Iowa City VA hospital looks forward and back after 60 years

IOWA CITY - It was in 1963, with U.S. involvement in the Vietnam War escalating and health care needs for veterans swelling, that Janis Vaught-Brezina joined the team of laboratory technologists at Iowa City's veterans hospital.

She was a green 22 years old at the time, but now - as the Iowa City Veterans Affairs Medical Center celebrates its 60th anniversary - Vaught-Brezina is the hospital's most tenured employee.

“I've spent 49 years in the same place - doing the same job in the same office - but it's changed a lot,” she said.

Iowa City's VA hospital admitted its first patient on March 3, 1952, and by March 8 it had 32, hospital officials said. Nearly 300 employees comprised the original staff at the facility, which started out with 490 beds and a patient capacity of between 500 and 600, VA officials said.

Today, the facility that was classified in 1952 as a “general medical and surgical hospital,” counts about 44,000 unique patients and nearly 1,400 employees in its system, which includes six satellite clinics. While the VA used to have wards stacked with four to five hospital beds per room, the hospital today has just 83 beds in private rooms, as many of today's clients are outpatients, according to Dawn Oxley, acting director of the Iowa City VA.

And, with the U.S. drawing down its troop presence in Iraq and Afghanistan, Oxley said the hospital is bracing for an inflated caseload.

“As more troops come back, I think we'll see an increase in patients,” she said.

The Iowa City VA has extensive renovations and expansions in the works including construction of a multilevel 400-car parking garage, a new 14,000-square-foot operating room, and a new three-story primary care addition that also will house a new emergency room and radiology services, according to Tim McMurry, associate director of operations for the Iowa City VA.

The hospital also is adding space for more services geared toward veterans of the Enduring Freedom, Iraqi Freedom and New Dawn operations. The VA will have clinics devoted to those veterans along with employee health, nuclear medicine, polytrauma and compensation and pension exam areas, McMurry said.

“With so many people returning, it's a new VA now,” McMurry said.

Vaught-Brezina remembered with fondness the “beautiful grounds” and flora that once surrounded the VA hospital but have since been turned into brick and mortar buildings. And she recalled how inpatients with minor injuries used to help out by running errands, pushing patients with more serious injuries in wheelchairs and watering the plants.

But, Vaught-Brezina said, she appreciates most of the changes that have morphed the VA into what it is today - a high-tech facility that, for example, uses video cameras and computer monitors to transmit doctors from Minneapolis into Iowa City patient rooms.

And, she said, the VA's safety standards have made vast improvements. When she started work there, Vaught-Brezina said, lab workers would measure fluids needing to be tested - including blood and chemicals - by sucking them up into an open pipette with their mouths.

The system worked most of the time, according to Vaught-Brezina.

“That's not to say I never got stuff in my mouth,” she said.

The technicians also ate, drank and smoked in the lab, and they didn't wear gloves, eye protection or face shields when she first started. Vaught-Brezina said the staff used to use beakers and flasks as cups for their beverages, and she said the chemical vapors at times would be so strong that the female workers' nylons would disintegrate.

Vaught-Brezina said she once spilled a chemical on herself that dissolved her undergarments. She also once got an alkaline in her eye and said the VA's safety standards today are infinitely improved.

She said tools and technology also have advanced, along with the types of tests the lab can run. Screenings and exams that used to be shipped over to the University of Iowa Hospitals and Clinics now can be done in house, Vaught-Brezina said.

“We get new instruments often enough that it keeps me on my toes,” she said.

Many of the changes at the VA have been driven by patient needs, according to Stanley Parker, acting chief of staff. Although more people are able to maintain an outpatient status, many of today's injuries are more acute, he said.

“I think the survival rate has changed,” Parker said. “People used to die of amputations.”

The VA also has gotten better at addressing head injuries, he said, and mental health has become more of a focus as understanding and treatment has improved.

“Fifty years ago, no one wanted to admit they had a head injury,” Parker said. “But our focus has changed over the years.”

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