Vol. 25 No. 40 www.cnic.navy.mil/bethesda/ October 17, 2013

Photo by Bernard S. Little

From left, Hospitalman Larissa Lemke, the most junior Sailor at Walter Reed NationalMilitary Medical Center (WRNMMC), Brig. Gen. (Dr.) Jeffrey B. Clark, WRNMMC direc-tor, and Capt. (Dr.) Kenneth Kelleher, the most senior Sailor at WRNMMC, cut the cakecelebrating the Navy’s 238th birthday on Friday in Building 10’s Eagle Zone.

By Bernard S. LittleWRNMMC Journal staff writer

Walter Reed National MilitaryMedical Center (WRNMMC) andNational Capital Region MedicalDirectorate (NCR-MD) celebratedthe U.S. Navy’s 238th birthday witha cake-cutting ceremony in Build-ing 10’s Eagle Zone on Friday.

The celebration began with mem-bers of the Junior Enlisted Mess sing-ing “Anchors Aweigh,” fight song ofthe U.S. Naval Academy, which hascome to be known as the Navy song.A Sailor also rang a bell honoring theNavy’s 238 years of selfless serviceto the nation, and ringing in its nextyear with hope and promise.

“It’s important we gather as oneteam and celebrate, every oppor-tunity we get, the diversity thatis Walter Reed Bethesda,” saidArmy Brig. Gen. Jeffrey B. Clark,WRNMMC director. He added cel-ebrating the U.S. Navy’s birthday,[and] recognizing its more than twocenturies of service, is “very spe-cial.”

Navy Rear Adm. Raquel Bono,NCR-MD director, agreed, saying,“It’s good to see the number of dif-ferent uniforms out celebratingthe Navy’s birthday. This is one ofthose occasions when we not onlycelebrate the legacy of our militaryand Navy, but [also recognize] thehistorical legacy every one of you is

helping to build every day [at Wal-ter Reed Bethesda]. So thank youfor what you are contributing to thehistory and legacy we are establish-ing here.”

Clark then cut the large sheetcake decorated with the U.S. Navyemblem and the words “Happy238th, Oct. 13, 1775.” Help in theendeavor came from WRNMMC’smost junior and senior Sailors, Hos-pitalman Larissa Lemke and Capt.Kenneth Kelleher, respectively.

Lemke said she “absolutely loves”the Navy and plans to make it a ca-reer, while Kelleher, a general sur-geon, joined the Navy during theVietnam era. Both said participat-ing in the cake-cutting ceremony

was “an honor,” and symbolized thetradition of passing the Navy’s tra-ditions and legacy from one genera-tion to another.

Secretary of the Navy Ray Ma-bus, in a video message shown atthe celebration, said, “Since ourbeginning in 1775, our Navy hasdefended America with pride, a tra-dition that continues today. As Sec-retary of the Navy, I have the honorand privilege of working with thefinest men and women our countryhas to offer. This was the case 238years ago, and remains as true to-day as it was at our Navy’s incep-tion. We are and will continue to be,

Navy’s 238th Birthday Celebrated at Walter Reed Bethesda

See BIRTHDAY page 10

Photo by Master-at-Arms Seaman April Beazer

Naval Support Activity Bethesda (NSAB)Commander Capt. David A. Bitonti hands outcake to staff members during the NSAB Navybirthday cake cutting ceremony in Building62’s main lobby Tuesday.

2 Thursday, October 17, 2013 The Journal

Base Parking ChangesOn, or about, Friday, Oct. 7 through

March 11 there will be a phased loss ofa portion of the ‘G’ parking lot on base.Also, around Oct. 17, the entrance to theBuilding 55 parking garage will moveand share the exit for the entrance intothe garage.

DHA, NCR-MD Town HallNational Capital Region Medical

Director (NCR-MD) Rear Adm. RaquelBono meets with Walter Reed NationalMilitary Medical Center staff on Mondayat 7 a.m. in Memorial Auditorium to dis-cuss the Military Health System gover-nance, the Defense Health Agency or-ganizational structure, market statusof the National Capital Region and herintent as NCR-MD director.

Breast Care Center Open HouseThe Breast Care Center at Walter Reed

Bethesda will host an open house Oct.25 from noon to 3 p.m. in the AmericaBuilding, third floor. There will be edu-cational vendors as well as entertainersand light refreshments. For more infor-mation, call Barbara Ganster at 301-295-6338.

Flu Shots AvailableStaff and beneficiaries at Walter Reed

Bethesda can receive the flu vaccinenow through Oct. 25 from 8 a.m. to 4p.m. Monday through Friday in Building9, first floor near Radiology. You mustbring your military ID, staff badge orCommon Access Card (CAC). For moreinformation, call Walter Reed NationalMilitary Medical Center Immunizationsat 301-295-5798.

Bethesda Notebook

Published by offset every Thurs-day by Comprint Military Publi-cations, 9030 Comprint Court,Gaithersburg, Md. 20877, a pri-vate firm in no way connectedwith the U.S. Navy, under ex-clusive written contract with theWalter Reed National MilitaryMedical Center, Bethesda, Md.This commercial enterprise news-paper is an authorized publication formembers of the military services. Contentsof The Journal are not necessarily the of-ficial views of, nor endorsed by, the U.S.Government, the Department of Defense,or the Department of Navy. The appearanceof advertising in this publication, includinginserts or supplements, does not constituteendorsement by the Department of De-fense or Comprint, Inc., of the products orservices advertised. Everything advertisedin this publication shall be made availablefor purchase, use or patronage without re-

gard to race, color, religion, sex,national origin, age, maritalstatus, physical handicap,political affiliation, or anyother non-merit factor of thepurchaser, user, or patron.Editorial content is edited,

prepared and provided bythe Public Affairs Office, Naval

Support Activity Bethesda, Md.News copy should be submitted to

the Public Affairs Office, Building 11, lowerlevel, Room 41, by noon one week pre-ceding the desired publication date. Newsitems are welcomed from all installationsources. Inquiries about news copy will beanswered by calling 301-400-2488. Com-mercial advertising should be placed withthe publisher by telephoning 301-921-2800.Publisher’s advertising offices are locatedat 9030 Comprint Court, Gaithersburg, Md.20877. Classified ads can be placed by call-ing 301-670-1700.

Naval Support Activity (NSA) BethesdaCommanding Officer: Capt. David BitontiActing Public Affairs Officer NSAB: John EppersonPublic Affairs Office NSAB: 301-400-2488

Journal StaffStaff Writers MC3 Brandon Williams-Church

MASN April BeazerSarah MarshallSharon Renee TaylorCat DeBinderRyan HunterKatie MolletKatrina Skinner

Managing Editor MC2 Nathan Parde

NSAB Editor MC2 John HamiltonWRNMMC Editor Bernard Little

Walter Reed National Military Medical CenterOffice of Media Relations 301-295-5727

Fleet And Family Support Center 301-319-4087WRNMMC Ombudsman VacantNSAB OmbudsmanJojo Lim Hector 703-901-6730Michelle Herrera 240-370-5421

Sexual Assault ResponseCoordinator 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-Reed-National-Military-Medical-Center/295857217111107

Uniformed Services University of the HealthSciences page:http://www.facebook.com/pages/Uniformed-Services-University-of-the-Health-Sciences/96338890888?fref=ts

As we face the Govern-ment Shutdown and Emer-gency Furlough, I want theNaval Support Activity(NSA) Bethesda staff, ten-ant commands and visitorsto know that NSA Bethes-da will do everything wecan to continue our level ofservice and support. As Idiscussed in my change ofcommand remarks, “sup-port” is in our name, andwith the Government Shutdown andEmergency Furlough, we will continueto do just that, and support our com-mand, tenants and visitors as theystrive to meet their mission and visitour installation. However, this Govern-ment Shutdown and Emergency Fur-lough also provide us the opportunityto support one another.

All of the tenant commanders andyour leadership have discussed andcontinue to discuss the lapse of appro-priations and the plan for mitigating itsimpact where you work. Unfortunately,the lapse of appropriations is a realitythat has affected our civilian employeesand their families. Civilian staff mem-bers that are not excepted have beenidentified. We will work diligently tominimize the impact this furlough willhave on our mission, those we supportand those who visit our installation.

This course of events is not what wewould choose, but it is an unfortunatereality which we will face together andovercome. It is very important thatwe cooperate with each other as we goabout our daily activities and work,that we take care of each other, andthat we remain fully aware of the im-pact this will have on all of our peopleand their families.

Per guidance from Commander, NavyInstallations Command (CNIC) andNaval District Washington (NDW), thefollowing information is provided:

• Entry Control Pointswill maintain normal hours.

• Security will maintainnormal operating proce-dures.

• Fire and EmergencyServices will maintain nor-mal operating procedures.

• Fleet and Family Ser-vices will retain their clini-cal team for normal opera-tions.

• Sexual Assault Preven-tion and Response will be unaffected.

•All Morale, Welfare and Recreationfacilities and services will continue asscheduled. Hours of operation shouldnot change.

• The Warrior Café will maintainnormal operations.

• The Navy Exchange, mini-mart,gas station, and Navy Lodge will keepnormal hours.

• Chapel Services will maintain nor-mal operations.

We have made the decision to exceptcivilian staff that works in these criti-cal areas. Government shutdowns arenot common and potentially create un-foreseen circumstances and challenges.If there is something that you needfrom NSA Bethesda, please let us knowvia your chain of command. For thosevisitors to our installation, please con-tact NSA Bethesda directly.

We will get through any challengesthis Government Shutdown and Emer-gency Furlough brings as long as we allstay focused on our missions, each oth-er, our staffs, and their families. Infor-mation updates will also be availablevia Facebook at http://www.facebook.com/NSABethesda.

Thank you all for what you do everyday. All ahead flank.All ahead flank,Capt. David BitontiNaval Support Activity BethesdaCommanding Officer

Commander’s Column

The Journal Thursday, October 17, 2013 3The Journal Thursday, October 17, 2013 3

By Mass CommunicationSpecialist 2nd ClassJohn K. Hamilton

NSAB Public Affairsstaff writer

October is “Talk about Prescrip-tions Month” and the medical profes-sionals at Walter Reed National Mil-itary Medical Center (WRNMMC)are stressing the importance of be-ing a conscientious consumer whenit comes to taking and purchasingprescriptions and over-the-countermedications, as well as adhering tothe prescribed recommendations byyour doctor or product label.

“It is very important to be a wellinformed consumer,” said EugenaChen, outpatient pharmacist atWRNMMC. “It helps the doctor bet-ter evaluate how well you are doingon your therapy and if changes needto be made. It helps you understandwhat you’re taking in case someonehas questions about if you’re feelingsick, what medications you are onand what conditions you have. You’llalso be more aware if you have aside effect to a medication or if yourmedication is not working properlyand better be able to talk to yourdoctor to let them know if somethingis bothering you or if something isnot right.”

Before starting new medicationsprescribed by your doctor, there area few general questions you mightwant answered to make sure youknow what it is for, how to take itand what to expect while you are onthe medication.

“You want to ask if there are signsto look out for to see if the medica-tion is working,” said Chen. “For ex-ample, if you are taking an antibioticand you have an upper respiratoryinfection, what signs can you look forto make sure it is working? It willhelp you monitor your therapy. Somemedications don’t have obvious signsthey are working, for instance bloodpressure medication. You might notnecessarily feel it on a day to daybasis, but obviously those are thingsthat you want to take regularly. So,you might want to ask how long I amon this therapy.

“Ask if there are any special ad-ministration issues with the medi-cation (should you be taking it withfood, should you avoid dairy prod-ucts, should you take it in the morn-ing or in the evening.) Not all medi-cations will have issues like that,but some of them are very specific.So, it is good to ask your doctor a lotof those questions or your pharma-cist, who would have a lot of thoseanswers as well.”

When it comes to taking over-the-counter medications, Chen urges pa-tients to read the labels and followthe directions carefully.

“A lot of cough and cold medica-tions will come in combinations. So,if you are taking something that isfor runny nose and something thatis for sneezing, a lot of times the in-gredients will overlap and you don’twant to take too much,” said Chen. “Alot of over the counter medicationsand pain medications contain Tyle-nol, which can be really bad for youif taken too much. Also if you are onprescription medications, you mightwant to check with your pharmacistor doctor to find out if your over-the-counter medications are interactingwith your prescription medications.

That is especially true for a lotof herbal medications and supple-ments; there is not a lot of informa-tion or research done on these. Sothat is something that you want tobe really careful with, even your doc-tor or pharmacist might not have alot of information about it and theymight not know for sure if it is goingto cause a problem with your pre-scriptions, so just be very cautiousabout what you are taking.”

Be mindful of where you are get-ting your medications. There can berisks when purchasing them overthe internet.

“Some internet pharmacies aremonitored and controlled by thegovernment, so that they are li-censed and are following the rules ofthe Food and Drug Administration(FDA) and the laws of this coun-try. However, there are a lot of ille-gitimate pharmacies out there thatcould potentially not be dispensingthings accurately and properly,” shesaid. “So, it is important to makesure you are going through a li-censed pharmacy. With unlicensed

pharmacies, you have no guarantee

about what they are giving you. They

could be mixing medications, saying

it is one thing when it is somethingelse and they could have completelyineffective medications like randomtablets made without any active in-gredients. It is good to avoid themunless they are valid and licensedpharmacies.”

There is a major issue in health-care and hospitals around the coun-try caused by improper use of anti-biotics. This improper use is makingbacteria develop resistances to medi-cation and is causing us to run outof antibiotics that will kill certaininfections, said Chen.

“To avoid this, make sure to takeyour antibiotics as directed for aslong as the course is set by your doc-tor,” said Chen. “So, if you’re sup-posed to take it three times a day fora week, make sure you’re not skip-ping doses or you’re not shortingthe course, like taking it five daysinstead of seven. The consequencesof not taking an antibiotic correctly,even if you are feeling better after afew days, could cause the infection tostill be an underlying problem andthe infection could come back worselater. When taking an antibiotic, it

Talk about Prescriptions Month

Photo by Mass Communication Specialist 2nd Class John K. Hamilton

Beltran A. Pastran, pharmacy technician at Walter Reed MilitaryMedical Center, organizes patients’ medication collected by thePyxis Medstation, an automated medication dispensing system.This machine can reduce the cost that hospital pharmacies incurfor carrying stock, increase the availability of billing and usage in-formation and increase the productivity of hospital staff.

See PRESCRIPTIONS page 10

01040449

4 Thursday, October 17, 2013 The Journal

By 2nd Lt. Brigette GrimesDietetic Intern

Walter Reed NationalMilitary Medical Center

Cramming down fast food duringyour commute or grabbing take-outmay be depriving you of essentialnutrients, like vitamins and min-erals, while racking up unwantedpounds.Trends show the number of meals

eaten away from home is associatedwith obesity in adults. Addition-ally, eating out results in a greaterintake of sugary soft drinks, greasyfast food, and increases overall totalfat and saturated fat consumption –which can all derail a healthy diet.Being able to control how your foodis prepared and what goes into yourmeal is a major benefit of cookingdinner at home. Even if cooking forjust one or two, it is possible to enjoyhealthy meals at home.

Principles of healthy eatingHealthy eating doesn’t mean you

have to swear off chocolate or carbs.It’s about balancing your diet, notdepriving yourself. Don’t be afraidto let yourself indulge on occasion,but do so in moderation. Fill halfyour plate with varieties of colorfulfruits and vegetables. Strive to in-clude half of your grains from wholesources, which are better for yousince they contain the whole grainkernel. Choose lean sources of pro-tein. In addition to chicken and fish,beef cuts with round or sirloin in thename are usually leaner protein op-tions. Beans and other legumes arealso good sources of protein as wellas dietary fiber. Limit added fats andsweets in your diet. The U.S. De-partment of Agriculture’s MyPlateguidelines recommend 6 ounces ofgrains, 2 ½ cups of vegetables, 2 cupsof fruit, 3 cups of dairy and 5 ½ ounc-es (or about the size of two decks of

cards) of protein per day, based on a2,000 calorie diet.

Tips for cooking healthy mealsPlan ahead – Jotting down your

weekly menu and creating a shop-ping list before you head to the storecan shave time off your shopping tripand your meal preparation. Plus,you’ll know you have everything youneed when you’re ready to cook.Strategize your meals – An easy

way to speed up the cooking processis to prepare ingredients once, butuse them twice. Boiled brown ricecan be served alongside salmon forone meal then combined with a canof black beans, ½ cup of shreddedcheese and lean ground beef as a fill-ing for stuffed peppers for another

meal. Leftover grilled chicken canbe nestled on a bed of greens, thentopped with dried cranberries andsliced almonds for a quick, healthysalad.Stock your pantry – In a pinch,

frozen vegetables and canned beansor tomatoes are great to have onhand for quick and easy dinners.Keep it simple – Cooking for one,

or even two, doesn’t have to be anextravagant event. Simple dinners,like pasta drizzled with 1 tsp. oliveoil, and topped with sliced chickenand cherry tomatoes, are quick andeasy alternatives to take-out. It canalso be much healthier for you.Spice it up – Don’t be afraid to mix

things up. Instead of eating chickenagain, choose a lean cut of beef roundor sirloin. Plain old mashed potatoes

can be swapped for mashed sweetpotatoes. Substitute a fresh seasonalvegetable, such as asparagus in thespring, eggplant in the summer ordark leafy greens (kale, Swiss chard,collards, or turnip) in the winter, foryour normal vegetable routine.One dish meals – Dishes that

serve as a whole meal are quick andeasy options. Look for recipes thatcombine several food groups, such asmeats, whole grains, legumes, andvegetables. Some healthier optionswould be vegetarian chili, chickenand rice casserole, and beef, vegeta-ble and barley soup.Utilize the freezer – Buy items in

bulk and freeze in portions for oneor two meals. Chicken breasts workgreat this way! Even if your recipeonly calls for one half of an onion,chop up the whole thing and savethe extra in the fridge or freezer fora future meal. Casseroles or stewscan be frozen in individual portionsallowing you to enjoy a home cookedmeal even when you’re short on time.Be sure to write the date and con-tents on items, and move older foodsto the front.Make it fun – When cooking for

one, it can be difficult to find inspira-tion for meals. However, there are agreat number of cookbooks and oth-er resources that cater to individu-als cooking for one or two. Anotheridea is to treat yourself to company.Inviting friends or relatives over tosample some of your new dishes canturn your evening routine into a fun,social event.Steering clear of take-out doesn’t

mean you have to spend hours in thekitchen. These strategies and tipscan help you make the most of yourmeals. Now put your cooking skillsto the test, and make a healthy homecooked meal tonight.For more information about nutri-

tion at Walter Reed Bethesda, call or301-400-1975 or 301-295-4065.

Ditch the Take-Out for a Home Cooked Meal

courtesy photo

By Ryan HunterNSAB Public Affairs

staff writer

“I saw her at night crying herselfto sleep, because she didn’t have anyfriends,” wounded warrior MasterSgt. Cedric King said, describing thereaction of his oldest daughter, Ama-ri, 9, after his family moved to NavalSupport Activity Bethesda (NSAB)one year ago. “We live at a hospital.For a child, there’s nothing normalabout that.”According to Child Psychologists

Dr. Ryo Sook Chun and Dr. RuthHoffman, reactions like these arecommon for military families with

children living at NSAB and the sur-rounding community. Of the approx-imately 16 school age children whocurrently reside on base, many mustleave their friends and other familymembers behind, move to unfamiliarenvironments and attend differentschool systems, all while witnessingthe recovery of an injured parent.“They have a lot of adjusting to do,”said Hoffman.To aid in these family transi-

tions, Chun and Hoffman work fora preventive, preclinical, outreachprogram called Operation BuildingResilience and Valuing Empowering(B.R.A.V.E.) Families. The program isdesigned to strengthen families with

children living at NSAB through avariety of group and one-on-one in-teractions with children and parentsduring their stay on base and in thesurrounding community.“We visit service members at their

bedside as soon as they arrive at thehospital,” said Chun, the program’sdirector. From there, Chun, Hoff-man and the two social workers thatmake up the Operation B.R.A.V.E.Families team work primarily as asource of information for incomingfamilies.Of the resources and information

provided, a great deal is dedicatedto advice, books, pamphlets and toysdesigned to help reintroduce chil-

dren to their injured family member.“Children have a whole range of feel-ings about seeing an injured parent,but we to try to encourage the par-ent to answer questions at a devel-opmental level that the child canunderstand,” said Hoffman.The program establishes relation-

ships with children as they arriveat the hospital and continues to ob-serve and aid their development af-ter their parents are moved to outpa-tient with ongoing afterschool craftsand homework groups.For many children on base, these

two groups are their only opportu-

Program Helps Children Transition To Hospital Life

See B.R.A.V.E. page 7

The Journal Thursday, October 17, 2013 5The Journal Thursday, October 17, 2013 5

By Bernard S. LittleWRNMMC Journal staff writer

Walter Reed National MilitaryMedical Center’s Senior EnlistedLeader, Command Master ChiefTerry Prince, answered a numberof questions from junior servicemembers of all branches, while dis-cussing a myriad of topics during atown hall on Oct. 7 in the MemorialAuditorium.

Most questions from those in at-tendance focused on the impactof the government shutdown andbudget on the force. The commandmaster chief explained the budgetwill be an ongoing challenge forthe military, but service membersmust continue to meet their re-sponsibilities and perform with theprofessionalism that helped WalterReed Bethesda establish its world-renowned reputation.

“Our reputation alone has car-ried us this far,” Prince said. Heexplained the “extraordinary” workat Walter Reed Bethesda must con-tinue, not only to set the course forthe future of military medicine, butalso for adequate funding to sup-port its current missions and goals.

Answering a question concern-ing tuition assistance [TA], Princenoted TA is also based on each ser-

vice budget. “It seems everythingis up for grabs right now, and it’simportant for enlisted personnelto research other avenues, such asgrants and scholarships [for fur-thering their education], and notget locked into one thing so you willhave a plan,” he added.

Prince encouraged the troops tovote in their [state and local] elec-tions, “[something] we don’t oftendo as Sailors, Marines, Soldiers andAirmen. The reality is if you wantto make a change, you vote with theperson who agrees with your opin-ions.”

Another topic Prince addressedduring the town hall was servicemembers living in the barracks atNaval Support Activity Bethesda(NSAB). He challenged supervi-sors, E-7s and above, to visit thebarracks at least once a month tocheck in on their troops. “It showshonor, courage and commitment toour people who are living there.”He added NSAB is also exploringputting resident advisors, E-5 andabove, back into the barracks, aswell as establishing a meal cardprogram for junior enlisted troopswho face the high cost of livingchallenges in the National CapitalArea.

Encouraging Sailors to become

familiar with the CredentialingOpportunity On-Line (COOL) pro-gram, the command master chiefexplained COOL allows Sailors toapply their military job skills andtraining toward certain civilianlicenses and certifications. Thismakes them more marketable andcompetitive should they decide totransition out of the military. Moreinformation about the program isavailable at the website https://www.cool.navy.mil.

He then urged the service mem-bers to get involved in organizationson the base. “I am a big proponentof people in a command being a partof an association in line with theirpaygrades.” He focused on the Ju-nior Enlisted Mess at Walter ReedBethesda, calling it a “power house”organization within the commandinvolved in many programs for ju-nior service members on base. “Theyactually look after each other, andpart of your responsibility as a Sol-dier, Sailor, Marine or Airman is togive back to the command and com-munity. We’re blessed to be wherewe are, regardless of your service,and it’s important to give back insome special way.”

Also with the number of mis-sions taking place at Walter ReedBethesda, Prince encouraged troops

to “look out for each other. We standon the shoulders of greatness andyou are carrying the load everyday,” he said. “I say that becausewe need to watch out and help eachother. Don’t be afraid to take thatstep [because] sometimes, it onlytakes a split second to keep some-

Command Master Chief Prince Emphasizes, ‘Mission First, People Always’

U.S. Navy Official Photo

Walter Reed National MilitaryMedical Center Command Mas-ter Chief Terry Prince

See MISSION page 9

1036253 01040803

6 Thursday, October 17, 2013 The Journal

By Master-At-ArmsSeaman April BeazerNSAB Public Affairs

staff writer

Physician assistants (PA)nationwide are recognizedannually during PA week,from Oct. 6-12.“It‘s a celebration of the

70,000 PA’s in the country,”said Patty Smith, a Neuro-surgery PA for Walter ReedBethesda (WRB). “We area minority and it’s a greatweek to gather together withcolleagues and celebratewhat we have done and whatthe PA profession has becomein this country.”There is a clear misconcep-

tion of what PA’s do, statedArmy Col. (Dr.) Michael Ros-ner, chief program directorfor the Neurosurgery resi-dency.“The PA’s are considered

the paraprofessionals thatallow physicians to not onlyexpand their patient carevolume but expand their out-reach to the community. ThePAs in Neurosurgery spe-cifically are considered theequivalent of any provider.We have a lot of patients that

come through the system thatare very appreciative of thehealthcare that they get here,but we have a handful of pa-tients that come through anddo not want to see PA’s. Theydon’t quite understand thatPAs are actually healthcareproviders and can interactwith patients independently.Even though residents moveon, the PA’s are always there.So, from a patient standpointthere is always that contin-ued interaction and follow-up.That is a huge advantage tohave that type of support andit allows you to expand yourcapabilities.”“We are extensions of the

doctor,” Smith said. “We dopretty much what they doand what they are comfort-able with us doing. [We per-form patient] histories, phys-icals, order lab tests, inter-perate [lab results] and orderradiological studies. We canalso do procedures and assistthe doctors in the operatingroom. We typically go in theOR and we do first assist aswell. We see patients in theclinic [and even] do roundson the floor.”Even though there is a PA

week, PA’s should be recog-nized year-round, Rosnermentions.“They truly are an appre-

ciated asset to have in anyclinic,” said Rosner. “Theyare able to double or tripleyour workload and basically

expand the outreach of theentire service. Without theircapabilities, we would behurting.”

PA Week Recognizes Behind-the-Scenes Work

Photo by Master-at-Arms Seaman April Beazer

Physician Assistant-Certified (PA-C) Amna Jadli demonstrates checking the vitalsigns of PA-C Karen Mao in the Neurosurgery Department at Walter Reed Na-tional Military Medical Center.

By Mass CommunicationSpecialist 2nd Class

Nathan PardeNSAB Public Affairs

staff writer

Eleven staff members atthe Navy Exchange (NEX)Bethesda Uniform Centerwere recognized by the act-ing U.S. Surgeon GeneralRear Adm. Boris D. Lush-niak Friday for their com-mitment to delivering ex-ceptional customer service.“You’ve done extraordi-

nary things in your posi-tion,” Lushniak said to theuniform center staff. “Of-ten times, you realize thatstandard things take placeevery day. Extraordinarythings take place every daytoo, and sometimes the twoget mixed in the course of aday’s work.”Lushniak, who oversees

the operations of the U.S.Public Health Service Com-missioned Corps (USPHS),said the uniform centerstaff recently went above-

and-beyond the call of dutyby shipping uniforms to of-ficers around the countrywhen the recent govern-ment shutdown did not al-low them to travel to pickup their uniforms.“Because of the furlough

situation and the govern-ment shutdown, we canceled

our officer basic course thismonth. This has been a dev-astating month for us,” saidLushniak. “But, the staff ofthe Bethesda uniform cen-ter has always treated theuniformed officers of theUSPHS with respect whiletaking care of their needs.”To formally recognize

this, Lushniak presentedthe uniform center teamwith certificates of appre-ciation, which read:In recognition “of out-

standing service and ex-traordinary support to theOffice of the Surgeon Gener-al and to the United StatesPublic Health Service of-ficers stationed around theworld.”Then, Lushniak took

a moment to recognizethe manager of the NEXBethesda Uniform Center,who recently accepted amanagement position at anew location.“Nakesha Tucker, we re-

alize today’s a big day foryou, as it’s your last dayhere. Congratulations onwhat I believe is a promo-tion to new responsibilities.We wish you all the best ofluck in your new assign-ment. Thank you so muchfor what you’ve done for thePublic Health Services.”Following the celebration,

Tucker shared more of thestory and the events that

brought the surgeon generalto visit.“Recently, a customer

noticed that an employee,Haiminot Gebeyehu, wastaking care of some ship-ping of goods and askedwhy,” said Tucker. “Thestaff member went on tosay, ‘Well, we’re bagging upthe public health serviceuniforms that we do everymonth because of the classbeing discontinued.’”Tucker explained, every

month, officers go throughthe Officer Basic Course,a two-week direct com-missioning program, be-fore reporting to the NEXBethesda Uniform Center topick up their new uniforms.The officers have their uni-forms tailored and receivealterations to ensure theyfit properly before attend-ing a ceremony where theyare commissioned as publichealth officers.The government shut-

down resulted in the latest

Uniform Center Staff Recognized by Surgeon General

Photo by Mass Communication Specialist 2nd Class Nathan Parde

Navy Exchange Bethesda Uniform Center staff posefor a picture Friday after receiving certificates of ap-preciation from acting United States Surgeon Gen-eral Rear Adm. Boris D. Lushniak.

See UNIFORM page 10

The Journal Thursday, October 17, 2013 7

By Bernard S. LittleWRNMMC Journal

staff writer

Brig. Gen. (Dr.) Jeffrey B.Clark held his first town hallsas the new director of WalterReed National Military Medi-cal Center (WRNMMC) lastweek in Memorial Audito-rium.

“I’m very proud to be aSoldier medic,” Clark said.“I’m very proud to have wornthis uniform.” He added heexpects Sailors, Soldiers, Air-men and Marines to feel thesame about serving in uni-form.Clark went on to trumpet

the efforts of civilians, con-tractors and volunteers atWalter Reed Bethesda, sayingthey should feel just as proudabout “what we do and whowe are [at WRNMMC].”What WRNMMC does is

“accomplish the mission, takecare of each other, and takecare of families,” Clark said.That mission is focused onpatient-centered care provid-ed at Walter Reed Bethesda,he explained.October is Patient-Cen-

tered Care Awareness Month,and the term “patient-cen-tered” is one that comesup frequently when Clarkspeaks. He explains patient-centered care supports activeinvolvement of patients andfamilies in their care, particu-larly in decision-making.The Institute of Medicine

defines patient-centered careas “providing care that is re-spectful of and responsiveto individual patient prefer-ences, needs, and values, andensuring that patient valuesguide all clinical decisions.”This is what Clark encour-ages his staff to do at the Na-tion’s Medical Center.“I feel like I can do what

we’re asked to do, and wecan do whatever we’re askedto do,” he said of the WalterReed Bethesda “One Team,”as he refers to his new staffat the nation’s largest jointmilitary medical center.“We are in the ‘say yes’

business, not only to thosewe serve, but to each other,”Clark said. “For example, apatient shows up five minuteslate for an appointment, whatare you going to do? You aregoing to see that patient iswhat you’re going to do.“A patient shows up an

hour late for an appointment,what are you going to do? Youtell the patient, ‘Ma’am or Sir,I’m going to see you, but youmay have to wait, or we canreschedule, whichever is bestfor you,’” Clark continued.This is all a part of being pa-tient-centered, he noted.“Saying ‘yes,’ and being

patient-centered is estab-lished upon the way we treateach other,” Clark said. “Thework environment, how wefeel about ourselves and ourorganization are foundationalto our [patient care].”

He challenged staff to cre-ate “safe, efficient and effec-tive systems” to make it easi-er to say yes. “Safety first andalways,” he added. “Safety ispatient-centered care [and]safety is taking care of eachother.”He also encouraged staff

to acknowledge the “greatwork” each other does everyday. “Say ‘thank you’ to eachother,” he said.

A culture of trust, trans-parency, open discussion andtaking advantage of learn-ing opportunities are keys topatient-centered care as well,said the WRNMMC director.“Every encounter, with

every patient, every time isspecial,” Clark continued.“Those we are privileged toserve must trust us, [and]they must know we care. Ourpatients don’t expect us to be

perfect, we don’t expect eachother to be perfect, but therehas be an underlying, funda-mental trust. That’s very im-portant,” he said.Clark concluded his first

town hall telling staff, “I amextremely proud to be ourcommander. Please be asproud of who we are, whatwe do, and most importantly,how we do it as I am to servewith you.”

Patient-Centered Care Top Priority of New WRNMMC Director

Photo by Bernard S. Little

Walter Reed National Military Medical Center (WRNMMC) Director Brig. Gen.Jeffrey B. Clark discusses his command philosophy during his first town hall withthe WRNMMC staff as its director last week in the Memorial Auditorium. “Wewill accomplish our mission, take care of each other, and take care of our fami-lies,” Clark said.

nity to socialize with otherchildren outside of school.“Without the program, myson, [Angel , 9,] might go allweek just being in a hospi-tal and never have an ac-tual friend,” said MilitarySpouse, Rosemary Rutland.The main goal of the af-

terschool programs is to,“provide an emotionally safeplace for kids,” and the par-ents believe it’s working saidChun. Children can speakfreely about issues bother-ing them while playing andstudying with credentialedpsychologists and socialworkers. Rutland describedthe program as “counselingwithout a counseling set-ting.”The Operation B.R.A.V.E.

Families program exercisesa great deal of freedom andflexibility in its operationof these initiatives. “It’s anoutreach program, [so] we donot require consultation orformal referral,” said Hoff-man. “We’ll run into someonein the cafeteria, sit and havea cup of coffee with them.In the context of all that,we provide our professionalsurveillance, and when it’sappropriate, we can makerecommendations.”When Military Spouse

Amy Oppelt started notic-ing her son, Peyton, 7, wasbeginning to act quiet andwithdrawn since moving tothe hospital, she wasn’t surewhat to do. “There were alot of things that were hap-pening behaviorally with myson that I hadn’t seen be-fore, but weren’t necessarilywhat I expected either,” shesaid. Oppelt began bringingher son to private counseling

services and afterschool pro-grams, before realizing theyoung boy had remained qui-et so as to not distract from

the recovery of his father, anamputee wounded warrior.“He had a lot of questions,but was just afraid to ask.

[The program] really helpedbreak open those communi-cation barriers.”Operation B.R.A.V.E. fam-

ilies is under the directorateof behavioral health, de-partment of psychiatry andchild/adolescent psychiatryservices, which means theservices they provide are notonly professionally advisedbut also free for woundedwarrior families. “We are allcredentialed hospital staff,”said Chun.For more informa-

tion about the OperationB.R.A.V.E. Families programcall 301-295-0576. The af-terschool craft and supportgroup is held on Mondaysfrom 3:50 to 5 p.m. and thehomework study club is heldon Wednesdays from 3:50 to5 p.m. Both groups are heldin the family area outsideof the Military AdvancedTraining Center on the firstfloor of Building 19.

B.R.A.V.E.Continued from 4

Photo by Ryan Hunter

Khamya King, 6, practices her penmanship as ChildPsychologist Dr. Ruth Hoffman helps during theThursday afterschool Operation B.R.A.V.E. Familiesstudy group.

8 Thursday, October 17, 2013 The Journal

By Mass CommunicationSpecialist 3rd Class

Brandon Williams-ChurchNSAB Public Affairs

staff writer

Navy Lodge at Naval Support Ac-tivity Bethesda (NSAB) received theHospitality Award for the large cat-egory for the first time October 10.

The award is presented annuallyto recognize the best Navy Lodge fordemonstrating the ‘spirit of hospital-ity’ with their superior guest service.To be eligible for a nomination in thelarge category, the lodge met specificcriteria including number of rooms,guest ratings, room cleanliness andfriendliness of the front desk em-ployees, among others.

“It’s an honor for us to win theaward and the [staff] feels the sameway,” said Navy Lodge General Man-ager Ana Herrera-Ruiz. “This awardwas the indication that we are goingin the right direction and we’re herereally taking care of the woundedwarriors and their families. I feelvery proud to be the general man-ager of this location because youcan see what you do really matters.Winning this award truly displaysthe fruit of working diligently every

day throughout the year. It is a com-bination of friendliness of the frontdesk employees, room attractive-ness that we receive feedback fromseveral sources. Throughout the lastyear, this lodge received more than25 Bravo Zulus for letters that weresubmitted to the CEO of the NavyExchange Service Command (Nex-com). The letters stated the experi-ence they had here at the lodge andhow the associates went beyond theirresponsibilities towards the guests.”

For the lodge to win the award,it maintained a level of experiencerated by its guests as second to none.

“The exciting thing is that it isimportant to identify [them] as thewinner but also they did this in themiddle of renovation,” said Rico Ma-caraeg, Navy Exchange Bethesdapublic relations manager. “Theystarted the process of renovation andthey are able to still hold the highstandards of our customers and ex-ceed their expectations.”

More interestingly, the lodge viedfor the award against considerablecompetition.

“Because this is a large category,we are competing against lodges

Navy Lodge Bethesda Receives Prestigious Award

See LODGE page 10

Photo by Mass Communication Specialist 3rd Class Brandon Williams-Church

General Manager of Navy Lodge Bethesda Ana Herrera-Ruiz ac-cepts the Hospitality Award from Naval Support Activity Bethes-da’s Commanding Officer Capt. David A. Bitonti Oct. 10.

0104017701041047

The Journal Thursday, October 17, 2013 9The Journal Thursday, October 17, 2013 9

one from making a decision thatcould prevent them from destroy-ing their life [and] the lives of thosearound them.” He said this not onlyinvolves suicide prevention, butalso sexual assault prevention andresponse.“At the end of the day, it’s not

about statistics or productivity, butabout people,” Prince continued.“Mission First, People Always,” headded, explaining the three ten-ants of Brig. Gen. (Dr.) Jeffrey B.Clark, the new WRNMMC director,are: “Take care of the mission; takecare of our families; and take careof each other.”For more information about

suicide prevention, call the Mili-tary Crisis Line at 1-800-273-8255(TALK), and press 1. Also, WalterReed Bethesda Pastoral Care canbe reached at 301-295-1510 from7:30 a.m. to 4 p.m., or 301-295-4611(Command Duty Office) after 4 p.m.For information about sexual as-

sault prevention and response, callthe Victim Advocate Hotline at 301-442-8225, or the Sexual AssaultResponse coordinator at 301-442-2053. The NSAB sexual assault re-sponse coordinators can be reachedat 301-400-2411 or 301-400-3366,and the WRNMMC sexual assaultresponse coordinator can be con-tacted at 301-400-2708. Informa-tion is also available at the websitewww.sapr.mil.The senior enlisted leader’s town

hall is held quarterly.

MISSIONContinued from 5

0104052701040825

10 Thursday, October 17, 2013 The Journal

kills the weaker bacteria first and strongerones take a bit longer to kill. If you stop takingthe antibiotic before the full course prescribedby your doctor, the stronger bacteria will mul-tiply and develop a resistance to the medica-tion and that antibiotic won’t work anymore.“You shouldn’t take antibiotics unless you

actually have an infection that has been de-termined by the doctor,” she added. “When youget an antibiotic, take the full course and takeit properly. A lot of people will not take the fullquantity of the antibiotic, leave some at homeand whenever they feel sick, they will take afew. It is not effective to cure an infection thatway and you may be taking an antibiotic thatis not correct for whatever infection you haveand you may not have an infection to beginwith. You want to make sure you are only get-ting and taking antibiotics that are prescribedby your doctor.”Care should be taken when discarding ex-

pired or unused medication.“The best way to dispose of medications

is twice a year when the Drug EnforcementAgency sponsors drug take back days,” saidChen. “You can go on their website where they

list several locations that can be filtered bystate where you can take back the medica-tions and they will destroy it properly. If youhave some at home and cannot make it to thedrug take back day, you can actually disposeof medications in the garbage, first by mixingthem with some undesirable substance such ascoffee grounds or kitty litter.“One of the reasons to dispose of medications

in this manner is diversion, you could havepeople going through and stealing your medi-cations especially controlled medications, onesthat can be illegally abused,” she added. “Youcould have kids, pets or people inadvertentlytaking things that you don’t want them to take.Most of the time [medications] just expire andthey are no good to use anymore, so you don’twant them lying around where somebody cantake them by accident.”For more information on the purchase, use

and disposal of medications, visit the FDAwebsite at www.fda.gov/drugs/resourcesforyou.Also, the WRNMMC pharmacies will be spon-soring a pharmacy services week from Oct.21 to Oct. 25, with a tentative schedule from10:00 a.m. to 2:00 p.m., where a pharmacist ortechnician will be on hand, in front of Ameri-ca’s Pharmacy and the Arrowhead Pharmacy,to answer any questions one may have aboutmedications. Please see the upcoming ‘Bethes-da Notebooks’ for a set schedule.

PRESCRIPTIONSContinued from 3

America’s ‘Away Team,’ the finest expeditionaryfighting force the world has ever known.”During the Battle of Lake Erie, “perhaps the

most dramatic and important battle in the War of1812, our Sailors really showed their mettle andtenacity, and in fact, were the asymmetrical advan-tage for our forces,” said Chief of Naval Operations,Adm. Jonathan Greenert. “Today, the all-volunteerforce – you - are our asymmetrical advantage. Thinkabout that as we celebrate our 238th birthday.”“For 238 years, our Navy has overcome enormous

challenges and faced adversity. We’ve risen withthose challenges and built a reputation as the stron-gest naval force the world has ever seen,” added Mas-ter Chief Petty Officer of the Navy Mike Stevens. Healso noted people, not resources or the environment,keeps the Navy moving forward. “This is our heri-tage,” he said.Looking forward, Greenert said for today’s Navy,

“War fighting is first; we [will] operate forward, andwe will be ready.We will use the genius of our diverseall-volunteer force, and we will be where it matters,when it matters, because that’s what [we’re] about[in] our great Navy of today.”The United States Navy traces its origins to the

Continental Navy and recognizes Oct. 13, 1775 as thedate of its official establishment – the date of the pas-sage of the resolution of the Continental Congress atPhiladelphia, Pa., that created the Continental Navy.

BIRTHDAYContinued from 1

class’s postponement; however the newly appoint-ed officers were still expected to report to work intheir new capacity.“Even though the class was put on hold, there

was a need to ship the uniforms because the officerswere called to duty,” said Tucker. “The commanderin charge wanted the uniforms to get to the officersso they could begin to tailor and wear their uniformsat their current station.”Therefore, the Bethesda uniform center staff took

it upon themselves to contact each of the 48 offi-cers, who had been scheduled to attend the class, toobtain their address and have all of their uniformitems shipped to their door, said Tucker.“We had uniforms sent as far as Mexico – all over

the world actually– everywhere you can think ofthat we go – that’s where Public Health Servicesgoes as well.”Tucker said she was not surprised to see her team

going the extra mile to meet the needs of their cus-tomers.“This kind of behavior is the norm,” she said. “Day

in and day out, we take care of our customers: fromenlisted, all the way up to O-10. When a customersteps through our doors, they’re in our home and wetry to make sure they’re taken care of just as if theyare at home.”Looking back on Lushniak’s visit, Tucker said it

was enlightening to see the surgeon general taketime to recognize a small group of dedicated indi-viduals.“It was a joyous occasion: to know that the com-

mitment to serve is appreciated,” Tucker said, withtears in her eyes. “To see it take place, on my finalfarewell … I’ll always hold Public Health Servicevery near and dear to my heart because of the com-mitment they make voluntarily to protect the nation(of our people) – it makes me speechless.”

UNIFORMContinued from 6

from Norfolk, North Island, Italy and Yoko-suka,” said Herrera-Ruiz. “Some of these loca-tions are great locations on the water, so forus to be able to win this award is a big accom-plishment. This lodge has never won it in thepast. The [staff] also completed their certifi-cations through their educational institute.All of the [staff] were certified 100 percent.That’s the only way we can reach the highestlevels of customer service through customerservice and training.”With many businesses suffering at the

hands of their customer service, keepingthat particular area in the front of the staff ’sminds is obviously a key interest for thelodge.“My staff works hard, but it’s more than

that,” said Herrera-Ruiz. “They have to beable to connect with the guests, because someof them are going through very difficult times.In our line of work you have to be able to bea mother, father, friend and even a priest tolisten to what they are going through in orderto connect with the guests. I think this is oneof the lodges that is the most challenging be-cause of the location and what the guests aregoing through. We have a lot of guests whoare terminally ill or their spouse is in thehospital because of their wounded warriorsituation. In order for us to have that level ofcustomer service is amazing. The guests taketime to write us and to give us some posi-tive feedback and that shows us that we areheaded in the right direction of exceedingcustomer satisfaction.”Nexcom also singled out one of the staff

from the lodge with the Worldwide Associateof the 1st Quarter recognition. Maritza Ma-drid received the award upon recommenda-tion from her manager.“One thing that stands out about Maritza

is her compassion when she found out abouta guest, Mrs. Collins, whose son was an Armywounded warrior, losing hope and not eating,”said Herrera-Ruiz. “Mrs. Collins was worriedfor her son and wanted to find authentic Mex-ican food, that same night Maritza returnedto the lodge with an authentic home cookedmeal for Mrs. Collin’s son. Three days later,she cooked another special meal for him.With Maritza’s help, Mrs. Collin’s son startedeating more and regaining hope.”Not only did the lodge receive the Hospi-

tality Award, it also helped to celebrate Na-tional Hospitality Week.Herrera-Ruiz pointed out that the staff

makes it a point throughout the year to makesure their guests have a clean and comfort-able stay at the lodge. This week allowed thestaff to show off their housekeeping and guestservice skills and have fun at the same time.The Navy Lodge Bethesda and others

worldwide hosted activities such as healthand safety awareness, vacuum cleaner dash,bed making contests and a laundry bag re-lay. The lodge also hosted a selection of foodfrom around the world and several musicalguests. Among the musical guests were StaffSgt. Randy White with ‘Musicians on Call’,Suzy Yazbeck, and the Mariachi band ‘Ma-riachi Los Mensajeros del Sur.’ The CulkinSchool of Traditional Irish Dance also did abrief performance for the celebration.“This base is a support activity for not just

the Navy but the other branches and the uni-formed health services,” said Macaraeg. “Itwas thrilling for the lodge to lead one of thediversity events here on base. It was excitingfor us to bring the diversity, not only from ourarmed forces, but more specifically Bethesda,the Navy Lodge and the diverse type of ser-vice members they see and their family mem-bers around the world. Tying it into culture,as well as being able to celebrate their awardwas awesome.”

LODGEContinued from 8

The Journal Thursday, October 17, 2013 11

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