DENVER (AP) -- Congress is showing an increased willingness to let VA doctors talk to veterans about medical marijuana in states where it's legal, although final approval is far from certain. The House approved a measure this week that would let Veterans Affairs Department doctors help their patients sign up for state medical marijuana programs, something the VA now prohibits. "I'm certainly open to it," Rep. Mike Coffman, a Republican and former Marine from pot-friendly Colorado, said Friday. A Senate committee approved a similar measure last month but the full Senate hasn't voted. Medical marijuana is now legal in 23 states and the District of Columbia, but pot remains illegal under federal law. Arguments for medical marijuana are getting a warmer reception from lawmakers amid nationwide concerns about overuse and abuse of prescription painkillers and psychotropic drugs. Coffman, chairman of a House Veterans Affairs subcommittee on oversight and investigations, said he wasn't enthusiastic when his state first approved medical marijuana. But if the drug helps veterans deal with post-traumatic stress, it could reduce the use of stronger prescription drugs and save taxpayers money, he said. The measures in Congress wouldn't permit the VA to provide patients with marijuana, Coffman said. It would only free doctors to talk about it with their patients. Rep. Earl Blumenaur, D-Ore., who sponsored the House measure, said medical marijuana could be safer and more effective than other drugs for veterans suffering from chronic pain or the stress disorder. Providing access to pot as an alternative "is critical at a time when our veterans are dying with a suicide rate 50 percent higher than civilians and opiate overdoses at nearly double the national average," Blumenaur said in a written statement. Research on whether marijuana helps with PTSD has been contradictory and limited, and the VA has warned that increasing numbers of veterans who suffer from it have become dependent on pot. The VA didn't immediately respond Friday to a request for comment on the proposals in Congress. Congress has killed similar measures in the past, but backers say the proposals are attracting more votes this time. Blumenaur's measure passed Wednesday 233-189, including 57 Republicans in favor. Coffman's subcommittee held a hearing in Denver Friday on problems in the way the VA prescribes and keeps track of drugs. He cited the case of a pharmacy technician at the Denver VA Medical Center who officials said was found in an operating room trying to inject herself with a painkiller stolen from a hospital refrigerator. BY DAN ELLIOTT
WARWICK, R.I. (AP) -- William Delaney, a former Marine, had already served four years of probation for an alcohol-related offense in Florida and was back in court, this time in Rhode Island, for driving under the influence. His newest brush with the law, combined with his alcoholism and depression, he feared, could close the door on the rest of his life. That was almost two and a half years ago. Delaney now mentors other veterans in that same court, and he's working toward earning his master's degree in social work to continue helping veterans. The Veterans Treatment Court opened five years ago in Warwick, Rhode Island, as the first specialty court in New England to help veterans avoid jail and turn their lives around. Like Delaney, most of the 220 veterans who have completed the program haven't committed another offense. The rate of recidivism stands at about 6 percent, according to the court. "We judge ourselves really harshly in addition to how the court judges us because of how far we've fallen," Delaney said. "It's just devastating. Even such a small thing as having a judge smile and say she understands, and having a treatment team that truly cares, it's a spark. It makes you believe you can do it differently this time." For Delaney, that jurist was Associate Judge Pamela Woodcock Pfeiffer. "She seemed like she cared. She reminded me of who I could be and who I was. I wasn't the bad guy," he said. "I wasn't the lost, drunk person. I could be something better again. That was the life-changing moment." Woodcock Pfeiffer also has kind words for the court and for veterans like Delaney. "I am totally convinced it's working," Woodcock Pfeiffer said. "People are very clear that if it were not for this, then they would have all these problems." The first veterans treatment court started in 2008 in Buffalo, New York. Similar courts sprang up nationwide as a way to help reform the criminal justice system, lower costs by reducing the prison population and recidivism rates, and connect veterans with treatment programs. Today, there are more than 250 and hundreds more are planned, according to Justice For Vets, which advocates for the establishment of the courts and provides training for jurisdictions with new courts. The Rhode Island court has received hundreds of referrals from District Court for misdemeanor cases. Veterans can opt to stay in District Court, where their case would likely be resolved faster. If they go to the veterans court, they have to follow whatever treatment the court prescribes to address substance abuse, behavioral or other issues and regularly check in with court staff, usually for 10 months to a year. At the end, often their case is dismissed entirely and expunged. The court currently has about 70 active cases. Chief District Judge Jeanne E. LaFazia said the veterans court gives people tools to reintegrate into their community. She credits Woodcock Pfeiffer for getting to know the veterans well, which invests them in the process. "By the time you get someone in here, they are often at rock bottom," LaFazia said. "You're helping them rebuild themselves. It's a remarkable difference." Both LaFazia and Woodcock Pfeiffer said the state has a duty to help veterans and give them a chance. The court holds graduation ceremonies for veterans who complete treatment. At a recent ceremony, Woodcock Pfeiffer praised the veterans for their hard work and asked them pointed questions about their future plans to make sure they would not fall back on old patterns. "I hope we've been able to give you hope, and the ability to control some of the things that sometimes control you," she said. The veterans were presented with a coin in the style of a military command coin, which is meant to show one's military affiliation and instill pride. It bears the last six words of the Pledge of Allegiance: With liberty and justice for all. BY JENNIFER MCDERMOTT
LOS ANGELES (AP) — After three military combat tours in war-torn Iraq, Chase Millsap returned home to get on with a civilian life. But there was one thing he couldn't do: leave a comrade behind, certainly not one who had saved his life. Especially not the former Iraqi military officer who had worked with the Americans and was now living a precarious existence as a refugee dodging Islamic State militants seeking to kill him. For the past two years, Millsap has been fighting a different kind of battle, one to gain asylum for the brother in arms he simply calls The Captain. "The Captain is the epitome of my personal commitment to take care of people," said Millsap, 33, who served in the Marine Corps and later joined the Army and became a Green Beret. For the time being, The Captain lives in southern Turkey, struggling to obtain refugee status in what he hopes will be the first step toward seeking permanent asylum in the United States. "If I go back, I'm sure I die," the 37-old Muslim and married father of two said recently during an interview over Skype. He agreed to speak, but, fearing for his safety, only wanted to be identified by his former rank. As he spoke, his 3-year-old daughter and 4-year-old son played in the family's living room. Millsap visited his friend last year at his cramped apartment, hoping he might help him expedite his refugee application. After running into one obstacle after another — The Captain couldn't get an interview at one government office because his papers were in English, not Turkish — Millsap returned to the United States and formed the nonprofit Ronin Refugee Project with a handful of other military veterans. It's dedicated to helping those who fought alongside Americans find safe harbor here or in other Western countries. After helping The Captain, they hope to turn their attention to others. "He's one of millions that's stuck in a system that is broken and he's just gonna continue to wait," Millsap said. "And so we decided to step up, me and a few other veterans." He will be in Washington on Tuesday to meet with members of Congress and others to discuss just how the U.S. might go about doing that. "That's really become my mission," said the newlywed who obtained his master's degree from the University of Southern California and then went to work this month as a community liaison helping U.S. veterans reintegrate into civilian life. Friendly and outgoing, Mills was a fresh-faced second lieutenant when he arrived in Iraq in 2006 to lead a contingent of U.S. Marines and Iraqi soldiers. The Captain, a lieutenant himself then, was among the latter group. "When I met The Captain, I was unimpressed at first," Millsap said, chuckling now. He was a Marine, after all, he is quick to add, and no decent Marine thinks anyone can do the job better than he can. Never mind that they were in the middle of nowhere, surrounded by danger in a foreign country where they didn't know the culture. His attitude began to change as The Captain patiently explained why he and his troops weren't getting buy-in from the locals or the Iraqi soldiers. It changed dramatically, however, after a sniper tried to take Millsap's head off during a routine patrol. "He quickly pushed me down and ran towards the gunfire and because of that, saved my life," Millsap recalled. The sniper, seeing an angry Iraqi soldier charging at him, chose to run rather than shoot again. "And that," Millsap added with a laugh, "is when I truly realized that this guy's OK." It was a coincidence that the two crossed paths a year later during Millsap's second tour. He was again in charge of a Marine contingent, and The Captain was now his Iraqi counterpart. The bearded soldier stared at him, incredulous that he'd returned to that hell. Millsap left the Marines after that tour to join the Army's Green Berets, rising to the rank of captain himself. The two didn't cross paths but kept in touch by phone and email — until one day, the communications stopped. The Captain, Millsap would learn a year later, had nearly been killed when an improved explosive device blew up his Jeep. He recovered and soldiered on until the Islamic State group began moving in and the death threats began. When calls to his home began identifying his children by name, he gathered up his family and fled to Turkey. Now, a typical day begins with physical therapy on his right arm, still damaged by the IED. That's followed by tasks like teaching his children the English alphabet, then studying English grammar himself so he can fine-tune his United Nations application for refugee status. The last time he met with a U.N. official, he said, he was told a decision might come within three months. That was four months ago. Now he's heard maybe in a month or two. Or maybe a year. He and Millsap check in by Skype once a week. During a recent call, he praised Ronin Refugee Project for not forgetting him. "I feel like you are my family. You are my brother. You and the other group of Marines are really gentlemen," he said before his voice began to break. By JOHN ROGERS
Newswise — CHICAGO Military surgeons face a unique challenge in that they serve as a “jack-of-all-trades” in an austere environment while deployed, only to return home to the expectation that they will compete with the standards of civilian surgical care, which has become increasingly subspecialized and highly dependent on minimally invasive technology. To address this issue, authors of a new article appearing online in the Journal of the American College of Surgeons ahead of print publication propose a new education and training paradigm that will benefit military surgeons and ultimately their patients in both practice environments.“The biggest hurdle we have to overcome is lack of operative activity. Evidence suggests that we fall significantly below our civilian counterparts in both overall case numbers and in case complexity,” said lead author U.S. Army Colonel Mary J. Edwards, MD, FACS, a pediatric surgeon at San Antonio Military Medical Center, Texas.The research team, consisting of surgeons from the San Antonio (Texas) Military Medical Center, the Naval Medical Center, Portsmouth, Virginia, and the Department of Defense Joint Trauma System, US Army Institute of Surgical Research, San Antonio, identified three levels of surgical education and skills training for military surgeons to participate in to sustain surgical skills: Core surgical competence: the basic credentials, training, and skills, usually obtained through graduate medical education and in-garrison surgical care, which form the foundation for readiness skills. Basic and advanced medical combat readiness skills: the basic essential medical skills required for all military medical personnel deploying to a war zone, and advanced surgical readiness skills that allow members of surgical teams to deploy and optimally perform in their assigned roles. Mission specific medical readiness skills: the required skills to perform a specific deployed surgical mission. In terms of Level 1 of their proposed training, the article’s authors suggest that stateside Military Treatment Facilities (MTF) be evaluated to become verified trauma centers within their community and with the American College of Surgeons (ACS). This proposal would expand the role of the MTFs which the military currently relies on for its local credentialing committees to ensure the clinical proficiency of their surgeons. Further, every military hospital would actively develop cooperative agreements with surrounding hospitals to allow military surgeons to provide care for civilian patients—stationing military physicians at Level I trauma centers will ensure these providers are constantly engaged in active trauma practice and are available to mentor additional military trainees, according to the authors.However, maintaining critical skills for military surgeons runs in two directions. Not only is there a need for a closer relationship between military and civilian surgical care, but military surgeons also need to possess a unique set of skills for performing operations while deployed. “Wartime surgery requires specific skills that cannot be completely obtained with practice at modern civilian trauma centers alone,” the authors noted. “War surgery requires aggressive operative intervention, frequently with staged procedures and often in an austere environment with no access to basic X-ray and lab capability and no local subspecialty support.” For military surgeons to be properly prepared, training such as The Tactical Combat Casualty Care Course and the Operational Emphasis version of the ACS Advanced Trauma Life Support (ATLS) course should be ongoing, and all deployed surgeons should receive timely training in war surgery evaluation and treatment and the Joint Trauma System’s clinical practice guidelines, according to study authors. However, training alone does not suffice for military surgeons to be properly prepared to compete with civilian care. “No amount of predeployment training can make up for lack of operative activity on a day- to- day basis,” said Dr. Edwards. “This shortcoming is the biggest challenge our surgeons in uniform face today.”Authors suggest that because maintaining a complete set of trauma-ready skills for all military active duty and reserve general surgeons may not be achievable, emphasizing a team approach is important. They suggest the designation of surgeons being deployed as either “trauma ready” or “trauma assist,” with trauma ready surgeons being matched to high-volume missions and solo surgeon locations, and trauma assist surgeons being matched to a location that already has a trauma ready surgeon. “The military views every surgeon who at one point completed a surgical residency equally in terms of their ability to provide combat casualty care,” according to the authors. “This [viewpoint] potentially sets the provider and the care team up for failure.” Authors suggest that trauma surgical capabilities be shared jointly between the Army, Navy, and Air Force, and the most qualified surgeons be deployed as “trauma ready,” regardless of service or active/reserve status. Further, authors suggest that a fellowship-trained trauma medical director be designated for every area of operations to function as the area leader in trauma system development and performance improvement. “As surgery in the United States becomes more subspecialized and technology dependent, the military must leverage its requirement for general surgeons who are able to function in austere environments with limited communications and equipment, with the appropriate expectation of a very high standard of surgical care to our beneficiaries when returning to the United States,” the authors noted. In addition to Dr. Edwards, other article coauthors are Kurt D. Edwards, MD, FACS, COL, MC, USA; Christopher White, MD, FACS, COL, MC, USA; Craig Shepps, MD, FACS, CAPT, MC, USN; and Stacy Shackelford, MD, FACS, Col, MC, USAF. “FACS” designates that a surgeon is a Fellow of the American College of Surgeons. The data in this manuscript regarding Army general surgeon operative volume was presented at the Excelsior Surgery Society meeting at the American College of Surgeons 101st Annual Clinical Congress, Chicago, IL, October 2015.Citation: Saving the Military Surgeon: Maintaining Critical Clinical Skills in a Changing Military and Medical Environment. Journal of the American College of Surgeons. # # # About the American College of SurgeonsThe American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 80,000 members and is the largest organization of surgeons in the world. For more information, visit www.facs.org.
Armed Forces Day in the United States Many Americans celebrate Armed Forces Day annually on the third Saturday of May. It is a day to pay tribute to men and women who serve the United States’ armed forces. Armed Forces Day is also part of Armed Forces Week, which begins on the second Saturday of May. A member of the US armed forces hugs his daughter. ©iStockphoto.com/videodet What Do People Do? Many events across the United States take place on Armed Forces Day to honor Americans in uniform who served their country in times of war and peace. Those who are honored on this day include people who serve the Army, Navy, Marines, Air Force and Coast Guard. National Guard and Reserve units may celebrate Armed Forces Day/Week over any period in May because of their unique training schedules. Events and activities may include: Multi-service military displays in areas open for the public. Various educational activities that teach children about the armed forces. “Support the Troops” themed motorcycle rides. Large parades and other local celebrations. Certain types of music are also played at Armed Forces Day events, including at memorials and at cemeteries, as a way to respect those in the armed forces who died for their country. For example, buglers have played a bugle call, known simply as Taps, on Armed Forces Day in recent years.Taps is usually sounded by the United States military at events such as flag ceremonies, memorial services and funerals. Public Life Traffic and parking may be affected in areas where large-scale events are held for Armed Forces Day. Background On August 31, 1949, Louis Johnson, who was the United States’ Secretary of Defense, announced the creation of an Armed Forces Day to replace separate Army, Navy and Air Force Days. The event stemmed from the armed forces’ unification under one department – the Department of Defense. The Army, Navy and Air Force leagues adopted the newly formed day. The Marine Corps League declined to drop support for Marine Corps Day but supports Armed Forces Day too. The first Armed Forces Day was celebrated on Saturday, May 20, 1950. The theme for that day was “Teamed for Defense”, which expressed the unification of all military forces under one government department. According to the U.S. Department of Defense, the day was designed to expand public understanding of what type of job was performed and the role of the military in civilian life. Armed Forces Day was a day for the military to show "state-of-the-art" equipment to Americans. It was also a day to honor and acknowledge Americans in the armed forces. Parades, open houses, receptions and air shows were held at the inaugural Armed Forces Day. Armed Forces Day is still celebrated nationwide today and is part of Armed Forces Week. Symbols Posters and other material used to promote Armed Forces Day often show images of Americans in the armed services dressed in their uniforms. Some posters show a collage of images, including images of those in the armed forces with their families or friends, as well as the United States Flag. Themes Some themes that were used for Armed Forces Day in the past included: Appreciation of a Nation Dedication and Devotion Freedom Through Unity Liberty Patriotism Power for Peace Prepared to Meet the Challenge Security Special Opportunity for Thanks Teamed for Defense These are only a few examples, and not a full list, of the Armed Forces Day themes in previous years.
VA researchers are doing amazing things to improve the lives of Veterans. Here’s just one example: the Smart Home. This unique project uses advanced technology to help patients with traumatic brain injury (TBI) independently plan, organize and complete everyday activities.Some Veterans with TBI have lost the ability to manage basic tasks like doing the laundry or taking out the trash. Smart Home has been described as a “cognitive prosthetic.” VA’s Smart Home helps them relearn those skills by tracking their movements around their house and then sending them text or video prompts when they get off track. The remarkable indoor tracking technology can pinpoint the Veterans’ location to within six inches. Ben “Ty” Edwards and wife Anna Edwards The Tampa VA Medical Center has installed the high tech equipment in five apartments housing 10 Veterans. It has a system that not only tracks their locations but has sensors that monitor the use of appliances. For example, the washing machine sensors determine when the Veteran puts soap in the machine and also shows when he or she empties the machine after the load is completed. If the user forgets to do either, a nearby screen prompts them to complete those steps. The Smart Home can also notify a caregiver if an activity is not completed. Other sensors in the bathroom determine how long a patient has been shaving and if they are taking too long, they are prompted to finish that task and move on.The technology promotes Veterans’ independence by providing reminders for the management of other daily activities such as medication, meal planning, and other necessary tasks. Smart Home has been described as a “cognitive prosthetic” with the goal of rehabilitating Veterans with TBI so they can function normally in society.A powerful feature of the Tampa Smart Home is the precision of the customized therapeutic information that can be provided to the recovering Veteran. Data for every interaction with clinical and medical staff are recorded continuously and analyzed, helping the staff visualize subtle but therapeutically significant behavioral changes. Reports are sent back to the clinical team on a weekly basisThis helps to better inform treatment plans and potentially prevent problematic medication effects on Veterans' memory, as well as gait and balance. Joseph “Pepper” Coulter and wife Jill Coulter A little more technical information? The Veteran patients and VA staff wear wrist tags linked to a real-time location system that tracks the tags using wall sensors. It’s ultra-wideband technology. The wrist tags broadcast their ID on a 6-to-8 gigahertz channel and uses time-delay-of-arrival and angle-of-arrival methods to determine position in three dimensions.The Smart Home innovation recently received third place in VA’s Brain Trust summit. The national summit brought together the public and private sector, Veterans, caregivers, clinicians and innovators to tackle the issues of brain health. One of the leaders of the project is Dr. Steven Scott, co-director of VA's Center of Innovation on Disability and Rehabilitation Research and chief of physical medicine and rehabilitation at the James A. Haley Veterans Hospital in Tampa. Scott is a nationally known expert in the fields of physical medicine and rehabilitation with research expertise in polytrauma and traumatic brain injury. Much of his work focuses on the rehabilitation and reintegration of Veterans who have experienced blast-related injuries.Advances like this are being celebrated this week, Research Week, at VA medical centers around the country.Join us as we celebrate 91 years of research excellence and attend one of the many activities being conducted nationwide.For more than 90 years, the VA’s Research and Development program has been improving the lives of Veterans and all Americans through health care discovery and innovation.VA research is unique because of its focus on health issues that affect Veterans. The groundbreaking achievements of VA investigators—more than 60 percent of whom also provide direct patient care—have resulted in three Nobel prizes, seven Lasker awards, and numerous other national and international honors.
The VA is opening its first primary care clinic at the Orlando VA Medical Center campus. While the new hospital is not yet ready to open, the Department of Veterans Affairs is moving the clinic— which serves about 1,200 clients — from a nearby annex to the Lake Nona hospital complex to begin serving veterans there. The move Tuesday marks the first time that Central Florida veterans will receive primary care at the yet to be completed campus. "We're trying to open up the clinic as timely as we can," Orlando VA spokesman Mike Strickler said. "At least the clinic is open for business. We're raising the flag to say we have a portion of the clinic open." In addition to the clinic opening, the $665 million VA medical complex in Orlando's Lake Nona area — just west of the Brevard County line — is to include a 134-bed hospital, 118-bed nursing home and a veterans benefit service center. Strickler said other departments likely will open while the final phase of the medical complex construction is completed and turned over from the builder to the VA, which is expected later this year. "It's demonstration of progress," said Bill Vagianos, president of the Brevard Veterans Memorial Center. "It's a gesture of good faith, certainly." Vagianos added that while it is good to see the opening of the clinic, the veterans' community has been frustrated by the delays in getting the medical center opened. The medical center will serve veterans from a 10-county area, including Brevard. Groundbreaking for the medical center was in October 2008 and was supposed to open four years later. "That hospital was supposed to open three years ago," Vagianos said. "I guess the veteran community has taken a cautious wait-and-see, given the track record the VA has demonstrated." Strickler said that more and more services will be available at Lake Nona until the medical center's grand opening, expected in June or or July. He said veterans will be pleased with the facility and the services that will be available to them. It marks the first time primary care services will be offered at the new Lake Nona campus. "It's a quantum leap in how we serve veterans," he said. by R. Norman Moody
BOSTON (AP) -- A 64-year-old cancer patient has received the nation's first penis transplant, a groundbreaking operation that may also help accident victims and some of the many U.S. veterans maimed by roadside bombs. In a case that represents the latest frontier in the growing field of reconstructive transplants, Thomas Manning of Halifax, Massachusetts, is faring well after the 15-hour operation last week, Massachusetts General Hospital said Monday. His doctors said they are cautiously optimistic that Manning eventually will be able to urinate normally and function sexually again for the first time since aggressive penile cancer led to the amputation of the former bank courier's genitals in 2012. They said his psychological state will play a big role in his recovery. "Emotionally he's doing amazing. I'm really impressed with how he's handling things. He's just a positive person," Dr. Curtis Cetrulo, who was among the lead surgeons on a team of more than 50, said at a news conference. "He wants to be whole again. He does not want to be in the shadows." Manning, who is single and has no children, did not appear at the news conference but said in a statement: "Today I begin a new chapter filled with personal hope and hope for others who have suffered genital injuries. In sharing this success with all of you, it is my hope we can usher in a bright future for this type of transplantation." The identity of the deceased donor was not released. The operation is highly experimental - only one other patient, in South Africa, has a transplanted penis. But four additional hospitals around the country have permission from the United Network for Organ Sharing, which oversees the nation's transplant system, to attempt the delicate surgery. The loss of a penis, whether from cancer, accident or war injury, is emotionally traumatic, affecting urination, sexual intimacy and the ability to conceive a child. Many patients suffer in silence because of the stigma their injuries sometimes carry; Cetrulo said many become isolated and despondent. Unlike traditional life-saving transplants of hearts, kidneys or livers, reconstructive transplants are done to improve quality of life. And while a penis transplant may sound radical, it follows transplants of faces, hands and even the uterus. "This is a logical next step," said Dr. W. P. Andrew Lee, chairman of plastic and reconstructive surgery at Johns Hopkins University School of Medicine. His hospital is preparing for a penis transplant in a wounded veteran soon, and Lee said this new field is important for "people who want to feel whole again after the loss of important body parts." Still, candidates face some serious risks: rejection of the tissue, and side effects from the anti-rejection drugs that must be taken for life. Doctors are working to reduce the medication needed. Penis transplants have generated intense interest among veterans from Iraq and Afghanistan, but they will require more extensive surgery since their injuries, often from roadside bombs, tend to be more extensive, with damage to blood vessels, nerves and pelvic tissue that also will need repair, Lee noted. The Department of Defense Trauma Registry has recorded 1,367 male service members who survived with genitourinary injuries between 2001 and 2013. It's not clear how many victims lost all or part of the penis. A man in China received a penis transplant in 2005. But doctors said he asked them to remove his new organ two weeks later because he and his wife were having psychological problems. In December 2014, a 21-year-old man in South Africa whose penis had been amputated following complications from circumcision in his late teens received a transplant. Dr. Andre van der Merwe of the University of Stellenbosch told The Associated Press that the man is healthy, has normal sexual function and was able to conceive, although the baby was stillborn. But his recovery was difficult, with blood clots and infections, the doctor said. For congenital abnormalities or transgender surgery, doctors can fashion the form of a penis from a patient's own skin, using implants to achieve erection. But transplanting a functional penis requires connecting tiny blood vessels and nerves. A bigger challenge than the surgery itself is finding donor organs. "People are still reluctant to donate," van der Merwe said. "There are huge psychological issues about donating your relative's penis." In the U.S., people or their families who agree to donate organs such as the heart or lung must be asked separately about also donating a penis, hand or other body part, said Dr. Scott Levin, a hand transplant surgeon at the University of Pennsylvania and vice chairman of UNOS' committee on reconstructive transplants. In Boston, Cetrulo said the transplanted penis has good blood flow and so far shows no signs of rejection. He said that Manning should be released from the hospital soon, and that the surgery had three aims: ensuring the transplanted penis looks natural, is capable of normal urination - which he hopes will resume in a few weeks - and eventually normal sexual function. Reproduction won't be possible, he said, since Manning did not receive new testes. Dr. Dicken Ko, who directs the hospital's urology program, said Manning has been shown post-operation photos but hasn't actually seen his new penis, since it is still bandaged. A big test, Ko said, will be when reconnected nerves start to take hold, bringing feeling back to the organ. "We don't know how he would feel until that times comes," he said. --- Associated Press writers Patrick Mairs in Philadelphia and Maria Cheng in London contributed to this report. Neergaard reported from Washington.
CHICAGO (AP) -- Rep. Tammy Duckworth lost both legs when her helicopter was shot down in Iraq, then went on to hold leadership roles in the Illinois and U.S. Veterans Affairs departments. Yet, the Democratic Senate hopeful now finds her record on helping military veterans under attack by her opponent, Republican Sen. Mark Kirk, as he tries to hold on to a seat Democrats believe is key to their efforts to regain the Senate majority. Kirk, one of the GOP's most endangered incumbents, has accused Duckworth of failing to protect veterans in her care and putting her political ambitions ahead of her duties. He's also touted the more than two decades he served in the Navy Reserve and his own high-profile efforts to highlight problems at the VA. This week his campaign launched an online ad featuring a hearing on a lawsuit two Illinois VA employees filed against Duckworth, accusing her of retaliating against them when she led the agency- complaints that have twice been dismissed. Kirk also has repeated claims by two whistleblowers who say Duckworth ignored their reports of misconduct at a federal VA hospital west of Chicago. Trying to take down Duckworth on veterans' issues is a bold move for Kirk, with even some Republicans saying they don't think voters will buy it. The strategy also could backfire. Kirk acknowledged during his 2010 Senate bid that he had exaggerated some of his own military record. And he risks alienating voters who see Duckworth as a hero. Garrett Anderson, who lost part of one arm and suffered traumatic brain injury in a roadside-bomb attack in Iraq, said Duckworth was the first service member the U.S. Army sniper spoke to when he woke up from a coma at Walter Reed National Military Medical Center in 2005. The 39-year-old University of Illinois graduate student plans to vote for Kirk this fall for a simple reason: Anderson is a Republican. But he said the ads targeting her are out of bounds and called Duckworth "a nice person" who has a strong track record of looking out for veterans. "I've seen a few of (the ads) and I don't like them because she served her country very well, and she's a decorated war veteran," Anderson said. Kirk's campaign says Duckworth's record is a legitimate area for criticism, and that there's no shortage of people who agree. They point to two employees at Edward Hines, Jr. VA Hospital near Chicago who say they took their concerns to Duckworth and other Democrats but heard nothing, and to an Illinois Auditor General report of the state Department of Veterans' Affairs that found inadequate financial controls and programs that were supposed to be implemented but weren't during the time Duckworth was leading the office. The two other employees, whose lawsuit is in court Thursday, say she tried to fire one employee and gave another a bad review that cost her raises after the women complained about facility leadership at an Illinois VA home, where they still work. Duckworth was appointed to lead the Illinois VA in 2006 by now-imprisoned ex-Gov. Rod Blagojevich. "Of course Duckworth is a war hero, and that's what makes this entire court case even more tragic," said Kirk campaign manager Kevin Artl. "These VA employees only wanted to prevent veterans from being abused, but instead were ignored and punished by Duckworth while American heroes suffered," Deputy campaign manager Matt McGrath called it "a cynical and desperate ploy." He said Duckworth gets most of her own health care at Hines and is "deeply familiar" with issues at VA medical centers. Duckworth was born in Thailand to a Chinese mother and an American father, who fought with the Marines in Vietnam. She joined ROTC during graduate school and later signed up with the Illinois National Guard. She was co-piloting a Black Hawk in 2004 when Iraqi insurgents hit it with a rocket-propelled grenade. Among her accomplishments, her campaign says, is launching the first 24-hour hotline for suicidal veterans and introducing legislation to improve mental health treatment that was signed by President Obama. Jon Soltz, who leads the liberal political action committee VoteVets, which is backing Duckworth, said the group is prepared to spend significant money to attack Kirk. "It's just a very dangerous strategy for them to continue to try to define Tammy Duckworth in this way, when if you just look at a picture of her you can see she's a war hero," Soltz said. Anderson, who works at the University of Illinois' Center for Wounded Veterans in Higher Education, doesn't believe either candidate has clear offered a plan for veterans. "They haven't given us a blueprint of what their objectives are," he said. by SARA BURNETT
VIRGINIA BEACH, Va. (AP) -- A retired Navy veteran must pay for two flags after stealing one from his Virginia Beach neighbor because it wasn't being illuminated at night. News outlets report a judge on Monday found John Parmele Jr. guilty of three misdemeanors after Parmele's neighbor Mike Anderson presented footage of the crime being committed. Parmele said he took the American flag to the Veterans of Foreign Wars to give it a proper retirement. Parmele says he had tried in vain to get Michael to illuminate the flag on his mailbox at night so it would be in accordance with federal code. Parmele was found guilty of stealing the flag, trespassing and destruction of property. He was ordered to pay a $300 fine and reimburse Anderson about $100. His 90-day jail sentence was suspended.