Career Geography, Part 4 (Almost Done, I Swear)

One of the things I’ve been most proud of working for the VA (Department of Veterans Affairs) is that our veterans have access to the most cutting-edge technology in the world.  There are many partnerships with research entities like DARPA and Rory Cooper and his cadre of geniuses at Brown University.  Oftentimes when the most advanced technology is released to the public, Prosthetics in the VA is the only customer as Medicare and private insurance companies are slow to respond.  If it’s approved by the FDA, the VA will provide it for veterans. A perfect example is the iBot, the wheelchair that climbs stairs. 

DEKA is a research and development founded by Dean Kamen, who invented the Segway, while trying to create the technology for this wheelchair that would raise the user to eye-level as well as help them maneuver up a flight of stairs.  It became available on the market in 2005 at a cost of $25,000.  The VA was the main customer as Medicare only covered 20% of the cost.  I refer to DEKA as a brain hive in New Hampshire.  The people working there are so smart you can hear a faint buzzing sound whenever you are in their midst.  You may know them as the people who created the gleaming silver skeleton of the bad guy in Terminator 2.

I know all this as I visited their main office when they were demonstrating their latest artificial arm technology.  My boss in DC, Fred Downs, is an arm amputee.  Even though there had been many developments in technology for artificial limbs, it was mostly with legs as arm amputees (especially from the Vietnam era) were less frequent, as most of the time a battlefield explosion that would take someone’s arm would also kill them.  As the body armor technology advanced, more and more arm amputees survived their injuries and the technology needed to catch up to that of legs.

DEKA was doing phenomenal things and had created an artificial arm that could be raised above shoulder level, a task previously unachievable.  It could also allow the user to grasp a bottle or can (without crushing it) and bring it to their lips to drink, another task we take for granted that was previously unavailable to the target audience. As Mr. Downs is a very well-known gentleman-about-DC, serving as the National Director of Prosthetics for the VA for more than 20 years and having written several novels and appeared both before Congress and in many movies and TV shows, Mr. Kamen asked him to demonstrate their latest achievement on an episode of 60 Minutes to be filmed at their offices less than 30 minutes from my office at the VA.  How could I not attend?

During my time in New England, a new Deputy had been hired in the Prosthetics office where I used to work; Dr. Billie Jane Randolph.  She had been one of the important people who had seen my presentation about success we had been experiencing in our region.  She asked if I would meet them in New Hampshire, so we could talk about possibly creating a program based on my work.  We converged on the DEKA offices and were immediately told by the 60 Minutes producer that as we had not been cleared to appear on camera, we had to ensure that we avoided being filmed.  After 15 minutes of dodging a very busy cameraman, we decided to withdraw to the employee kitchen to eat and get to know each other. 

Just like Jackie, I was immediately enthralled as BJ and I clicked.  She was from the boonies of Kentucky but had risen through the ranks of the Army and serving as George W Bush’s physical therapist in the White House.  Armed with a PhD in Education, she was a force of nature, so when she asked me to come to DC to create an education-based review and audit program I was unable to say no.    So, in February 2009, I temporarily returned to my old job for what was to be a 90-day detail. 

Once there, I jumped in with both feet, creating an auditing tool, selecting and training team members from across the agency and planning weekly visits to all 153 VA hospitals over the course of three years.  We had ranked each facility’s Prosthetic Service based on our national metrics and started with the lower performers as they needed the most assistance.  Unlike other federal audits, ours was education based, meaning if we found a deficiency, we would immediately halt the audit and have a training session with all staff, followed by a meeting with the leadership to show them how we had found the deficiencies and how to proactively address them in the future. 

As the end of the 90 days neared, I was asked to extend another 30 days to lead the first two audits as a demonstration of how they should be accomplished; Tuscaloosa, Alabama and Pittsburgh, Pennsylvania were selected, and the training commenced.  Over the next two years, my detail was extended in 30-day increments while our teams conducted audits at facilities, ranging from Alaska to Puerto Rico, Hawaii to Maryland and many states in between.  The plan was to complete an audit at every location, but after we had completed our 53^rd trip, we were asked to take a step back, review our findings and develop a national conference, sharing what we had learned, both areas of consistent concern as well as Best Practices.  We used this conference in Boston to highlight some of the best performing sites we had found, including San Diego and Fresno, California as well as Boise, Idaho. 

One of the locations I had personally audited was Palo Alto, California, one of the largest and most complex VAs in the country.  It was one of five Polytrauma Level One sites, which was the first stop in the VA for any veteran discharged with a significant injury such as spinal cord injuries, amputations, traumatic brain injuries and visual impairments.  The five were in disparate parts of the country to ensure proper triaging before being sent to their home facility.  Due to this designation and the integral piece Prosthetics plays in returning veterans to as close to normal function as is possible in their homes, these facilities (Richmond, Virginia; Tampa, Florida; Minneapolis, Minnesota; San Antonio, Texas; and Palo Alto) should have a stellar Prosthetic Service.                While there is no such thing as a perfect program, there were significant issues in Palo Alto and after my report was shared with facility leadership, I promised I would find them the right leader to take them to the level where they should be.  I tried to find the person with the right mix of subject matter expertise and leadership skills.  I reached out to those I felt would be successful, but most were unwilling to move for family or career reasons.  I couldn’t fault them for that.  I realized I knew of only one person who was both the perfect fit and a gypsy at heart; me.  I asked me if I was interested and, lo and behold, I was.  

             
               In June 2011, I packed up my life and drove across our great land, almost literally from sea to shining sea with my best friend Christopher and a 2006 Dodge Charger crammed to capacity with clothes, books and other belongings I didn’t trust the movers to deliver unscathed.

If you had told me, even six months before, that I would be living in California at any point in my future, I would have thought you were crazy, yet here I was.  Welcome to Silicon Valley, home to 15-year-old millionaire tech nerds, weirdly aggressive hippies, astonishingly over-priced tract homes and the trust fund babies of Stanford, the only university I know of with Louis Vuitton and Tiffany’s retail stores on its campus.  How would I fit in? 

What if Goldilocks was a Red-headed Dude?

                It has arrived.  We celebrated Daddy’s one year anniversary in California with the purchase of a new recliner.  He also celebrated with a bag of iced animal crackers he stole from my shelf in the pantry and he thinks I don't know, but I do.  This new recliner is leather because that particular material is less prone to retaining smells and subsequently my monthly Febreze supply can be at least halved.  This will free up significant cash reserves to be used for all manner of fun things like SusieCakes salted caramel apple cupcakes and thrift store sweaters, as the fall season is upon us.  Well, not so much ‘us’ here in the sorta-western-central-just-south-of-Napa-Valley part of CA, but for the rest of you people who have to suffer through extreme weather outside of the 55-80 degree year-round range.  Apparently, money can buy happiness.

                Now I’m not saying that anyone out here in Silicon Valley used their significant brain power to harness the weather and make it as wonderful as it is.  I’m simply positing that the Steves, Jobs and Wozniak, had to have spent their youth doing something besides playing three dimensional chess, paintball and inventing computers, if I am to believe the hobbies and interests portrayed by the nerdy geniuses on the Big Bang Theory.  If Sheldon built a CT Scan in the wilds of Texas, one of the Steves could have built a weather-controlling device at the behest of a golf-loving father.

The unnervingly nice weather is one of the things that delights and confounds my father, who has spent all but three of his 71 years in locations where the presence of any moisture, like saliva, is a sign one is from elsewhere.  The one three month stretch he spent in California, during the summer before my senior year in high school, was as a welder in Boron, which is reportedly as fun as you would imagine a town named after an element in that section of the periodical table would be.

As my Daddy has a shoulder injury from long ago, I was able to talk him in to getting a remote controlled chair that will recline the back and lift the feet with the push of a button.  As persnicketiness is apparently hereditary, he was adamant that he ‘tryout’ the chair prior to purchase.  This required a sojourn to the La-Z-Boy showroom in Santa Clara, about 15 miles from our house.  He is a lifelong customer of this particular merchant as their name is his retirement mantra.  And they are sole producer of what is known as a ‘Big Boy’ recliner.  To the uninitiated that pretty much means a loveseat with elevated leg supports.  This recliner, while just a smidge smaller than his previous chair, is still wide enough to necessitate full size sheets were one to outfit it properly for sleep, which is the activity most enjoyed in this particular piece of furniture.

You can only imagine the circumstances that arose when he, not unlike a dog, felt the need to ‘mark’ his territory by subsequently farting in each chair.  He ambled his way around the showroom and sat in every chair including those I knew he would never buy, like ones with floral chintz or wooden legs.  This was while he was still using his wound vac for the “lower back” surgery.  The vac is housed in a shoulder harness that looks like a tiny messenger bag.  He was very self-conscious about tha bag when anyone of any level of brain power could see there were tubes running from his “man purse” to his body and deduce it as a medical device. 

However, to ensure that all and sundry knew of his macho-ness, he, very loudly, stated that he was “not carrying a man purse”.  He was but a simple macho paratrooper forced to wear a “contraption” because of my “a-double-s surgery”.  My face turned the color of my orange chinos and I immediately took up with an Asian family standing nearby, convinced them I was an in-store designer and helped them find the perfect sectional sofa.

He was looking forward to getting his chair that day but it had to be special ordered because he wanted one that had an extra-long leg rest for reasons known only to him.  His inseam is 27” but his patented way of sitting (a series of leg hikes, contortions and scooting) and his need for 100% of his feet and shoes to be supported by the chair make it almost impossible to find the perfect chair.  And the perfection of the chair is important because he spends all day and all night in this de facto bed.

Lately, however, due to his increased pain from his back he has been spending an inordinate amount of time in an actual bed.  He has a hospital bed from the VA but he says the mattress is “too hard”.  I put an egg crate mattress topper but he is adamant that it is still too hard, like an overweight Gingerlocks as his hair is still red, despite the copious amounts of white in his beard.  He is forced, he says, to sleep in the guest bedroom, which is the most attractively decorated room in my home.

      

When I first moved into this house, I chose this bedroom for its central location and it became an art deco haven filled with my favorite furniture like a cream linen headboard and mirrored dresser, nightstand and lamp.  The boldness of the purple accent wall is tempered by the pewter comforter and occasional chair with pops of pink and lime green found in the wall art, throw pillows and vases.  It is an amazing room from which I was summarily roused by the nightly brouhaha that emanates from his bedroom due to his and apparently Lulu’s sleep apnea. 

I now reside in the former guest bedroom which while it is well decorated with a leather wrapped sleigh bed and a color scheme of coral, aqua and off-white, is not a room to make one ‘feel fancy’ which was one of the main purposes of the art deco world I attempted to create.  If one cannot make up for childlessness with fabulous décor, what is the point of celibacy?  I would have ridiculously fabulous children were I to ever find a woman brave, forgiving and fantastical enough (like, say, a former Miss America) to undertake a life filled with more pizzazz than is warranted outside of a theatre.  I am the physical manifestation of jazz hands, dear readers, and I am aware that I am a bit much, at times.

My father protests that there is too much “fancy” in this house, but I think it interesting that he chose the best bedroom with little fanfare.  I came home from work one day and there he lay, like a dead sea lion oddly placed in the housewares section of better department stores nationwide.  Don’t look at me like that; Tractor Supply hats and suspenders do not scream art deco people.  What it does scream is, “Help Me!” a point that is, by now, moot.  He looked so out of place I almost thought there had been an attempted burgle from a narcoleptic criminal.  What?  I prefer burgle to burglary.

He has insisted that the mattress, a pillow top from Serta, is “too squishy” but it seems that it is more than “just right” as he has slept in that bed for the last two weeks, on a blanket on top of the comforter lest his ‘old man smell’ ruin the ice-pink 800 thread-count sheets from the people who brought you the pyramids.  What?  I’m not being mean, it’s not like the man sleeps in pajamas; he sleeps in the same clothes he wears all day.  The only difference between his ‘awake and going to Wal-Mart’ outfit and his ‘dozing/sleeping’ outfit is that the latter doesn’t include the hat, glasses or teeth, but does include the phone.

So it has fallen to me to break in the recliner, if you will.  I spent most of Saturday afternoon watching a Big Bang Theory marathon while he slept away the effects of his medicines and it was a revelation.  You would imagine something that large would seemingly envelop you and you would be right.  I was so comfortable curled up in that chair, I chose to skip my snack as it was all the way in the other room and my body said, “Seriously dude, do not get up”.  Apparently my body’s inner voice has assimilated to California-speak much more quickly than the rest of me.

With the level of comfort in was experiencing, I made the decision to watch the latest Dr. Who episode without the added delight of Snapple or Garden Salsa Sun Chips, my latest favorite thing, when Daddy chose the stroke of 6:00, the start time of said BBC sci-fi selection, to arise and request assistance with medicine, food, etc. 

No worries, I told myself, it will re-run at 9:00.  You can already guess that he arose again at the stroke of 9:00, demonstrating that timing is everything.  And the timing in the future shall be that of a move to the nursing home nearest Shreveport, LA and his sister, if he makes me miss another episode of one of only four shows I watch in any given week.  What?  It’s not like I haven’t admitted to being downright persnickety.

Y’all need to pay attention…and buy my book (www.authorhouse.com). And that is all I’m saying.