VAnguard

Inside: 2003 Budget Proposal, 4 ✩ National Shrine Commitment, 7 ✩ VA in Manila, 8

U.S. DEPARTMENT OF VETERANS AFFAIRS

MARCH 2002

Olympic Support page 10

2 VAnguard

INTRODUCINGTom Iverson

CCCCCONTENTSONTENTSONTENTSONTENTSONTENTS

CCCCCOLUMNSOLUMNSOLUMNSOLUMNSOLUMNS 17-20

VAnguardVA’s Employee Magazine

March 2002Vol. XLVIII, No. 2

Printed on 50% recycled paper

Editor: Lisa RespessEditorial Assistant: Matt Bristol

Photo Editor: Robert Turtil

Published by theOffice 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

❏ 2003 Budget Proposal 4President requests record increase for VA

❏ CARES Update 5VISN 12 facilities to be realigned

❏ Gulf War Illnesses 6VA/DoD study links ALS, Gulf service

❏ Shrine Commitment 7NCA making progress on initiative

❏ VA’s Manila Office 8Serving veterans in the Philippines

❏ 2002 Winter Olympics 10VA employees lend their support

❏ Job Shadowing 15Students get up-close look at VACO jobs

On the cover: The Salt Lake City VA MedicalCenter is located just across thestreet from Olympic Stadium forthe 2002 Winter Games. Employ-ees from the medical center andregional office took on a varietyof volunteer assignments to helptheir community host the firstWinter Olympics held in the U.S.since 1980. Photo by Tod Peterson

If you spot the vintage 1942 U.S.Army ambulance cruising the streetsof Reno, Nev., you can bet TomIverson is behind the wheel.

As Voluntary Service assistant inthe VA Sierra Nevada Health CareSystem and curator of their MilitaryHeritage Museum, Iverson takes theVA message to the streets by drivingthe ambu-lance inparades,ceremoniesand othercommunityevents.

At eachstop he talkswith curiousonlookersabout thesacrifices ofAmerica’sveterans andthe role VAplays in theirtransitionfrom mili-tary tocivilian life.“He’s theface of VA inthe commu-nity,” saidLisaHoward, theVA SierraNevadapublic affairsofficer.

Serving in the military was hisfamily’s “patriotic duty,” Iversonexplained, and he joined right out ofhigh school, just as his brother andfather had done before him. Hetrained as a helicopter crew chief andserved in Vietnam with the 173rd

Airborne Brigade from 1969 to 1970.He went on to serve 20 years in theArmy, retiring in 1988. He joined VAfull-time in 1994, after completing atwo-year work/study program.

The ambulance was donated tothe medical center by the mother of a

veteran who restored militaryvehicles, and volunteer Rex Scollardgot it into showroom condition.

Last year, Iverson drove theambulance in about seven commu-nity events, including the ArmedForces Day parade and a hometownChristmas parade. He’s displayed itat the state fair, at a conference of

emergencymedicaltechnicians,and at alocal highschool onCareer Day. Thereactions ofsomecommunitymembershave beensurprising.“I found alot of peopledidn’t evenknow therewas a VAhospital herein Reno,”Iverson said.“I try toencouragethem,especiallythe Vietnamveterans, tocome backand checkout the VA.

They didn’t get a warm receptionback in the ’70s, but a lot haschanged since then.”

In this photo, taken by volunteerCharles “Bud” Lemmond, Iversonlooks the part, wearing a crisp WorldWar II-era uniform and chewing onan old stogie as he flips through thepages of a 1940s YANK magazine. Hehas a similar photo of his father, whoserved in the Army Air Corps duringWorld War II. ❏

By Matt Bristol

March 2002 3

OutlookJohn Hancock, Director,Office of OccupationalSafety/Health andWorkers’ Compensation

Get Involved in PreventingViolence in the Workplace

Violence inAmerica hasreached epi-demic propor-tions, accordingto recentreports ofworkplacemonitoringorganizations.News reports

all too frequently confirm this as theydetail violent workplace episodes.

Yet these dramatic events thatseize national and local headlines areonly a small part of what we experi-ence day-to-day. The majority ofviolent and aggressive incidents arenot fatal assaults, but everydayoccurrences of rude and aggressivebehaviors—intimidation, verbalthreats, harassment, and physicalabuse—that undermine effectiveservice.

The tragedy of these subtle, andsometimes not so subtle, incidents isthat they often go unreported, andtherefore unresolved.Regrettably, these actsof workplace violenceare often accepted asroutine events andconsidered “part of thejob.” This informalculture of violence tolerance forms abase on which progressively aggres-sive and violent behaviors maybuild. Self-esteem, morale, andservice can be diminished as a result.

In recognition of the need formore active effort to reduce work-place violence and to obtain andshare knowledge, the VeteransHealth Administration (VHA)assembled a team of experts andprofessionals with specializedknowledge and trained as “Preven-tion and Management of DisruptiveBehavior” (PMDB) Master Trainers.These experts provide excellent state-of-the-art program assistance for anyVA organization. PMDB contacts arelisted on the VA Office of Safety andHealth violence prevention Web site,

vaww.va.gov/vasafety, under “ViolentBehavior Prevention.”

In developing prevention pro-grams, VHA is taking the additionalleadership step of sponsoring anational violence prevention “standdown” satellite broadcast this year.As part of the VHA stand down, theVeterans Benefits Administration(VBA), National Cemetery Adminis-tration (NCA) and all VA CentralOffice (VACO) organizations will beable to share valuable informationfor developing and maintainingeffective violence prevention pro-grams.

It is important that factors thatcontribute to workplace violence berecognized and defined, and thatsystems are in place to measure andquantify the costs and consequencesof aggressive and violent behaviorsso that programs can be developed toreduce and prevent them.

We must expand our concept ofviolence prevention to embrace acollaborative approach that includes

the whole work environment.Adopting proactive methods in-creases possible intervention options.Our goal is to help employees andmanagers understand the humanand business value of reducingworkplace stress, aggression andviolence by linking interventions toorganizational performance.

Our research shows that an“empowered” work climate isstrongly associated with lower stressand aggression and higher employeesatisfaction. “Work climate” refers tothe way work processes are struc-tured and managed, and deals withissues such as scheduling work(work-rest schedules, hours of workand shift work), job design (complex-ity of tasks, degree of worker con-

trol), interpersonal aspects of work(relationships with supervisors andco-workers), management style(autocratic, participatory manage-ment, teamwork), and organizationalcharacteristics (culture, communica-tions).

Effective strategies for conductingwork organization interventions toimprove work climate need to bedeveloped. Intervention research is anew and multidisciplinary field thathas not been traditionally applied toemployee safety and health research.We are participating in studies of VAorganizations with VA and privatesector partners to identify effectiveviolence intervention strategies. I amparticularly encouraged by thesupport and participation we havereceived from our partners in VBAand NCA.

Secretary Principi clearly stated inhis Oct. 19, 2001, letter to all employ-ees that violence in the VA work-place will not be tolerated and thathe expects more to be done to reduce

violence in VA.Violence preven-tion must be acollaboration ofmanagers, employ-ees and theirrepresentatives,

and veterans and their representa-tives. These groups need each other’ssupport to foster an understandingof the causes of aggression andviolence, establish firm parameters ofacceptable behavior, and take part inproviding interventions tailored toaddress the root cause of violence foreach workplace. Every personworking in, being served by, orvisiting VA facilities deserves to betreated fairly and equitably, withdignity and respect.

I will continue to reach out toorganizations and individuals whowant to form these partnerships toenhance our ability to serve veteransand I encourage you to participate inyour organization’s violence preven-tion activities. ❏

We must expand our concept of violence prevention

to embrace a collaborative approach that includes

the whole work environment.

4 VAnguard

President Bush is seeking a $58billion budget for VA in fiscal year2003, an increase of $6.1 billion overthis year’s budget. If approved byCongress, this funding increasewould be the largest ever for VA.The new budget also would give VAthe largest increase in health carespending in history—an 8.2 percenthike.

VA Secretary Anthony J. Principisaid the proposed budget furthersthe Department’s three highestpriorities—improving the timelinessand accuracy of claims processing,ensuring that veterans receive high-quality health care, and meeting theirburial needs while maintaining VA’scemeteries as national shrines.

The budget requests $25.5 billionfor medical programs, a $2.7 billionincrease; $31.5 billion for veterans’benefits programs, a $3.4 billionincrease; and $138 million to operatethe national cemetery system, a $17million increase. It also includes thelargest request for capital programs(construction and grants) since 1996,totaling $537 million.

Significant new initiatives in thebudget include:

� $892 million to fund certainfederal retiree benefits as proposedby the Administration’s ManagerialFlexibility Act of 2001;

� $179 million for a new competi-tive grant program replacing pro-grams currently administered by theDepartment of Labor that helpcreate, expand or improve employ-ment and training programs forveterans; and

� an annual $1,500 medical care

Two VA Health Care Networks Merge

President Seeks Record VA Budget Increasedeductible for higher-income, nonservice-connected veterans.

Why the need for such a largeincrease in health care funding? VAhas experienced unprecedentedgrowth in enrollment for health care.In 1995, 2.9 million veterans wereenrolled; by 2001, that number hadjumped to 6 million.

Open enrollment since 1996 hasresulted in particular increases in thenumber of higher-income,nonservice-connected veterans(Priority 7s) coming to VA for care.Thirty-three percent of total enrolleescurrently fall into this group, andthat number is expected to leap to 42percent by 2010 with no policychange.

New congressional mandatessuch as emergency care, mentalhealth, long-term care andCHAMPVA for Life are othercontributing factors to the need formore funding, as are the aging of theveteran population and increasedcosts for pharmaceuticals and healthcare in general.

The president’s proposed budgetalso supports a VBA workforce of13,139, 125 over the current level,and establishing new nationalcemeteries near Miami, Pittsburgh,Detroit and Sacramento. ❏

Secretary Anthony J. Principi testifies at a House Veterans Affairs Committee hearing on theFY 2003 budget proposal. With him are, from left, Acting Under Secretary for Health Dr.Frances Murphy, Principal Deputy Assistant Secretary for Management Mark Catlett, andActing Under Secretary for Benefits Guy McMichael.

In the first major change to theVeterans Health Administration(VHA)’s health care network struc-ture since it was set up in 1995, twoof the 22 Veterans Integrated ServiceNetworks (VISNs) are merging.

VISN 13, headquartered inMinneapolis, oversees VA facilitiesin Minnesota, North Dakota andSouth Dakota. VISN 14, headquar-tered in Lincoln, Neb., manages VA’shealth care resources in Iowa andNebraska.

The move is being made toincrease efficiencies and redirectresources to patient care, accordingto VA Secretary Anthony J. Principi.He pointed out that VISN 14 servesfewer veterans than any of the 22networks, and VISN 13 serves thethird fewest. The combined network,called VISN 23, will still rank as theeighth smallest among the 21 remain-ing networks.

Putting the two VISNs under onemanagement structure will result ina single, large operating budget thatwill create efficiencies by reducingoverhead costs and eliminatingduplicative services. No facilities areslated to be closed under this merger.

Principi named VISN 13 DirectorRobert Petzel, M.D., to serve asinterim director for the new network.He’s been charged with developingan integration strategy. A joint VISN13/14 advisory committee willmanage the merger.

Discussions with groups affectedby the merger, including employeeunions and veterans service organi-zations, will be a part of the integra-tion process. Though the number ofemployees affected by this mergerhas not yet been determined, it isexpected to be small. The consoli-dated VISN office will be located inMinneapolis. ❏

March 2002 5

Secretary Anthony J. Principiannounced last month that hedecided to approve the VA healthcare delivery changes for VISN 12(Chicago) recommended to him lastsummer in the first phase of theCapital Asset Realignment forEnhanced Services (CARES) process.

For the Southern Market, whichencompasses the Chicago area, theSecretary approved shifting inpatientservices from the Lakeside Divisionof the VA Chicago HealthcareSystem to its West Side Division. Alarge, multi-specialty outpatientclinic will be maintained at Lakeside,and West Side will be remodeled.The Lakeside property will be madeavailable for other government andcommercial uses.

The Hines VA Hospital will berenovated, including the BlindRehabilitation and Spinal CordInjury Centers. Sharing opportunitiesbetween the North Chicago VAMedical Center and the adjacentNaval Hospital Great Lakes will beenhanced.

In the Central Market (Wiscon-sin), 75 nursing-home beds will betransferred from the Tomah VAMedical Center to the Madison VA

Medical Center, bringing it to fullcapacity. The Tomah and MilwaukeeVA Medical Centers will be reno-vated, and both facilities will retaintheir current missions.

Milwaukee also will continue tosupply spinal cord injury services. Inaddition, three community-basedoutpatient clinics are recommendedin Green Bay and Wisconsin Rapids,Wis., and Freeport, Ill.

In the Upper Peninsula of Michi-gan (Northern Market), the IronMountain VA Medical Center will berenovated and will continue as anactive facility and telemedicine hub.A new community-based outpatientclinic is recommended for DeltaCounty.

The Secretary’s decision followeda 60-day public comment period onthese three options, during whichmore than 13,000 comments fromveterans, veterans service organiza-tions, VA employees, Congress andother interested parties were re-ceived. Comments were reviewed bythe National CARES Steering Com-mittee before final recommendationswere presented to the Under Secre-tary for Health, and then to theSecretary for the final decision. In

light of the Sept. 11 terrorist attacks,a reassessment of VISN 12’s capabil-ity to meet its Defense Departmentcontingency role under these optionsalso was conducted before the finaldecision was made.

VA Deputy Secretary Leo S.Mackay Jr., Ph.D., traveled to Chi-cago on Feb. 8 to announce Principi’sdecision to VISN 12 employees, localveterans, interested communitymembers, and local media. He toldthe groups that every effort will bemade to minimize the impact ofthese changes on employees andpatients.

VISN 12 will develop implemen-tation plans for the changes, whichwill be phased in over a period ofseveral years. Because the changeswill be gradual, staff reductions areexpected to be accomplished mainlythrough attrition, early retirements,reassignments to programs whereservices are being enhanced, andreassignments to other locations.Reductions in force will be a lastresort.

CARES studies will be conductedthroughout the VA health caresystem. The process is expected to becompleted in two years. ❏

The Center for Veter-ans Enterprise paidtribute to those whopromote business owner-ship opportunities forveterans during a cer-emony held in VA CentralOffice on Feb. 14, exactlya year after the center’sofficial dedication as partof the VA Office of Small& Disadvantaged Busi-ness Utilization.

Among those honoredwere several employeeswho provided support forthe center during itsfounding. Jack Hackett,from VBA’s VocationalRehabilitation and Em-ployment Service; TomPamperin, of VBA’s Compensationand Pension Service; and FranHeimrich, with the VA Office ofPublic Affairs, each received achieve-

ment awards from Deputy SecretaryLeo S. Mackay Jr., Ph.D., and Scott F.Denniston, director of the VA Officeof Small & Disadvantaged Business

Utilization. Also honoredwere representatives fromthe U.S. Air Force, theAssociation of Govern-ment Marketing Assis-tance Specialists, and theDefense ContractingAgency. Ben Reyes, owner ofIron Eagle EnvironmentalServices, received the firstEnterprising Veteran’sAward. A service-con-nected disabled veteran,Reyes contacted the centerfollowing the Sept. 11terrorist attacks to volun-teer his firm’s environ-mental clean-up services.He is also a volunteer onthe Northport New York

Indian Veterans Outreach Counciland encourages Native Americanveterans to come to VA for theirhealth care needs. ❏

First Veterans Enterprise Awards Program Held

VA Deputy Secretary Leo S. Mackay Jr., Ph.D., congratulatesEnterprising Veteran’s Award winner Ben Reyes.

Final CARES Decision for VISN 12 Announced

6 VAnguard

Preliminary results of a study byVA and Department of Defense(DoD) researchers indicate veteranswho served in the Gulf War arenearly twice as likely as their non-deployed counterparts to developthe fatal neurological disease amyo-trophic lateral sclerosis (ALS),commonly known as Lou Gehrig’sdisease.

Those findings prompted VASecretary Anthony J. Principi toannounce in December that theDepartment would immediatelybegin compensating veterans whowere deployed to the Gulf regionbetween Aug. 2, 1990 and July 31,1991, and later developed LouGehrig’s disease.

“The hazards of the modern daybattlefield are more than bulletwounds and saber cuts,” Principisaid at a news conference announc-ing the decision. “We have to beconscious of that and act accord-ingly.”

He said the study results areconsidered preliminary because theyhaven’t yet been peer-reviewed orpublished in an academic journal.But since the disease progressesrapidly, usually causing death in twoto five years, he didn’t want to waitto begin compensating the affectedveterans and their survivors. The lawallows VA to adjudicate the claims ofthese veterans on the basis of theevidence available now.

The epidemiological study, one ofthe largest ever conducted, began inMarch 2000 and involved nearly700,000 service members deployed toSouthwest Asia during the period,and 1.8 million who were not de-ployed to the Gulf during that time.Researchers found 40 cases of ALSamong deployed veterans, a rate of6.7 per million, and 67 cases amongthe larger group of non-deployedveterans, a rate of 3.5 per million.About half of the veterans with ALSidentified by the study have died.

In the wake of Principi’s an-nouncement, the Veterans BenefitsAdministration (VBA) stepped up itsefforts to help the affected veterans.VBA centralized its ratings of theclaims of Gulf War veterans withLou Gehrig’s disease as well as theclaims of their survivors.

A memo to VA regional offices

urged local officials to move quicklywhen they identify Gulf War veteranclaims, and immediately encouragethose veterans to file for service-connection for ALS. VBA’s DataManagement Office providedregional offices a list of deployedGulf War veterans where VBArecords indicated a claim for ALS oran undiagnosed neurological condi-tion to assist in getting benefits tothese veterans.

ALS is a rare disease that destroysthe nerve cells controlling musclemovement. The cause is unknown,and there is no effective treatment.

Principi said the findings of thisinvestigation warrant further study,and he will devote additionalresources to the issue. The investiga-tion, jointly funded by DoD and VAfor $1.3 million, included casereviews, examinations and at-homeinterviews of the participants.Follow-up studies will examinewhether the Gulf War veterans whodeveloped ALS had anything incommon that might point to a cause.

In January, a new advisorycommittee was appointed to help VAoversee its research into the health

problems of Gulf War veterans. The12-member Research AdvisoryCommittee on Gulf War Veterans’Illnesses, composed of medicalexperts and veterans, was estab-lished by Congress to advise theSecretary on proposed research.

The panel must submit an annualreport on the status and results ofgovernment research activities andresearch priorities identified by thecommittee. Although the committeewill not conduct research, its charterinstructs members to review “allrelevant research, investigations, andprocesses” done in the past to assessthe methods, results and implicationsfor future research.

James H. Binns Jr., a Vietnamveteran, former principal deputyassistant secretary of defense, andchairman of the board of ParallelDesign, Inc., of Tempe, Ariz., willlead the new advisory committee.

An expert panel of scientists andsubject matter authorities will assistthe committee, functioning as anauxiliary to review the group’sfindings and provide expert guid-ance to the committee and theSecretary. ❏

Some of the Veterans HealthAdministration (VHA)’s highestperforming clinical programs wererecognized as being among the finestin the nation during a “virtual”award ceremony conducted Jan. 29in VA Central Office and broadcastto each VHA network office viavideoconference technology.

Sixty-five clinical programs at 27different VA medical centers weredesignated “Clinical Programs ofExcellence” by Dr. ThomasGarthwaite, former Under Secretaryfor Health, in what was his lastaward ceremony as head of VA’shealth care system. The clinicalprograms recognized were judgedamong the best in American healthcare during a rigorous peer evalua-tion process and, as programs ofexcellence, will serve as modelswithin the VA health care system.

Winners were selected in 18clinical categories covering areassuch as cardiac surgery, renal

dialysis, HIV and substance abuse,and had to meet stringent criteria inorder to receive the two-year clinicalprogram of excellence designation.The program’s top achiever was theVA Palo Alto Health Care System,home to six clinical programs ofexcellence. The VA New YorkHarbor Health Care System and theSan Francisco VA Medical Centereach had five clinical programsrecognized during the award cer-emony.

Dr. Kenneth Kizer started theClinical Programs of ExcellenceAwards in 1997; they are presentedevery two years. Programs at severalfacilities have received the designa-tion three times a row. Among thoseare: the substance abuse program atthe Cleveland VA Medical Center;the renal dialysis program at theDurham, N.C., VA Medical Center;and the cardiac surgery program atthe West Roxbury, Mass., VA Medi-cal Center. ❏

VA, DoD Study Links ALS to Gulf War Service

VA Clinical Programs Among Nation’s Finest

March 2002 7

NCA’s Shrine Initiative: Commitment to Dignity

Maintaining the many historic features of national cemeteries, likethis Civil War monument at Cave Hill, Ky., National Cemetery, isan element of the national shrine commitment. NCA has begunconservation efforts to retard deterioration of the fragile stone,which is in poor condition. Last month, the cemetery hosted a 140thanniversary ceremony for the monument. Carved by AugustBloedner, a member of the 32nd Indiana (First German) Infantry, ithonors fallen soldiers of that unit. About 130 people attended theceremony, which included Union re-enactors in “mourning,”cannon and rifle salutes, and a wreath laying.

T he words “national shrinecommitment” are heard moreand more at VA’s nationalcemeteries. They appear in the

1973 law that established the nationalcemetery system within VA anddecreed: “All veterans cemeteriesshall be considered national shrinesas a tribute to our gallant dead.”

VA’s National Cemetery Admin-istration (NCA), now operating 120national cemeteries, has always takenthese words to heart. Recently, theVeterans Millennium Health Careand Benefits Act directed VA tostudy what improvements couldensure that national cemeteries meetthe appearance standards of the bestin the world. The words “nationalshrine commitment” seemed aperfect name for this initiative.

To maintain more than 2.5 milliongraves in a manner befitting thosewho rest in its cemeteries, VArequested $10 million in its proposed2003 budget to renovate gravesitesand to clean, raise and realignheadstones and markers. This is thesame amount received in FY 2002and doubles the FY 2001 nationalshrine commitment funding.

Dramatic appearance changesresulted at the four cemeteries thatreceived last year’s funds. NCAanticipates even more improvementsas the program continues and morecemeteries are included.

“The pace of burials in ournational cemeteries is increasing,”

said UnderSecretary forMemorialAffairs RobinL. Higgins.“Qualitymaintenanceof moregravesites is abigger part ofour strategicplans thanever. Wewant there tobe no doubtthat thosewho rest innationalcemeteries arein hallowedground.”

The UnderSecretary added that the full scope ofNCA’s national shrine commitmentawaits completion of the studyrequired by the Millennium Act.Maintenance of large cemeteries isongoing. Cemetery age, climate,burial rates and other factors affectmaintenance requirements.

The FY 2001 funds were used toclean, raise and realign 170,000upright headstonesor flat gravemarkers and toperform othergravesite repairs atLong Island (N.Y.),Golden Gate (SanBruno, Calif.), FortSam Houston (SanAntonio, Texas)and Willamette(Portland, Ore.)national cemeter-ies. Some FY 2002funds will be usedto complete thework.

Long IslandNational Cemeteryhas received $3.3million to raise,realign and clean80,000 headstonesthis year, follow-ing last year’srepairs on 40,500headstones.Golden GateNational Cemetery

received nearly $2 million to reno-vate 90,000 gravesites this year. Withlast year’s project funding, 100,000grave markers were raised, cleanedor realigned.

Willamette National Cemeteryhas received $997,000 to raise, realignand clean 10,600 flat grave markersand renovate the gravesites. Lastyear, the cemetery improved 20,400grave markers and renovated morethan 1 million square feet of turf.Fort Sam Houston National Cem-etery received $1.9 million this yearfor work on more than 41,000headstones and markers and renova-tion of more than 5,500 gravesites.Last year, the cemetery got $293,000to raise, realign and clean 10,000headstones.

Newly funded this year are theMemphis and Wood (Milwaukee,Wis.) national cemeteries. MemphisNational Cemetery received $935,000to raise, realign and clean 37,000headstones. Wood National Cem-etery received a total of $771,000 forthe same work on 17,000 headstonesand renovation of nearly as manygravesites. ❏

By Jo Schuda

Contract workers place sod during gravesite renovation at WillametteNational Cemetery in Portland, Ore.

8 VAnguard

VA’s Unique History, M

S cattered across the warmwaters of the South China Sea,about 7,000 miles southwest ofSan Francisco, are the islands

of the Philippines. The archipelago ishome to more than 19,000 VAbeneficiaries—veterans, widows andchildren.

Many Filipino veterans foughtside-by-side with U.S. soldiersduring the Japanese invasion ofWorld War II. Some served with theRegular Philippine Scouts, alsoknown as the “old scouts,” Filipino-manned units of the U.S. Army.Others served in the PhilippineArmy or with U.S.-backed guerrillaunits. Some survived one of the mostnotorious episodes of the war in thePacific, the Bataan Death March.

Today, Philippine units are onceagain working with U.S. troops aspart of Operation Enduring Freedom.U.S. Special Forces troops are aidingthe Philippine army in their hunt forthe terrorist group Abu Sayyaf,Arabic for “Father of the Sword.”The extremist group has ties toOsama bin Laden’s al Qaeda net-work and is best known for a seriesof high-profile kidnappings in whichthey are believed to have nettedmillions.

Far to the north of Abu Sayyaf’sstronghold on Basilan Island is theIsland of Luzon and the Philippinecapital of Manila, home to the VARegional Office and OutpatientClinic. More than 200 employeeswork in the office, delivering benefitsand providing health care to eligibleFilipino veterans and dependents. Itis the only VA facility located outsidethe United States or its territories andis one of the largest agencies operat-ing out of the U.S. Embassy inManila. In addition to its VA mis-sion, the office also administers theU.S. Social Security program in thePhilippines.

The Manila office traces its rootsto the early 1900s, when the UnitedStates assumed formal sovereigntyover the Philippines. In 1921, Presi-dent Warren G. Harding signed theVeterans Bureau Act, and a yearlater, the U.S. Veteran Bureau Officein Manila was open.

Back then, the office administeredbenefits for Filipinos who served inthe Regular Philippine Scouts.Originally formed in 1901 anddisbanded in the 1940s, the RegularPhilippine Scouts were always partof the U.S. Army. They are entitled toall VA benefits under the same

criteria as veterans of the U.S. armedforces.

The Tydings-McDuffy Act of 1934required the Commonwealth Armyof the Philippines to respond to thecall of the U.S. President underspecified conditions. Those condi-tions were met on July 26, 1941, andPresident Franklin Delano Rooseveltordered the Commonwealth Army toserve with the U.S. armed forces inthe Far East during World War II. Atthe outbreak of the war, there were17 employees in the VA Manila officeadministering to the needs of 7,500veterans.

When the Japanese invadedManila in January 1942, they sealedthe VA office building and employ-ees were not permitted to enter. AllVA personnel dispersed and theAmerican personnel remaining wereinterned for the duration of the war.The VA office was officially re-opened less than a month after theliberation of Manila, in March 1945.The Philippines gained indepen-dence from the U.S. in 1946.

Fifteen years after the end of thewar, in 1960, the VA office trans-ferred to its present location in theU.S. Embassy compound. Former VAAdministrator Thomas K. Turnagewas on hand for the dedication of theoffice’s outpatient clinic when itmoved to a new stand-alone buildingin 1987.

Filipino citizens who serve in theU.S. armed forces are eligible for thesame VA benefits under the samecriteria as other U.S. military veter-ans. During World War II, Filipinosserved in a variety of units, someunder U.S. control, others with noties to the U.S., and still otherssomewhere in the middle. Over theyears, federal law, internationaltreaties and court cases have takenup the question of which VA benefitsthese various groups are entitled to.

Administering VA benefits claimsin the Philippines can be trickybusiness. When Filipinos need to getsomething done, they often turn to a“middleman.” It’s a practice deeplyingrained in their culture and affectsalmost every aspect of life. For VApurposes, this middleman is often

Field investigators like Alberto Villanueva travel to all corners of the Philippines making sureclaims for VA benefits are legitimate and that benefit checks are getting into the right hands.

March 2002 9

ission in the Philippinescalled a “claims fixer.”

Many of them are not recognizedby VA as legitimate representativesof the veterans, as members ofveterans service organizations wouldbe. Crooked middlemen look tomake a profit by convincing un-knowing beneficiaries to submitfraudulent evidence in support of aclaim. In return, they request a fee ora percentage of the benefit payment.The Manila office runs a continuingeducation campaign aimed atalerting beneficiaries about thesedubious tactics.

To determine the legitimacy ofevidence submitted in support of aclaim, and to hand-deliver benefitchecks to ensure they get to therightfully entitled beneficiary, theManila VA office operates a FieldInvestigation Unit. Comprised of 11field investigators, this unit isresponsible for conducting fiduciaryfield examinations and “non-pro-gram” field investigations. Last year,they conducted more than 1,800examinations and investigations.“Our field investigators are our frontline of defenseagainst fraudulentactivities,” ex-plained Jon Skelly,assistant director ofthe Manila VAoffice.

Field investiga-tors travel to allcorners of thePhilippines, anarchipelago of morethan 7,000 islands.They traversemountains, junglesand rivers usingany type of trans-portation avail-able—bicycle,horseback, or raft.

One fieldinvestigator, RalitoJ. Daylin, survivedbeing bitten by avenomous cobraduring an investi-gation in a remoteprovince. “I was allalone, but luckily I

had my cellphone,” he said.“I called mysister who hasmedical trainingand she told mewhat to do.” Hemade a smallincision on hisleg to let thewound bleed.As he sat thereon the side ofthe road, an oldman camewalking by. Itwas “like amiracle,” saidDaylin. Theman sucked thevenom from hiswound and he was able to drive tothe nearest town for medical treat-ment. Alex DeGuzman is chief of theManila field section and has been afield investigator since 1982. Deliver-ing benefits to the proper recipientsisn’t just his job—it’s personal. His

father servedalongside U.S.troops during WorldWar II. He survivedthe Bataan DeathMarch and laterescaped from aJapanese prisoncamp. During hisescape, he was shotin the back. Afterrecovering in ajungle hideout, heorganized a guerrillaunit and battledJapanese OccupationForces for theremainder of thewar. DeGuzman’sfather was awardeda Purple Heart, buthe never applied forVA benefits, saying,“Service to mycountry is free.” During one fieldinvestigation,DeGuzman andcolleague Rosel

Matienzo had to park their jeep andwalk to a veteran’s house, which aguide assured them was “very near.”They left their jeeps and set out at6 a.m. Ten hours later, after hikingover three mountains and crossing arope bridge suspended 50 feet abovea raging river, they finally reachedthe veteran’s home.

With darkness setting in,DeGuzman took “one of the fastestdepositions in long hand I have evertaken.” By 10 p.m. they had madetheir way back to a small town wherea police officer agreed to let themsleep in a municipal office building.They tried to make it as comfortableas possible, with DeGuzman sleep-ing on a cleared desk and Matienzostretched out between two chairs.

A recent study revealed thatthrough the efforts of the FieldInvestigation Unit, the Manila VAoffice saved taxpayers an estimated$1,345,000 in fiscal years 2000 and2001. But Rick Johnson, the ManilaVA veterans service center manager,noted that investigators do morethan save taxpayer money. “Thesebrave investigators are ensuringthose who have rightfully earnedbenefits do not have the gratitude ofour nation diminished by payingbenefits to those who have notearned them.” ❏

By Matt Bristol and Jon Skelly

Transportation is a constant challenge for the Manila fieldinvestigators, who often must find creative ways of getting wherethey need to go.

10 VAnguard

2002 Winter OlympicsVA Volunteers Stay Busy Behind the Scenes

Stephanie Hatton-Ward, a clinical nurse coordinator with the VA Salt Lake City Health CareSystem, volunteered at the Salt Lake Olympic Committee headquarters.

Emergency TeamsPrepare for Worst-Case ScenarioM illions watched last month

as top athletes faced off ininternational competition atthe 2002 Winter Olympics.

They saw America sweep themen’s snowboarding half pipecompetition, an Olympic first, andwatched off-the-ice drama unfoldafter a French judge admitted feelingpressured to vote for a Russianfigure skating team in a controversialgold medal decision.

What they couldn’t see on the TVscreen were the thousands of volun-teers working behind the scenes tohelp make the Games a success.

Many were from the VA SaltLake City Health Care System, whichis located just up the hill from whereathletes ate and slept in the high-security Olympic Village. Somevolunteered their medical skills totreat athletes in the Olympic Poly-clinic, located inside the village. Theytreated athletes suffering fromdehydration or the flu, or helpedthose with sports injuries such asligament damage or stress fractures.

Mark Elstad, M.D., director of theVA intensive care unit (ICU) andprofessor of medicine at the Univer-

sity of Utah School of Medicine,served as medical director of thepolyclinic. He spent six weeksrunning the 24-hour clinic, whichinvolved treating high-profileathletes and supervising the staff of80 volunteer physicians, nurses andmedical specialists. His tour markedthe culmination of nearly four yearsof planning.

Elstad said he got involvedbecause the VA affiliate, the Univer-sity of Utah School of Medicine, wassubcontracted to staff the polyclinicand sought volunteers from withinthe medical school staff, many ofwhom are also VA employees. Hecompared his experience to being oncall for six weeks in an ICU with abusy rotation. “Maybe this is a littleworse,” he said, laughing. “At leastin the ICU I know what I’m doing.”

Joining Elstad in the polyclinicwas Dr. Ronald Gebhart, chief ofstaff at the medical center, who usedseven days of annual leave to serveas a primary care physician. This wasGebhart’s second Olympic tour; hewas a volunteer during the 1996Summer Olympics while working atthe Atlanta VA Medical Center. He

said it was an exciting change of paceto treat world-class athletes in topphysical condition.

Physical therapist Brian Murphy,who serves as clinical manager forrehabilitation services at the medicalcenter, saw his share of sportsinjuries in the polyclinic. The formerArmy paratrooper sent in his resumea year-and-a-half before the Gamesbegan and was one of about 40physical therapists chosen from morethan 400 applicants. “It’s like a who’swho of sports therapists from allover America,” said Murphy, whochairs the VHA Physical AdvisoryCouncil.

Sandy Sweitzer, R.N., alsosubmitted her volunteer applicationsmore than a year before the Gamesbegan. The Salt Lake OrganizingCommittee received three times as

(continued on page 12)

A new team was invited to SaltLake City for the 2002 WinterOlympics. But they weren’t there tocompete and no one wanted them tobe called into action.

When Salt Lake City was chosento host the Winter Olympics, fewAmericans considered terroristattacks on U.S. soil a credible threat.Sept. 11 changed that. The terroristattacks placed increased emphasis onsecurity procedures for high-visibil-ity events such as New Year’s Eve inTimes Square and SuperBowl XXXVIin New Orleans.

The Olympics are the ultimate inhigh visibility, and were targeted in1972 by Palestinian terrorists whokilled 11 Israeli athletes. To preparefor the possibility of another terrorattack, a joint team of hospitaldecontamination experts from VISN8 (Bay Pines, Fla.) and VISN 7(Decatur, Ga.) were brought in toboost Salt Lake City’s ability torespond to weapons of mass destruc-tion or other disaster incidents.

March 2002 11

Many employees from the VA Salt Lake City Health Care System and VA Regional Office volunteered theirtime and skills to help make the 2002 Winter Olympics a success. They joined hospitality crews assigned towelcome the thousands of international guests descending on Salt Lake City, provided medical treatment toathletes and spectators, and supported behind-the-scenes emergency preparedness operations. Here are a fewof their stories.� Ian Willard, a supervisory veterans service representative from the regional office, staffed the Salt Lake IceCenter (the Delta Center), site of all figure skating and some short track speed skating competitions. He wasstationed in the Olympic Family Member Lounge and was responsible for ushering dignitaries to their reservedseats.� Sylvia McKee, R.N., an education coordinator at the medical center who is active in the Utah NursesAssociation, served on the International Olympic Committee’s Medical Commission and helped establish criteriafor volunteer nurses as part of the Intermountain Health Care Nursing Committee.� Sharon Jones, a visual impairment coordinator, and Janet Cook, a patient services assistant, helpedtransport the Olympic Committee of Slovenia. Jones said the committee contacted her because she isSlovenian and belongs to a national heritage organization.� Phillip A. Kithas, M.D., provided medical treatment for athletes competing in the Paralympics.� Penny Jensen, a nurse practitioner in primary care, provided medical care during the Olympics.� Faith Gartrell, a nurse anesthetist, was at the Utah Olympic Park as part of the media services team.� Tracy Dustin, a registered nurse, provided health care support at the Medals Plaza.� James Cypress, an environmental care supervisor, joined his church choir on stage for the opening cer-emony to back up Gladys Night, Aretha Franklin and other entertainers.� Harald E. Olafsson, O.D., chief of optometry, worked 14 shifts in the polyclinic inside Olympic Village.� Medical Residents Helen Hollingsworth, Tim Lahey, Heather McGuire and Marinka Kartalika providedmedical care at the polyclinic and the media center.� Stephanie D. Hatton-Ward, R.N., a clinical nurse coordinator, volunteered in the Salt Lake Olympic Com-mittee headquarters.� Richard Brown, R.N., who works in outpatient mental health, staffed a Red Cross first aid station set up at aPark-and-Ride site near Park City, Utah, where many of the downhill events were held.

VA Olympic Volunteers

many applications as it had volun-teer positions and held a series ofinterviews to sift through the volun-teer pool. Sweitzer, a clinical coordi-nator at the medical center, made itthrough three interviews and wasassigned a position in the wardrobedepartment for opening and closingceremonies of both the Olympic andParalympic Games. “It was thechance of a lifetime,” she said.

Her department was made up ofabout 300 volunteers responsible foralterations and custom fitting formore than 5,000 costumes used in theopening ceremony alone. Shestitched the silvery gowns worn bythe “crones,” the 25-foot tall, stilt-wearing mystical creatures which ledthe opening procession.

She described the momentPresident Bush entered the stadiumfor the opening ceremony. “All thedignitaries had to pass through ourstaging area,” she explained. “TheSecret Service told us the president

was coming and lined us into ahuman chain. He walked by and puthis hand on my shoulder to say ‘hi’to the kids. It was wonderful, justwonderful.”

Native American dancers fromthe five tribes of Utah followed thethunder and lightning of the“crones” in the opening ceremonyprocession. Among them wasKathleen First Raised, a secretary inthe medical center’s audiologydepartment.

She is a member of theAssiniboine tribe of the Fort PeckIndian Reservation in northwesternMontana, which was invited toparticipate by the NorthwesternBand of Shoshone, one of Utah’s fivetribes. She was joined by her father, aKorean War veteran, and her twonieces.

Volunteers also emerged from theranks of the Salt Lake City VARegional Office. Don Wardle, aveterans service representative,

submitted his volunteer applicationlast February. Nearly six monthslater he was chosen to be a sectorcoordinator at the Utah OlympicOval, site of the long track speedskating competition.

He started his Olympic duties onJan. 5, and in the weeks leading up tothe Games, supervised seven special-ists responsible for security, accesscontrol and loss prevention at thevenue. During the Games, he led agroup of 22 volunteers who workedall aspects of venue operations,including hosting, ticket collection,spectator control and security.

The Olympics bring togetherworld-class athletes for internationalcompetition. But they also can bringout the best in people like thethousands of volunteers who contrib-uted countless hours of their timeand energy to help make the WinterGames a success. ❏

By Matt Bristol

12 VAnguard

“This [the Olympics] is what theycall a National Security High RiskEvent,” explained Dr. Kristi L.Koenig, VA’s chief emergencymanagement consultant. “And thereare some unique aspects to considersince the VA medical center is soclose to the Olympic venue. Forexample, we need to be able toprotect not only the athletes andspectators, but also VA employeesand veteran patients.”

In the months leading up to theGames, Bill Bossert, an area emer-gency manager from the VA NorthTexas Health Care System, met withleadership from VISN 19 (Denver)and the VA Salt Lake City HealthCare System to assess their disasterresponse capabilities. They decidedto bring in a team of hospital decon-tamination experts composed ofmembers of the VISN 8 Haz-Mat/WMD Mobile Hospital Decon Teamand VISN 7’s Emergency MedicalResponse Team. “We train andpractice together,” explained BruceMartin, the VISN 7 area emergencymanager, “now we’re deployingtogether.”

This joint team was made up ofabout 30 specialists certified in“Awareness and Operations LevelHospital Decontamination” by the

Emergency Teams (cont.)

Members of the VISN 8 Haz-Mat/WMD Mobile Hospital Decon Team and the VISN 7Emergency Medical Response Team set up a decontamination site near the emergency roomentrance of the Salt Lake City VA Medical Center.

Occupational Safety and HealthAdministration. They spent theweeks of the Olympic opening andclosing ceremonies manning adecontamination site set up near theemergency room entrance of the SaltLake City VA Medical Center.

Thomas H. Weaver, director ofthe Bay Pines VA Medical Centerand co-coordinator of the Bay Pinesteam, said their mission had threeprimary goals: to protect the VAmedical center, support other federalagencies such as the Public HealthService, and to train a new Salt LakeCity decontamination team. Comingfrom the Sunshine State, Weaver saidhis team gained valuable experienceworking in Salt Lake City’s sub-zerotemperatures. “We’ve never reallytrained below 40 degrees, so thisallowed us to improve our coldweather capabilities.” He said theopportunity to coordinate andinteract with emergency teams fromother agencies was another benefit oftheir Olympic experience.

“We learned a lot,” said Martin,who also provided emergencysupport during the 1996 SummerOlympics. “But the most importantwas how to work together as a team… it was exceptional, really out-standing.” ❏

Landmark AgreementBenefits VA and Navy

VA Deputy Secretary Leo S.Mackay Jr., Ph.D., and Navy Secre-tary Gordon England signed alandmark agreement last month thatwill benefit both North Chicago VAMedical Center and the neighboringGreat Lakes Naval Training Center.

Under the agreement, a 48-acreparcel of land will be transferredfrom VA to the Navy. Immediatelyadjacent to the Navy’s RecruitTraining Command, the land will beused in Great Lakes’ nearly $1 billionboot camp construction project.New barracks with dining facilitiesand classrooms, along with a drillhall, will be built on the land. It is theformer site of a nine-hole golf coursefor veterans, and hasn’t been usedsince former VA Secretary JesseBrown decided that VA funds couldno longer be spent on golf courses.

The land will allow Great Lakesto create a training campus thatplaces buildings where they will bestsupport training operations. It alsoenables the planning of buildablesites into the layout of the new bootcamp, giving Great Lakes flexibilityto prepare for any expanded missionthat might be assigned in the future.

“This agreement permits theNavy to expand its only recruittraining command in the smartest,most efficient way possible,” Secre-tary England said.

In exchange for the land, theNavy has agreed to buy electricityand steam for its new facilities from aplanned VA-sponsored co-genera-tion energy center. This agreementwill provide VA substantial energysavings in the future.

“The agreement reaffirms ourcommitment to work with theDepartment of the Navy and DoD tolook for additional ways to maximizeour resources in order to effectivelyserve both our nation’s veterans andour active duty personnel,” saidMackay.

The two officials signed thememorandum of understanding at aFeb. 8 ceremony at the North Chi-cago VA Medical Center. The VAmedical center and the Great LakesNaval Hospital already have severalsharing agreements in health care

(continued on page 13)

March 2002 13

Desperate times breed desperatemeasures, and for Sherry Rockwell ofBremerton, Wash., the word desper-ate was a serious understatement.The wife of a disabled Vietnam vet,Sherry suffers from leukemia,asthma, arthritis, fibromyalgia andseveral heart ailments, and untilrecently was forced to live on welfareto cover her enormous medicationbill each month.

A seemingly good bit of newscame in February 2001, when herhusband Phil, who is treated at theSeattle VA Medical Center, had hismonthly disability compensationincreased. Unfortunately, the in-crease in VA compensation benefitsmeant that it was no longer possiblefor Sherry to receive welfare benefits.The result was devastating—she lostaccess to the medicines that sheneeded to live.

“I had no means of getting anymedication,” said Rockwell. “Be-cause of my leukemia, my plateletcount was up around 2 million and

my doctor gave me abouta month to live. I wasgetting really desperate. Ihad to beg the peopledown at the welfareoffice to extend mybenefits, even though Iwasn’t eligible. ThankGod they did.” Things looked bleakuntil Seattle VA MedicalCenter’s Lena Swansontold Rockwell about theMeds by Mail programand put her in contactwith Ted Benn, thenational Meds by Mailcoordinator. The MedsBy Mail program is runfrom VHA’s HealthAdministration Center(HAC) in Denver, andhas more than 8,000users. The programprovides prescriptiondrugs to the beneficiarythrough the mail at nocost to the recipient. Beneficiaries subscribeto Meds by Mail throughthe Civilian Health andMedical Program of theDepartment of VeteransAffairs (CHAMPVA), a

program that specifically targets thedependents of 100 percent-disabledveterans or of veterans who havedied from a service-related condi-tion.

Benn enrolled Rockwell in bothCHAMPVA and Meds by Mail;unfortunately, this was only thebeginning of the process to get helpand medication for her. The averageCHAMPVA claim can take severalweeks or even months to process.After enrollment in CHAMPVA,Rockwell’s Meds by Mail claim hadto be forwarded to Cheyenne, Wyo.,to the Pharmacy Servicing Center,where CHAMPVA enrollment isverified for all Meds by Mail recipi-ents. That part of the process some-times takes several weeks.

Benn, however, recognizing thatRockwell was in dire need of hermedication, expedited the process. “Ihad not one, but two CHAMPVAcards in my hand within 72 hours,and my medication within twoweeks,” said Rockwell. “I’ve been

dealing with the VA for years andfigured I was going to just get therunaround again and have to waitfor months and probably die. Butsomeone was really looking out forme to have all of these people in theright place at the right time andwilling to help.”

“Sherry called and I could tellthat she was in trouble,” said Benn.“This isn’t anything we wouldn’t bewilling to do for any of our Meds byMail people. I simply expedited itthrough our process here in Denverand through Cheyenne.”

While Rockwell’s case was a littleextreme, it did not surprise HACDirector Ralph Charlip that his staffwent the extra mile to help. “Al-though this case is an unusualexample of how this program canwork, it is a good example of howthe Department is committed toserving the special need veterans andtheir families that rely on the Medsby Mail program.”

For more information on theCHAMPVA or Meds by Mail pro-grams, call the Health Administra-tion Center’s toll-free line at 1-800-733-8387, Monday through Fridayfrom 9 a.m. to 5 p.m. EST. ❏

By Glenn JohnsonHealth Administration Center

Agreement (cont.)

Meds By Mail Program’s Routine Miracles

The Meds by Mail program provides prescription drugs tomore than 8,000 VA beneficiaries.

services and are exploring moreopportunities to share resources.

Just days after the agreement wassigned, VA and DoD officials met todiscuss more inter-agency coopera-tion opportunities. It was the firstmeeting of the DoD-VA Joint Execu-tive Council, made up of members ofthe new DoD-VA Health ExecutiveCouncil and the DoD-VA BenefitsExecutive Council.

The meeting’s agenda included areview of standardized billing andreimbursements, joint procurement,computerized record systems andcapital assets management. Mackayco-chairs the Joint Executive Councilwith Under Secretary of DefenseDavid Chu. Improving efficiency,maximizing resources and enhancinghealth care for veterans and militarypersonnel are key objectives of thecouncil. ❏

14 VAnguard

Historians peg him as a brutal,paranoid and unpredictable leader.During his 36-year bloody reign asking of ancient Judea, Herod theGreat ordered the executions of onewife and three sons, and, in a vainattempt to destroy the infant Jesus,directed the infamous Slaughter ofthe Innocents.

Though it’s been more than 2,000years since his death in 4 B.C.,clinicians and scholars took a freshtry at unraveling the mystery of whatkilled 69-year-old Herod the Greatduring this year’s historical clinicalpathologic conference (CPC) spon-sored by the VA Maryland HealthCare System and the University ofMaryland School of Medicine inBaltimore. Their conclusion? KingHerod, as he is called in the Bible’sNew Testament, died of chronickidney disease.

The diagnosis was reachedthrough the medical investigativework of Jan Hirschmann, M.D., staffphysician at the VA Puget SoundHealth Care System and professor ofmedicine at the University ofWashington’s School of Medicine.Hirschmann revealed his diagnosisbefore an audience of 200 “medicaldetectives” and scholars gathered atthe eighth annual historical CPC atthe University of Maryland School ofMedicine on Jan. 25.

Ordinarily, a CPC serves as a

teaching forum where medicalstudents can observe how an experi-enced clinician, working only withthe case history of an unnamedpatient, can accurately diagnose theprobable cause of illness or death.But for Hirschmann, the challengepresented by the historical CPC wastwo-fold. Working with a “blind”case study, he had to develop andpresent a credible diagnosis of thehistorical subject.

“The texts that we depend on fora close description of Herod’s lastdays list several major features of thedisease that caused his death—among them, intense itching, painfulintestinal problems, breathlessness,convulsions in every limb, andgangrene of the genitalia,” saidHirschmann.

Past speculation pointed tocomplications of gonorrhea as thecause of Herod’s death. ButHirschmann decided to dig deeperand focus on a single symptom of hisfinal illness.

He first determined what diseasescould possibly cause it, then ex-plored whether any of those diseasescould explain the othersymptoms.“When I first looked atthe general diseases that causeitching, it became clear that most ofthem couldn’t explain a majority ofthe features of Herod’s illness,” hesaid. “At first, I considered

Hodgkin’s disease and some diseasesof the liver.”

Of the diseases Hirschmannexplored, the disorder that accountedfor nearly all the features of Herod’sillness was chronic kidney disease.Still, one feature of the ruler’sillness—gangrene of the genitalia—was not explained by that diagnosis.“I finally concluded that the mostlikely explanation was that hischronic kidney disease was compli-cated by an unusual infection of themale genitalia called Fournier’sgangrene.”

That kind of detective work ispart of the attraction of this confer-ence, according to Philip A.Mackowiak, M.D., director ofmedical care at the VA MarylandHealth Care System and professorand vice chair of medicine at theUniversity of Maryland School ofMedicine. The only one of its kind inthe world, the annual conference isthe brainchild of Mackowiak, whoeach year selects a new historicalfigure for study as well as a guestclinician and noted historians whobring their own insights. Since 1995,the historical CPC has examined thedeaths of such notables as EdgarAllan Poe, General George A. Custer,and Wolfgang Amadeus Mozart.

For Mackowiak, the conferenceserves a much greater purpose thanthat of a clinical exercise. “Thehistorical CPC is cross-disciplinary. Itlinks medicine to art, music, litera-ture and history in a special way thatgives the liberal arts greater rel-evance to clinicians,” he noted. “Intraining physicians, we emphasizethe science of medicine so much thatwe tend to ignore the relationship ofmedicine to society in general. Thisconference teaches our students andresidents the importance of consider-ing the art of medicine as well.”

This year’s program even fea-tured a guest appearance by Herodthe Great himself, as played in fullcostume by religion scholar PeterRichardson, Ph.D., professor emeri-tus at the University of Toronto’sDepartment for the Study of Reli-gion. Richardson as Herod wasinterviewed onstage by anothernoted scholar, Ross ShepardKraemer, Ph.D., professor of reli-gious studies at Brown University. ❏

Taking a New Look at an Ancient Mystery

Religion scholar Dr. Ross Kraemer interviews “King Herod,” as played by fellow scholarDr. Peter Richardson.

March 2002 15

About 30 high school studentsfrom the Washington, D.C., metroarea visited VA Central Office onFeb. 5 for VA Groundhog JobShadow Day. The students spenttime with employees in a wide rangeof fields, from photographers andvideo producers to health carespecialists and attorneys, as theylearned how to apply education tothe workplace.

“This program demonstrates theconnection between academics andcareers,” said Alice Bell, an employ-ment specialist in the Office ofDiversity Management and EqualEmployment Opportunity, whocoordinated the Groundhog JobShadow Day. “And it gives VAemployees a chance to play animportant role in helping studentssort out the choices they must makeas they prepare for life beyond highschool.”

Before teaming with their men-tors, the students were encouragedto gain the most from their experi-ence by Angela Haney, a formerHispanic Association of Colleges andUniversities intern who was hired asa budget analyst in the Office ofFinance after completing her intern-ship. Some of the Department’s top-level managers volunteered to serveas mentors for the visiting students,

Looking for an easy way to findeducational videos, satellite broad-casts, CD-ROMs, online courses, andother learning tools? Try the VALearning Catalog, developed byVHA’s Employee Education System(EES).

Easily accessible from the EESWeb site at vaww.ees.lrn.va.gov, the

High School Students ‘Shadow’ VACO Employees

Kendra Fowler, a student at D.C.’s Eastern High School, sits in on a meeting of VHA officialswhile shadowing Acting Under Secretary for Health Dr. Frances Murphy.

and one young lady spent her dayfollowing in the footsteps of Dr.Frances M. Murphy, Acting UnderSecretary for Health.

After spending a few hours withtheir mentors, the students met withemployees who recently joined VAto talk about their transition fromschool to work. Later, as they ate

lunch, the students heard fromHoward University student and VAintern Malcolm Beech II as hedescribed his experience as an internthrough the National Association forEqual Opportunity in Higher Educa-tion. To learn more about thisnational program, visit the Web sitewww.jobshadow.org. ❏

Online Learning VA Learning Catalog allows employ-ees to find all relevant and updatedinformation about learning courses(accredited or non-accredited), plusother material like handouts, bro-chures and course descriptions.Some e-learning courses can becompleted directly from the Website.

In the catalog, employees can findthe location of videos and software,dates and times of satellite broad-casts, and the topic and targetaudience of virtually all availableitems. The catalog offers a descrip-tive list of more than 500 EES prod-ucts and programs that are currentlyavailable, as well as detailed explana-tions of products that will be avail-able in the future.

A new feature added to the Website is a schedule of conferences andsatellite broadcasts. The week-at-a-

glance schedule gives the date, time,and channel of the broadcast up toeight months in advance, and thethree previous months. Employeeswho are interested in getting moreinformation on upcoming or previ-ous broadcasts can contact theproject manager of each broadcast,also listed on the calendar.

Melissa McCanna, coordinator ofthe VA Learning Catalog, has beengetting positive feedback fromemployees who have used it, likeJudy Janovec, project supportassistant with the VA Nebraska-Western Iowa Health Care System.“This new catalog system is wonder-ful,” Janovec said. “Everythingunder one roof!”

For more information about theVA Learning Catalog, contactMcCanna atMelissa.McCanna@lrn.va.gov. ❏

16 VAnguard

Four of the originalplayers portrayed inthe 2000 Walt DisneyPictures release“Remember theTitans” spoke aboutthe struggles andtriumphs of their 1971AAA state champion-ship football seasonwith employeesgathered Feb. 13 for aVA Central OfficeBlack History MonthCelebration.

The team wasformed in 1971, whenAlexandria, Va., schooladministrators mergedthree high schools intoone, T.C. WilliamsHigh School, as a wayto bring racial andeconomic balance to their schoolsystem. Former community rivals,divided by athletic and racial lines,were forced to become one of thefirst integrated football teams. Theirsuccess on the playing field set thetone for a community strugglingwith tension and mistrust.

Paul Hines, the team’s offensiveline coach, spoke about the lessons

he and head coach Herman Boone,who was played by Denzel Washing-ton in the film, tried to teach players.“We said, ‘You don’t have to lovethat guy you’re playing beside, butyou will respect him.’”

Respect was the underlyingtheme as three former players sharedstories of how they came to respectone another. “You can respect a

Original Titans Tell Story of Struggles, Triumphs on the Fieldperson for the goodtackle or block theymade,” explainedlinebacker RufusLittlejohn. “Once wehad that respect, webegan to like oneanother. We foundsome of us listened tothe same music andhad the same goals.”

Terry Thompson,#96, credited thecoaches with moldingthe players into acohesive team. “Ilearned a lot aboutteamwork, and itstarted with thecoaches … they abusedus equally,” he said.Center Jerry Buck, aNaval Academy

graduate, said he knew the playershad become a team when “80 guyscould drink from the water fountainin under three minutes.”

Littlejohn provided the finalinsight. “If I learned anything, it’s tohave integrity and honor in what youdo,” he said. “You never know whensomeone is going to look back andwrite a story about you.” ❏

National Salute 2002

At the McGuire VA Medical Center in Richmond, 189 feet ofwall space was covered with colorful homemade valentines duringNational Salute to Hospitalized Veterans. The cards and letters,many from schoolchildren, poured in for patients there and allover the country thanks to advice columnist Ann Landers’annual call to her readers to send valentines to hospitalizedveterans during National Salute week.

Actor Gerald McRaney, chairman of the 2002 National Saluteto Hospitalized Veterans, greets Leonard Brady, a patient atthe Baltimore VA Medical Center. McRaney visited patientsthere and at McGuire VA Medical Center in Richmond, Va.

Paul Hines, second from left, offensive line coach of the 1971 high school footballchampionship team depicted in the film “Remember the Titans,” forms a huddlefor old time’s sake with former players (from left) Terry Thompson, RufusLittlejohn and Jerome Buck.

March 2002 17

MEDICALadvances

Patients More Likely to Get Life-SavingHeart Medication at VA Hospitals

Heart-attack patients receiving treatment at VA medicalfacilities are more likely than patients at private hospitals toreceive life-saving heart medications, according to a report inthe Dec. 11, 2001, issue of the journal Circulation.

Researchers led by Laura A. Petersen, M.D., of theHouston VA Medical Center, analyzed the records of more than30,000 heart patients from both private hospitals and VAmedical facilities. They found 51.4 percent of heart-attackpatients considered “ideal candidates” for thrombolytic drugsreceived the clot-busting medication upon their admission to aVA facility. At private hospitals, the figure drops to 47.2 percent.

Upon discharge, nearly 71 percent of heart-attack patientsconsidered candidates for angiotensin converting enzymeinhibitors received the medication at VA medical facilities,compared to just 58 percent at private hospitals. The medica-tion has been shown to decrease the death rate after heartattack. Also at discharge, 87.4 percent of candidates receivedaspirin at VA facilities, compared to 75.9 percent of patients inprivate hospitals.

“The medications we looked at have all been demonstratedin big, randomized clinical trials to save lives, either in the shortterm or the long term,” noted Petersen.

Can Self-Hypnosis Help Smokers Kick theHabit? VA Researchers Investigate

Researchers at the San Francisco VA Medical Center areconducting VA’s first clinical trial to learn if self-hypnosis canhelp smokers fight off their tobacco cravings. Tim Carmody,Ph.D., director of health psychology and clinical professor ofpsychiatry at the University of California at San Francisco, saidsmokers in this study would learn how to use self-hypnosisskills to strengthen their resolve to quit, particularly at themoment of a craving.

The study will enroll 360 participants over the next year. It isVA’s first randomized trial comparing the efficacy of self-hypnosis training with individual smoking cessation counseling.Other researchers have tried hypnosis as a tool for smokers,with a wide range of success rates, but this will be the first VAclinical trial to actually test its efficacy.

Participants have a 50-50 chance of receiving counseling orhypnosis training. All participants receive eight weeks ofnicotine patches. Those receiving hypnosis will initially behypnotized by a counselor and given suggestions regardingreasons for quitting and strategies for staying abstinent. Whilehypnotized, the participants will also learn a signal they canlater use to quickly and naturally re-experience the hypnoticstate any time they are confronted with the urge to smoke. It ishoped that the hypnotically suggested stop-smoking messageswill reinforce the commitment to quit and bolster confidence inthe ability to resist the urge to smoke.

Carmody’s new clinical trial should provide a more definitiveanswer about hypnosis because it uses a saliva test to assessthe smokers’ success or failure 12 months after treatment hasbegun. If the subject has not quit smoking, the test will findsmall amounts of nicotine by-products in the saliva. Previoustrials simply used self-reporting, a less than scientific measureof smoking habits. Additionally, Carmody’s study will assesswhether certain characteristics make a smoker more likely tosucceed with the hypnosis method.

Research Reveals Extent of Alzheimer’sPsychological Toll on Caregivers

Caring for a loved one with Alzheimer’s or other form ofdementia can be physically and emotionally demanding. Newresearch suggests the psychological toll on caregivers maycontinue long after their spouse has passed away. The study,conducted by researchers at the Houston VA Medical Centerand Ohio State University, showed 41 percent of formercaregivers showed symptoms of mild to severe depression fortwo to three years after their spouse’s death.

“One assumption has been that the psychological health ofcaregivers would improve once the burden of caregiving ends,”said Dr. Susan Robinson-Whelen, a researcher at the Center ofExcellence on Healthy Aging with Disabilities at the HoustonVAMC and the study’s lead author. “However, we found that thenegative effects of long-term caregiving for a spouse withdementia may continue well beyond the caregiving years.”

The researchers studied 49 former and 42 currentcaregivers who cared for a spouse suffering with dementia, and52 non-caregivers as a control group. All participants wereassessed on a variety of psychological measures for four years.Study results showed 41 percent of former caregivers hadsymptoms of depression compared to 43 percent for currentcaregivers and 15 percent for non-caregivers. The study waspublished in the Journal of Abnormal Psychology.

Imaging Technique Detects CardiacWarning Signs in Diabetics

A non-invasive imaging technique called stress myocardialperfusion imaging, or stress MPI, was shown to be moreaccurate than clinical assessment alone in detecting cardiacwarning signs in diabetics, according to results of a studypublished in the January 2002 issue of Circulation.

The Centers for Disease Control and Prevention estimatesthere are about 16 million Americans with diabetes, yet only 10million know they have the disease. Identifying potential heartproblems is an important aspect of managing diabetes, asthose with diabetes are two to four times more likely than othersto have cardiovascular disease or stroke. About 800,000 newcases are diagnosed in the United States each year.

In the study, researchers provided both a standard clinicalassessment and a stress MPI to 929 patients with diabetes.The patients were then monitored for heart attack, cardiacdeath and revascularization (bypass surgery or angioplasty).The findings showed an abnormal stress MPI was an effectivepredictor for heart attack and cardiac death in both men andwomen. This research was conducted as a substudy of theEconomics of Noninvasive Diagnosis trial and took place at fivehospitals across the nation, including the St. Louis, Mo., VAMedical Center. ❏

18 VAnguard

HONORSand awards

Rear Admiral Matthew G.Moffit presented Ronald J.Henke, director of VBA’sCompensation and PensionService, with a plaque fromthe Department of the Navyrecognizing VBA’s efforts insupporting the PentagonFamily Assistance Centerfollowing the Sept. 11 terrorattack. C&P Service set up aclaims processing unit at theassistance center to provideinformation and assist familymembers applying for VAbenefits. The resultingDependency and IndemnityCompensation claims wereprocessed on site andauthorized within 48 hours ofreceipt. Lessons learned fromthe Pentagon assistancecenter will be applied toimproving VBA’s CasualtyAssistance Program nation-wide.

The Harry S. TrumanMemorial Veterans’ Hospitalin Columbia, Mo., receivedan employment service awardfrom the RehabilitationServices for the Blind Pro-gram in the Missouri Divisionof Family Services. Thefacility was recognized fordeveloping employmentopportunities for the blindthrough a telephone operatorcontract with AlphapointeAssociation for the Blind.

The American GeriatricsSociety awarded its 2001Dennis W. Jahnigen MemorialAward to Dr. EvelynGranieri, associate director ofeducation for the PittsburghVA Geriatric Research,Education and ClinicalCenter. The award is theSociety’s highest honor foradvancing geriatrics educa-

tion in medical and healthprofessional schools. Granieriis an associate professor atthe University of PittsburghSchool of Medicine, director ofeducation services andfellowship director for theuniversity’s Division ofGeriatric Medicine.

Dudley S. Childress,Ph.D., a VA researcherwhose groundbreaking workin prosthetics and rehabilita-tion technology has helpedthousands of people withsevere disabilities, receivedVA’s Magnuson Award onFeb. 11 during the VAnational meeting for rehabilita-tion investigators. A re-searcher at the VA ChicagoHealthcare System andprofessor at NorthwesternUniversity, Childress is amongthe pioneers of myoelectriccontrol, which applieselectrical signals frommuscles to prosthetic limbs.His team developed the “sipand puff” wheelchair to enablequadriplegics to performcertain activities by breathingin or out. The MagnusonAward was established in1998 in honor of Paul B.Magnuson, M.D., chiefmedical director for VAfollowing World War II.

Dave Pettit, chief ofbiomedical engineering in theVA Northern CaliforniaHealth Care System, wasselected as VA BiomedicalEngineer of the Year for 2001.His careful attention to detailand dedication to the VAmission have had a significantimpact on the quality ofpatient care and the successof the Biomedical EngineeringProgram throughout VISN 21

(San Francisco). The awardhonors VA engineers whodemonstrate exceptionalperformance, leadership anddedication to biomedicalengineering.

During the Jan. 2002 VHANational Leadership Boardmeeting, VISN 3 (Bronx, N.Y.)Director James J. Farsettareceived the Virtual LearningCenter VISN ChampionAward. As winner of theaward for the second year in arow, VISN 3 employees wererecognized for sharing theirinnovative practices withothers by posting the mostlessons, 327, on the VirtualLearning Center during fiscalyear 2001. Employees canshare their innovativepractices by visiting thelearning center home page atvaww.va.gov/vlc.htm.

The Illinois Council onTuberculosis presented aservice award to Jan Collins,

infectioncontrolofficer attheMarion,Ill., VAMedicalCenter,for her“out-standing

service in the fight againsttuberculosis.” A microbiolo-gist, Collins specializes ininfectious disease prevention.“It is so important to be awareof the fact that [tuberculosis]is not a disease of the past.We must never get compla-cent in aggressively control-ling the disease,” she warned.According to the Centers forDisease Control, America wascomplacent from 1985 to1992, and the number oftuberculosis cases in thiscountry rose 20 percentduring that period. Thanks toincreased awareness andtreatment, the number oftuberculosis cases has

decreased for the past eightyears.

Armstrong Atlantic StateUniversity presented its firsthonorary doctorate degree toalumnus Dr. Irving Victor forhis long and distinguishedmedical career. Victor helpedfound the Chatham CountyEmergency Medical Servicesand served as chief of staff atSavannah’s three majorhospitals. The 1941Armstrong graduate is aconsultant at the SavannahPrimary Care Clinic, which isoperated under the Ralph H.Johnson VA Medical Centerin Charleston, S.C. He seesabout 30 patients a week.

Fred H. Rodriguez Jr.,M.D., director of Pathologyand Laboratory Medicine atthe New Orleans VA MedicalCenter, was awarded theDistinguished Service Awardof the Board of Registry of theAmerican Society for ClinicalPathology. He was recog-nized for his 14 years ofservice to the Board. Duringthat time, he served in variouscapacities, including governoron the Board of Governors.The Board of Registry is thepreeminent national certifica-tion agency for non-physicianmedical laboratory personnel.The American Society forClinical Pathology is anonprofit medical specialtysociety organized for educa-tional and scientific purposes.A native New Orleanian,Rodriguez received abachelor’s degree in Biologyfrom the University of NewOrleans and medical degreefrom Louisiana State.

David J. Irvine, medicalmedia program manager atthe Battle Creek, Mich., VAMedical Center, accepted therole of chair of the MedicalMedia Council. The councilrepresents a network of morethan 300 media professionalsfrom across the country. ❏

Collins

March 2002 19

you heardHAVE

Veterans service organi-zations play an important rolein enhancing the delivery ofVA services to America’sveterans and dependents.When the widow of a service-connected disabled veteranwas facing financial difficultiesas she struggled to raise threechildren by herself, she turnedto Fred Tremblett, of theveterans service groupAMVETS, for help filing aclaim for Dependency andIndemnity Compensation.When he found out about herfinancial difficulties, Trembletttook her claim to Al Padilla,the public affairs officer at theSan Diego VA RegionalOffice, and asked if there wasany way to expedite it. Padilladiscussed the case withBarbara Myers, assistant

veterans service centermanager, and within fivehours, the team of Sue Haak,Mike Cavalier, Dave Colton,and Sandy Del Rosario hadprocessed and awarded thewidow’s claim.

President George W.Bush signed legislation Jan.24 renaming the Saratoga,N.Y., National Cemetery theGerald B. H. SolomonSaratoga National Cem-etery. Solomon, the formerNew York congressman, diedOct. 26, 2001. At the time ofhis death, he was co-chairinga task force commissioned bythe president to recommendreforms in the delivery ofhealth care to veterans andmilitary retirees through bettercoordination between VA and

Former Senator and astronaut John Glenn, above left,stopped by the VA Central Office Broadcast Center onJan. 31 to film part of a public service announcement forVA’s Compensated Work Therapy Program. The U.S.Marine Corps veteran filmed the opening and closingsegments of the announcement encouraging businesses toparticipate in VA’s work therapy program. There are worktherapy programs at 100 VA medical facilities. The nationalprogram is coordinated by Psychosocial Rehabilitation, partof the Mental Health Strategic Health Care Group, at theBedford, Mass., VA Medical Center.

the Department of Defense.Among his accomplishmentsfor veterans, Solomonspearheaded the effort tocreate the Cabinet-levelDepartment of VeteransAffairs and successfully led adrive to establish theSaratoga National Cemetery,where he is now interred.

Federal employees cannow keep frequent-flier milesearned on official travel,thanks to legislation PresidentBush signed Dec. 28. The2002 defense authorizationbill allows federal employeesto collect frequent-flier milesand other airline promotionalperks while traveling onofficial government business.It also allows employees to“convert” to personal usefrequent-flier miles they

earned before the new law.Previously, airline perks suchas travel upgrades or fliermiles were consideredgovernment property. Formore information, visit theGeneral Services Administra-tion Web site at www.gsa.gov.

The Preventive Medicineand Rehabilitation Service ofthe Central Texas VeteransHealth Care System is thefirst VA outpatient rehabilita-tion program to receiveaccreditation by the Commis-sion for Accreditation ofRehabilitation Facilities. “Weare very proud of this accredi-tation,” said Dr. Valerie VanWormer, chief of staff. “Itshows our veterans we areproviding them with medicalrehabilitation services of thehighest quality.” ❏

Employees from the Board of Veterans’ Appeals col-lected and shipped nearly 100 boxes of warm clothing,books, candies and other items to families in Bosnia-Herzegovina and U.S. troops stationed there as part of aNATO peacekeeping force. The effort began when thecommander of a hospital support unit stationed at EagleBase Tuzla, Army Col. Rhonda Cornum, contacted herfriend Alice A. Booher, an attorney at the Board, to ask forthe Board’s help in organizing a clothing drive for needyfamilies and hundreds of orphans whose lives had beenshattered by years of war. The Board took on the project,and over a five-month period, collected donations fromemployees, friends, local school groups, military units andother groups. Their shipment of clothing totaled more than70,000 cubic inches. Above, Air Force Col. Kory Cornum,left, and BVA attorneys Vito Clementi and JeanneSchlegel bag boxes bound for Bosnia.

20 VAnguard

HEROES✩ ✩ ✩ ✩ ✩

In the Introducing column ofthe December 2001 issue, weneglected to mention thecontributions of Dr. TesfaiGabre-Kidan, a primary carephysician with the VA PugetSound Health Care System,who has been instrumental inestablishing and conductingcultural competency training.

Correction

VA Secretary AnthonyJ. Principi honored mem-bers of the entertainmentindustry Feb. 1 for produc-ing the annual AmericanVeterans Awards (AVA)program. The show, whichaired Feb. 10 on theHistory Channel, is a star-studded Hollywood galaheld to recognize celebrityveterans and honor allveterans for their service tothe nation.

Principi presented theSecretary’s Award, VA’shighest award to thosewho support theDepartment’s mission toserve and honor veterans,to Vietnam veteran HarryShaw, the show’s founder.Secretary Principi said the award was “in recognition for all his hard work … and ingratitude for everything he and everyone associated with this program has done onbehalf of America’s veterans.”

Deputy Secretary Leo S. Mackay Jr., Ph.D., made a guest appearance on the show tohonor actor Hal Linden, chairman of last year’s National Salute to Hospitalized Veter-ans. During the program, which was hosted by former Secretary of Defense WilliamCohen and his wife Janet Langhart Cohen, “NYPD Blue” star Dennis Franz, a Vietnamveteran, received the AVA “Veteran of the Year award.” For more about the program,visit www.avashow.com on the Internet. ❏

Secretary Honors American Veterans Awards

Honoree Harry Shaw talks with AVA co-host Janet Langhart Cohen.Behind them are, from left, AVA honorary chair Jack Valenti, AVAproducer Tonia Craig, and actor Gerald McRaney, chair of the 2002National Salute to Hospitalized Veterans.

Brenda Smith, a licensedvocational nurse and 25-yearemployee of the San Fran-cisco VA Medical Center,saw a 92-year-old veteranweeping in the facility’sNursing Home Care Unit. Sheasked why he was crying andhe told her his wife was in thecity hospital and he had noway to visit her. Smithassured him that he wouldhave an opportunity to visit hiswife, and when she got offduty, she drove him to thehospital. They stayed forabout an hour before drivingback to the nursing home.Later that day, the veteran’swife passed away. Though

Smith was off duty the day ofthe funeral, she drove theveteran to the cemeterywhere his wife was beingburied so he could say hisfinal farewell. “I only didwhat’s right,” she said. Theveteran’s family, made up ofthree generations of VAvolunteers, was grateful forSmith’s considerate actions.

After finishing his Jan. 18shift at the Brookings, Ore.,Outpatient Clinic, NickLong, R.N., stopped by thebank to take care of somebusiness. As he spoke withthe bank teller, he noticed she

was having difficulty breath-ing. He suggested she take aseat and try to catch herbreath, but she insisted shewas OK. When he realizedthe woman’s breathing wasgetting worse, he asked anemployee to call 911 andasked another teller to get thewoman into a chair or onto thefloor, since she looked as ifshe was about to faint. He ranoutside, where colleaguesSharon Carlson, VARoseburg HealthcareSystem public affairs officer,and Lynn Johnson, alicensed practical nurse at theclinic, were waiting inCarlson’s car. He grabbed afirst aid kit from the car andasked Johnson for help.Johnson ran inside andcomforted the victim whileexplaining techniques forcontrolling her breathing.Their efforts helped calm thevictim and she remained

conscious until the emergencymedical crew arrived.

Police Sgt. Frank Juddheard a call for help whilehaving lunch in the maincanteen at the Bath, N.Y., VAMedical Center. He ran to theother side of the room andsaw a man choking, his faceturning blue. Judd asked if hecould breathe and the manshook his head from side toside to indicate he couldn’t.Judd moved into position toperform the Heimlich maneu-ver and dislodged a piece ofhot dog. With his airwaycleared, the man resumedbreathing and refusedadditional treatment when theambulance arrived. Later, hesent an e-mail message to theVISN 2 (Albany, N.Y.) Website to describe his experienceand thank Sgt. Judd for“averting a bad situation.”

Anne M. Rahtjen, apharmacist from the Ralph H.Johnson VA Medical Centerin Charleston, S.C., wasplaying bridge when an 82-year-old man collapsedacross the room. She askedanother player to call 911while she checked his pulse.His heart had stopped, soRahtjen immediately beganCPR and continued untilemergency medical techni-cians arrived. Thanks to herquick thinking and knowledgeof CPR, the victimsurvived. ❏

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