Office of Public and Intergovernmental Affairs
Remarks by Deputy Secretary Sloan Gibson
Project Healing Waters Fly Fishing
March 15, 2016
Several years ago, I went to West Point for the first home game of the season. At lunch before the game, I was seated next to a young soldier. His dad, Craig, introduced me to his son, Army Sergeant First Class Cory Remsburg.
America met Cory when President Obama introduced him during the 2014 State of the Union Address. A few years earlier, Cory had been one of nine Army Rangers whose vehicle was hit by a 300-pound improvised explosive device outside Kandahar.
All were casualties. One Ranger was killed. Another lost a leg. And a third—Cory Remsburg—was thrown into a nearby canal, the right side of his head shattered and caved in. The only news Cory’s battlefield commander could give Craig when they spoke on the phone was, “The last time we saw him, he was still alive.”
Parents cling to that kind of hope.
Cory underwent six surgeries at military hospitals in Afghanistan, Germany, and Bethesda, before arriving weeks later at the VA polytrauma center at the James A. Haley Medical Center, where he’d be for the next year. When Cory arrived at the polytrauma center, he was comatose—in a state doctors described as “vegetative.” His odds for recovery were not great.
His dad Craig well-remembers their first 24 hours there—a veritable parade of doctors coming in to conduct initial assessments. The last one to stop by was a recreation therapist, and she was talking about all the things Cory was going to do. Craig was like, “Recreation therapy? He’s comatose!”
Craig had never heard of sports therapy, and he certainly didn’t understand how important it was going to be to his son’s recovery.
Let me tell you about some of the folks at the Tampa polytrauma center—now celebrating its tenth year. The Chief of Recreation Therapy there is Cathy Williams. Cathy’s been with VA in Tampa for two and a half decades. She’s been a sports therapy disciple since she was seven, when her brother broke his neck. Wheelchair racing saved him.
Dr. Steven Scott is the Chief of Physical Medicine and Rehabilitation Services. He’s been involved in rehabilitative medicine for over three decades. In fact, he and a colleague coined the term poly-trauma in response to the complexity of compound injuries Veterans were surviving coming out of Desert Storm.
I don’t know if anyone who has explained sports therapy’s immense importance to Veterans like Cory more succinctly than Dr. Scott: “Recreational therapy,” he’s said, “give[s] a freedom to those who fought for our freedom, freedom to run when they couldn't stand, freedom to think when they could not remember their name, freedom to be successful when they felt lost, and a feeling of hope for a new meaningful life at home.”
Hope is what Dr. Scott, Cathy, their team of 21 professionals, and the whole staff at Tampa is about. There’s simply none better.
Last October, I was in Tampa with the MyVA Advisory Committee, and we all visited the polytrauma center. Dr. Rich Carmona, one of our committee members, was there. Rich was the 17th Surgeon General of the United States, a disabled Special Forces Veteran of Vietnam. Here’s what he said about the sports therapy they’re doing in Tampa: “Nobody is doing this. Nobody. What they’re doing is truly world-class.”
Well, Cory and his family and the folks at the polytrauma center never gave up hope. They rallied to Cory’s side, working his limbs, massaging his body, and stimulating his brain with a wide variety of sensory experiences—from his favorite music to aroma therapy to TV sitcoms—everything they could think of to bring him to consciousness.
Three months after the blast, Cory woke up, one of the seven-out-of-ten patients with severe TBI brought back to life through VA’s Emerging Consciousness program. And as important as that first step is—returning to consciousness—being conscious is a far cry from being brought back to life.
There’s a lock on being truly brought back to life, on moving ahead, on living life to the fullest. Our job, yours and mine, is giving Veterans the right key to open that lock.
VA traces its sports therapy program back to the National Home for Disabled Volunteer Soldiers 150 years ago. Back then, it was pretty tame, things like billiards and bagatelle; chess, checkers and, dominoes; cards, backgammon, and quoits; croquet, walking, and boating there on the grounds.
Today, greater battlefield survival rates than we’ve ever witnessed—coupled with medical advances in brain injury and post-traumatic stress and technological advances in prosthetics—have opened a whole new, wide world of opportunity for our nation’s wounded, ill, and injured troops and Veterans.
And kids serving today are more active—physical fitness and adventure and extreme sports are a part of their lives. What’s more, they’re an integral part of their identities. So coming back to life after coming back to consciousness is all the more challenging for them. And all the more important.
Moving ahead, living life to the fullest extent possible after the kinds of devastating injuries Servicemembers survive today, requires a lot of keys on the chain to open that lock on life.
That’s why, for example, the polytrauma center in Tampa has a climbing wall. It’s why they have their own sailboat. It’s why Special Ops Veteran of Afghanistan, Iraq, and Bosnia Josh Collins went from TBI and PTSD treatment at the polytrauma center to paddle boarding—“’Standup paddle boarding brought balance back to my life,’” he’s said.
It’s why things like SCUBA, flat water and white water kayaking, equine therapy, cycling, snowboarding, bob-sledding, skiing, slalom skiing, blind slalom skiing, blind swimming, archery, shooting, biathlon, triathlon, marathons, fine arts . . . fly fishing . . . Paralympics, Summer Sports Clinic, Winter Sports Clinic, Wheelchair Games are all so vitally important.
All of those are different keys to life after injury. And VA doesn’t have all the keys. People like you and other non-profits and community partners have many of them.
Cathy Williams put it like this: “It’s not about treating Veterans in the hospital. It’s about treating them in the community. They’re going to live in the community, at home. That’s why community partners are so important.”
When I was with the USO, I realized three areas where I don’t believe any organization can meet the challenge on its own. One is Veteran homelessness. One is mental health.
And the third is career transition. And when you’re talking about the Nation’s wounded, ill, or injured troops or Veterans, you’re often talking about mental health and transition challenges.
VA can’t meet those on our own. So I want to talk about collaboration.
When I arrived at USO, great people were working hard and doing their best for the organization. We were about lifting the spirits of troops and their families. Conventional wisdom is about doing what is best for the organization, so you can be there to sustain the work.
But the interests of the organization can’t be subordinated to the interests of those we’re serving. Collaboration dictates that we do what is best for those we serve—Servicemembers, Veterans, and their families. I discovered that as we pushed to extend collaboration to other organizations, that paradigm breaks down. Suddenly you can’t be about your organization.
We’re all competing for donor dollars, so why collaborate? So, why collaborate with TAPS? Why collaborate with Ride to Recovery? Why collaborate with Project Healing Waters?
Because together, we can do even more for those we serve than we can working separately. So you shift from conventional to collaborative, and you take a leap of faith. And you trust that doing the best for those we serve will be best for the organization over the longer term.
A few years back, I once spent the better part of a day with Jim Collins. Jim Collins wrote a monograph entitled Good to Great and the Social Sectors. One of the things Jim talks about is the engine that drives the non-profit world, and he talks about the virtuous cycle.
He explains that in the private sector there are universal metrics like earnings per share and return on equity so you can attract more capital.
But in the non-profit world, Brand Reputation is what matters most—Brand Reputation drives the virtuous cycle. You get some resources, and you go do some good things with those resources, and people learn that you did good things with those resources, and they give you more. And so you start working that virtuous cycle.
Think about how authentic that is for you and your organization—the authenticity of being grounded in the difference you make for those you serve.
But how do you measure it? How do you evaluate it all? I’ve always thought about the processes like this: inputs, activity, output, outcomes, and impact. We’re used to measuring what we do in regard to input and activity. How many hours have we put in? How much have we spent?
How many grants have we awarded?
By the way, we’re taking applications now through April 28 to apply for FY16 Adaptive Sports Grants. I trust you’re applying. There’s another $8 million on the table this year.
The further you go toward outcomes and impact, the harder it is to measure. But these are the very elements we need to focus on. Think about outcomes and impact and how those bring you together in a collaborative organization.
Outcome—families welcoming their Veterans back after struggles with demons like alcoholism and addiction.
Outcome—healthy rather than destructive lifestyles.
Outcome—reduced suicide rates for Veterans participating in recreational therapy and adaptive sports.
Outcome—Veterans needing fewer medications and getting off of things like narcotic pain killers.
Outcome—a Veteran smiling ear to ear as his wheelchair is put in the water so he can fly fish rather than just watch from the bank.
Outcome—an injured Veteran and his Veteran wife reporting their “new sense of independence and great camaraderie. Our whole family was impacted by our accident,” she wrote, “and our whole family has been touched by Project Healing Waters. They are a gift from God.”
Impact—a Veteran happy again after long periods of sorrow.
Impact—Veterans finding fulfillment living every day to the fullest.
Impact—a parent seeing a son canoeing for the first time after coming out of a coma and realizing, “My son’s going to get through this and flourish.”
That’s the ultimate impact we’re all after—a happy and fulfilling life for those we serve.
I’ll shift gears. I’ve been at VA for about two years now, but I haven’t forgotten what it feels like to look at the Federal government from the outside in—to think about what the American people expect of government:
- Governmental departments working collaboratively, rather than functioning as silos.
- Federal agencies working with states and counties and cities in true inter-governmental collaboration.
- Processes engaging NGOs and the private sector in meaningful public-private partnerships.
- Programs tackling significant challenges and providing appropriate support to those among us in greatest need.
- Goals and objectives based on measureable outcomes for those served.
- Sustained effort and steady progress reported year by year against those outcomes.
In my view, those are the characteristics of good government, of best-in-class collaboration—relationships with non-governmental partners in communities to bridge gaps in support during Servicemembers’ treatment, recovery, and reintegration processes. And one of the places I see that kind of best-in-class collaboration is Project Healing Waters.
After a decade of caring for wounded Veterans—during an era of intense operational tempo—you’re still going strong:
- Thousands of Veterans served annually—free of charge.
- Nearly 3,000 volunteers dedicating a day, a week, a month of their time throughout the year . . . hundreds of thousands of hours.
- Referrals directly from therapists and social services encouraging their patients and clients to participate.
- Diverse partnerships with the Department of Defense, the Department of Veterans Affairs, with Warrior Transitions Units, with private foundations, with local businesses and fly-fishing clubs and chapters.
- Sustainable programs tailored to fit local requirements on a model you’re scaling nationally so your efforts and experiences make a difference in communities across the country.
- Clients becoming volunteers themselves and encouraging their peers to benefit from what they found—building a brotherhood among Veterans like Russ Marek, Alf Fischer, and Vince Bellisario who found the solace they needed in Project Healing Waters. Russ, Alf, and Vince are back here now as volunteers, demonstrating the art of tying flies.
- Taking the funding you receive and investing it into the program to build organizational capacity and relationships among the teams of regional coordinators, medical professionals, and Veterans.
- Sharing best practices, standardizing and institutionalizing what works, and delivering it across the country.
- Investing in people so you can get a great, long-term return on donor dollars.
With productive partnerships and that kind of best-in-class collaboration that focuses on outcomes and impact, the world is your oyster. Together, we can accomplish things for Veterans beyond our wildest imagination.
While I with the USO, I saw the new USO space under construction in Tampa, Florida. When I was there, I asked for a tour of VA’s new Polytrauma Center, also under construction. A few minutes later, this crusty-looking guy in blue jeans and a cowboy hard hat showed up to take us through the site. It turned out to be Mike Tixier, a West Point grad I remembered from cadet days.
Mike gave us a great tour. By the time we were actually on the amazing polytrauma floor, it was clear that he cared deeply about the work he was doing. In fact, one of the folks with me said, "Mike, you seem to be very passionate about what you're doing here."
He paused, which made me look right at his face, and I realized there were tears in his eyes. And he said, "That's because I know who it's for."
We all know who it’s for.
It’s for people like Cory Remsburg and countless others on the often arduous journey back to life. Cory Remsburg’s back home in Phoenix now, in therapy five days a week for three or four hours a day. Speaking and walking are still a challenge, but he’s learning to drive again. His mother says he never admits to being tired, and he won’t stop an exercise until he’s told to. He’s still a Ranger at heart.
Not long ago he rafted the Colorado River for six days straight. He slept along the river banks, and, with the assistance of fellow wounded warriors, he hiked out seven and a half miles along the Bright Angel trail.
Hiking, rafting, canoeing. Tying flies. Building rods. Fly fishing. Whatever the endeavor, all of these things are about coming back to life, about hope. About families succeeding again.
Ed [Nicholson, President/Founder Project Healing Waters], Bob [Fitch, Vice Chairman], thanks for inviting me to share some time with you and these great people.
And on behalf of all Veterans, thank you for the gift of hope you give to Veterans and families who need it.