Journal 121213

Vol. 25

No. 48

www.cnic.navy.mil/bethesda/

December 12, 2013

New Smoking Policy Advocates for Clean Air

By Ryan Hunter NSAB Public Affairs staff writer A new smoking policy was issued from Naval Support Activity Bethesda (NSAB) Commanding Officer David A. Bitonti, which outlines rules and encourages more stringent enforcement of smoking regulations on base.

“According to the Surgeon General of the United States, ‘There is no question that the use of tobacco products impairs the health and readiness of the Armed Forces of the United States,’ and I couldn’t agree more,” said Bitonti.

Outlined in the policy are locations that currently, and will continue to prohibit smoking. Tobacco use, including smokeless tobacco, is prohibited in all buildings on the NSAB installation including entryways, exits and other egress points to buildings and garages.

These areas include the living and common areas of the Bachelor Quarters, the Navy Lodge, Fisher Houses and other family living quarters.

While there are multiple outdoor areas, there are no designated smoking areas around Buildings 1-10, 19, 63, 42, A-E and 43-48.

The document also discourages those who smoke while walking from one place to another on base.

Bitonti made a special point to discourage military personnel from doing so, stating that, “it is inappropriate and detracts from military bearing.”

These rules apply not only to service members, but also government civilian employees, volunteers,

contractors, residents, patients and visitors on the NSAB installation. Anyone on base who doesn’t adhere to the policy and are found using tobacco in unauthorized areas is subject to disciplinary action.

Civilian and contract government employees may receive notices of disciplinary action ranging from a letter of caution to removal from their jobs. Military members who fail to adhere to policy rules may be referred for disciplinary action under the Uniformed Code of Military Justice.

Many of the rules outlined in the policy reflect the conditions already found on base which won’t affect smokers directly. “Those who already smoke on base know tobacco can only be purchased at the Navy Exchange, it’s not advertised and it’s sold alongside smoking cessation products. This has always been the case here,” said NSAB Executive Director Bill Meekins.

He continued to stress that for those looking to quit, the base in partnership with Walter Reed Bethesda, will continue to offer services and support.

Bitonti urged cooperation of service members, staff and residents to make sure smokers are utilizing the approved locations on the installation. “We want to provide a healthy and smoke free environment - we can’t do that without everyone’s help. If you see someone smoking in a building, near an entrance, near an exit or anywhere outside of the designated area, politely ask them to stop. It is best to be politely reminded.”

Courtesy Photo

All military members, government civilian employees, volunteers, contractors, residents, patients and visitors on the NSAB installation must adhere to the new tobacco use regulations.

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Thursday, December 12, 2013

The Journal

Bethesda Notebook

Chaplain’s Corner In October 2013, I began serving as the Wa r r i o r T r a n s i t i o n Brigade (WTB) Chaplain at Walter Reed National Military Medical Center (WRNMMC) in Bethesda, Maryland.

Shortly after my arrival at the WTB, I had the privilege of meeting with WTB Soldiers and their Families at our monthly evening meal in the Navy Lodge.

This setting provides many ministry opportunities for military personnel who have been wounded in combat, injured and those with illnesses and other medical concerns.

Every day presents its own unique challenges and opportunities for ministry. As one example, a Soldier and her mother requested to speak with me when I arrived in my new position as WTB chaplain. They just wanted to come by to say hello and have a discussion about spiritual matters, just like they had done with the former WTB Chaplain. The Soldier explained to me that when she first received the news from the doctor that her condition was incurable, she put her trust in God to help her cope with such a hopeless prognosis. She also recalled her own experience with despair when the doctors said there was nothing else they could do. As I reflected on our conversation, I was astonished with the Soldier’s faith and acceptance and her ability to reflect, having the personal awareness to articulate her thoughts and feelings as she embraced this difficult challenge in her life.

This Soldier, knowing that she might not be healed, experienced a cri-

Published by offset every Thursday by Comprint Military Publications, 9030 Comprint Court, Gaithersburg, Md. 20877, a private firm in no way connected with the U.S. Navy, under exclusive written contract with the Walter Reed National Military Medical Center, Bethesda, Md. This commercial enterprise newspaper is an authorized publication for members of the military services. Contents of The Journal are not necessarily the official views of, nor endorsed by, the U.S. Government, the Department of Defense, or the Department of Navy. The appearance of advertising in this publication, including inserts or supplements, does not constitute endorsement by the Department of Defense or Comprint, Inc., of the products or services advertised. Everything advertised in this publication shall be made available for purchase, use or patronage without re-

Drunk, Drugged, Driving

The Army Substance Abuse Program at Walter Reed Bethesda is hosting a Drunk, Drugged and Driving Prevention program on Dec. 17 at 2 p.m., in Memorial Auditorium and on Dec. 20 in the National Intrepid Center of Excellence auditorium at 10 a.m. For more information, call Jenny Sexton at 301-295-8115 or 301-473-1538.

Comedy is the Cure

Comedian with a Message Bernie McGrenahan will present his “Comedy is the Cure, Happy Hour” program on Dec. 18 at 8 a.m. in Clark Auditorium and 2 p.m. in Memorial Auditorium. For more information, call Jenny Sexton at 301-295-8115 or 301473-1538.

CFC Drive Continues

sis of faith. She chose to have hope in God. During our conversation, I was reminded of the words of the late great preacher and theologian James S. Stewart from Scotland. Stewart wrote, “Let us consider the most inescapable ‘Either/Or’ of life; either despair - or faith. Either blank, unrelieved pessimism or a gambler’s throw with your soul. Either darkness and futility and ultimate night, or the vision of God standing within the shadow, keeping watch above his own.”

Ministry with wounded, ill and injured warriors provides us with many teachable moments. My own faith increases and is strengthened when I meet people like this Soldier who choose to embrace life’s struggles with such courage and resilience. As the WTB chaplain, I seek to offer hope as I build and nurture relationships with these warriors by listening to their story.

The Combined Federal Campaign (CFC) of the National Capital Area continues at Naval Support Activity Bethesda and Walter Reed National Military Medical Center. For 50 years, CFC has been a vehicle for federal, postal and military employees to make charitable donations to approved organizations under the CFC umbrella, making CFC the largest, most successful and only approved workplace charity campaign in the federal government. Walter Reed Bethesda’s CFC reporting number is 4031502. To donate, contact your section key worker for details. Donate online at www.cfcnca.org (click on donate now) or at mypay.dfas.mil on the MYPAY website (use code 0990). The campaign runs until Jan. 15.

Ask Your Leadership

‘Ask Your Leadership’ is a staff communication tool for you to view and post questions or comments for official responses from the Walter Reed Bethesda command leadership.

The tool is on the WRB Intranet page. Click on the Town Hall/Leadership Forum icon, and then click on ‘Ask Your Leadership’.

Chaplain (MAJ) B. Vaughn Bridges Warrior Transition Brigade Walter Reed National Military Medical Center

gard to race, color, religion, sex, national origin, age, marital status, physical handicap, political affiliation, or any other non-merit factor of the purchaser, user, or patron.

Editorial content is edited, prepared and provided by the Public Affairs Office, Naval Support Activity Bethesda, Md. News copy should be submitted to the Public Affairs Office, Building 11, lower level, Room 41, by noon one week preceding the desired publication date. News items are welcomed from all installation sources. Inquiries about news copy will be answered by calling 301-400-2488. Commercial advertising should be placed with the publisher by telephoning 301-921-2800.

Publisher’s advertising offices are located at 9030 Comprint Court, Gaithersburg, Md. 20877. Classified ads can be placed by calling 301-670-1700.

Naval Support Activity (NSA) Bethesda Commanding Officer: Capt. David A. Bitonti Acting Public Affairs Officer NSAB: John Epperson Public Affairs Office NSAB: 301-400-2488 Staff Writers

Journal Staff

MC3 Brandon Williams-Church MASN April Beazer Sarah Marshall Sharon Renee Taylor Cat DeBinder Ryan Hunter Katie Mollet Katrina Skinner

Managing Editor

MC2 John Hamilton

WRNMMC Editor

Bernard Little

Walter Reed National Military Medical Center Office of Media Relations 301-295-5727 Fleet And Family Support Center 301-319-4087

NSAB Ombudsman Michelle Herrera

240-370-5421

Sexual Assault Response Coordinator Hotline

301-442-2053

Visit us on Facebook: Naval Support Activity Bethesda page: https://www.facebook.com/NSABethesda Walter Reed National Medical Center page: http://www.facebook.com/pages/Walter-ReedNational-Military-Medical-Center/295857217111107 Uniformed Services University of the Health Sciences page: http://www.facebook.com/pages/ Uniformed-Services-University-of-the-HealthSciences/96338890888?fref=ts

The Journal

Thursday, December 12, 2013

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Clinical Learning Environment Contributes to World-Class Care

By Bernard S. Little WRNMMC Public Affairs staff writer Important in the delivery of world-class care at Walter Reed Bethesda, is ensuring interns, residents and fellows are actively involved in patient safety and quality improvement (QI).

The Clinical Learning Environment Review (CLER) Program was formed nearly a year ago at Walter Reed National Military Medical Center (WRNMMC) to focus on staff training.

“This program is part of the national effort by the Accreditation Council on Graduate Medical Education (ACGME) to enhance the training for our house staff, and the ACGME will be conducting a site visit [here] within the next year,” said Cmdr. (Dr.) Katherine Schexneider, assistant deputy commander for the Education, Training and Research (ETR) directorate at WRNMMC. She added the site visit will be similar to The

Photo by Bernard Little

From left, Cmdr. (Dr.) Katherine Schexneider, assistant deputy commander for Education, Training and Research at Walter Reed Bethesda, Victor Mosley, patient safety administrator, Navy Capt.

(Dr.) Jerri Curtis, executive director, National Capital Consortium (NCC) and associate dean of Graduate Medical Education (GME) at the Uniformed Services University of the Health Sciences, and Gene Monroe, Walter Reed Bethesda’s Joint Commission specialist, discuss the Clinical Learning Environment Review (CLER) program.

This program is part of the national effort by the Accreditation Council on Graduate Medical Education (ACGME) to enhance the training for house staff, physicians in training, at healthcare institution providing physician training.

Joint Commission (TJC) survey, lasting two to five days, and will be the first to evaluate WRNMMC’s CLER program.

“We must embrace the CLER program re-

quirements,” explained Navy Capt. (Dr.) Jerri Curtis, executive director, National Capital Consortium (NCC) and associate dean of Graduate Medical Education

(GME) at the Uniformed Services University of the Health Sciences on Naval Support Activity Bethesda. The underlying principle of the CLER is safe healthcare

settings are necessary to prepare interns, residents and fellows to be safe healthcare practitioners, she added.

Curtis, who oversees GME training in the NCC, added, “WRNMMC and all of our GME programs must only assign residents and fellows to learning and working environments that facilitate patient safety and healthcare quality. We have several initiatives that the GME leadership is actively working on to achieve the goals of [CLER].”

Schexneider agreed, adding that CLER’s number one goal is to ensure a training environment optimal to worldclass educational and patient care outcomes. She said at WRNMMC, the largest academic medical center in the Military Health System, house staff members are active participants in CLER objectives, participating on patient safety and quality committees.

“Their perspective and input is especially valuable,” Schexneider continued. “They also

serve on Root Cause Analysis and Partnership for Patients teams, our major quality improvement initiatives.

These command-wide groups supplement the program-specific QI projects many of our house staff completes, so they really have the chance to delve deep into their own specialty and see the big picture of quality and safety.”

Walter Reed Bethesda’s CLER program has six focus areas, Schexneider explained. The six areas include patient safety, QI, transitions of care, duty hours, professionalism and supervision.

• Patient safety includes providing opportunities for house staff to report errors, unsafe conditions and near misses, as well as participate on WRNMMC’s safety and quality committees.

• Quality improvement allows house staff to not only participate on the safety and quality committees, but also allow them to use data

See CARE page 10

Tis the season..

WRB Honors Staff, Volunteers, Lights Holiday Tree

By Katrina Skinner WRNMMC Journal staff writer In his first holiday tree-lighting ceremony as director of Walter Reed National Military Medical Center (WRNMMC), Brig. Gen. Jeffrey B. Clark, used the occasion to thank staff and volunteers for “who we are, what we do, and most importantly, how we do it.”

The director’s constant message to the WRNMMC community is, “We do three things at Walter Reed Bethesda: accomplish our mission, take care of each other, and take care of our fami-

lies. Mission, people good leaders do both.

“It’s good for us to gather and it’s especially good for us to gather at this time of year,” Clark said during the tree-lighting ceremony last week in the crowd-filled quarterdeck of Building 10. He also encouraged those in attendance to pause and reflect on their blessings while enjoying the fellowship of each other.

“On the day before Thanksgiving, we lit the menorah to begin the eight-day celebration of Hanukkah and today we light our holiday tree, which stands next to our menorah. We are one team,” Clark added.

According to Clark,

the Walter Reed Bethesda one team consists of beneficiaries, families, service members, civilian employees, cont r a c t o r s, v o l u n t e e r s and others. Along with WRNMMC Command Master Chief Terry Prince, he honored those who have served on the team the longest: civilian staff and Red Cross volunteers with 40 years of federal or volunteer service, respectively.

Civilian staff recognized for their 40 or more years of federal service included: Muriel “Mike” Jones (63 years of federal service); Janet Kapur (45 years); Carolyn Stoneburner (44 years); Susan Reid (42 years); Francine

Bryant (42 years); Dorothy Gibson (42 years); Robert Harvey (41 years); Loretta Aiken (41 years); Darlene Allen (41 years); Richard Battistelli (40 years); Madelyn Denson (40 years); Audrey Franklin (40 years); and Shirley Richmond (40 years).

American Red Cross volunteers honored for their years of volunteering included: Lina Czubas (58 years); Betty Byrd (44 years); and Rose Mologne (40years).

Following the award of certificates, members of the Walter Reed Bethesda community fellowshipped, sang carols, reflected on the year gone by and hung ornaments on the 25-foot-tall tree.

Photo by Katrina Skinner

Walter Reed Bethesda Director Brig. Gen. Jeffrey B. Clark (right) and Command Master Chief Terry Prince (rear) salute the medical center’s civilian employees and Red Cross volunteers with 40 or more years of federal or volunteer service during the holiday tree-lighting ceremony last week in Building 10.

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Thursday, December 12, 2013

The Journal

Travis Mills Moves Forward

Wounded Warrior Retires, Looks to Next Chapter in Life

By Bernard S. Little and Sarah Marshall WRNMMC Public Affairs staff writers Standing at a podium in the Warrior Café on Nov. 19, Army Staff Sgt. Travis Mills shed tears as he looked at his 2-yearold daughter, Chloe, run back and forth between her mother, Kelsey, and grandfather, Dennis Mills.

While speaking at his retirement ceremony on this sunny November afternoon, the staff sergeant said he is beginning a new chapter in his life, and is grateful to be standing, but even more thankful to be, “The dad I was always going to be [when Chloe was born].”

Critically injured on April 10, 2012 by an improvised explosive device, while on foot patrol during his third tour of duty in

Afghanistan, Mills is one of only five quadruple amputees from the conflicts in Iraq and Afghanistan to survive his injuries.

Thanking the entire healthcare team at Walter Reed Bethesda “for giving [him] the tools to go on with life,” Mills, fighting back tears, said, “Thanks for helping me get through this. I’m moving on, and I’m going to miss it, but it’s time to go forward. It’s time to get Chloe a backyard with a swing of her own and get my dog back from my parent’s house. I’m excited to move forward. Thank you everybody for everything you’ve done and for allowing me to go on with life.”

Among those instrumental in Mills’ recovery and rehab was Army Maj. (Dr.) Amy Kim, who cried with Mills as they said their goodbyes. “He’s just been so amazing,” she

said. “He has an extraordinary attitude about life with a powerful energy which radiates through everybody.”

Person after person at Mills’ retirement said he has been an inspiration, not only to his fellow wounded warriors, but other patients and bombing victims as well, stating, he has gone to the sides of numerous, newlyarrived service members to show them they could overcome their wounds and continue to lead a good and positive life. He was also frequently called upon by his chain of command to mentor other service members in need of encouragement during their difficult time.

Photo by Bernard S. Little “Walter Reed Bethesda is a better place when Travis Mills and Army Maj. (Dr.) Amy Kim, one of Mills’ physicians people like Staff Sgt. during his recovery at Walter Reed Bethesda, share an emotional

See MILLS page 5

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goodbye during his retirement from the Army on Nov. 19 at Walter Reed Bethesda.

The Journal

Thursday, December 12, 2013

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Severe Winter Storm Survival Tips “Information is your most valuable tool,” said Ganz. “The best thing you can do when facing a winAlthough it’s been ter weather advisory is to three years since the know when it’s coming, ‘Snowmageddon’ blizzard, where it’s going and how Naval Support Activity hard it will hit. You can’t Bethesda (NSAB) Safety do anything without first Manager Jim Ganz and knowing that.”

NSAB Emergency Manager Ron Kunz believe Health “Your health and the that base staff and residents should know what health of those around you to do if it happens again. should be a primary con“Being prepared is cern no matter where you only one part of the bat- are or what you are doing tle,” said Ganz. “Knowing this winter,” said Ganz.

Avoid overexertion what to do can save your life. If you keep only a few when shoveling snow. tips in the back of your According to Kunz, overmind it can make a huge exertion can bring on a heart attack, a major difference.”

Here are some of the cause of death in the winsurvival guidelines the ter. If you must shovel managers outlined in the snow, stretch before going event of a winter storm outside. Also eat regularor under conditions of ex- ly and drink ample fluids treme cold. to avoid overheating.

Kunz advises those exposed to the elements for Inform yourself On the Hazard Spe- long periods of time to be cific Guidance document mindful of frostbite. The issued by Kunz, the very symptoms of this medical first piece of advice to the condition include: loss of general public for win- feeling and white or pale ter storms is to, “Listen appearance in extremities to your radio, television, such as fingers, toes, ear or NOAA Weather Radio lobes, and the tip of the for weather reports and See WINTER page 9 emergency information.”

by Ryan Hunter NSAB Public Affairs staff writer

Courtesy Photo

“If you are at home when a winter storm hits, the best thing you can do is stay there,” said Naval support Activity Bethesda Safety Manager Jim Ganz. “Drive only if it is absolutely necessary.”

MILLS Continued from 4

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Mills are around,” said his squad leader, Staff Sgt. Jack Herbert. “Since he came here, he’s been a leader and a mentor to all of the other Soldiers in my platoon. No one asked him to go to other injured service members’ rooms to provide encouragement; he did that totally on his own.”

Herbert added, “When the bombing at the Boston Marathon occurred, Staff Sgt. Mills was the first person to ask, “What can I do?”

“When he first came to my office, Staff Sgt. Mills said he would be out of here in 18 months.

I rolled my eyes and said, ‘Sure, yeah, okay.’

“He’s actually leaving

in 17 months,” Herbert said.

“I still don’t believe in everything Travis says, but I’ve learned doubting him is not a very smart thing to do,” Herbert added. Capt. Daniel Samotis, Mills’ company commander, also praised Mills’ “extreme determination.”

“I’ve never heard his name in a negative light, only in a positive light,” Samotis said. “I’ve heard his name at least once a week for at least one good thing that he has done, whether it was how he was progressing or for his community outreach in helping other service members. It’s been an inspiration to me as well.”

Harvey Naranjo, a physical therapist and the adaptive sports coordinator at Walter Reed Bethesda, reflected, it is “bittersweet” to see patients like Mills move

on because of the relationships that form between the caregivers and wounded warriors, but “you see these guys getting on with life.”

Kerry Quinn, Mills’ physical therapist, agrees. “[Mills] is a lot to take in at once, in a good way though,” she explained.

“He’s very motivated.

We’ll tell patients here, ‘It’s going to be OK. Things are going to get better, but to have someone like Travis come in his room and say, ‘It’s OK, it’s going to get better’ -they believe him because he’s been there, he’s been through it.”

“He’s been amazing,” added David Beachler, a prosthetist who helped create Mills’ prosthetics. “[He] pushed our limits in terms of [adaptive technology].”

Kelsey Mills said she and her husband expect

there to be some challenges as they begin the new chapter in their lives away from Walter Reed Bethesda, which will take them along with their daughter Chloe, to a new home in Maine.

“Here [at Walter Reed Bethesda], it’s their own little world; there are amputees everywhere – a lot of people like us,” said Kelsey. “Out in the real world, it’s going to be a shock, I think, to not be around that, but we’ll always have them [Walter Reed Bethesda] to lean on.”

With tears in his eyes, Travis Mills said of his recovery, “It’s just attributed to everyone here who is great and helped me, as well as my daughter. I find a reason to go forward – my 2-year-old daughter and my wife by my side, so it works out.”

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Thursday, December 12, 2013

The Journal

WRNMMC Celebrates Diwali, Festival of Lights

By Sharon Renee Taylor WRNMMC Public Affairs staff writer Rows of lights illuminated bright colors and festive flowers in Memorial Auditorium as the medical center celebrated Diwali, the Hindu “Festival of Lights,” Nov. 15.

Nearly 200 staffers, service members, family and friends celebrated the observance hosted by the Pastoral Care Department at Walter Reed National Military Medical Center (WRNMMC) for the second year.

Observed between October and November, Diwali, also called Deepavali, is an official holiday in India and 10 other countries around the world. Peace, prosperity, health, victory of good over evil and uplifting of spiritual darkness are celebrated during the festival.

“Diwali is celebrated in some parts of India as a New Year, a new beginning,” explained Hospital

Corpsman 3rd Class Piragash Swargaloganathan of the Cardiovascular Catheterization Laboratory in the WRNMMC Cardiology Department.

“People buy new clothesit is part of the tradition.

Fiscally, they close last year’s fiscal account and open a new account. In different traditions, it is celebrated a little differently but the thing is the light.”

The glittering lights symbolize the inner light of enlightenment, the light of knowledge over the darkness-the darkness of ignorance and evil, Swargaloganathan said. “There are many significant events and stories behind the festival but the message is the same.”

Army Chaplain (Col.) Robert L. Powers, department chief, Pastoral Care, called it a privilege to be asked to offer the opening address for the celebration.

“It’s a celebration of goodness and light, as well as the protection and prosperity that we

closer together as a community and a nation.”

The Nov. 15 Diwali celebration was the second for Religious Programs Specialist 2nd Class Rice Croft with the Department of Pastoral Care.

The Sailor explained what he appreciates about the Festival of Lights.

“I would say it was the all-inclusiveness and respect for different faith groups and beliefs,” said Croft, who is a non-denominational Christian.

“When you go, you don’t feel like an outcast; it’s inclusive of all religions,” he said.

Adarsh Rakumar, a principal investigator at Armed Forces Radiology Research Institute, began the Diwali observance at WRNMMC by offering a traditional Hindu prayer Photo by Sharon Renee Taylor called Ganeh Pooja. LakA young Indian dancer performs at Walter shmi Swaminathan, a Reed Bethesda’s Diwali celebration on Nov. local dance teacher, per15. formed, followed by traditional songs, music and feel from family, [along think these are all things more dance from commuwith] this concept that that many faith groups nity members as well as we have an eternal na- share in common, and it local children.

After the program ture,” Power said. “I should help us all draw

concluded, attendees dined on a vegetarian meal with dishes made from wheat flour, potato, cashews, tamarind rice, chick peas and peanuts.

The meal included ledu, a sweet made from lentils.

“The sweets are mostly for festivals,” explained Hospital Corpsman 3rd Class Sunil Sudigala, of Neurosurgery Clinic.

Powers shared what he believed to be the connection between Festival of Lights, WRNMMC, and the medical center’s mission.

“I think that Walter Reed [Bethesda] is a beacon of light to the nation, and the very things that we’re talking about during this celebration, we represent to the world,” Powers explained. “The concept that something’s greater than ourselves, the concept of being connected to a larger community, the compassion that drives us towards healing and hope for those who are injured by war and disaster, [as well as experience] illness.”

OB/GYN Paves the Way in Women’s Health Care, Research

By Sarah Marshall WRNMMC Public Affairs staff writer Residents, fellows and staff members from Walter Reed Bethesda’s Obstetrics and Gynecology (OB/GYN) Department recently showcased their expertise and innovative research during a national scientific conference in Baltimore.

The American Congress of Obstetricians and Gynecologists (ACOG) Armed Forces District Meeting, also known as the District X Meeting, was held Oct. 27-30, organized and hosted by Walter Reed B e t h e s d a ’s O B / G Y N Department to develop standards for national practices in Obstetrics and Gynecology. ACOG is divided into a num-

ber of districts by location, each holding annual meetings, such as last month’s, showcasing research and awarding staff, fellows and residents for their outstanding work, explained Army Col. (Dr.) Joseph Gobern, program chair for the meeting and OB/ GYN department chief.

“The focus is on the research that’s being developed in the military healthcare system. Since it includes all branches of service, we have an opportunity to compare ideas, get some best practices, and also collaborate on research,” Gobern said.

With more than 200 attendees, from Hawaii to Germany, Gobern said the conference culminated research projects that residents and staff physicians have been work-

ing on for years.

Generally, OB/GYN interns at Walter Reed Bethesda first present their research at the start of their residency as a case report at the medical center’s annual resident research day in May. During this annual event, second-year residents present research proposals, while thirdand fourth-year residents typically go on to present their research at the ACOG’s annual district meeting, explained Army Lt. Col. (Dr.) Sandra Hernandez, of the Urogynecology Service at Walter Reed Bethesda.

Of the 128 submissions, 49 were oral presentations and 79 were posters, she said. Research topics varied, including gynecological oncology, surgical procedures and infertility.

“A number of research projects [looked] at proteinomics and genomics, and their potential for improving the treatment of cancer, so that is essentially looking at proteins in genes that we can identify to help treat cancer,” Gobern added.

The Army colonel went on to note that, the meeting is an opportunity for residents and fellows to present their research in a supportive and public forum, in front of their peers.

Hernandez agreed.

Many participants were presenting their work for the first time, allowing them to gain confidence and foster a desire to continue advancing research, she said.

At the meeting, the Fellow’s Award was given to the top three papers from those in

Courtesy photo

fellowship training - all three were from Walter Reed Bethesda. Lt. Cmdr. (Dr.) Kate Oliver won the Fellow’s Award

for her research involving a molecular pathway that appears to influence

See OB/GYN page 10

The Journal

Thursday, December 12, 2013

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Photos by Ryan Hunter and Mass Communication Specialist 2nd Class John K. Hamilton

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Thursday, December 12, 2013

The Journal

Parking Changes Continue Onboard NSAB

By Master-at-Arms Seaman April Beazer NSAB Public Affairs staff writer Although still under construction, a new parking garage opened to staff on board Naval Support Activity Bethesda (NSAB) on Dec. 2. The same day, red parking spaces, available to hospital staff and those who park at the Navy Exchange (NEX), were closed off.

Ryan Emery, Transportation manager for NSAB, announced changes with parking regarding the new Sanctuary Hall garage, located on Taylor road, east of building 17.

“When the red parking spots were closed off at the NEX, NSAB staff went to other areas designated for red parking, like this new garage, called Sanctuary Hall,” said Emery.

“That particular garage is still somewhat under construction.

The elevator bearings are not [yet] operational, but there is adequate lighting and there is everything you need to park. It has been given to us by the con-

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tractor a little early to alleviate some of the parking problems we have here. In March the other 200 spaces will be available, so when it is complete, it will have close to 500 parking spaces. [And soon] there will be a new parking map sent out so everyone knows where parking is and is not allowed.”

The upcoming construction will affect other parking locations as well, Emery mentions. “[In the future] we are also going to lose parking in Lot G, [the lot closest to the North Gate,] said Emery. “[However, because] construction came through early, we don’t have to shut down part Lot G as soon as we thought we would. We are [also temporarily] allowing staff to park in the new [Sanctuary Hall] garage early to help offset demand.”

The hospital is about to change some of their parking as well, Emery continues.

“Building 55 will be completely patient-only parking, except for handicapped [parking spots], which will still be open to the staff as well as the wounded

warriors who live in building 50,” said Emery. “That is going to happen on or around Dec 16.

After that, there will be some pushes to other lots. There are volunteers and vendors who park in Building 55 and their parking spaces will be moved to a different garage. More information will be released on this when final decisions are made.”

One of the biggest benefits for staff, especially those with red parking permits, is the ability to park closer to the gym in Building 17, said Emery.

“Parking closer to the hospital and the NEX garage is no longer available to those with red parking passes, so it will impact those who normally have that as part of their routine. However, they will still be able to park in the multi-use parking garage which is still down the street,” Emery mentions. “For patients, this will help de-conflict parking confusion. Towards the end of December or January, it shouldn’t be hard for patients to find a place to park. It has always been our focus to minimize any

Courtesy Photo

The newly-built Sanctuary Hall garage located on Taylor Road is now open to non-handicapped staff with red placards and proximity cards. impacts to patients. With the reduction of the NEX garage and [the opening of the] Sanctuary Hall garage it is an equal swap of parking spaces with the hospital. It is a bit of a pickup for tenants and the university.”

Emery hints at another garage is planned for construction

on base. “It is going to be built between the Navy Lodge and the Child Development Center and will have about 500 parking spaces. [The addition of it] will bring us closer to the total amount of parking spaces we

See PARKING page 9

The Journal

WINTER Continued from 5 nose. “If symptoms are detected, seek medical help immediately,” said Kunz.

Even those not directly exposed to cold temperatures may still succumb to hypothermia. This condition, characterized by uncontrollable shivering, memory loss, disorientation, incoherence, slurred speech, drowsiness and exhaustion can be deadly.

“If these symptoms of hypothermia are detected; get the victim to a warm location; remove wet clothing; warm the center of the body first; and give warm, non-alcoholic beverages if the victim is conscious. Get medical help as soon as possible,” said Kunz.

At Home

Proper management of heat is imperative for those weathering out a storm at home.

“Conserve fuel, if necessary, by keeping your residence cooler than normal,” said Kunz, who advised temporarily closing off heat to unoccupied rooms. Keeping house occupants in a community space, like a living room or den, will

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Thursday, December 12, 2013 take advantage of naturally occurring body heat and reduce heating fuel dependency.

Special care was emphasized by both managers when using portable heaters. Kerosene heaters should be refilled outside and placed indoors with good ventilation to avoid build-up of toxic fumes. All heaters, electric or otherwise, should be at least three feet from flammable objects.

“If you are at home when a winter storm hits, the best thing you can do is stay there,” said Ganz. “Drive only if it is absolutely necessary.”

start a trip and pulling over if you feel tired can ensure a safe journey.”

For those planning to travel long distances the Travel Risk Planning System (TRiPS) is an invaluable tool. The system plans automated travel routes and notifies supervisors and their subordinates of travel plans in the event of an emergency. “Since the program’s inception about 300,000 navy personnel have traveled using approved TRiPS assessments with zero associated fatalities,” said Ganz.

Winter Driving

If your vehicle malfunctions and you find yourself on the road during a snow storm, it is important that you stay within the visible vicinity of your vehicle. According to both managers, it is the most likely place a rescuer would find you.

“Do not set out on foot unless you can see a building close by where you know you can take shelter,” said Kunz. “[Even then], be careful; distances are distorted by blowing snow. A building may seem close, but be too far to walk to in deep snow.”

If you cannot contact help via cell phone or are not immediately visible on the road,

“It may be surprising, but the most dangerous activity you do on any given day is getting behind the wheel of a vehicle,” said Ganz. “That risk is significantly elevated during the holiday period and even more so during a winter storm.”

Ganz suggested planning for a trip long before rubber hits the road. “The Holidays mean traffic jams. Expect them,” He said. “Traveling during the daylight hours, driving reasonable distances, keeping others informed of your travel plans, taking breaks every two hour or so, getting rest before you

Stranded in Vehicle

Ganz lists multiple ways of attracting the attention of rescuers. Turn on your blinking hazard lights or place a distress flag on the radio antenna or window. Turn on the inside light at night so passersby can see you. If stranded in a remote area, stomp large block letters in an open area spelling out HELP or S.O.S. and line the letters with rocks or tree limbs.

“While you wait with your car try to stay as warm as possible,” said Kunz. “Exercise to maintain body heat, but avoid overexertion. In extreme cold, use road maps, seat covers, and floor mats for insulation.

Huddle with passengers and use your coat for a blanket. If your vehicle still has fuel, run the engine and heater about 10 minutes each hour to keep warm. When the engine is running, open an upwind window slightly for ventilation. This, along with periodically clearing snow from the exhaust pipe, will protect you from possible carbon monoxide poisoning.”

While stranded in a car, fuel and battery power will be limited and require sparing use and close monitoring. “Be careful not to waste battery power.

Balance electrical energy needs with supply,” said Kunz.

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PARKING Continued from 8 want on board the instillation.

That garage, which is going to be built in Lot H, will begin construction September 2014.”

The instillation is partnering with the hospital to serve our staff well, but also making sure that patients have good places to park, Emery continues.

“A lot of these moving pieces will come into place sometime in 2015. Parking availability will be a lot more comfortable than it is now. We are now gaining parking spaces, which is good for everyone. People will not see as much loss, but it will take some time to get there.

NSAB is still committed to all tenants to make sure that their missions are met. We want to help tenants onboard by providing alternative transportation information assistants and administering transit benefits.

We have also allocated parking champions to manage their own parking placards. We are [planning] to administer more parking placards within the next year as we observe the progress of everything coming together,” said Emery.

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Thursday, December 12, 2013

CARE Continued from 3 to improve systems of care, reduce health care disparities and improve patient outcomes.

• Transitions in care entail how WRNMMC demonstrates effective standardization and oversight of the progression of house staff through GME. • Duty hours ensure fatigue management and mitigation to ensure patient safety.

• Professionalism entails the integrity of Walter Reed Bethesda fulfilling its educational and professional responsibilities to the house staff.

• Supervision dictates how Walter Reed Bethesda maintains and oversees policies of guidance concordant with ACGME requirements at the institutional and program level.

“Our residents must graduate with a full appreciation of the importance of safety and quality, and the knowledge and skills to make a difference in both, during their careers,” Schexneider said.

“The [CLER] program is improving communication between learners, educators, and healthcare mission leaders in a manner that fosters

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The Journal collaboration and accomplishment of shared missions such as continuous Joint Commission survey readiness,” added Col. (Dr.) Michael R. Nelson, deputy commander for ETR at WRNMMC. The overlap of CLER and Joint Commission preparedness is astounding and will propel us all to be better caregivers and educators. This program will benefit our patients as we enhance our focus on patient safety and quality improvement as an institution.”

During the ACGME site visit to evaluate Walter Reed’s GME and CLER program, evaluators will look at its culture of safety, Schexneider said. “They’ll want to see if both attending physicians (faculty) and house staff are engaged in the six focus areas, how we measure our success in the six areas and what we see as opportunities for improvement.

“A healthy clinical learning environment really involves everyone in the hospital – techs, nurses, doctors, everyone on the team,” Schexneider added. “We all contribute to safe, high-quality care. The CLER program, at its core, is just ensuring that house staff members are part of that effort to give our patients the best quality and safest care possible.”

OB/GYN Continued from 6 drug-resistance to one of the main types of chemotherapy.

“If we are able to leverage this pathway in folks who have [gynecologic] cancers, we may be able to conquer the platinum resistance and provide more durable remissions or cures to our patients,” Oliver explained. “It would be revolutionary to the treatment of gynecologic cancers, should this type of molecularly targeted therapy be successful.”

Army Maj. (Dr.) Micah Hill won the Fellow’s Award for his thesis paper, involving progesterone, a steroid hormone, and nuclear receptors. The Army major explained this work could potentially help in understanding progesterone-resistant diseases, such as endometriosis.

The third Fellow’s Award winner, Dr. Kevin Byrd, gave an oral presentation on Gynecologic Oncology. Army Maj.

(Dr.) Ryan Heitmann won Best Poster for his research involving Reproductive Endocrinology, and Army Capt.

(Dr.) Charles Katz won the Chairman’s Award. He also presented on Reproductive Endocrinology.

By presenting their work at this scientific meeting, Hernandez added the residents and fellows had a chance to hone their skills and “continue to present extremely well in these national conferences.”

OB/GYN residents and fellows who receive their training at Walter Reed Bethesda also have a unique opportunity, as the medical center has the only GYN Oncology fellowship, as well as the only Minimally Invasive Gynecologic Surgery fellowship, and the only Female Pelvic Medicine Reproductive Surgery fellowship, also known as urogynocology, in the Department of Defense.

Having these programs allows residents and fellows to conduct significant research, which she said “really paves the way for future treatment of patients, clinically, surgically and medically.”

For more news from other bases around the Washington, D.C. area,

visit www.dcmilitary.com.

The Journal

Thursday, December 12, 2013

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Thursday, December 12, 2013

The Journal

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