us millionsof dollars in remediation ac-tivities. It requires a signifi-cant amount of employeetime to recover from attacks.They make all our jobs moredifficult and steal resourcesfrom our primary mission,serving veterans.

You can help preventthis loss. Take an active rolein virus defense. Find out ifyour computer is protected.When antivirus programs areloading, let them run to

completion. Be suspicious ofe-mail messages from peopleyou do not know. Look forsuspicious activity, like a con-stantly active hard drive.Make sure data files and pro-grams you load on yourcomputer are authorized andfree from viruses. Talk toyour ISO about viruses andsteps you can take to dealwith them.

The goal of our Enter-prise Architecture program isto develop an integrated in-formation technology systembased on modern technology,common applications and

consolidated management.This means improved accessto information, better com-munication of that informa-tion between administrationsand, ultimately, better servicefor veterans.

It also presents securitychallenges. Cyber securitycannot be done in differentways at different locations. Ithas to be done the same wayacross the entire enterprise.Enterprise Architecture isgiving VA the opportunity topull it all together and de-velop the best cyber securityprogram in government.

Cyber security functionsare now centralized at VAheadquarters in the Office ofCyber Security. Our job is toeliminate IT security redun-dancies and create efficiencies

through consolidation, train-ing and professionalization.

We are giving immedi-ate attention to the VA ISOfield force. Most performthose duties part-time or ascollateral responsibilities.Within a few months, wewill provide training oppor-tunities and an ISO careerpath with defined positions,grade structure and certifica-tion requirements. Our VAInformation Security Confer-ence coming up June 23-27in San Francisco will be thelargest meeting of its kindoutside the Department of

Defense and will includetraining and certificationprograms in a new VA ISOcareer path. This will openup IT career opportunitiesthroughout VA and provideyou the best information se-curity support in federal gov-ernment.

Don’t miss your weeklyhelping of “VA News,”news for and about VAemployees delivered eachweek in a digestible 10-minute video shown dailyat 4 a.m., noon, 4 p.m.and 10 p.m. (EasternTime) over the VAKnowledge Network sat-ellite link to your facility.

Are You Watching?

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March/April 2003 5

outlook

Volunteers Are Integral to VA CareJim W. DelgadoDirector, Voluntary Service Office

The time and talents shared by VA volunteers are cru-cial to maintaining the services we provide and theyare vital links to the communities where we work andlive.

Volunteers are one of ournation’s most valuable re-sources, and in VA they areviewed as essential to VAcare. The week of April 27,thousands of these dedicatedmen, women and youngpeople will be saluted fortheir efforts and commit-ment to serving America’sveterans.

We thank the VA volun-teers for their unselfish andunwavering devotion to serv-ing those who have served tomaintain our country’s free-dom. The time and talentsshared by VA volunteers arecrucial to maintaining theservices we provide and theyare vital links to the commu-nities where we work andlive.

The VA Voluntary Ser-vice (VAVS) Program, thelargest centralized volunteerprogram in the federal gov-ernment, has provided morethan 56 years of service toAmerica’s veterans seekingcare in VA health care facili-ties. Since 1946, VAVS vol-

unteers have donated 521million hours of service.With more than 350 na-tional and community orga-nizations supporting the pro-gram, VAVS also includes aNational Advisory Commit-tee of 61 major veteran, civicand service organizations.

In fiscal year 2002,118,594 VAVS volunteerscontributed a total of13,063,451 hours of service.This equates to 6,259 full-time employee equivalent po-sitions. The current mon-etary worth of these hours is$209 million (IndependentSector formula estimates acalendar year 2002 volunteerhour at $16.05).

VAVS volunteers and

their organizations annuallycontribute an estimated $40

million ingifts and do-nations toVA facilities,whichsupplementcongres-sional appro-priations.These con-tributionsenable VA toassist directpatient careprograms, aswell as sup-port servicesand activities

that may not be fiscal priori-ties from year to year.

VAVS has been quick torespond to many challengesover the past few years. Wehave encouraged the designof contemporary and innova-tive volunteer assignments tomeet the needs of changinghealth care delivery. Healthcare is now being deliveredcloser to where veteran pa-tients reside; likewise, oppor-tunities exist for individualsto volunteer closer to theirhomes or jobs.

We have felt a tremen-dous impact from the agingof the VA volunteer popula-tion, whose average age is 68.While still critical to theprogram’s viability, volunteers

who have contributed fivedays a week for 45 years areno longer able to contributein that capacity. This year,Voluntary Service CentralOffice and field staff devel-oped an aggressive recruit-ment strategy to assist in theexpansion of service to veter-ans through volunteerism.

VAVS is changing withthe times to recruit new vol-unteers through the use ofinformation technology. Vol-unteer opportunities arelisted on the Internet and po-tential volunteers are able toexpress their interest throughthe VAVS Web page. VAVShas developed the first Web-

based timekeeping databasein VA, which will be installedin all VA facilities by the endof this fiscal year.

You, the VA employee,play a critical role in the suc-cess of our volunteer pro-gram. How you interact withthe volunteers you work withdirectly affects how they feelabout volunteering andwhether or not they recom-mend volunteering at VA totheir relatives, friends andneighbors.

You, too, can actively re-cruit volunteers. Check withyour local VAVS programmanager and find out moreabout volunteer opportuni-ties at your facility so you areready to discuss them with

your friends and neighbors.VAVS is an invaluable

resource to VA. The caringand unwavering devotion tohelping others that is demon-strated daily by VAVS staffand volunteers are incalcu-lable.

Without volunteers, thequality of services and pro-grams designed to enhancepatient care would be com-promised. Every day is Veter-ans Day for the staff and vol-unteers who, in the truespirit of community service,unite in their efforts to helpveterans and promote therecognition and honor ournation’s heroes deserve.

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6 March/April 2003

Treating theInvisible Woundsof War

The department’s two War-Related Illness and InjuryStudy Centers (WRIISCs,

pronounced “risks”) are now up andrunning, providing clinical care tocombat veterans with difficult-to-di-agnose illnesses and conducting fo-cused deployment health research.

Located at the VA medical cen-ters in East Orange, N.J., and Wash-ington, D.C., these centers have afour-pronged mission aimed at en-hancing the quality of care providedto veterans with postdeploymenthealth concerns. The components oftheir mission are clinical care, edu-

cation, research and risk communi-cation.

Historical PerspectiveHealth care providers through-

out history have expressed concernfor the health of combat veterans.Since the Civil War, there havebeen documented examples of ill-nesses believed to be combat-con-nected, but little medical proof.

Interest in the study of deploy-ment health has grown over theyears, particularly since the VietnamWar. The Gulf War and the mysteri-ous illnesses that have plagued its

veterans helped create political mo-tivation for in-depth study of themedical concerns of combat experi-ences.

The Institute of Medicine andother scientific bodies began lookinginto the under-studied field of de-ployment health. In response, Con-gress enacted the 1998 VeteransProgram Enhancement Act thatmandated the creation of centers tostudy war-related illnesses andpostdeployment health.

In 1999, a joint National Acad-emy of Sciences and Institute ofMedicine committee supported thedevelopment of National Centerson War-Related Illnesses andPostdeployment Health Issues andrecommended that VA proceed withestablishing the centers. The NAS/IOM committee endorsed the VA

Treating theInvisible Woundsof War

Applying lessons fromthe past, VA hasopened two new cen-ters specializing inthe study and treat-ment of war-relatedillnesses.plan to create a center programmodeled after VA’s successful Geri-atric Research, Education and Clini-cal Centers.

In August 2000, requests forcenter proposals were sent toVAMCs throughout the country. InMay 2001, following a peer-reviewedselection process, VA Secretary An-thony Principi announced the selec-tion of the East Orange and Wash-ington sites. The directors of thecenters are Dr. Benjamin Natelsonin New Jersey and Dr. Han Kang inD.C.

“We’ve learned that combat ca-

DOD PHOTO

The mysterious illnesses that have plagued Gulf War veterans helped set the stage for in-depth study of postdeployment health concerns.

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feature

sualties do not always result in vis-ible wounds. Inevitably, some veter-ans return with health problemsthat, while difficult to diagnose, arenonetheless debilitating,” said Sec-retary Principi in announcing theselection of the centers.

Clinical CareOne aspect of the centers’ mis-

sion is to provide clinical care forveterans suffering from unexplainedillnesses. A veteran’s primary carephysician refers the veteran to theWRIISC program after tests con-ducted at their home VAMC fail toprovide any conclusive answers.

A multidisciplinary medicalteam at the WRIISC studies theveteran’s medical records and theneither recommends treatment or re-quests that the veteran undergo fur-ther evaluation there. The evalua-tion may include a thorough historyand physical exam, consultationwith specialists, diagnostic proce-dures, physical and exercise testing,psychological evaluation, exposureconsultation, risk communicationand patient education.

Treatment recommendations aregiven to the veteran and his or herprimary care provider for follow-upat the home VAMC. “Consistently,patients tell us they are happy withtheir evaluation at our center. Theyhave the time to talk about theirpresent health concerns and alsoabout the risks of exposure,” said Dr.Drew Helmer, clinical director ofthe East Orange center.

EducationIn addition to providing clinical

care, the WRIISCs also educateboth veterans and their primary careproviders about the risks of combatexposures. Many health care provid-ers may not fully appreciate the rolethat combat exposures can play inundermining a veteran’s health,even years after the experience. Thislack of awareness has troubled veter-

ans. VA’s centers, together with theDepartment of Defense’s Deploy-ment Health Clinical Center(DHCC), have begun to addressthese concerns.

The WRIISCs work closelywith the DHCC and other DoDpartners. Collaboration between VAand DoD resulted in the develop-ment of clinical practice guidelinesfor the care of veterans withpostdeployment health concerns.

“Primary care providers are of-ten the ones who see veterans withpostdeployment health concernsfirst,” said Michelle Kennedy Prisco,research nurse practitioner for theD.C. center. For that reason, theguidelines were written to educateclinicians on how to identify andtreat patients with combat healthconcerns.

The centers educate three maingroups: veterans and their families,clinicians, and veterans service orga-nizations (VSOs). This last group

serves an invaluable role as an inter-mediary between VA and veterans.By educating VSO representatives,the centers hope that informationabout their services will filter downto veterans. Similarly, the needs andconcerns of veterans expressed bythe VSOs can help improve the ser-vices provided by the centers.

ResearchResearch is another key focus of

the WRIISCs. Because of the wide-ranging and elusive nature of theconditions that affect combat veter-ans, especially those who served inthe Gulf War, research is a time-consuming and expensive process.

In the last decade, the govern-ment has spent $213 million on 224research projects studying Gulf Warillnesses. But despite the intense ef-forts of VA and other members ofthe medical community, researchinto possible causes and treatmentshas largely been inconclusive.

■ The Veterans Program Enhancement Act, which mandated the establish-ment of the centers, is also known as Public Law 105-368.■ Information on eligibility can be found in Information Letter 10-2002-018.(Web link: www.va.gov/publ/direc/health/infolet/10200218.pdf) The letter spe-cifically outlines the criteria used by the DoD to determine who is a combatveteran. The rules are the same as those used to determine eligibility for read-justment counseling at VA’s vet centers.■ Patients should be referred to a WRIISC by their primary care physician.Veterans who live in VISNs 1-4 are sent to the East Orange, N.J., center. TheWashington, D.C., center receives veterans who live in VISNs 5-8. Veteransfrom other VISNs are referred through a national referral program adminis-tered by VA’s Environmental Agents Service and are assigned on an alternatingbasis to one of the centers.■ Web resources:

WRIISC-NJ (www.wri.med.va.gov)WRIISC-DC (www.va.gov/WRIISC-DC)Deployment Health Clinical Center (www.pdhealth.mil)VA/DoD Clinical Practice Guideline for Post-Deployment Health Evaluation and Management (www.pdhealth.mil/clinicians/ PDHEM/toolkit/frameset.htm)Environmental Agents Office (vaww.va.gov/environagents or www.va.gov/environagents)

More Information and Resources

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8 March/April 2003

The research goals of each ofthe WRIISCs are very different. TheEast Orange WRIISC’s research fo-cuses on the pathophysiology ofcombat exposure—the study andunderstanding of the causes of unex-plained illnesses. Its distinctive re-search focus is partly due to the staffof the center. “We have a lot of ex-pertise as a group in studying GulfWar veterans,” said Helmer. “It isone of the strengths of our pro-gram—we have and have had a lotof research protocols that look atcauses.”

The D.C. WRIISC focuses onpopulation-based studies. “We studythe big picture to answer long-termquestions about combat popula-tions,” explained Andrew Lincoln,research health scientist at the cen-ter.

Risk CommunicationThe fourth component of the

WRIISC program is risk communi-cation, a process that helps care pro-viders and veterans develop close re-lationships through discussion of theveteran’s individual experience. Atthe centers, risk communication en-ables clinicians to inform veterans ofthe latest available informationabout the scientifically acceptedlinks between combat exposure andpostdeployment health concerns.

The centers’ risk communica-tion model emphasizes open discus-sion with veterans and their fami-lies, clinicians, and VSOs. Simplyput, “Risk communication is dia-logue,” said Aaron Schneiderman,the D.C. center’s risk communica-tion specialist.

It delivers scientific informationto an individual or community atrisk. It’s a two-way process, whichensures that the message is bothproperly delivered and correctly un-derstood. The centers’ messages helppatients understand what type ofrisks they might have incurred dueto combat exposures.

“Veterans have a lot of con-cerns,” said Schneiderman. “It is im-portant to tell them what we know,but also to tell them what we don’tknow.” The centers conduct privateinpatient and outpatient interviewsin their Resource Room, which alsohouses a collection of printed infor-mation materials and a computerwith Internet access.

According to the staff, WRIISCpatients see a difference in the carethey receive at the centers. The staffis keenly aware that illnesses nowthought to be associated with com-bat were at first discounted byhealth care providers.

Veterans also see a difference inthe intensity of care they receive ata WRIISC. “They see us as the ex-perts and the best chance to get areasonable answer,” said Helmer.“We have learned a lot since 1991,due to open communication, trustand a better understanding of thepathophysiology. We understand ex-posures better.” Still, he noted, “Wesay ‘I don’t know’ a lot.’’

“If we can give a veteran with ahealth concern, even a lingeringconcern, some reassurance about theoutcomes—they just want to knowwhy,” said Lincoln.

By Melissa Hebert

■ Combat veterans are those whohave served in a theater of combatoperations in any period of servicefrom World War II to recent opera-tions, including peacekeeping opera-tions.■ Combat exposes veterans to a va-riety of possible dangers, includingmalnutrition, endemic infectious dis-eases, psychological stresses, cli-matic exposures, toxic and noxious agents, and poor hygiene.■ Common postdeployment complaints among Gulf War veterans include:headache, sleep that is not restful, fatigue, depression, and joint pain.

Combat Vets and Their Health Concerns

VA officials and guest speakers at a Dec. 6 Open Houseand Grand Rounds Presentation at the D.C. WRIISC,from left: Dr. Jonathan Pincus, chief of Neurology, D.C.VAMC; Sanford Garfunkel, director, D.C. VAMC; LauraMiller, VA Deputy Under Secretary for Health for Op-erations and Management; Dr. Linda Schwartz, formerchair of the VA Advisory Committee on Women Veter-ans; Dr. Frances Murphy, VA Deputy Under Secretaryfor Health Policy Coordination; and Dr. Han Kang, di-rector of the D.C. WRIISC.

ANDREW WHITE

DOD PHOTO

Toxic and noxious agents are among thedangers combat may expose veterans to.

DOD PHOTO

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Working for aBetter TomorrowLast year, CWT programs reintroduced morethan 13,000 veterans to the therapeutic valueof work.

CWT program participants Dwayne Reid, left, andGerry Smith work behind the counter at the Fresh StartCoffee Shop.

MICHAEL KLEIMAN

Veterans Construction Team members Marc Buchan,foreground, and Chad Robbins put the finishingtouches on the renovation of the VA Inspector GeneralField Office in New England.

DEBORAH OUTING

Ajob provides several ben-efits not listed in the em-ployee handbook. It gives

us a sense of purpose, belonging andpersonal satisfaction. Without work,we have no reason to get up in themorning and nowhere to go duringthe day.

Thousands of veterans acrossthe country know exactly what it’slike to be without work. But An-thony Campinell hopes to changethat. As associate chief consultantfor psychosocial rehabilitation inVA’s Mental Health StrategicHealth Care Group, he believes noveteran should be denied the oppor-tunity to work.

Veterans who are homeless,former substance abusers, those withmental illnesses and spinal cord in-juries all benefit from having a job.“The clinical literature is very clear,”said Campinell. “These veterans areable to work, they want to work,and they benefit from work.”

Compensated Work Therapy(CWT) programs are a major step inreintroducing veterans to the thera-peutic value of work, ultimatelyhelping to reintegrate them intotheir communities. Veterans in theprogram receive an individualizedrehabilitation plan combining clini-

cal treatment or counseling andwork-based therapy.

A Fresh StartThere are more than 100 CWT

programs operating at VA medicalcenters nationwide. Some involverelatively small-scale projects, suchas the Fresh Start Coffee Shop inthe lobby of the Albuquerque, N.M.,VA Medical Center, where five orsix formerly homeless veterans serveup frothy lattes and cappuccinos tovisitors and employees.

Since opening in 2001, FreshStart has earned nearly $200,000.The revenue covers the shop’s op-erational expenses and the veterans’salaries, and supports a sister shop,the Jump Start, located in the men-tal health clinic and staffed by veter-ans with mental illnesses. It has alsoallowed Brian M. Pilgrim, Ph.D., aclinical psychologist who heads themedical center’s CWT program, toextend vocational rehabilitation ser-vices to more veterans.

Last year, the Commission onAccreditation of Rehabilitation Fa-cilities recognized the Fresh StartCoffee Shop as a fiscal best practicein program management. Sincethen, Pilgrim has received abouteight telephone calls from CWT

managers across the country inter-ested in replicating his model. Hemakes sure to stress the program’sprimary goal. “This is not a business,it’s therapy,” he said. “When donecorrectly, this is probably one of the

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10 March/April 2003

Charles McGeough is working to create strategic partnerships that provideemployment opportunities for veterans enrolled in VA’s CWT program. His ef-forts paid off in December 2002 when Secretary Principi signed a partnershipagreement formalizing a national alliance between VA and Bank of America.

“These partnerships lead to competitive employment for veterans,” saidMcGeough, national marketing director for CWT/Veterans Industries based atthe Dallas VA Medical Center. “These corporations know they can look to usfor a qualified labor source.”

The agreement complements existing partnerships between VA and com-panies such as Marriott International Inc., and the nonprofit Goodwill Indus-tries International Inc. The Marriott alli-ance took root in 2000, when the De-partment of Labor provided a grant to anonprofit group on the West Coastcalled U.S. Vets.

U.S. Vets used part of the moneyto fund a six-week hospitality courseconducted in conjunction withMarriott. CWT program managersscreen and refer veterans to the pro-gram. Of the second CWT class of 27veterans who entered the program, 25are now working for Marriott as con-ference room managers, audiovisualspecialists, front desk staff, and inother hospitality positions.

“We demonstrate to businesses that we can match their needs with aveteran’s strengths. This is not charity or a handout. Veterans have the skillsand abilities; it’s often just a matter of helping them overcome a spotty re-sume,” said McGeough.

Partnering with American Industry

Veterans in the CWT program take part in a six-week hospitality program run by Marriott Interna-tional.

COURTESY OF RALPH ZACCHEO

better modalities of treatment interms of getting veterans recon-nected with their community andexcited about life and their poten-tial.”

Building a Brighter FutureOther CWT programs are more

ambitious, such as the VeteransConstruction Teams run by BernieCournoyer at the Bedford, Mass.,VA Medical Center. Cournoyer ac-tively seeks contracts from federalagencies to perform various con-struction projects. His teams re-cently renovated the Officer’s Clubat Hanscom Air Force Base, Mass.,and are currently working on aproject for VA’s New England Officeof the Inspector General.

Last year alone, these teamslanded contracts valued at $5.5 mil-lion. Revenue covers supplies, toolsand equipment, but also helps sup-port the cost of treatment, “whichallows us to bring more veteransinto the system,” said Cournoyer, alicensed rehabilitation counselor.There are currently about 80 veter-ans on the construction teams. Eachearns between $8 and $15 an hour,depending on how well they meettheir rehabilitation goals.

A major focus of the program isbuilding work ethic. “These guyscome in here really struggling. Theyare physically, emotionally and spiri-tually bankrupt,” said Cournoyer.“We teach them how to deal withothers, how to handle supervision,

to be punctual and show initiative.We give them meaningful work, anidentity and a sense of achieve-ment.”

Veterans leaving the programoften go on to jobs where they’reearning $40,000 or $50,000 a year ormore. They become self-supportive,productive members of their com-munity. As a result, they develop asense of purpose, pride and self-es-teem.

And they appear to gethealthier, as well. While reviewingthe medical histories of veterans onthe construction teams, Cournoyerfound they averaged nine hospitaldays a year prior to joining CWT.

Once in the program, the averagedropped to one day a year.

Cournoyer helped replicate theprogram at VA facilities in WestHaven, Conn., East Orange, N.J.,and Temple, Texas. He’s currentlytrying to set up construction teamson several South Dakota NativeAmerican reservations where theunemployment rate is near 90 per-cent.

Transforming Lives on theReservation

Dr. Camilla Madden, a psy-chologist who directs the CWT pro-gram at the VA Black Hills Health

Continued on page 15

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Portland’s Healing Garden Grows

Mother Nature sows seeds ofremembrance and healingat the Vancouver Division

of the Portland, Ore., VA MedicalCenter in a half-acre memorial gar-den dedicated to Vietnam veterans.

The garden, funded by a Ger-man widow who lived in the U.S.during the Vietnam era, was de-signed to symbolize the journey vet-erans made as they left militarybases in the Pacific Northwest forwar in Southeast Asia.

It is a journey that begins withfamiliar Douglas firs and broad-leafrhododendrons and ends on a nar-row trail amid strands of toweringbamboo and elephant grasses. Thetrail leads to a shallow re-flecting pool where thewater’s gentle ebb and flowcreates soft ripples. It is aplace of quiet contempla-tion. Framing the pool arememorial brick pavers pur-chased by area veterans andtheir loved ones. Each bearsa personal inscription of ser-vice, sacrifice or loss.

One bears the nameRonald R. Righter, BravoCo., 2/28, 1st Infantry Divi-sion. Righter said one of thereasons he purchased a me-morial brick was to help re-lease some of the anger and frustra-tion he harbored about the way hewas treated during and after the war.

Drafted in 1966 at the age of18, Righter was on patrol near PhuLoi (about 30 kilometers northeastof Saigon), when an enemy soldierhiding in a tree detonated a landmine near his position. Metal shrap-nel riddled his neck, arms, chest andlegs. “I took about three or four stepsand keeled over,” he said. He spentthree months recovering from hiswounds before being reassigned toanother unit.

Back in Seattle he paid $68 fora cab ride to his parents’ home inRidgefield, Wash. The cab stoppedat two restaurants along the way sohe could get something to eat. ButRighter, who has worked as a me-chanic at the Vancouver Division ofthe Portland VAMC for the past 30years, was refused service because hewas wearing his military uniform.

The garden grew out of achance encounter in Salzburg, Aus-tria, between Lore Baak, a German-born widow, and Jeanie DeGraff, aU.S. Consular agent. Baak, whospent most of her life in Americabut moved back to Germany whenher husband died in 1982, had al-

ways wanted to establish a memorialto Vietnam vets. In 1999, she gother chance when she met DeGraffand they discussed her proposal tofund a memorial.

Later that summer, DeGraff re-turned to Portland to visit relativesand called the Portland VA MedicalCenter to relay Baak’s offer of finan-cial support. Anne Marie Murphy,chief of Community Developmentand Voluntary Service at the Port-land VAMC, remembered takingthe call. “She didn’t have a clearidea of how much money we were

talking about, but I told her wecould help,” Murphy said.

It started with a check for$10,000. Weeks later another onearrived, this time for $14,000. Bythe time Murphy received a thirdcheck for $50,000, she had estab-lished a separate General Post Fundto track the donations. She also be-gan brainstorming ideas for a perma-nent memorial. A call to SusanFishbein, regional public affairs of-ficer in Los Angeles, provided aunique concept. “Why don’t youbuild a garden?” Fishbein suggested.

Murphy liked the idea and puttogether a committee to guide theplanning process. Committee mem-

ber Peter Romano, a VAvolunteer and Vietnam vet-eran, knew a local landscapearchitect, Bruce Johnson,who could help. Johnson, aVietnam-era veteran, drafteda design and Murphy sentthe final plans to Germanyfor Baak’s approval. By thispoint, Baak had donatednearly $300,000 to the me-morial garden fund.

Since its dedication inNovember 2002, the gardenhas had a powerful impacton Vancouver-area residents.Hundreds have already pur-

chased memorial bricks and Murphycarries applications everywhere shegoes.

“The Voluntary Service officegets five or six contacts a day frompeople who want to buy them,” shesaid, explaining that the $40 salesfee is used to pay for the inscriptionservice and help maintain the gar-den. New memorial bricks will beinstalled each summer until theplaza reaches its capacity of between800 and 900 bricks.

The garden’s design symbolizes the journey veterans madeto war in Southeast Asia.

MICHAEL D. MOODY

By Matt Bristol

VAnguardfeature

12 March/April 2003

The 10-bedroom brick colonial stands less than a quarter-mile fromthe main entrance of the huge Minneapolis VA Medical Center. It’snot a straight shot—visitors must walk around heavy equipment and

mud puddles from nearby construction. But to the residents who call ithome for up to two months at a time, this Fisher House is a welcome worldaway from the bustling hospital.

On any given day of the week, Fisher House is home to between 20 and30 people: veterans undergoing episodic, long-term treatment for cancer,heart disease and other chronic illnesses; family members giving care andsupport to veterans staying there; and family who need to be close to veter-ans confined to the hospital. All come from across the upper Midwest andbeyond.

‘Rules of the House’Until recently, distance from home and loved ones could only be

bridged by a hotel at the veteran’s expense, or sometimes even the medicalcenter lobby. Fisher House has changed all of that.

Fisher House residents are able to care for themselves, which is one ofthe “Rules of the House,” and the facility has every amenity to support this.Up to 10 families at a time stay in comfortable bedrooms and suites fur-nished with televisions and private telephones. A shared kitchen, privateand shared baths, laundry facilities, a comfortable and spacious living room,dining room and activity areas make this residence nothing less than ahome for people who need a sanctuary in which to rest, gain strength, andfind support and friendship.

Residents not only take care of themselves, but as they invariably willtell you, Fisher House creates an environment that encourages them to takecare of each other. In the kitchen, family activity rooms, at mealtime, allthrough the day and into the evening, there are opportunities for residentsto share their hopes, heartbreaks, home remedies, specialty therapeutic reci-pes and more to ease the burden of disease, and to bridge the abyss of pain,loneliness, isolation and fear.

Construction and OperationThere are currently six Fisher Houses (Albany, Bay Pines, Cincinnati,

Denver, Minneapolis and West Palm Beach) on VA grounds. There are also25 Fisher Houses located on military bases in the U.S. and Germany.

Patients, families find comfort and support atVA Fisher Houses.

ROBERT TURTIL

ROBERT TURTIL

ROBERT TURTIL

James Davis relaxes with a game of soli-taire.

Jerry Hanson manages the Minneapolis VA Fisher Housewith Maggie Swenson.

Leta Cruse uses the house computer as Kathy Hessburglooks on.

Sanctuary in aTime of Need

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March/April 2003 13

feature

William SivleyArmy Reserve Capt. William Sivley,36, a patient advocate at the Wash-ington, D.C., VA Medical Center,was called to active duty on Nov.27, 2001, and spent a year at FortDrum, N.Y., home of the Army’s10th Mountain Division, counselingsoldiers returning from the frontlines of the War on Terror.

Domestic violence became a toppriority for the Army’s Family Advo-cacy Program following a string ofmurders at Fort Bragg last summer.In those cases, four special opera-tions soldiers, including three re-turning from combat tours in Af-ghanistan, killed their wives. Armyinvestigators suspect the murders

A leg injurykept him fromserving hiscountry inuniform dur-ing WorldWar II, butZacharyFisher didn’tlet it stop himfrom doing hispart for thewar effort. Heput his con-structionskills to use

helping the U.S. Army Corps of Engi-neers build coastal fortifications.

It was a sign of things to come. Bythe time he died in 1999 at the age of88, the prominent New York City real-estate developer and philanthropistwas widely regarded as one of thenation’s strongest supporters of the

men and women serving in the armedforces.

A native of Brooklyn, N.Y., Fisherdonated millions of dollars to militaryand veterans’ causes. He often ex-plained that his generosity was his wayof expressing gratitude to those whoprotected America’s freedom and gavehim the opportunity to succeed. “I’llnever be able to pay the debt I owe allthe members of the armed forces whosacrifice daily to preserve America’sway of life,” he once said.

His philanthropy towards veteransbegan after World War II, when he andhis wife, Elizabeth, a former USO per-former, helped finance the Veterans’Bedside Network, which gave hospital-ized veterans the chance to write, di-rect and act in their own shows andbroadcast them from one VA hospitalto another.

Fisher devoted much of the late1970s and early 1980s to saving the his-

toric, battle-scarred aircraft carrier In-trepid from the scrap heap. He foundedthe Intrepid Museum Foundation andlater spearheaded the opening of theIntrepid Sea-Air-Space Museum inNew York City, which is now theworld’s largest naval museum.

In the 1980s, he provided financialassistance to military families affectedby the tragic bombing of the Marinebarracks in Beirut and the gun turretexplosion aboard the USS Iowa. FisherHouses and scholarships for childrenof servicemembers are also part of hisphilanthropic legacy on behalf of mem-bers of the military and veterans.

President Bill Clinton honoredFisher’s lifelong good works by pre-senting him the Medal of Freedom, thenation’s highest civilian award, in 1998.And shortly after his death, Fisher be-came only the second private citizen,after Bob Hope, to be granted honoraryveteran status by Congress.

The Fisher Family Legacy

Zachary Fisher

The houses are designed in thestyle of the local area. The FisherHouse Foundation constructs andfurnishes them; each costs about$750,000. Though the Foundationprovides the bulk of the funding,VA facilities are expected to raise aportion of the construction costs,usually through donations fromcommunity groups and veterans ser-vice organizations.

When completed, the buildingis turned over to the government,which then assumes responsibilityfor operation and maintenance. Onmilitary bases, a nominal charge ismade, and often waived, for eachday’s stay. VA charges nothing.

The medical center’s PhysicalPlant maintains the building andfurnishings. Residents do their ownshopping and cooking, though Can-teen Service vouchers are offered toveterans receiving ongoing thera-peutic care. Contributions from pri-

vate citizens, corporations, VAfundraisers, civic organizations, andVSO support help make the house ahome. (See your CFC booklet, orvisit www.fisherhouse.org for infor-mation on ways you can help.)

“A lot of people go home andtell their local VSOs about theirstay, and then the VSOs follow upwith donations. We are very happyabout this wonderful donation,” saysFisher House staff member KathyHessburg, motioning to the newcomputer in the foyer as newcomerLeta Cruse prints out a descriptionof her husband’s artwork posted on aWeb site. Residents often use thecomputer to keep in touch withhome, family and friends via e-mail.

Home Away From HomePart housekeeper, concierge and

mom, Hessburg has worked at VAfor 29 years, the last seven at FisherHouse. She has seen firsthand the

“huge support system” it provides.Many veterans come back for treat-ment of new or recurring illnesses,which Hessburg says is “like seeingfamily return.” She regularly wit-nesses patients and family memberstalking amongst themselves, sharingtreatments they’ve discovered duringtheir own health battles.

Hessburg enjoys connectingwith veterans and their families atFisher House. “It’s a second home tome,” she says. “When I retire, I planon sticking around, if just to bakecookies.”

For Jerry Hanson, the most re-warding part of working there is“watching as a patient’s sad faceturns into a smile” when they firstsee the Fisher House. The 30-yearVA employee manages the housealong with his fellow patient repre-sentative Maggie Swenson.

Most residents arrive on Mon-days and return home on Fridays,

March/April 2003 13

FISHER HOUSE FOUNDATION PHOTO

VAnguardfeature

14 March/April 2003

with an occasional patient stayingover the weekend. The usual stay isup to one month, with veteransfrom as far away as Alaska taking upshort-term residence.

Cancer, heart disease and Min-neapolis’ Brain Injury Center arenot the only reasons people come tothis Fisher House. Leta Cruse hadnever even heard of the facility,much less expected to be a resident,before visiting the Minneapolis areawith her husband Michael, who wasparticipating in the National Veter-ans Creative Arts Festival.

The Vietnam veteran was aboutto present the painted china he hadcreated for the Festival when he feltsevere pain in his abdomen. He wasrushed to the medical center’s ER,just a few floors from the artist gal-lery at the Festival, and diagnosedwith a ruptured appendix.

For the Cruses, it was sheer luckthat Michael was participating atthe VA co-sponsored Festival, andeven more that it was held at a facil-ity with a Fisher House. Had theybeen at home in Alma, Ark., at thetime of this crisis, doctors told them,Michael most likely would havedied, given the distance to VAmedical care from their hometown.

Surgery to remove his appendixwas to be performed two days later,but as long as Michael lay in themedical center bed, Leta would stayat Fisher House. The couple had the

comfort of knowing that she wouldbe at his bedside every day, andcould get there in moments if theneed arose.

Michael has suffered for yearswith numerous health problems, andLeta devotes all of her time to car-ing for him. Had it not been forFisher House, she wouldn’t haveknown what to do to stay close toher husband. “I wasn’t expectingthis,” she says. “I can’t believe it,this is incredible. I feel like crying.”

Some Fisher House residentshave the advantage of having rela-tives who live near the medical cen-ter, with children or grandchildrenrunning around the house or in theyard adding to the homelike atmo-sphere. Seventy-two-year-old Ko-rean War Army Veteran ElvernKletscher is quick to show snapshotsof his family. He’s beaming withpride. His son Brad, an attorney, vis-its regularly from his home 25 milesaway. Elvern is expecting his wifeArlene to arrive soon for a one-weekstay.

This is Kletscher’s second visitto Fisher House. He spent sevenweeks here in 1996 for prostate can-cer treatment. The 33 days of treat-ment he has just begun is for esoph-ageal cancer. He is a retired dairyfarmer, father of six, grandfather of11. To him, the facility is “likehome, one big family, everyoneknows and looks out for each other.It’s something great that Mr. andMrs. Fisher did, especially for reallysick people who have to come andgo.”

Kletscher’s son Brad has stoppedby for a half-hour visit after drop-ping off a child at an evening activ-ity. He had shared his father’s con-cerns about getting into FisherHouse while undergoing treatment,explaining that his father “normallyhates being away from home. Every-one was so relieved that he didn’tneed to stay in the hospital forseven weeks” for his daily radiation

treatments. For his dad, FisherHouse is a home away from home,Brad says, and it’s a nice place forvisitors to come, including his kids,ages 3 and 5. “In the hospital, [thechildren] would be running allover.” Elvern reports that the otherresidents welcome the kids. “Theylove to see them. It’s so good to feeltheir energy.”

James Davis, a 63-year-oldArmy veteran, felt he was success-fully fighting prostate cancer whenthe FDA pulled his herbal treatmentfrom the market. He lost his job of38 years as a supervisor at a meat-packing plant just after being diag-nosed at the Mayo Clinic, and wasleft with no insurance and no placeto go. It was then that he looked toVA for help. The closest VA facilitythat could provide the six weeks ofdaily treatment he needed was Min-neapolis, 100 miles and a four-hourround trip from his home in AlbertLea.

James’ wife Helen sits in thedining room working a crosswordpuzzle while James moves back andforth from a game of solitaire to aprogram on Egypt airing on TheLearning Channel. Fisher Houseisn’t the Davis’ home, but it fills aneven greater need now as they headout from their temporary residenceto where James receives his daily 45-minute treatment.

“Fisher House provides a muchmore relaxed atmosphere for treat-ment,” James says. “Rest is so impor-tant, and there is absolutely nostress, no downers here.”

More to ComeSecretary Principi has recom-

mended five more VA sites (Hous-ton, Brooklyn, Dallas, Palo Alto andSeattle) to the Fisher House Foun-dation for the construction of newhomes. Using criteria set by theFoundation, VA chose these sitesfrom 14 applications submitted by

Brad Kletscher, left, visits his father Elvern, a KoreanWar veteran.

ROBERT TURTIL

Continued on page 15

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March/April 2003 15

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VA medical centers from across thenation. The criteria cover factorssuch as the availability of vacantland, the size of the proposed loca-tion and its distance and travel timeto treatment facilities, the facility’scommitment to provide one full-time employee equivalent to serve asFisher House manager, and thetreatment programs the medicalcenter offers.

Letters of endorsement fromVSOs, local, state and federal politi-cians, and information on applicablestate grants or local financial/volun-teer support are also considered inthe selection process. Finally, theapplication must include signatureapprovals of the facility and VISNdirectors.

Completed applications are sub-mitted to the Deputy Under Secre-tary for Health for Operations andManagement and the Office of Pa-tient Care Services for joint review.From there, a list of selected sites areprovided to the Under Secretary forHealth for concurrence and for-warded to the Secretary for ap-proval.

Once approved by the Secre-tary, the list of recommended sites issent to the Fisher House Founda-tion. The final decision on sites ismade by the Foundation, which hascommitted to building one new VAresidence each year. Constructionon the latest sites could begin asearly as next year. For more informa-tion on VA Fisher Houses and theapplication process, contact JillManske, VA Social Work Servicedirector, at (202) 273-8549.

By Robert Turtil

CWT continued from page 10

Care System, invited Cournoyer toEagle Butte, S.D., in February forthe dedication of a newly renovatedCWT workshop on the CheyenneRiver Sioux Reservation. It is one ofonly two established CWT facilitieson Native American reservations.The other, on the Standing RockSioux Reservation in McLaughlin,S.D., also operates under Madden’sguidance. She said both workshopsare the result of the joint efforts ofthe VHA Mental Health StrategicHealth Care Group in VA CentralOffice and the VA Black HillsHealth Care System.

Veterans at these sites recyclefilm for Polaroid Corp., assemblevarious wood products, and manu-facture flag cases sold nationwide.At one point, the Cheyenne Riverworkshop was the third largest em-ployer on the 12,000-person reserva-tion.

Work is only one aspect ofMadden’s holistic rehabilitationplan. “I use a broad-based systemsapproach to healing that includesworking with the community as wellas the individuals and their families.I find that works well with group-oriented cultures,” she said. This en-courages veterans to build “thera-peutic communities,” where theycan find support from their familiesand one another.

Her approach has transformedthe lives of men like Tim Swimmer,a Vietnam veteran who battled alco-holism and post-traumatic stress dis-order for 30 years. A CWT graduate,he is now involved in a therapeuticwork site at the Indian Health Ser-vice and serves as team leader forthe Cheyenne River CWT work-shop.

Local tribal leaders also havetaken note of Madden’s accomplish-ments. “She’s like a shining light,”Bryce In the Woods, chairman ofveterans affairs for the CheyenneRiver Sioux Tribe, told the Rapid

City (SD) Journal. “It was pretty in-spiring, what Dr. Madden broughthere and what she’s doing for ourvets.”

Opportunities for work will im-prove significantly if Madden andCournoyer succeed in establishingNative American Veterans Con-struction Teams. “There are almostalways some sort of constructionprojects on the reservation,” said CBAlexander, minority veteran pro-gram coordinator at the Fort Meadecampus of the VA Black HillsHealth Care System. “Often, be-cause of the inability to find quali-fied workers, they bring in outsidersto do the work.”

The Future of CWTFrom coffee shops to construc-

tion teams, more than 13,000 veter-ans took part in CWT programs lastyear with nearly half landing com-petitive jobs after completing theprogram.

With a solid framework inplace, Campinell, who is based atthe Bedford, Mass., VA MedicalCenter, is examining ways to bringthe program to its full potential.“There is enough capacity withinthe program to provide services to amuch larger group of veterans,” hesaid.

Topping his list are the approxi-mately 50,000 veterans in the VAhealth care system diagnosed withschizophrenia who are under age 50and not working. “Successful modelsshow work-based rehabilitation canbe closely integrated with existingmental illness treatment plans andprovide tremendous benefits to vet-erans,” said Campinell. He pointedto the Diagnostic and StatisticalManual (DSM) IV, to reinforce hismessage. “If occupational dysfunc-tion is listed [in DSM IV] … wehave a medical responsibility to re-spond.”

For more information aboutCWT programs, visit the Veterans

Fisher Houses continued from page14

Industries Web site at www.va.gov/vetind.

By Matt Bristol

VAnguardWomen in VA

16 March/April 2003

The Legacy of VA Women PioneersTo commemorate Women’s History Month, VAnguardreflects on the lives of two women pioneers who daredto dream. One forged a trail straight to the top of amale-dominant bureaucracy of the 1970s. The otherwanted to improve the safety of VA health care andworked tirelessly to make her dream a reality. Theirdedication and compassion inspired those who knewthem. Let their stories inspire you.

Dorothy L. StarbuckIt’s been nearly 20 years since Dorothy L. Starbuck

retired as Chief Benefits Director. But you can still hearher name from time to time in the corridors of VBAheadquarters in Washington, D.C. Photos of her greet-

ing former presi-dents and otherdignitaries gracethe walls of theconference roomnamed in herhonor. Her risefrom GS-4 adjust-ment clerk to headof the then-Depart-ment of VeteransBenefits is the stuffof legend.

Six months after the Japanese attack on Pearl Har-bor, Starbuck left her native Colorado for Army officercandidate school at Fort Des Moines, Iowa. She wasnamed to Gen. Omar Bradley’s staff and served inFrance and Germany. After the war, Gen. Bradley wasnamed Administrator of the Veterans Administration.Starbuck followed and joined VA’s Branch Office No. 7in Chicago as a GS-4 adjustment clerk.

By 1962, she was appointed assistant manager ofthe Baltimore VA Regional Office. It was the first timea woman had been named to a VA managerial position.A year later, she was named manager of the regional of-fice in Denver.

Starbuck led by example, often working late intothe night. Her dedication to serving America’s veteransled to her being named Chief Benefits Director, thesame position as today’s Under Secretary for Benefits, in1977. She went on to hold the job longer than any ofher nine predecessors, under three Administrators.When she retired in 1984, she was responsible for ad-ministering $16 billion of the department’s $26 billionbudget.

At her retirement, VA Administrator Harry Walters

praised her career accomplishments. He called her man-agement approach “direct, compassionate, but forcefullypersuasive” and said with her retirement the departmentlost a motivated, dedicated leader. “We all owe her ourrespect and gratitude,” he said.

Starbuck died in July 1996. She was 78 years old.She is buried in Fort Logan National Cemetery in Colo-rado.

Sue KinnickUsing scanners and bar codes to reduce medication

mix-ups helped launch VA into the leading edge of pa-tient safety. The core idea for the project can be tracedback to 1992 when Sue Kinnick, a registered nurse atthe Topeka, Kan., VA Medical Center, saw a Hertzrental car employee use a hand-held scanner to read acode in the trunk of the car she was returning. If Hertzcan track cars nationwide this way, she thought,couldn’t VA track patients’medications in the sameway?

She shared the idea withsupervisors at the TopekaVAMC, planting the seed forwhat would become VA’s BarCode Medication Adminis-tration (BCMA) program.

Kinnick died in 1997 af-ter a prolonged battle withbreast cancer, but not beforeworking with a VA team de-veloping a system to imple-ment her idea in a 1994 pilotproject at the TopekaVAMC. The pilot project was so successful it was ex-tended throughout the hospital and later within theEastern Kansas Health Care System. Ultimately, it wasadopted VA-wide. Now, it appears the rest of the nationmay follow suit. Under a March 13, 2003, Food andDrug Administration (FDA) proposal, hospitals nation-wide would be asked to adopt a medication bar codescanning system to help reduce medical errors.

News of the FDA proposal brings a smile to thefaces of those who knew Kinnick. Colleagues say sheworked on the project right up to her death and wasconcerned it might never extend beyond Topeka. Herlast words were to “keep fighting to keep the project go-ing,” according to pharmacist Chris Tucker, nationalBCMA project manager at the Topeka VAMC, in aVAnguard interview.

Starbuck

Kinnick

VAnguard

March/April 2003 17

Women in VA

■ VA ranks 5th in the employmentof women among the 17 Cabinet-level agencies in the federal gov-ernment.

■ Women make up nearly 61 per-cent of the total VA workforce.

■ As of fiscal year 2002, VA em-ployed 116,420 women; 8,184 areveterans of the U.S. Armed Forces;2,474 are disabled veterans.

■ Women make up 58 percent ofVeterans Health Administration em-ployees.

■ Thirty-seven percent of womenemployed by VA are between 41and 50 years of age.

■ The number of women employedby VA in grades GS-13 to 15 in-creased 13 percent from fiscal year2001 to 2002.

Women in theVA Workforce

Last Oct. 28, women VA employeesGS-14 and above, representing allVA programs and organizations, metwith Secretary Principi to discussconcerns and develop strategies toenhance the employment, advance-ment and training of women inmiddle and senior management.

That discussion convinced theSecretary that coordinated depart-ment-wide action was needed, andto get the ball rolling, he establishedthe Secretary’s Taskforce on the Em-ployment and Advancement ofWomen.

Secretary Principi charged thetask force with developing a com-prehensive plan that would correctimbalances in the employment, ad-vancement and training of womenwithin VA. On April 2, the taskforce presented the Secretary strate-gies responding to his instructions toaddress the following:

■ expand the Women’s Execu-tive Leadership Forum to field facili-ties;

■ obtain best practices informa-tion from private and public sectoremployers;

■ work with professional groupssuch as Executive Women in Gov-ernment and the National Associa-tion of Female Executives to en-hance VA’s ability to recruit and re-tain highly skilled women and pre-pare them for executive positions;

■ identify ways to publicize andrecognize accomplishments ofwomen in government;

■ develop and implementmentoring programs; and

■ conduct focus groups and sur-veys throughout the department.

The task force met twice andconducted focus groups (men in-cluded) in Washington, D.C., LittleRock, Ark., Los Angeles and NewYork City. After listening to the fo-cus groups and looking at current

workforce data, the group told theSecretary that much has to be done.

Though nearly 61 percent ofthe VA workforce are women, 62percent of these women hold posi-tions at the GS-12 and below gradelevels. At the end of fiscal year2002, 52 of VA’s 300 Senior Execu-tive Service members were women.Why the imbalance? The task forcereported these “common trends”across the department:

■ lack of cohesive leadershipdevelopment programs;

■ lack of supervisory and mana-gerial sensitivity;

■ lack of managerial account-ability for diversity;

■ unwritten higher standardsfor women than for men; and

■ lack of senior leader women.To reverse those trends and ulti-

mately increase the number ofwomen at higher management lev-els, the task force presented the Sec-retary nearly 20 strategies designedto attract and retain women andrecommended the establishment ofa Secretary’s Advisory Council onDiversity composed of VA and non-VA experts on recruitment and ad-vancement of women, minoritiesand persons with disabilities. In ad-dition, the group recommended con-solidation of the VA annual EEOAwards Program into one centrallyadministered recognition programfocused on accomplishments directlylinked to standardized measurableperformance targets.

“Secretary Principi considersthe employment and advancementof women critical to ensuring thatwe provide the highest quality ofservice to veterans, which includeswomen veterans,” said VentrisGibson, Deputy Assistant Secretaryfor Human Resources Management.“The task force recommendationsprovide him and top VA leaders the

ideas and direction that will achievehis goal.”

And while the task force reportunderscores the need for action, italso noted VA accomplishments.Nearly half the candidates selectedfor VA’s current SES candidate de-velopment program are women anda number of VA-wide programsaimed at increasing awareness of andsensitivity to women in VA arecoming on line, such as theWomen’s Executive Leadership Fo-rum, a new Web page and amonthly VA Knowledge Networktalk show.

By Chris Scheer

Report on Employment of Women Released

VAnguardWomen in VA

18 March/April 2003

Leadership Perspectives: Career

Musumeci

Gibson

Nora Egan began her VA career in 1975 as a GS-9 staff-ing specialist in headquarters. Today, as VA Chief ofStaff, she’s one of the highest-ranking women in the de-partment, working closely withthe Secretary and Deputy Secre-tary in managing day-to-day op-erations.

Though not the first womanto hold that position, Eganachieved other “firsts” amongwomen leaders as she rosethrough the ranks: Personnel Of-ficer for VA Central Office,Deputy Assistant Secretary forPlanning, and Deputy UnderSecretary for Management in VBA.

The decision to leave Human Resources and takeon other challenges was a difficult one for her. She’dspent much of her career there, enjoyed the work andthe people, and was hesitant to leave.

But she took the career advice of those who encour-aged her to “spread my wings and try something new. Imade the transition and I’m glad I did, because as Imoved through I developed different sets of skills andperspectives which I think have made me well-suited forthe position I have now.”

Her advice to those who aspire to leadership posi-tions? “Anybody can give orders. The real trick to beinga leader is to have a vision, to have the integrity to fol-low through with it, and to make people want to dowhat needs to be done to accomplish that goal. Leader-ship requires integrity, clarity of vision, and a willingnessto listen and to support the people who work for you.”

Egan

VAnguard asked some VA executives to reflect on their ca-reers and offer words of wisdom to the up-and-comingleaders of tomorrow. Looking for some tips on how tomake the most of your career? Read on.

Laura J. Miller joined VA in 1978 as a Presidential Man-agement Intern at the GS-9 level. Today she serves asDeputy Under Secretary for Health for Operations andManagement in VA Central Office. Best career advice sheever received: “Develop good relationships across theboard and know the details.” Her proudest moment as aVA employee: “[Standing] with other employees as we wel-comed veterans returning from the Gulf War and subse-quently were available to them for care.” Her advice toothers: “Put your work ahead of your career … the careerwill follow.”

MaryAnn Musumeci, R.N., joined VA as a staff nurseGS-7 equivalent in 1972. She is currently director of the

Bronx VA Medical Center and thefirst woman to hold that position.Her most significant career challengewas making the leap from nursing tohospital administration. Best careeradvice she ever received: “If you con-tinue to work hard (and long hours)and continue applying for adminis-trative-type positions, something willeventually come along. Be innova-tive! Never despair and give up!”

Her advice to others: “You have to set milestones overyour career with specific goals. Never lose sight of thesegoals, work hard and you will achieve.”

Ventris C. Gibson joined VA as a GS-6 personnel clerk in1980. She went on to become the first woman appointedDeputy Assistant Secretary for Hu-man Resources Management in VACentral Office, a position she hasheld since 2000. Career advice sheoffers up-and-comers: “Do your best,take on the difficult projects, and re-member, lions don’t need to roar.”Words from her father that have car-ried her far: “Make sure that thepath you wish to travel is the oneyou truly desire. If you don’t knowwhere you’re going, any road can take you there.”

Millie Hughes-Fulford, Ph.D., has nearly 30 years withVA. She started her career in 1973 and now serves as di-

rector of the Laboratory of Cell Growth at the San Fran-cisco VA Medical Center. One of her proudest achieve-ments was training as an astronaut with NASA whilemaintaining her laboratory. “I started working in the labafter astronaut training, which meant that I had a secondshift from 6 p.m. to midnight. I wrote grants on the week-ends, bought a copy machine for home to reproduce thegrants to send in for peer review. After two years, I re-ceived my first independent grant and continued workingat night and weekends until my flight in May of 1991.”Best career advice she ever received: “Keep your mind onyour goals and do not waiver from them.” Her words ofwisdom to those just starting out in VA: “Seek out mentorswho will help you achieve your goals.”

VAnguard

March/April 2003 19

Women in VA

Advice from the Top

Johnson

Parthemore

Geraldine Johnson joined VA in 1971 as a stay-in-schoolclerk. Today she is the Associate Deputy Under Secretary

for Management in the VeteransBenefits Administration, the highestVBA position held by an AfricanAmerican woman. She completedher undergraduate college studies as asingle parent. Deciding to becomemobile “was crucial to moving up inVBA,” she said. Best career adviceshe ever received: “Always be willingto take on new and more challengingassignments. Be known as a finisher.

Never forget your roots.” Her words of wisdom to those onthe rise: “Do the basics, educate yourself, foster relation-ships, set your goals. Make a plan and work the plan.”

Dr. Sandra Gracia-López joined VA in 1986 as a fellow inNuclear Medicine at the San Juan, Puerto Rico, VA Medi-cal Center. She became the first woman chief of NuclearMedicine there in 1989, and chief of staff in 2002. Amongher proudest moments were when San Juan’s NuclearMedicine Service was recognized as the most efficient inVA, and when she got the news she’d been selected aschief of staff. Best career advice she ever received: “Tonever say ‘no’ to administrative advancement.” Career ad-vice she would give others: “To face all challenges withhonesty and to continue studying and learning from expe-rienced colleagues.”

Linda W. Belton is director of VISN 11 (Ann Arbor,Mich.), a position she has held since joining VA in 1995.“My first day of work in VA was also the first day of thegovernment shutdown in 1995. I was unbelievably im-pressed with VA employees who continued to delivercare—and who found inspired ways to support their co-workers—not knowing when they’d receive their next pay-check.” The best career advice she ever received: “Your at-titude is showing!” Career advice she offers those just start-ing or in the midst of VA careers: “Meet your own expec-tations (they’re usually the hardest). Be authentic. Be an-chored to something greater than yourself. Be a quiet revo-lutionary.”

Cathy Smith started her VA career in 1976 as a GS-3 fileclerk. She now directs the Denver VA Regional Office.“Mobility has contributed both to my career opportunitiesand to my stress level. Having gone through various moveswith VA, I have had the joy of making friends across thecountry and the challenges that relocation naturally pre-sents.” Her best career advice: “You never have to make a

decision at someone else’s pace.” To those on the rise, sherecommends staying true to self. “Our organization willnever have enough individuals with personal character.Know your ethical and moral standards. You will be repeat-edly challenged to compromise. Having a good foundationwill be invaluable, especially through the most tryingtimes.”

Genie Norman retired in 1998 with 33 years of VA ser-vice. She started in 1965 as a medical record librarian andclimbed all the way to Associate Chief Medical Directorfor Administration. Her advice to those on the rise: “De-velop a career plan but always be flexible in trying toachieve your goals. Changes occur so rapidly that having acareer vision too far down the road just isn’t practicable.Work on as many projects, task forces and committees asyou can and never say ‘no’ when an opportunity to in-crease your knowledge or visibility presents itself.” She alsooffered a retiree’s perspective: “Set your goals at a levelthat you can comfortably achieve without sacrificing yourpersonal and family life. When your career is finished, hav-ing family and friends as an integral part of your daily lifeis of extreme importance. Balancing career and personallife must be a priority and the formula is different for ev-eryone.”

Jacqueline Parthemore is chief ofstaff at the VA San DiegoHealthcare System, a position shehas held for nearly 20 years. Shestarted her VA career as a researchassociate in 1974. She advises aspir-ing leaders to seek out mentors.“Take advantage of the myriad ofmen and women who are willing toprovide mentoring to you,” she said.“Though you may not ‘click’ with ev-ery one of them, they each have something to teach you.”

Kristine Arnold began her VA career 34 years ago as aGS-5 adjudicator trainee. She rose to become the firstwoman to serve as director of VBA’s Compensation andPension Service. She’s now director of the Seattle VA Re-gional Office. Fear of the unknown once kept her frommoving up from a lower-level position in which she’dgrown comfortable and confident. The best advice she gotat that time was to “look past my fears and my comfortzone and draw on my personal strength to seek new profes-sional challenges.” Her advice to others: “Be yourself.Know your priorities for your personal as well as your pro-fessional path.”

VAnguardWomen in VA

20 March/April 2003

Washington, D.C., has always beena magnet for people who want towork where the pace is set for therest of the country. Perhaps at notime in history was this truer thanduring World War II.

Hundreds of thousands jour-neyed to and from the nation’s capi-tal, looking for opportunity as wellas a way to serve their country. Inthat short period, Washington wentfrom a sleepy, muggy, backwatertown, to a bustling, still muggy, cos-mopolitan center.

Like so many women who cameto serve in newly burgeon-ing government offices, Vila(Vi) Hunter arrived as ateenager. Today, after 60years in the federal govern-ment, she literally has herfinger on the pulse of VA.

Shortly after young ViHunter graduated from highschool in Stevens Point,Wis., the school principalcame out to her family’sdairy farm to suggest thatshe take the Civil ServiceExam. “He sat down withmy parents and myself andsaid, ‘They need a lot ofgirls in D.C. to work,’”Hunter recalled.

She and a neighbor took theexam, and waited. Her neighbor wassoon called for a position, butHunter heard nothing. She movedinstead to Chicago and began work-ing in a war production plant, rivet-ing tarpaulin covers for Army cargotrucks. This, she felt, was preferableto working on the farm or clerkingin an insurance office back home.One Wednesday evening in August1942, Hunter received a telegramfrom Washington requesting thatshe report for duty the followingMonday. At the time she was train-ing for a well-paying night job on

the production line. Her supervisordiscouraged her from taking the po-sition in D.C., warning of the dan-gers for a young woman in the city.But Hunter decided to take achance on Washington. After brieflyreturning home to Wisconsin, whereher parents bought her much-needed office clothes, she boarded atrain bound for D.C.

The neighbor she had taken theCivil Service Exam with met her atthe train station in Washington andhad lined up a place for her to stay.In those days, it wasn’t unusual fortwo or three “government girls” to

share a tiny one-bedroom or effi-ciency apartment. By comparison,Vi, staying in a room at the home ofa family that was vacationing at thebeach for the summer, lived in spa-cious luxury.

Hunter went to work for theWar Production Board as a juniorclerk-typist. She remembers workingin World War I-era buildings withno air conditioning on the NationalMall. “We’d have to weigh downstacks of papers so that theywouldn’t be blown away” by thehuge fans used to bring some com-fort to the workers inside, Hunterrecalled. Winters and summers back

then seemed much more extremethan what D.C. suffers through onaverage. “I remember snow blowinginto the office and under the doors,”said Hunter, as well as “so muchheat and humidity, there’d be [con-densation] on everything, every-where, all the time.”

Evenings and weekends werespent volunteering at the localUSO, where Vi worked at the infor-mation desk from 6 to 10 p.m. She’doften attend dances there, or hostother events. She’d spend Sundayafternoons touring Washington withvisiting servicemen and then cook-

ing meals with them back atthe USO. She would visitsick and wounded service-men at Walter Reed andForest Glen Hospitals. Viworked 1,500 hours at theUSO and remembers thethrill of being invited to theWhite House for a “thankyou” lawn ceremony held byPresident Truman towardthe end of the war.

Life in Washington dur-ing the war years was diffi-cult, but not extremely so.Vi remembers that duringher first year in D.C., there

were air raid drills, blackouts, andsearchlights constantly crisscrossingthe sky, preparing and protecting thecity from the possibility of attack. Ina post-9/11 world, being remindedthat D.C. has long been a potentialtarget can be oddly reassuring.

Since Vi didn’t have a kitchento cook in, she usually ate at one ofthe popular low-cost D.C. cafeterias.And like most other American citiesat that time, Washington was cleanand safe.

Her work involved preparingstatistics and historical records onairplane engine materials. Sheworked closely with officials from

Vi Hunter: Still Going Strong After 60 Years

Secretary Principi presents an award to Vi Hunter honoringher 60 years of federal service.

MICHAEL L. MOORE

VAnguard

March/April 2003 21

Women in VA

There’s only one woman in the historic photo of President Franklin D.Roosevelt signing the GI Bill of Rights on June 22, 1944, but she’s frontand center, looking right over the president’s shoulder. She’s Edith NourseRogers, a lifelong veterans’ advocate and one of two women who have hadVA medical centers named in their honor.

Her commitment to the welfare of veterans began during World War Iwhen she toured the battlefields of France and Great Britain while accom-panying her congressman husband on an official trip. After returning toWashington, D.C., she worked as a Red Cross volunteer at Walter ReedArmy Medical Center.

In 1922, President Warren G. Harding appointed Rogers as a dollar-a-year inspector of veterans’ hospitals. She toured the country visiting hospi-tals and communicating their needs directly to the Harding, Coolidge andHoover administrations.

When her husband died in 1925, she was elected to serve out his con-gressional term. She went on to serve 35 years in Congress, chairing the

Committee onVeterans’ Affairsin the 80th and 83rd

Congresses.Of the more

than 1,200 billsRogers introducedduring her longcongressional ca-reer, more thanhalf dealt with vet-erans’ and militaryaffairs. She securedpensions for Armynurses, a perma-nent nurse corpsin VA, and major

appropriations to build VA hospitals.During World War II she sponsored legislation creating the Women’s

Army Corps (WAC). She helped draft the GI Bill, which accounts for herprominent place at the signing of the landmark measure.

She died in Boston in 1960 during her nineteenth congressional cam-paign. The VA medical center in Bedford, Mass., was named the EdithNourse Rogers Memorial Veterans’ Hospital in 1978.

The other VA medical center named in honor of a woman is Saginaw,Mich. That facility bears the name of Aleda E. Lutz, who never got thechance to lead a long and distinguished life. War cut it short.

More than 400 military women died during World War II, and Lutzwas the first one to lose her life in a combat zone. As an Army flight nurse,she flew 196 missions, evacuating wounded soldiers and caring for them onthe flights back to medical facilities behind combat lines.

During her last mission, an evacuation effort over Lyon, Italy, theplane went down. She was only 29 years old. On Dec. 28, 1944, she wasposthumously awarded the Distinguished Flying Cross. In 1990, Saginawbecame the only VA medical center named for a woman veteran.

The Women Behind the Names

Edith Nourse Rogers is the only woman pictured with Presi-dent Roosevelt as he signs the GI Bill.

Boeing, Chrysler and Ford, often ar-ranging for their travel to D.C.meetings. All of this came to an endin mid-1947 when she received thepink slip that so many “governmentgirls” got after the war.

After that first experience withgovernment service, Vi returned toWisconsin and the family dairyfarm. Six months had passed whenshe got an unexpected telegram ask-ing her to report back to D.C. towork for the Veterans Administra-tion. Although it was at a pay ratelower than the job she had previ-ously held, Vi was keen on returningto Washington. It was February1948 when she started working forthe Department of Insurance. Hereshe would take part in the sequenc-ing of servicemen’s records. It was“very dull” work, Hunter said. But itwasn’t long before she moved intostatistical work.

Over the next 55 years, Hunterworked through many changes ofadministration and reorganizations,rising steadily to the position ofmanagement analyst with the mostrecent incarnation of her section,VA Central Office’s Workforce In-formation Systems Team. Her areaof expertise is understanding thePAID system and how to extract in-formation from the database to pro-duce statistical analysis for reportson the flow of human resourcesamong VA’s 225,764 employees.This information is regularly used byOMB, OPM, and Congress, as wellas for VA strategic human resourceplanning.

Hunter has no immediate plansto retire, none that she will talkabout anyway. First she wants to“square away some reports and havesome good people to train in thiswork.” She wants to make sure thatthe projects she has been responsiblefor “continue to fly right” before shelets go.

By Robert Turtil

VAnguardfeature

22 March/April 2003

Getting Healthy at WorkDetroit VAMC’s new Employee Wellness Project is helping workers getfit and relieve stress in a convenient and supportive environment.

DAVID GRIFFITH

DAVID GRIFFITH

Annie Grubbs-Neal works out in an aerobics class; behind her are Nancy Gibson, R.N., left,and Bobbie Allen, M.D.

From left: Art Cordis, Annie Grubbs-Neal, ShawnFlaharty, Natalie Campbell and Russell Jones participatein a weight training class.

These are stressful times foremployees working in theVA health care system. VA

is treating more veterans with fewerstaff and resources. In Detroit, 600new patients applied for care in De-cember, and that’s been a relativelyaverage number in recent months.

Employees get lots of questionsfrom veterans about waits and de-lays. Customer service is more im-portant now than ever before.

Recognizing that the only con-trol employees have in this environ-ment is over their own behavior andattitudes as individuals, AFGE Local

933 and management at Detroit’sJohn D. Dingell VA Medical Centerdecided to take action to help themdeal with stress and fatigue. Theyformed a Wellness Committee, andthe group has created a morale-boosting program called the Em-ployee Wellness Project.

Launched in January, the pro-gram offers free, on-site exerciseclasses and lectures on nutrition andfitness to employees who want to getfit and relieve stress in a convenientlocation and supportive environ-ment. It was promoted through anenrollment handout encouraging

employees to sign a pledge to them-selves to give the program a try and,more importantly, to stick with it.

The program began with a fit-ness screening conducted by twophysicians and other volunteers.Weight, height, body fat percentage,flexibility, blood pressure at rest andafter two minutes of activity, andheart rate at rest and after two min-utes of activity were documented foreach participant. Numbers were as-signed to participants so that datacollected during the screening wouldremain anonymous.

Staff members with expertise inpersonal fitness volunteer their owntime teaching classes and offeringencouragement to help co-workersbecome as healthy as they can be.Classes are available before work,during lunch breaks and after work.

The program includes activities

VAnguard

March/April 2003 23

feature

The Detroit VA Medical Center’s Employee Wellness Project was promotedthrough an enrollment handout explaining the purpose of the program and en-couraging employees to sign up, tailor it to their own goals, and stick with it.Here are some excerpts:

The John D. Dingell VAMC Employee Wellness Project was developed toencourage staff to become more physically and emotionally fit. The WellnessProject offers opportunities to exercise mind, body and spirit through physicalexercise, meditation and lectures.

It is our hope that we will have your COMMITMENT to make a change inyou, for you. NOW really is the time to do it. You will never have more supportor a better opportunity than this one. It is our suggestion that you sign thispledge to yourself.

I will give the Wellness Project my best effort. If something interferes with mycommitment, no matter what it is, I will keep coming back and starting over if Ineed to. This is a “one day at a time” venture. I will keep my attention focusedon here and now and do what I have to do today to be the healthiest person Ican be. I won’t worry about what I did yesterday or how much I have to do toget really fit over the long haul. Today, I’ll do the best that I can.

Signed:________________________ Date:_________________________

Involvement in the program is free and purely voluntary, and while datawill be collected, it will be anonymous. Only you need to know the statisticsabout your fitness. You will be assigned a number at the initial fitness checkand that number will be used to track your progress throughout the program.We understand (from personal experience) that some of you may feel asthough even you don’t want to know your fitness data. This is temporary! Whatmay feel embarrassing now will soon help you feel great when you see howmuch progress you make. Everyone has her or his own personal style for doingthings. Pick and choose what you like from the program and if you don’t likesomething, don’t do it.

Signing Up and Sticking With It

Editor’s Note: For more informationabout the John D. Dingell VA MedicalCenter’s Employee Wellness Project,contact Talbot at (313) 576-3340.

in which employees at all fitnesslevels can participate. Off-shifts canparticipate using videos. Offered areweight training and calisthenics;pilates; yoga; aerobics; meditation;walking (on their own or with co-workers in the medical center’s base-ment); biking (on their own and ingroup outings during the spring andsummer); and swimming (on theirown).

Signs posted around the base-ment mark out distances for walkersand offer lighthearted motivation.Five-and-a-half laps equal one mile.“Only 1,530 laps to Chicago,” onesign reads. “You need to do 18 lapsto walk off a Snickers bar” and “Ahot dog bun will cost you 27 laps,”read others.

Each participant is asked to turnin a weekly activities log, with ap-proximate equivalencies in laps,which allows the committee togauge participation and benefits ateach level.

A monthly lecture series pro-vides information about nutritionand other fitness concerns. Confi-dential weigh-ins are done duringthe monthly meetings, and partici-pants get encouragement and sup-port for their efforts.

The Wellness Project costslittle. The local union funded DVDand VHS equipment. Instructorswork for free on their own time. T-shirts and other items for the pro-gram are being paid for throughfundraising activities.

So far, the program has been abig hit with employees. “TheWellness Project has had such an in-credible impact on my work and so-cial life,” said participant Lisa Olney,administrative officer in Pathologyand Laboratory Medicine.

“Not only has it contributed tomy 35-pound weight loss, but also tomy positive outlook on how medicalcenter management views employ-ees by their concern for our well-be-ing.”

“I am so happy that the VAMChas implemented exercise programsfor employees,” said Natalie M.Campbell, ward secretary in Hemo-dialysis. “I can step away from mystressful day to enjoy yoga andpilates, and after work I get a goodweight training workout.” She addedthat she has worked at the medicalcenter for 11 years, and theWellness Project is the best em-ployee program she’s ever seen.

Arthur Cortis, a health techni-cian in the Nursing Section, calledthe program “a refreshing, progres-

sive, outside-the-box thinking pro-gram that is proving to be an uplift-ing addition.”

Fifty-five employees signed upfor the initial health screening, andthe committee expects interest togrow.

By Ann Talbot

VAnguardfeature

24 March/April 2003

VA’s Only Active Nobel Prize Winner Revealed

A Talk with Dr. Andrew Schally

Dr. Schally accepting the Nobel Prize in Medicine in 1977 forhis research on brain hormones. That same year, the awardalso went to Dr. Rosalyn S. Yalow, of the Bronx VAMC, for herwork in the development of the radioimmunoassay.

Dr. Andrew V. Schally and his work have addedprestige and international recognition to re-search in VA for decades. Awarded the Nobel

Prize in Physiology or Medicine in 1977, today he headsthe Endocrine, Polypeptide and Cancer Institute at theNew Orleans VA Medical Center, where he continueshis scientific endeavor after 40 years of groundbreakingresearch in the area of peptide hormone chemistry,physiology and medicine.

Before becoming a Nobel Laureate, he authored1,000 scientific and medical articles; since that time, hehas added another 1,200 to his credit. In a Nobel pre-sentation speech honoring Dr. Schally, it was noted thathis work has “establish[ed] a firm basis for turning thefantasy and mystery [of hormones] into reality.”Through exploring peptide hormones, Dr. Schally “un-covered a substantial part of the link between body andsoul.”

His research helped pinpoint several biochemicallinks between the brain and the pituitary gland. Dr.Schally laid the foundation of modern hypothalamic re-search and his work continues in the heart of the Cityof New Orleans, where VA’s only active Nobel Prizewinner excels as both dedicated VA researcher and pro-fessor of medicine at Tulane University School of Medi-cine. Given the rare opportunity to discuss his researchand reflect upon his legacy, Dr. Schally took time out tooffer personal reflections on his work and on being aNobel Prize winner.

Q: What did receiving the Nobel Prize in Physiologyor Medicine in 1977 mean to you then and now?A: The Nobel Prize in Medicine is of course the highestrecognition that can be bestowed upon a medical re-searcher, but frankly I did not have much time in 1977,nor since then, to reflect upon it. The Nobel Prize iscertainly a highly emotional and proud event in the lifeof a scientist, but the ceremonies are linked to many du-ties and obligations that take all of a Laureate’s time.Now I am so busy with my cancer research that, can-didly speaking, I seldom think about the Prize. However,I am reminded about it during my trips, particularlyabroad where the Nobel Prize is the source of much ad-miration and surrounds the Laureate with enduringhonor, great prestige, and gives him a place in history.

Q: What has been or is your biggest challenge as aninternationally known researcher?A: There have been two main challenges in my medicalresearch career. The first started in 1954-1955 when Iwas still an undergraduate in Canada, beginning mywork on the hypothalamic control of the pituitarygland. The challenge was to prove that the hypothala-mus (part of the brain) controls the pituitary gland andthrough it the other major endocrine glands such as thethyroid, adrenal, ovaries and testes. This could beproven only by the identification of specific neurotrans-mitter hormones in the hypothalamus. Since these neu-rotransmitters are present in the brain only in minisculeamounts, the work on the identification involved theextraction and purification of hundreds of thousands offragments of hypothalami. My research group and I usedpig hypothalami obtained from slaughterhouses, most ofwhich were donated by Oscar Mayer & Company, themeat packers.

In 1969, we finally obtained in pure form the thy-rotropin releasing hormone (TRH), and identified itsstructure. TRH controls the secretion of pituitary TSH(thyroid stimulating hormone), regulating the thyroidgland. Two years later, in 1971, we were the first toidentify and synthesize the luteinizing hormone-releas-ing hormone (LH-RH, also called Gn-RH for gonadot-ropin-releasing hormone), which controls the secretionof pituitary gonadotrophic hormones LH (luteinizinghormone) and FSH (follicle stimulating hormone) andthus regulates the reproductive processes.

My second main challenge started about 1976-1978

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March/April 2003 25

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after I realized that analogs (derivatives) of hypotha-lamic hormones could be used for cancer therapy be-cause of their enormous biological activity. At thattime, I decided to change my research field from neu-roendocrinology to endocrine oncology. This new chal-lenge became the development of new, improved meth-ods for the treatment of cancers that represent majornational and international health problems, such asprostate cancer, breast cancer, colorectal and pancreaticcancer and other malignancies.

These new treatment methods are based on hypo-thalamic peptide analogs—hence the name of the insti-tute, Endocrine, Polypeptide and Cancer Institute. Thischallenge continues. Since the patients at VA representa cross-section of the U.S. patient population, theywould clearly benefit from these new therapeutic meth-ods.

Q: What has been your most rewarding experience asan internationally known researcher?A: Perhaps the most rewarding experience as a re-searcher occurred in June 1971 at the meeting of theEndocrine Society in San Francisco, at which I an-nounced the structure of LH-RH. There was muchdrama surrounding that presentation because severalgroups were in hot competition.

The large Imperial Ballroom of the San FranciscoHilton, where I gave my paper announcing the struc-ture, was very crowded. I listened with excitement andsuspense during the preceding lectures in which my sci-entific competitors did not report the structure of LH-RH; when my turn came, I rose to my feet and an-nounced it, winning the race with the other groups.This presentation was described by others in several ar-ticles and books. It was one of the most joyous momentsin my life, to announce for the first time the solution tothe problem which had fascinated me and others for solong, especially inasmuch as the discovery was expectedto have a great scientific, clinical, and even social im-pact.

Of course, a steady source of personal reward is myresearch and constant small advancements we make atour cancer institute and especially the realization thatthousands of patients are benefiting from my discover-ies, particularly the prostate cancer patients. I am veryproud that this work was done at VA, which has sup-ported my work for 40 years.

Q: What do you hope your legacy will be?A: It is difficult to delineate my legacy since my life’swork is not yet finished. We have developed four newindependent approaches to the treatment of variouscancers based on at least seven different classes of anti-

tumor compounds. These antitumor peptides have beentested preclinically and shown to inhibit a variety of hu-man cancers (prostate cancer, pancreatic cancer, gastriccancer, colon cancer, malignant brain tumors, lung can-cer, renal cancer, bone tumors, osteosarcomas, melano-mas, hepatocellular carcinoma, lymphomas, breast can-cers, ovarian cancers and endometrial cancers) trans-planted into nude immunosuppressed mice.

In 1982, we discovered a new method for the treat-ment of advanced prostate cancer, which is the mostcommon cancer in U.S. men and the number two causeof cancer-related deaths. This novel approach, based onthe use of LH-RH analogs, is today the preferredmethod for treatment of advanced prostate cancer.

Other methods we have developed still remain tobe tested and implemented in the clinics. These newtherapeutic methods could result in the reduction ofside effects, prolongation of survival of cancer patients,and improvement in the quality of life. Many patientswith cancer, perhaps millions of them, would benefit. Ihope that some of these methods will be effective in aclinical setting.

Of course the Nobel Prize in Medicine for the dis-covery of hypothalamic (brain) hormones can be con-sidered a legacy in its own right. However, I hope thatin the next few years that I have allotted myself, someof these new methods for cancer therapy can be imple-mented clinically and would thus increase my legacy.

Q: What is your motivation to continue your workeven after 40 years?A: As I said earlier, my life’s work is not finished. Formore than 40 years, I have been working on hypotha-lamic hormones and with the help of clinicians includ-ing my wife Ana Maria Comaru-Schally, M.D., FACP,we have been able to convert our findings into diagnos-tic and therapeutic tools. Before I fade away, I want tofurther improve the methods for the treatment of vari-ous cancers. I believe that we are on the threshold ofimportant new discoveries.

The most urgent and perhaps the closest to a scien-tific and medical solution is the therapy for relapsed, an-drogen independent prostate cancer. Every year 40,000men die needlessly in the U.S.A. from this malignancyand double that number in Europe. Better therapiesmust also be developed for other cancers such as breast,ovarian, lung, brain, pancreatic, colorectal, gastric andrenal cancer, which represent major national and inter-national health problems and for which present thera-pies are inadequate.

By Stacie Rivera

VAnguardaround headquarters

26 March/April 2003

Former VA Deputy Adminis-trator Everett Alvarez Jr., ischairing the 15-member na-tional CARES Commission.The independent commis-sion will play a critical objec-tive role in assessing pro-posed CARES initiatives thataddress the future health careneeds of veterans, and howand where VA can best pro-vide those services.

The commission held itsfirst public meeting Feb. 19and 20 and will continue tohold public hearings both inWashington and across thecountry. The group is ex-pected to present its findingsand recommendations to the

Secretary this fall. The Secre-tary must accept or reject therecommendations as a whole.

Alvarez, best known asthe first American aviatorshot down over North Viet-nam, was taken prisoner ofwar in 1964 and held inNorth Vietnam for morethan eight years. He wasdeputy director of the PeaceCorps from 1981 to 1982,deputy administrator of VAfrom 1982 to 1986, and hasheld numerous posts in theprivate sector. He is nowowner of a McLean, Va.,consulting firm.

The CARES Commis-sion will operate as a federal

advisory committee, com-posed of people with exper-tise in various aspects ofhealth care and particular in-terest in the efficient deliveryof benefits and services to thenation’s veterans.

The members are:Charles Battaglia, formerstaff director of the SenateCommittee on Veterans’ Af-fairs; Dr. Joseph Binard,former VA physician andspecialist in spinal cord in-jury treatment; RaymondBoland, Wisconsin secretaryof veterans affairs and presi-dent of the National Associa-tion of State Directors ofVeterans Affairs; ChadColley, former national com-mander of the DisabledAmerican Veterans and atriple amputee from the Viet-nam War; Vernice Ferguson,former executive in the VAnursing program; Dr. JohnKendall, dean emeritus andprofessor of medicine emeri-tus at Oregon Health and

Rural American Indians andAlaska Natives who served inthe military will receive en-hanced medical care througha new agreement between VAand the Department ofHealth and Human Services.

The agreement, signedin February by VA DeputySecretary Dr. Leo S. MackayJr. and his HHS counterpart,Claude A. Allen, at the Na-tional Congress of AmericanIndians Executive Council’swinter session in Washing-ton, D.C., will encourage co-operation and resource shar-ing between the two agenciesto make sure veterans whoare American Indians or

Secretary Principi kicked off VA’s observance of Black HistoryMonth on Feb. 11 by dedicating an exhibit honoring AfricanAmericans who received the Medal of Honor.

In a ceremony held during a workshop on diversitysponsored by the VA Office of Diversity Management &Equal Employment Opportunity, the Secretary also honoredClarence Sasser, a former VA employee who received theMedal of Honor for his courage under fire in Vietnam.

The exhibit honors more than 80 African Americanswho are among 3,400 recipients of the nation’s highest awardfor valor in action against an enemy force.

National CARES Commission Named, Begins Its WorkSciences University;

Dr. RichardMcCormick, former directorof mental health care withthe VA Health Care Systemof Ohio; Richard Pell Jr.,former VA chief of staff;Robert A. “Bob” Ray, formerAmerican Legion com-mander in Ohio; SisterPatricia Vandenberg, formerpresident and chief executiveofficer of Holy Cross HealthSystem in South Bend, Ind.;Raymond John Vogel, formerVA under secretary for ben-efits; Jo Ann K. Webb, direc-tor of federal relations for theAmerican Organization ofNurse Executives; Maj. Gen.Michael Wyrick, formerdeputy surgeon general, U.S.Air Force; and Al Zamberlan,former VA health care re-gional director.

Vogel will serve as vice-chairman of the commission,and Richard E. Larson, a 29-year federal executive, willserve as executive director.

Alaska Natives get qualityhealth care.

“VA and HHS are set-ting the stage for an ongoingcollaboration to provide opti-mal health care for morethan 165,000 American In-dian and Alaska Native veter-ans,” said Secretary Principi.“We are combining ourstrengths and expertise to im-prove health care for theseveterans, particularly to in-crease access and enhanceservices.”

While there have beenlocal efforts between VAhealth care facilities and In-dian Health Service clinics inthe past, this agreement will

VA Honors African-AmericanMedal of Honor Recipients

New Agreement Will ImproveCare For American Indian Vets

An exhibit honoring the more than 80 African Americans whohave received the Medal of Honor was unveiled in Washington,D.C., as part of VA’s observance of Black History Month.

ROBERT TURTIL

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March/April 2003 27

around headquarters

Secretary Honors VA Central Office Reservists, Guard Members

encourage more agency-widecooperation, affecting all In-dian nations.

“Our two departmentshave a history of working to-gether to care for America’sveterans and underservedcommunities,” said HHSSecretary Tommy Thomp-

son. “Under this new agree-ment, the Indian Health Ser-vice and VA will work to im-prove health care for ourAmerican Indian and AlaskaNative veterans by sharinginformation, developinghealth promotion programsand allowing for joint ap-

pointments, financial reim-bursements and provider cer-tification.”

The agreement will alsoimprove communication be-tween the agencies and tribalgovernments and create op-portunities to develop strate-gies for sharing information

and information technology.The technology sharing willinclude VA’s electronic medi-cal record system, bar codemedication administrationand telemedicine. VA andIHS will co-sponsor continu-ing medical training for theirhealth care staffs.

VA Central Office employeeswho serve in the NationalGuard and U.S. military re-

serve forces were honoredduring a Feb. 12 ceremonyin VA headquarters. The cer-

emony occurred during aweek in which the Depart-ment of Defense activatednearly 40,000 military reserv-ists in preparation for pos-sible war with Iraq.

Secretary Principi, alongwith the Pentagon’s ThomasF. Hall, Assistant Secretary ofDefense for Reserve Affairs,thanked the honorees fortheir service to veterans andcommitment to America.

“We are honored tocount men and women suchas you among our VA em-ployees,” Principi said. “Youcontinue the proud traditionof citizen-soldiers who standready to answer our nation’scall to defend Americaagainst those who seek toharm us.”

Assistant Secretary of Defense for Reserve Affairs Thomas F. Hall,center, joined Secretary Principi to honor VA Central Office em-ployees who serve in the National Guard and military reserveforces.

ROBERT TURTIL

Emergency Preparedness Officials Plan for Future Terror Attacks

He presented a com-memorative pin to the em-ployees and assured themthat if they are called to ac-tive military duty, their jobswill still be there when theyreturn. About half of the 115VA Central Office employeeswho serve in the reserves andNational Guard attended theceremony.

Nationwide, about15,000 VA employees are re-servists or Guard memberssubject to activation. TheSecretary encouraged VAfield facilities to hold similarevents locally.

A wealth of informationfor VA employees who arereservists or Guard membersis available at www.va.gov/ohrm/reservist.

Emergency preparedness ef-forts in Washington, D.C.,are a hot topic these days.Reporters from The Washing-ton Post and Federal Timescalled VA Central Office re-cently to interview officialsabout what they’ve done toprotect employees in theevent of future terrorist at-tacks.

“Sounds like you folksare very thorough,” said theFederal Times reporter as theinterview came to a close.“You bet we are,” respondedMick Kicklighter, AssistantSecretary for Policy, Planningand Preparedness, “because

we take this very seriously.”Serious was the tone as

officials from VA’s offices ofPolicy, Planning and Pre-paredness, Human Resourcesand Administration, andCyber Security came togetherfor the March 13 interview.“We’ve had emergency plansfor many, many years,” saidRobert Schultz, PrincipalDeputy Assistant Secretaryfor Human Resources andAdministration. “We used tofocus on evacuating thebuilding in case of a fire.Now the plan includes takingshelter in place.”

Shelter in place means

staying put if it’s unsafe to gooutside. To prepare for thatpossibility, officials havestockpiled enough medicalsupplies, food, drinking wa-ter, soap, toilet paper, andeven glow sticks, to allowemployees to remain in VACentral Office for up tothree or four days.

Approximately 4,000employees in seven or eightdifferent buildings make upwhat’s called the Washington,D.C., VA campus. Keepingthem informed with realtime, accurate information inthe event of an emergency isone focus of the VA head-

quarters emergency plan.Currently, a public ad-

dress system would be usedto alert employees to a terror-ist attack. But with mostworkers using desktop com-puters, another option maysoon be in place. “It’s calledCENS, Computer Emer-gency Notification System,”explained Kevin Hanretta,executive assistant in the Of-fice of Policy, Planning andPreparedness. CENS is asoftware application thatwould be installed on eachemployee’s computer.

In the event of a terror-Continued on page 28

VAnguardintroducing

28 March/April 2003

Hector Ocasio accomplishesmore before 9 a.m. thanmany people do all day. Heroutinely rises at 4 or 5 a.m.and completes onlinecoursework. He earned hisMBA in Health Care Man-agement online throughTouro University Interna-tional. He has made com-puter-based learning a habit.

A supply technician atthe Ponce, Puerto Rico, VAOutpatient Clinic, Ocasiogot special recognition fromSecretary Anthony J. Principirecently when he received anaward for completing moreVA Learning Online (VALO)courses than any other em-ployee since the programwent national.

Ocasio puts the honorof receiving his OutstandingScholar Award on a par withthe pride he felt whenawarded the Combat Infan-try Badge for his Army ser-vice during the Gulf War. “It

was surreal,” he said of histrip to Washington, D.C., onJan. 29. He spoke with theSecretary and made remarksto the audience. “I was float-ing,” he recalled. “I hadgoose bumps.”

Ocasio didn’t begin tak-ing online courses for recog-nition, but for personalgrowth. “You do things be-cause you think that’s theright way. It doesn’t makeyou deserving of an award,”he insisted.

Dedication to doingthings “the right way” hashelped him progress withinVA from his beginnings as astudent intern at the SanJuan VA Medical Center in1993, to his current position.Professional mentors taughthim that education providesthe edge in seeking promo-tions. He would like to usehis recently acquired gradu-ate degree and the skills helearned through VALO to

further his VA career inhealth care management oracquisitions and contracting.

In pursuit of his goals,Ocasio’s enthusiasm foronline coursework has con-tinued unabated since hisaward. He has completed 12courses since the ceremony,bringing to 40 the numberhe has taken since September2002.

“I highly recommendit,” he said. “Employees atMicrosoft and other big cor-porations are taking the samecourses and [VA employees]get them for free.” Thecourses offer something forthose with all career pathsand interests. Because VALOcourse design integrates au-dio and visual elements, itscourses are more interactivethan online alternatives andshould appeal to people withmany learning styles.

Courses facilitate self-de-velopment and professional

advancement, according tothis award-winning VA em-ployee. They are availableonline at www.vcampus.com/valo, 24 hours a day, 7 days aweek. “Learning is there totake. Just get on and try it—it’s good!” he said. So insteadof counting sheep the nexttime you can’t sleep, followHector Ocasio’s lead and be-gin advancing your career forfree, from home, and in yourspare time through VALearning Online.By Andrea Strobel

Hector Ocasio

Ocasio

ist attack, the headquartersCrisis Response Team woulduse the system to send a pop-up message to the computerof each employee. “It puts anemergency screen right upfront on their desktop andallows us to type in the exactnature of the threat,” saidHanretta.

Part of being preparedmeans knowing how to re-spond should the Office ofHomeland Security raise thenational threat level. “We re-view our plan several times aweek to make sure we knowwhat the threat is and wherewe stand in terms of beingprepared,” said Kicklighter.

As part of that plan, VAissued guidelines for indi-

viduals, families and manag-ers recommending specificactions based on the threatlevel. With the current threatlevel at code orange—denot-ing a high risk of terrorist at-tacks—the guide recom-mends exercising cautionwhen traveling, reviewingyour personal disaster plan,donating blood if a need isannounced, and observing allprecautions listed underlesser threat levels, such asconfirming personal emer-gency telephone numbers,practicing alternate routes toand from work, and watch-ing for strangers or unusualactivity.

Don’t have a personaldisaster plan? It’s not too lateto start one. Dorothy R.

Hartung, a health systemspecialist in VA’s Office ofPublic Health and Environ-mental Hazards, wanted tomake sure everyone in heroffice knew how to respondto an emergency. In theweeks after 9/11, she askedsupervisor Dr. Susan Matherif she could prepare a bro-chure outlining what to doin the event of another terrorattack. Mather agreed andHartung went about seekinginput for the brochure. “Itwas the right thing to do atthe right time,” she said.

Though it was originallyintended for her office, wordof the brochure spreadquickly. She started gettingphone calls and e-mail mes-sages from people across the

country asking for copies ofthe brochure. The Washing-ton, D.C., Board of Educa-tion asked for copies; so didthe Smithsonian’s NationalPortrait Gallery and the U.S.Postal Service.

The tri-fold brochurewas ultimately adopted bythe VA Crisis Response Teamand called the Family Emer-gency Plan for VA Employ-ees. “I think people like itbecause it’s so simple, every-one can understand it and it’snot intimidating,” saidHartung. To download acopy, visit the VA IntranetWeb site atvaww.vhaco.va.gov/pubhealth/terror.htm and click on per-sonal emergency prepared-ness.

Continued from page 27

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March/April 2003 29

medical advances

Ephedra Should beRestricted or BannedUse of the popular diet andbodybuilding supplementephedra should be restrictedor banned, concluded re-searchers at the San FranciscoVA Medical Center in astudy published in the March18 issue of the Annals of In-ternal Medicine. They foundthe risk of an adverse reac-tion to ephedra is 200 timesgreater than all other herbalsupplements combined.

“It comes down to arisk-benefit ratio,” lead au-thor Stephen Bent, M.D., astaff physician at the SanFrancisco VA Medical Cen-ter, told the Newark (NJ)Star-Ledger. “The benefits forephedra are not at all well es-tablished. It is a minimalbenefit that goes away whenyou stop using the product.And the risks are really sub-stantial.”

Ephedra has been linkedto high blood pressure, ir-regular heartbeat, stroke, sei-zure and nearly 100 deaths.

In February, a supplementcontaining ephedra was asso-ciated with the death of 23-year-old Baltimore Oriolespitcher Steve Bechler, whodied of heatstroke after col-lapsing during a workout attraining camp.

Bent and colleagues ana-lyzed data from the Ameri-can Association of PoisonControl Centers and foundproducts containing ephedrawere responsible for 62 per-cent of adverse reactionsamong all herbal-related inci-dents in 2001. During thatsame period, these productsaccounted for less than 1 per-cent of total herbal supple-ment sales in the U.S.

Senior study authorMichael Shlipak, M.D., aresident at the San FranciscoVAMC, said ephedra is un-safe for routine and unsuper-vised use. It has been bannedby the National FootballLeague and the InternationalOlympic Committee, amongothers.

HIV Drugs Not CausingRise in Vascular DiseasePotent HIV drugs are notcausing a rise in cardiovascu-lar and cerebrovascular prob-lems, reported researchers atthe VA San Diego HealthCare System in the Feb. 20issue of the New EnglandJournal of Medicine.

Researchers studied theoutcomes of 36,766 patientstreated for HIV in the VAhealth care system from 1993to 2001. They found a steadydecline in the rate of deathsand hospital stays due to vas-cular disease, even as the useof highly active antiretroviraltherapy (HAART) increased.The finding may reassuredoctors and patients who seebenefits from HAART butworry about vascular compli-cations as a side effect.

The study also found a75 percent drop in the over-all death rate among VA’sHIV patients between 1993and 2001, consistent withother evidence thatHAART—which becameavailable in 1996 and wasquickly adopted by VA prac-titioners—may prolong sur-vival. “Fears about vasculardisease as a side effect ofthese drugs shouldn’t keeppatients and their doctorsfrom using the best treat-ments available, consistentwith guidelines,” said studyleader Samuel A. Bozzette,M.D., Ph.D., an infectiousdisease specialist with the VASan Diego Health Care Sys-tem, University of California,San Diego, and the RANDCorporation.

Though the study is thelargest of its kind to date, itanalyzed data only from aneight-year span and may notreflect the rate of serious vas-cular disease with longer-term use of HAART.

Multiple Sclerosis Cen-ters will Improve Care,Promote ResearchVA will establish two newcenters to improve care andpromote research into mul-tiple sclerosis, a chronic neu-rological disease. The twocenters will be located at theBaltimore VA Medical Cen-ter and jointly at the Port-land and Seattle VAMCs.

Each center will conductresearch covering basic bio-medicine, rehabilitation,health services delivery andclinical trials. They also willcoordinate activities of exist-ing programs for MS patientsat other VA sites. The centerswill facilitate access to carefor veterans regardless oftheir location through ad-vances in telemedicine.

“Taking advantage of

VA’s strengths as a system ofmedical facilities linkedthrough technology with su-perb academic affiliationswill result in significantprogress toward an under-standing of MS,” said Dr.Robert Roswell, VA UnderSecretary for Health. MS af-fects 350,000 Americans,22,000 of whom are veteransenrolled in VA’s health caresystem.

Detroit VA ResearcherPatents Protein toBlock CancerAdhip Majumdar, Ph.D., aresearch scientist at the JohnD. Dingell VAMC in Detroitand Wayne State University,received two patents and ex-pects a third that offer newprotein-therapy and gene-therapy options for cancer.He also has discovered aprognostic marker for cancerprogression.

Majumdar has focusedhis research on aging and theincrease in gastrointestinal(GI) cancer. He is particu-larly interested in a receptorwith demonstrated connec-tions to cell proliferation andcancer called the epidermalgrowth factor receptor. Hehypothesized that blockingthe epidermal growth factorreceptor might help halt thespread of GI cancers.

By cloning a small pro-tein associated with agingcells, he produced epidermalgrowth factor receptor-re-lated protein, or ERRP. In-serting the protein’s cDNAinto colon cancer, breast can-cer and prostate cancer cellssignificantly inhibited theirgrowth. Majumdar and histeam are currently attempt-ing to determine whetherputting ERRP into a cancer-ous tumor would cut thereceptor’s activity and stopthe cancer from spreading.

ROBERT TURTIL

Ephedra has been linked to nearly 100deaths.

VAnguardhave you heard

30 March/April 2003

A Seat at the Table

Julie Gough, second from left, was one of four fans of the ABCdaytime show “The View” picked to appear on a special FanDay episode with hosts Meredith Viera, third from left, and JoyBehar, third from right.

COURTESY OF JULIE GOUGH

Millions of Americans watching ABC’s daytime show “TheView” on Feb. 4 saw lucky fan Julie Gough take a seat atthe table with hosts Meredith Viera, Star Jones and JoyBehar. Gough, a program analyst in the Office of Policyand Planning in VA Central Office, was one of four fansselected to appear on the special Fan Day episode.

Her road to “The View” began in October when sheentered a contest to take the place of host BarbaraWalters for a day. Though she wasn’t selected, the pro-ducers invited her back for the Fan Day episode. Shehosted a couple of segments, discussed some of her fa-vorite products, and won a trivia contest based on herknowledge of the show. “I had the best time and won atrip to Disney World,” she said.

The VA North Texas Health Care System held a Valentine’sDay ceremony honoring 22 employees who are military re-servists and National Guard members. Cong. SamJohnson (R-Texas), who had just marked the 30th anniver-sary of his release from a Hanoi prison cell, Cong. MartinFrost (D-Texas), and retired military brass were on hand togreet the honorees and thank them for their service.

A poster listing the names of seven employees whohad already been deployed was displayed at the cer-emony, and will remain in the Dallas VA Medical Centerchapel until all of the deployed employees have returned.Yellow ribbons holding individual name cards for each de-ployed employee have also been placed in the atrium, andwill be removed only after each has returned. The localtribute was in keeping with the example set by SecretaryPrincipi two days earlier when he honored headquartersemployees who are reservists and Guard members.

Employees from the VACentral California HealthCare System joined severalcommunity organizationsand businesses to help raisemoney for the United Wayby pulling a Boeing 727 jet.The inaugural event pittedteams of 25 members againstthe clock in an attempt topull the 86,000-pound jet adistance of 12 feet. Al Perry,director of the health caresystem, and his team placed aclose second in the standings.But VA won the day by plac-ing first in participation foryielding two full teams and

raising the most money,$8,000. Organizers are an-ticipating more than 30teams for next year’s compe-tition.

A new 292-acre nationalcemetery is coming to Wash-ington County, Pa., nearPittsburgh. A local architec-tural and engineering firm,Marshall-Tyler-Rausch, is de-veloping a master plan forthe facility’s design and VAhopes to award a construc-tion contract in early 2004.Plans call for a small portionof the cemetery to open for

burials in late 2004. About19,000 grave spaces will beavailable when the first phaseof construction is completedin 2006. VA’s 2003 budgetincludes $16 million to buildthe cemetery.

Two VA employees weredirectly affected by the lossof the space shuttle Colum-bia on Feb. 1. Former astro-naut Dr. Millie Hughes-Fulford, director of theLaboratory of Cell Growth atthe San Francisco VA Medi-

cal Center, and her teamspent a week with astronautsand technicians at theKennedy Space Center priorto the Columbia’s launch.They directed the crewthrough a series of experi-ments designed to study theeffects of microgravity at thecellular level. Following thedisaster, NASA called JimBagian, also a former astro-naut, now director of VA’sNational Center for PatientSafety, to help with the in-vestigation.

Cong. Sam Johnson greets Tonia Hatchett, chaplain and AirForce reservist, as (from left) Cong. Martin Frost, Director AlanHarper, and Mrs. Johnson look on.

The ‘Stars’ Fall on Dallas

NANCY GRAY

VAnguard honors and awards

March/April 2003 31

Tuning in to the Veteran

The National Associa-tion of Clinical Nurse Spe-cialists named Ann M.Busch,R.N., ofthe Port-land,Ore., VAMedicalCenter,ClinicalNurseSpecialistof theYear. Busch, who has beenwith the medical center’sLiver Transplant Program forseven years, is the first recipi-ent of this award. In her rolewith the transplant team, sheleads clinical rounds, pro-vides follow-up informationto referring physicians, re-searches how to manage re-sources more effectively, andhelps train physicians andnurses in the clinical care oftransplant patients.

The SoutheasternMichigan Society of Health-System Pharmacists pre-sented their Innovative Prac-tice Award to Mary E.Burkhardt, a program man-ager for the VA NationalCenter for Patient Safety inAnn Arbor, Mich. She wasrecognized for being one ofthe first pharmacists in thenation to work on patientsafety issues full time.Burkhardt has worked withthe American Society ofHealth-System Pharmacistsdesigning an educationalmodule for medication safetyofficer training and develop-ing medication safety learn-ing sessions for their nationalmeetings.

Morris Weinberger,Ph.D., a nationally notedhealth-services researcherwith the Durham, N.C., VAMedical Center and the Uni-

versity of North Carolina,Chapel Hill, received VA’s2003 Under Secretary’sAward for OutstandingAchievement in Health Ser-vices Research. The award,VA’s highest honor for inves-tigators in this field, was pre-sented Feb. 13 at the VAhealth services research na-tional meeting in Washing-ton, D.C. A medical sociolo-gist, Weinberger has con-ducted numerous studiesaimed at improving care forchronic health conditions.

Fred H. Rodriguez Jr.,M.D., director of Pathologyand Laboratory Medicine atthe New Orleans VA Medi-cal Center, was named secre-tary of the American Societyfor Clinical Pathology(ASCP). ASCP is the largestorganization for pathologyand laboratory medicine inthe world.

Gregory T. Howard, alicensed practical nurse at theTuscaloosa, Ala., VA MedicalCenter, was elected presidentof the National Federation ofLicensed Practical Nurses.He is only the second man toserve as president in theorganization’s 54-year history.

VA Deputy SecretaryLeo S. Mackay Jr., Ph.D.,presented the first Secretary’sGroup Award for ExceptionalAccomplishments to theCleveland VA RegionalOffice’s “Tiger Team” dur-ing a Jan. 31 ceremony. Theteam was recognized for pro-cessing more than 21,000disability claims from veter-ans age 70 and older. Mostof the claims had been pend-ing for more than a year.Their efforts reduced the na-tional backlog of such claimsby more than 50 percentduring a 15-month period.

At the ceremony, Mackaypresented team leader PhillipJ. (Jack) Ross, director of theCleveland VARO, with theExemplary Service Award.

The Federal Library andInformation Center Com-mittee named the library atthe James A. Haley Veterans’Hospital in Tampa as thesmall federal library of theyear. The Tampa library hasbeen a nationally recognizedleader in the field of patienteducation for many years,thanks to the dedicated ef-forts of Library Chief NancyBernal and the library staff.

The International Per-sonnel Management Associa-tion appointed Marisa W.Palkuti, director of HumanResources Development Ser-vice in VA Central Office, tothe Publications AdvisoryBoard for Public PersonnelManagement. Theassociation’s professionaljournal is published quarterlyfor human resources manag-ers and executives in thepublic sector. Members ofthe board review articles sub-mitted for publication andsuggest future story topics.

Kenneth A. La Faso,principal senior attorney inthe Los Angeles RegionalCounsel office received the2002 Distinguished ServiceAward from the Departmentof Justice, United StatesAttorney’s Office for theCentral District of Califor-nia. He is the first federalagency civil attorney to re-ceive the award in that dis-trict. La Faso was recognizedfor providing excellent writ-ten legal work, witness inter-views, medical records re-views, and other litigation as-sistance to the U.S.Attorney’s office.

Dr. Irene Trowell-Har-ris, director of the VA Centerfor Women Veterans, re-ceived the third annual JamesD. Weaver Society Awardduring the Association ofMilitary Surgeons of theUnited States 108th annualconference in Louisville, Ky.,Nov. 11, 2002. A retired AirForce/Air National Guardmajor general, Trowell-Harriswas recognized for her distin-guished military career. Theaward is named for a formerPennsylvania congressmanand Air National Guard sur-geon.

VA presented the “En-terprising Veteran” award toJames E. Jardon II, presidentand chief executive of Jardon

&HowardTech-nologies,Inc.,head-quar-tered inOrlando,Fla., dur-ing a

Feb. 14 ceremony in VACentral Office. The companyearned more than $40 mil-lion in 2002 and employsmore than 700 people.

Two VA experts wereappointed to an advisorycommittee for an interna-tional symposium on the dia-betic foot. David G.Armstrong, director of po-diatry research at the South-ern Arizona VA Health CareSystem, and Benjamin A.Lipsky, director of the Gen-eral Internal Medicine Clinicat the Seattle VA MedicalCenter, are the only Ameri-cans on the eight-membercommittee. The symposiumis scheduled for May 22-24in the Netherlands.

Busch

Jardon

VAnguardheroes

32 March/April 2003

Plans for a relaxing Sat-urday afternoon outing at ago-cart track quickly changedwhen Minneapolis VA Medi-cal Center Medical SupportAssistant Erica Gysland ob-

served acrowdstandingaround afallenman whodidn’t ap-pear tobebreath-

ing. Although none of theother bystanders attemptedto help, Gysland and anotherpatron performed CPR untilthe ambulance arrived. Twoweeks later, Gysland was in-vited to meet the man shehad saved. Flanked by thevictim’s daughter and his car-diologist, Gysland was in-formed that without her as-sistance, the man would al-most certainly have died.

Terry A. Ducote Sr., a20-year veteran of the Louisi-ana National Guard and vol-unteer at the Alexandria, La.,VA Medical Center, wasmaking his rounds on the 2nd

floor last fall when he cameupon an elderly patient inthe hallway who was chok-ing, gasping for breath andabout to pass out. Ducoteimmediately performed theHeimlich maneuver and suc-cessfully cleared the patient’sairway.

Reuben G. Pinkson,area emergency manager atthe Oklahoma City VAMedical Center, was drivinghome after a Saturday roundof golf with some friendswhen he saw a small DodgeNeon whiz through a stopsign and collide with apickup truck. The occupantsof the Neon, a mother and

daughter, were ejected fromthe vehicle. Pinkson de-scribed it as a “horrible”sight. For 30 minutes, he andhis friend attempted to resus-citate the victims. Whenemergency personnel arrived,the mother was declareddead. Her daughter died laterduring surgery. “These wereneedless deaths,” wrotePinkson in an e-mail describ-ing the incident. He offeredthis lesson learned: “Pleasebuckle up and live life to thefullest!”

Fred Contreras, a nursepractitioner at the VA SantaRosa (Calif.) Community-Based Outpatient Clinic,was driving home from workwhen he witnessed a head-oncollision involving three carsand six victims, includingtwo young children. Herushed to the scene andpulled a 3-year-old childfrom the wreckage. He beganto triage the victims and di-rected paramedics to thosewith the most serious injurieswhile continuing to care for a7-year-old girl who was inshock.

Vietnam veteran FrankDekle couldn’t believe hiseyes when he read a HonoluluAdvertiser story suggesting re-mains found in Laos mightbelong to Jack C. Rittichier,a Coast Guard pilot whose“Jolly Green Giant” helicop-ter was shot down during arescue mission over Laos in1968. For the past 13 years,Dekle, who also served in theCoast Guard, has worn anMIA bracelet inscribed withRittichier’s name. The news-paper story announced aValentine’s Day repatriationceremony open to the publicat Hickam Air Force Base inHawaii. Dekle wanted to at-tend, but has limited mobil-

ity after suffering a stroketwo years ago. He is cur-rently in rehabilitation at theSpark M. Matsunaga VACenter for Aging in Hono-lulu. When Assistant Direc-tor James Carilli and fouremployees, including a nursefrom the Center for Aging,heard about the ceremony,they got a van with a speciallift and made other arrange-ments so Dekle could attend.Their efforts gave him an ex-perience he said he’d neverforget. Dekle plans to retirehis bracelet and return it toRittichier’s family if the re-mains are positively identi-fied as his.

VA Police Officer MarcLafeniere and Agent CashierGloria Johnson came to theaid of a jogger who got hitby a car on the street outsidethe Manchester, N.H., VAMedical Center on themorning of Dec. 13. As theyinitiated first aid, SusanGeorge, R.N., stopped to as-sist. Officer Lafeniere asked abystander to get help from anearby fire station andstarted directing traffic awayfrom the scene. Johnson andGeorge continued to providefirst aid until paramedics ar-rived to take the victim to alocal hospital.

VA Hudson ValleyHealth Care System PoliceOfficer Josie Graham hadjust gotten off duty at theMontrose campus on themorning of Dec. 18 and wastraveling up Route 9 whenshe came upon the scene of amotor vehicle accident. Of-ficer Graham called the VAPolice, who contacted theState Police for assistance andan ambulance. Officer Gra-ham remained at the scene ofthe accident, set up flares andassisted with vehicle traffic

until local police and EMSpersonnel arrived.

Sue Harris, decision re-view officer at the Mont-gomery, Ala., VA RegionalOffice, made one Vietnamveteran very happy. JohnMiles filed a disability claimback in 1969, which was de-nied. He reopened it in1975, 1990, 1994, 1997 andagain in 2001, but the deni-als continued. Harris took agood hard look at his claimand found that he clearlyshould not have been deniedservice-connection for hisdisability. Thanks to herdedication, Miles finally re-ceived his long overdue ben-efits.

While taking a break onthe morning of Dec. 5,Housekeeping Aid BobbyShaw of the Dorn VA Medi-cal Center in Columbia,S.C., no-ticed apatientweavingas hewalkedthegrounds.Shawwasabout toask the veteran if he neededassistance when the man fellto the ground and beganturning blue. Using his CPRtraining, Shaw quickly placedthe man on his back, el-evated his head and checkedfor breathing and a pulse.Finding none, he began CPRwhile another veteran raninto the hospital for help. Bythe time medical staff ar-rived, the victim had re-gained a pulse. Sadly, despiteShaw’s heroic efforts, thepatient’s condition was toocritical and he could not besaved.

Gysland

Shaw