2009 Braceland Seminar Recap

For those of you who have not been to the Braceland Seminar lately, and for those of you who have never been to the Braceland, you really missed a good one. This year’s seminar was one of the densest, most information-packed conferences we have ever put on. It was held on 16 May 2009 in a large, decorative hall on the 11th floor of the stately Marines’ Memorial Club in San Francisco’s Union Square, our traditional venue in that fantastic city. We began with pastries, fruit, juice and all the Starbucks coffee one could drink as we caught up with old friends and met new colleagues.

CAPT Paul Hammer led off the academic program with a review of how the Naval Center for Combat and Operational Stress Control plans to fulfill it’s mandate as a clearinghouse for mental health programs and best practices. CAPT Ed Simmer followed with an update on a myriad and comprehensive series of programs which are coming online as the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury ramps up. Following a coffee break, CAPT Bob Koffman led us through a review of data on psychological trauma, and the new BUMED-sponsored programs which are on the horizon to improve our clinical practice, including several web-based initiatives. Then LCDR Patcho Santiago taught us about the Disaster/Preventive Psychiatry Fellowship offered at USUHS, and presented the results of his research on predicting outcomes based on positive alcohol abuse screens. CAPT Noel Howard rounded out the morning with a highly informative brief on where the combined Dod-VA disability evaluation system merger stands, which will roll out soon to more centers.

Lunch was a delicious sandwich buffet which included curried vegetable soup and two salads, dressed mixed greens and pesto pasta primavera. The sandwiches were huge. Most only took a half. The choices were Roast Beef with Horseradish and Brie on Potato Rosemary Bread with Red Onions and Watercress; Grilled Chicken, Fontina, Roasted Peppers, Caesar Dressed Baby Greens and Tomato on Focaccia; and Grilled Vegetables and Baby Spinach on Focaccia. For dessert we had little bakery pastries, such as petite Napoleons and iced lemon custards. We had so much food left over that we could have fed at least eight Marines, or maybe two members of the Tennessee Army National Guard.

For our lunch program, CAPT Koffman presented a video he didn’t have time to include in his morning presentation, and CAPT Howard spent a few minutes answering questions he took after his presentation which had value to the larger group. CAPT Klam rose and presented the Hogan Award to LT Kevin Nasky of NMC Portsmouth for this year’s outstanding resident research paper. This is the second year in a row that LT Nasky has received the Hogan Award.

CAPT Gail Manos received the 2009 Sears Award for distinguished contributions to the Navy Psychiatry community. She was not able to be present. Here is her acceptance statement to the community:

“I appreciate the honor of this award very much. I am not able to be with you today, because today is my day to redeploy home. Please understand how honored I was just to be nominated. I certainly never expected to win. I interact frequently with psychiatrists across the country in my role with the ABPN and the RRC. I can tell you there are no finer psychiatrists collectively than those in the Navy. While I enjoy many things about Navy psychiatry, for me there is no more a rewarding role than participating in the education and career development of our residents and junior psychiatrists. They carry the future of Navy Psychiatry, and I am proud of them all. To all of you at the luncheon, thank you again for this honor. I am sorry to miss this year's Braceland, and I look forward to seeing you next year.”

VADM Mateczun spoke first in the afternoon. It’s hard to summarize VADM Matczun’s talk, because he packs about 15 subjects into 30 minutes. He spoke about our history as Navy Psychiatrists, and he challenged us to be leaders and learn the business of Navy Medicine or be left behind to follow others. CAPT Klam reviewed our manning numbers, and guess what? They are gradually getting better and should continue to slowly improve. The take home message for me from CAPT Klam’s talk was that if you are eligible for multi-year specialty pay, you would be wise to lock in the money now.

It wasn’t too long after lunch that the hotel delivered cookies, brownies and sodas, and people descended on the sweets. But it was a no-break afternoon snack as we launched into the resident portion of the Braceland.

LCDR Paul Sargent of NMC San Diego spoke on a new tool for psychiatry residents’ self-evaluation, sparking questions about how we decide the relative progress of our trainees. LT Heather Kurera of NMC San Diego discussed her project to investigate the effects of antidepressants on neuropsychological function related to combat performance, which touched off a quick review of the Navy small arms training policy. LCDR Vic Ruterbusch of NMC San Diego, the dynamic speaker he is, presented the results of his efforts treating inpatients with logotherapy. Vic sold us logotherapy like they sell juicers and rotisseries on info TV. “But wait, there’s more.” I wanted to go out and get it because how could I lose? LT Jennifer Thomas of NNMC Bethesda delivered an abbreviated, lush assessment of mental health services in New Orleans after Hurricane Katrina, which was highly academic and touchingly personal. In my view her review put New Orleans just ahead of Alaska in terms of available mental health resources, which places this historic American city in the league of third world nations. LT Ken Richter of San Diego closed the seminar with a case report of malingered combat-related PTSD, discussing the finer points of detecting malingering and its motivations, which provoked questions of whether our civilian counterparts in Deployment Health Clinics and the VA system maintain vigilance regarding malingering.

The 2010 Braceland Seminar will take place on 22 May in New Orleans, Louisiana. We have a great conference every year. Please plan to be with us next year in The Big Easy.