You may have heard about the Center for the Intrepid (CFI), but you may not realize the worldclass work it’s doing for veterans right here in San Antonio. Its main goal is to maximize the potential of the military’s wounded warriors to live and work productively, whether they choose to remain on active duty or return to civilian life. The CFI sits adjacent to Brooke Army Medical Center (BAMC) at Fort Sam Houston and saw its first patients on Feb. 15, 2007. The CFI is an advanced outpatient rehabilitation center blending therapy, simulation and extreme sports to offer the full spectrum of outpatient care for amputees, burn patients and limb salvage patients.
The CFI wouldn’t exist at all if it weren’t for the foresight, dedication and generosity of Arnold Fisher, a New York philanthropist and one of four senior partners at Fisher Brothers, a leader in New York City real estate. He has a history of service to members of the military and their families, serving as chairman and CEO of the Fisher House Foundation from 1999 to 2003 and currently as its vice chairman. The Fisher House Program constructs homes near military rehabilitation facilities and hospitals to house the families of military personnel and veterans who undergo treatment. Started by Fisher’s uncle, Zachary Fisher, in 1990, the Fisher House Program has served over 10,000 families at 40 Fisher Houses around the world.
When he became the chairman of the board of trustees of the Intrepid Foundation in 2003, Fisher wanted to learn how else he could help veterans. The Center for the Intrepid was born out of that investigation. He helped raise funds from 600,000 citizens to make the CFI possible. At first, he was criticized for building the CFI, because some people thought the U.S. government should have built it. His response was, “Why should the government build it when I can build it in half the time, at half the cost, and twice the quality?” The CFI was built in just 16 months and treats about 140 to 145 patients each month, generating 500 to 600 patient visits during that time. One of the main reasons the CFI was built in San Antonio is because it was beneficial for it to be close to BAMC’s Institute of Surgical Research, also known as the BAMC Burn Unit. They share similar missions and treat many of the same patients. Walter Reed Hospital has a similar facility in Washington, D.C., but the CFI has more square footage and houses more resources.
The CFI’s four stories and 65,000 square feet of advanced rehabilitative facilities include clinical, research and administrative space, a gait lab, a computer-assisted rehabilitation environment, a pool, an indoor running track, a two-story climbing wall and a prosthetic fabrication lab. The CFI receives worldwide attention from groups including foreign dignitaries, celebrities, politicians, researchers and media. Even the Discovery Channel was making its way to the CFI recently to showcase some of the amazing work that happens there. One of the unique features of the facility is the Gait Analysis Lab, which is home to the Computer Assisted Rehabilitation Environment (CAREN), a critical part of the center’s research mission. The CAREN is a 21-foot dome with a 300-degree screen upon which a variety of “virtual realities” may be displayed. This simulator is the first of its kind in the world and holds much promise for the rehabilitation of the patients at the CFI.
We’ve profiled three intrepid women who make the CFI a center for worldwide excellence right here in San Antonio.
As the director for the Center for the Intrepid, Col. Jennifer Menetrez oversees every aspect of what happens with rehabilitation, patient care, research, administration and partnerships. She also drives all of the Center’s goals for today so it can continue to thrive tomorrow. It’s no wonder, then, that the woman at the helm of this world-class center also once conducted the orchestra while she was a pre-med student at Wellesley College. “I guess some of that has always been in me. I just didn’t realize it,” she says. “So now, I’m kind of conducting the orchestra and playing in it at the same time.” Coordinating a broad variety of resources at the Center for the Intrepid is not unlike conducting a symphony, and getting all the players to work together in harmony is no small task. Still, Menetrez is up for the challenge and is perfectly comfortable in her role because it helps make such an impact on the lives of those who are treated at the Center. “The greatest thing that you can do is to see somebody through the whole process,” she says. “How much more meaningful can it be than to take care of this patient population that has given so much in service to our country?”
It’s that approach to the whole rehabilitative process that Menetrez appreciates so much about her work at the Center for the Intrepid. While she studied pre-medicine at Wellesley College, she also participated in ROTC through the Massachusetts Institute of Technology to help pay for school. She initially thought she wanted to be a surgeon and even completed a surgical internship at William Beaumont Army Hospital in El Paso. “But I wanted more of a dialogue with the patients,” she says. “Instead of going in and doing the surgery and getting out, I wanted to take a more holistic approach to medicine.” After a two-year assignment in Germany as a general medical officer, Menetrez returned stateside for a physical medicine residency at Walter Reed Hospital in Washington, D.C. “I didn’t realize that what I wanted was in physical medicine, which is like family practice for the disabled,” she explains. “It covers nonoperative orthopedics, traumatic brain injuries, spinal and nerve injuries — basically anything that created an impairment that led to a disability.” Walter Reed has the only physical medicine training program in the Army, and she stayed on as a staff doctor to be involved with general medical education as well as inpatient rehab and the amputee clinic. But after a few years, Menetrez grew interested in developing her own style and interests and came to BAMC in 2000 to practice away from a training program. “When you’re removed from an academic setting, you get to hone your own skills,” she says. “You do it your own way.” The Bethesda, Md., native also preferred San Antonio as a place to call home. “It’s just right,” she says. “People here are very nice, and everything’s at the right pace.” Sharing her home are her husband and three children.
One of her first duties in San Antonio was to organize a three-day conference called the “short course” that focused on topics related to physical medicine and rehabilitation (PM&R). Physical medicine is a relatively small specialty, and the course had traditionally seen attendance from a handful of other military practitioners. However, Menetrez worked to open it up to civilian and military attendees, organizing compelling speakers and securing the resources she needed to make it memorable. The year she organized the short course, there were 80 attendees, which was far greater than the seven who had attended the year before. Menetrez continued to thrive and in 2005 helped BAMC join Walter Reed as a designated amputee care center. But it wasn’t until she had a chance to meet Arnold Fisher that she could imagine the full capabilities of what might come next. Fisher has a long history of supporting America’s armed forces, and served as chairman and CEO of the Fisher House Foundation, which constructs homes to house military personnel, veterans and their families as they undergo medical treatment. Fisher also became the chairman of the Board of the Trustees of the Intrepid Foundation in 2003 and was instrumental in raising the resources to make the Center for the Intrepid a reality. “He asked me if I could have anything I wanted for the Center, what would it be?” she recalls. “I didn’t know how to respond to that, because we just don’t think like that.” Under Fisher’s leadership, the Intrepid Fallen Heroes Fund gathered donations, and the Center for the Intrepid’s capabilities began to take shape. “They needed somebody in charge of what should go into the Center,” she says, “and luckily, I’m pretty organized.” That understatement belies the huge undertaking Menetrez faced in getting the Center for the Intrepid up and running, all while she continued her clinical duties at BAMC. However, it also shows how skilled she is at synthesizing a range of moving parts. Some of the best ways to orchestrate the entire project were to “take a lot of notes and date them,” she says, “and listen and ask a lot of questions.” When asked if she could think of any lessons learned that might have gone differently, she can’t recall an example. “I try not to dwell on what not to do; that’s why I don’t remember them,” she says. “It’s the whole theme of rehab,” she explains, which is moving on after something bad happens.
The Center for the Intrepid demonstrates Menetrez’s view of what makes a job in the military so rewarding “You really can make out of it what you want to,” she says. “This is really the culmination of my whole career. What could be better than that?”
COL. (RET.) REBECCA
HOOPER, P.T., PH.D.
With 31 years of military service behind her, Col. Rebecca Hooper knows a thing or two about responsibility. So, it might be a bit ironic that less than a month after retiring from active duty as a colonel, she signed on for one of the biggest military responsibilities of her career. In 2006, she accepted a job as the program manager for the Center for the Intrepid at BAMC. She also found a spot that perfectly blended a lifetime of experience and interests. After graduating from Miami University, Hooper joined the Army to help pay for her graduate studies in physical therapy at Baylor University. She paid back her commitment at Fort Jackson in South Carolina and then tried private practice for a few years. “I thought, “There’s got to be more than this,'” she says, “and I wanted to go back into the Army because it has so many opportunities.” Some of those opportunities have afforded great experiences for Hooper along the way, including many chances to tackle both the administrative and practical sides of medicine. She served in Korea for a year as the only physical therapist on her post. “When you’re in a situation where you’re the only one, you have to rely on yourself,” she says. That sense of self-reliance propelled Hooper through her other clinical and staff assignments and led to her position as the 15th chief of the Army Medical Specialist Corps. She was responsible for over 1,000 Army occupational therapists, physical therapists, dietitians and physician assistants worldwide. Striking a balance between patient work and administrative management can be a challenge, but Hooper found the administrative side is where she really thrives.
Today, though she’s no longer on active duty, she’s a critical part of the mission of the Center for the Intrepid for active-duty patients. When military servicemen and women sustain the kinds of injuries that require intensive physical therapy, emotional therapy and complete rehabilitation, San Antonio’s Center for the Intrepid makes sure they have every resource they need to recover fully. “I make sure the building and the people in the building have what they need to accomplish their work,” says Hooper. “Somebody has to take care of the people so they can take care of the patients.” That means Hooper is responsible for keeping everything running, including the computer systems, building maintenance, staffing needs, equipment requests and administrative programs. She also often acts as the CFI’s public face, giving tours to foreign dignitaries, corporate representatives, media and charitable organizations.
It’s a job that Hooper has taken to heart since before ground was ever broken on the Center. “I got in literally from the ground floor,” she says. “I know where every stud is behind these walls. I walked around here with a hardhat along with the architects to oversee where every office was laid out and placed. And now I take care of it like I take care of my own house.” She’s committed to keeping it just as nice as it was the day it opened. “It’s a gift from the American people.” She is referring to the donations that came from 600,000 citizens to make the Center for the Intrepid the center for excellence it is today. It’s a thought that’s never far from her mind and a responsibility she takes very seriously.
One of her accomplishments is building relationships between the Center for the Intrepid and other services that work on similar missions. She compares working with other groups like the Veterans’ Administration and the Fisher House Foundation to building walkways. She tells a story about how architects building a University of California campus deliberately designed it without walkways between the buildings. “They knew the students would tell them where the pathways needed to be and the best way to construct them,” she says. Hooper applied the same methodology to constructing relationships with the Center for the Intrepid. “We couldn’t build those bridges until we learned from everybody here what the best way was to do it,” she says. “We had to work to find the right way instead of deciding first what it should be and making it fit.” Some of those bridges that get built extend across the country and around the world. “I hate being tied to the computer,” Hooper says. That’s a good thing, because the groundbreaking work that comes from the Center for the Intrepid generates attention from all sides, and it often falls to her to welcome parties who are interested in learning more about the center’s mission. On any given day, she could be receiving a delegation from Poland, giving a tour to representatives from Sweden or talking to patients about the progress they’re making.
Another part of Hooper’s work is to interact with patients every day. “Our goal is to maximize their performance, regardless of whether they stay in the military or not,” she says. It’s that kind of responsibility to the soldiers in and out of uniform that makes the mission of the Center for the Intrepid so special. In May, 30 patients competed in a triathlon that included a 500-meter swim, 10-mile bike ride and 2-mile run/walk. Her pictures from the event stay on her computer, and she recalls all of the participants by name. “When they come in for the first time, they think there’s no way they can do this,” she says. Then, through the weeks and months of rehabilitation, “their personality changes, and it’s worth it.” Hooper’s responsibilities to the Center for the Intrepid are as great as they are rewarding. “I get to solve problems and talk to patients all day long,” she says. “Without a doubt, this is the best job the military has given me.”
LT. COL. RACHEL
EVANS, P.T., PH.D.
“What can we do to help you attain your vision?” That’s the question the Army has repeatedly asked Lt. Col. Rachel Evans over the last 21 years. Her answers have led her through the ranks from private first class to lieutenant colonel, earned her a degree in physical therapy and a Ph.D. in exercise physiology and brought her to San Antonio, where she serves as the research director at the Center for the Intrepid. Today, the Army continues to help Evans attain a number of visions. She gets to make huge contributions to her field, conduct research that’s changing the face of exercise physiology and impact the lives of soldiers and civilians who will benefit from her work for years to come. Her path to San Antonio started in her hometown of Portland, Ore., when she enlisted in the Army to help pay for college. While she was a student at the University of California Santa Cruz, Evans injured herself waterskiing and “became a physical therapy patient,” she says. The one-on-one attention she got helped her decide to switch gears from pre-med to physical therapy so she could help other patients in the same way she was helped.
She picked up more of a time commitment along the way as the Army continued to pay for her education, but she also picked up some great insight. “As I got higher in rank, I realized I got to do my thing,” she says. She also found great mentors, including Col. Chuck Scoville and Col. Karl Friedl, who told her to “tell me what you want to do, and I’ll help you do it.” Shereceived her M.A. from Baylor University in physical therapy and later earned her Ph.D. from Brigham Young University, where she worked to apply what she learned in academics to actual practice. “The program had an applied nature to it,” she says. “It’s basic science, but I wanted a real, human element too.” That mix of academics and empathy would become valuable tools as Evans put her skills to work with the military’s patient population across the country. She served as a physical therapist at a number of military posts, including Fort Leonard Wood in Missouri and Fitzsimmons Army Hospital in Colorado, and welcomed the opportunity to apply all of her classroom learning “to a real population and not just rats.” Again, the Army continued to provide ways to help her attain her vision, as she found plenty of opportunities to work with a real population who needed physical therapy and rehabilitation. Evans also became involved in a program helping amputees with their rehabilitation after losing limbs. She realized, “These guys are giving up arms and legs. This program is the right thing to do, and it has been ever since.” The research element of her work is most compelling and also comes with great reward, since the knowledge that she helps to gather goes on to help others. “Whatever you do carries on,” she says. “It’s like a written legacy.”
While she was stationed in Natick, Mass., at the Army Research Institute of Environmental Medicine, Evans had a chance to collaborate on a project in San Antonio with her colleague, Army physical therapist and Ph.D., Rebecca Hooper. As the director of the Bone Health Research Program, Evans had expertise in designing research programs that would lead to outcomes that could be applied in practical ways. It was just the kind of insight that would fit perfectly with the mission of the Center for the Intrepid to support the clinical and rehabilitative needs for wounded soldiers. Before the Center for the Intrepid was built, teams of experts, including Hooper, were working on ways to incorporate research into supporting the center’s clinical and rehabilitative mission. Evans didn’t realize it at the time, but her trip to San Antonio was about a much bigger purpose than collaborating on a simple project. “I wasn’t here for long before Becky turned to me and asked, “You know why you’re here, don’t you?'” Evans was going to be a key element in bringing the best resources to help the Center succeed. “I knew I just had to come here,” she says, and now she and her teenage son live in San Antonio.
Today, Evans is proud to serve as the research director for the Center for the Intrepid. Her team leads 10 ongoing research projects, including one that documents the best kinds of training scenarios, and another that assesses the functional outcomes for different kinds of prostheses. “These young people are doing some amazing things,” she says of her patients and fellow soldiers. “Some of them seem like kids to me, but they’re just scared, like anybody else.”
Her research also gets to incorporate cutting-edge technology to help soldiers “return to whatever capacity they want to, whether it’s competing in the Paralympics, returning to active duty, sitting on the couch or going on a hike,” she says. In the Gait Analysis Lab, patients use the Computer Assisted Rehabilitation Environment (CAREN) to help them navigate realistic situations they’ll encounter in everyday life. For example, they rehabilitate in a virtual-reality environment, where they’re able to walk on a wide treadmill that replicates various scenarios, such as New York City streets, where the patient would have to move out of the way to avoid crowds. Evans also sees a big part of her job as team building, as she pulls together a team of researchers to support the main clinical mission. “It’s part of an active-duty mission, it’s what we’re tasked to do, and it’s the right thing to do,” she says.
“The Army can give you lots of opportunities,” she says. “All of my experiences in the military have led to this job, where I get to apply everything the Army’s taught me.”
Author: Rachel Bell
Photographer: Liz Garza Williams