Director's Message May 26, 2023

They honor those they have lost and thank them for their service and their sacrifice. This tradition is one of the many ways we cope with the unimaginable loses that our country sustains in war.

When we think of the cost of war, we never think about the buildings that were destroyed or the money that was spent. First and foremost, we think of the young people who died in an effort to preserve our country as a bastion of freedom and democracy that sets an example for the world. There is no higher cost in any war than that of the soldiers, sailors, airmen, and marines who do not make it home.

At VA Pacific Islands Health Care System (VAPIHCS), we often focus on caring for the Veterans because that is our sacred task and it is our honor to care for the men and woman who worn the cloth of our nation. Our mission is an important one, and I hope all our ohana feels proud of the work that we do here. Yet -when we look up from the daily tasks of our lives- let us take time to give a thought to the men and women who were lost in combat, who never made it home to be in our care. OUR honored dead will always be in our hearts.  Memorial Day is a special time when those who have made the ultimate sacrifice can be remembered and honored for their selfless service.

In honor of Memorial Day, our clinics will be closed on Saturday, May 27, 2023, and Monday, May 29, 2023. Please have a safe Memorial Day.

Skin Cancer Awareness Month

In Hawaii we see a lot of sun. That can be a good thing because sunlight often makes people more cheerful. However, it can also be a dangerous thing. I hope that all our VA Pacific Islands Health Care System (VAPIHCS) Veterans are wearing reef-safe sunscreen when participating in outdoor activities. Even if you don’t typically get a sunburn, you are still getting exposed to Ultraviolet (UV) light.  That means you still need to be wearing sunscreen to help prevent skin cancer.

Race and ethnicity influence a person’s skin tone, which can affect the appearance of skin cancer. In lighter skin tones, skin cancer may be red, brown, or black. In deeper skin tones, it may be a similar color to the surrounding tissue. Caucasian people are more likely to develop some kinds of skin cancer, but if you’re not Caucasian, that doesn’t mean that you don’t have to worry about skin cancer. Melanin does provide some protection against UV light, which is the leading cause of skin cancer. However, all people are at risk.

If a new growth of rash appears, look out for:

Asymmetry: Look for growths with an asymmetrical shape.

• Border: Check for irregular borders.
• Color: Look for uneven pigmentation, a growth with more than three colors, and concerning colors such as red, white, blue, and black.
• Diameter: Check for large growths that are bigger than the diameter of an eraser.
• Evolving: A growth that changes over time may be cancerous.

People should also look for:

• raised bumps or nodules
• open sores that do not heal or that come back
• wart-like growths
• scaly patches
• black, pearly, and translucent skin growth
• moles that bleed or grow

Speak with a doctor as soon as possible about any growths with these characteristics by calling 1-800-214-1306. Remember; don’t assume you’re safe just because you don’t sunburn. Skin cancer can happen to anyone. Be proactive and keep an eye on your skin.

Age-Friendly Care

The concept of an “age friendly” organization was the project of The John A Hartford Foundation, and the Institute for Health Care Improvement. It is supported by the American Hospital Association and the Catholic Health Association of the United States. The goal of this framework is to deliver health care in a way that is mindful of the Four M’s:

What Matters: Know and align care with each older adult’s specific health outcome goals and preferences.

Medications: If medications are necessary, use age-friendly medications that do not interfere with What Matters of Mobility.

Mentation: Prevent, identify, treat, and manage depression, dementia, and delirium across settings of care.

Mobility: Ensure that older adults move safely every day in order to maintain function and do What Matters.

Seeking to become an age-friendly organization was easy for VAPIHCS, since we already do these things through the Whole Health program. Your care should always be guided by what matters to you, because that is what Whole Health is all about. We seek to see the Veteran as a whole person, and to treat them in ways that are culturally sensitive, mindful of each Veterans specific needs, and with a focus on mental, physical, and spiritual health.

If you haven’t come in for your yearly physical yet, please make an appointment. It's important to see your doctor at least once per year. When you are there, make sure your doctor knows what matters to you, and ask about programs that you may find useful. For example, our Move program is an excellent way to keep up with daily exercise. We might have a research study that you would like to participate in as well. A medication review might give your doctor a chance to talk to you about side-effects, and substitutions for medications that are not working well with your lifestyle.

No matter what you like to do or how your health is, we want you to age with the grace and dignity that you deserve. We are focused on providing age-friendly care to our Veterans. Ask your doctor about changes you can make as you age to stay healthy, manage health conditions, and accomplish your goals for your golden years.

Thoughts from Chaplain Richie Charles

Duke Kahanamoku, born in 1890 in Honolulu, Hawaii, and gained fame as a swimmer and surfer, becoming an iconic figure. He won multiple Olympic medals, including three gold and two silver, between 1912 and 1924, solidifying his reputation as a legendary athlete. Despite his success, Duke was known for his graciousness, with it even being said that he would intentionally slow down during races to avoid humiliating his competitors.

The AAU, which stood for the Amateur Athletic Union, was the organization that regulated the Olympic sports in the United States. In 1911, Duke emerged victorious and shattered records at a swim meet organized by the local Hawaii chapter of the AAU. But his impressive times raised suspicion among AAU officials in New York City, who doubted the accuracy of his results. Otto Wahle, chief aquatics advisor to the leader of the AAU and the official record-keeper for swimming, sent a letter questioning the legitimacy of Duke's performances. Ironically, Wahle was a former swimmer himself and knew Charles Daniels, whose records Duke was said to have broken.

Undeterred by the controversy, Duke focused on the 1912 upcoming Olympic competitions. He represented the United States and won the gold medal in the 100-meter freestyle at the 1912 Olympics in Stockholm – a first in a series of several of his Olympic triumphs.

Duke Kahanamoku did not merely break world records; he transcended the limiting expectations placed upon him by others. Throughout life, it is often true that our abilities and potential might be doubted by some. But sometimes, the limits others place on you may say more about them than they say about you. A person may doubt another’s abilities simply because they were not able to accomplish the successes of another. But negative words will not be able to limit us unless we believe them and accept them as true. Let’s decide to believe the right words.

One Team, One Ohana!
Adam M. Robinson, Jr., MD, MBA, CPE
Director, VA Pacific Islands Health Care System
VADM, MC, USN, (RET)
36th Surgeon General, USN

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