VA HOSPITAL ADMINISTRATOR
April 26, 2005

Of the more than 10,000 soldiers wounded while on duty in Iraq, hundreds face major life-long injuries which are taxing both their families and the nation's military medical system. As a part of her reporting on this issue of long-term care for the some of the most severely wounded, NewsHour health correspondent Susan Dentzer spoke with Sandy Garfunkel, director of the Washington D.C. Veterans Administration Medical Center. The following is an extended transcript of their conversation. The NewsHour Health Unit is funded by a grant from The Robert Wood Johnson Foundation.

 

April 26, 2005: Susan Dentzer reports on efforts to care for the seriously wounded from Iraq. Extended Interviews Joseph Briseno, Sr., father of wounded soldier Dr. Steven Fish, Biseno's doctor at the VA Hospital Dr. Sandy Garfunkel, Director of the Washington D.C. Veterans Administration Medical Center Suzanne Mintz President of the National Family Caregivers Association Past Reports: Online NewsHour Special Report: Coping with U.S. Combat Injuries Nov. 9, 2004: Soldiers struggle with the lasting effects of post-traumatic stress disorder. July 16, 2004: Soldiers suffering from brain injuries face unique challenges. Dec. 3, 2003: A soldier recovers after loosing part of both his legs. April 11, 2003: Susan Dentzer visits with two soldiers recovering from war-time injuries. March 29, 2003: A look at advances in battlefield medicine Browse the NewsHour's coverage of health   The U.S. Department of Veterans Affairs

SUSAN DENTZER: Jay Briseno is an extremely disabled young man. How typical is he, at this point, of the population that the VA is having to care for? DR. SANDY GARFUNKEL: For this hospital he's, he's not typical at all. He is probably our most severely injured veteran. We, we're not a spinal cord injury center, so we generally don't treat spinal cord injury patients, and as you know he's, he is paralyzed from the neck down and has very severe injury, so I would say, by far, he is, he is the most severely injured patient that we deal with. SUSAN DENTZER: And his parents have made the decision to have him cared for by them largely in the community with a lot of support by the VA. DR. SANDY GARFUNKEL: Yes. SUSAN DENTZER: How typical is that? DR. SANDY GARFUNKEL: Well, the family has really made the decision. The family has made what is an unusual decision, really, to sacrifice a good deal of their personal lives to, to care for Jay at home and they spend literally 24 hours a day, seven days a week caring for their son. We, we provide nursing. We, we hire an agency who provides nursing care to Jay. Our physicians take care a Jay. Sometimes they go out to the, to the home. By the time Jay comes in for some special care our, our pulmonary physicians take care of his breathing issues, our therapists, our respiratory therapists make sure that he, he can breathe clearly. Our physical therapists give him some physical therapy. Our lab people do lab tests on him. The equipment that he has, the bed that he's in, the breathing equipment that he has is all provided by this medical center. So we actually provide, working with the family, total care for, for Jay. SUSAN DENTZER: And again, that's unusual, for the combination of the family having a child who needed such intensive care. DR. SANDY GARFUNKEL: Right. It's very unusual. If somebody who did need that kind of care, generally would be in a hospital setting, in Jay's case he would be in our intensive care unit for an extended period of time, obviously, and be receiving that level of care, but totally through VA staff. In this case, his family provides 24 hours a day, provide loving care to Jay and fully participates in the car that he receives. SUSAN DENTZER: Now all of this costs a lot of money, so let's talk about that. What has the VA expended on his care? DR. SANDY GARFUNKEL: I can't tell you exactly what we've expended but, but the--I would estimate that if we go through a whole year, considering everything that we do, it approaches a half a million dollars a year, and that, by the way, is probably what it would cost if Jay was in the medical center in our intensive care unit. But this is, this is a veteran, our job is to take care of veterans, and we don't--we--obviously, we're cost conscious of what we do but we, we do what's necessary to keep our veterans alive and to hopefully nurse 'em back to health The Brisenos want to see that Jay gets everything that, that he can get, and, and that's what we want to see as well, and one reason I think we have such a good relationship with the family is that they know that we're going to do everything we can for Jay and, and they want everything for Jay. So we're on the same wavelength.