Public Health Service officer pitches in at JBER

by David Bedard
JBER Public Affairs

1/31/2014 - JOINT BASE ELMENODRF-RICHARDSON, Alaska -- A man emerged from his car on a July day wearing a dress-white uniform. He strode across the Joint Base Elmendorf-Richardson hospital parking lot, plotting a course to his office in the hospital's Lynx Wing.

An Airman, wearing his utility uniform, ambled on an intercept course with the doctor en route to his car.

The two locked eyes for a brief moment, before the Airman scanned the unfamiliar uniform for shiny brass. All he could spot were two dark shoulder boards with four yellow stripes each. Biting his lip, the Airman decided he had better cover his bases, and rendered a crisp salute. The doctor returned the courtesy.

The Navy-like uniform belongs to Public Health Service Capt. Kelton Oliver, medical director of the Traumatic Brain Injury Clinic at the JBER hospital. As one of six uniformed services, the PHS Commissioned Corps uses a combination of Navy and Coast Guard uniforms with PHS insignia.

Oliver said his assignment to the JBER Hospital's TBI Clinic is part of an agreement between the Department of Defense and the PHS designed to address behavioral-health issues associated with combat deployments. According to the PHS website, the 2008 initiative ensures service members, their families and veterans receive the behavioral health care they need by increasing services such as psychiatric counseling, family and group therapy, and preventive services.

Years before becoming a part of this partnership, Oliver said he began his service in uniform as a Security Forces Airman, guarding missiles at Minot Air Force Base, N.D., before he volunteered for a special operations assignment. After six years of service, he left the Air Force and worked as a police officer at the University of Oklahoma for four years, where he earned a degree in chemistry.

During his studies, he decided to become a medical doctor. Oliver's vocational calling led him into medicine, but his time with the Air Force led him back to the uniform.

"A lot of it had to do with the fact that I could continue to work toward a [uniformed service] retirement, and I enjoyed being in the military," he said. "I liked the military lifestyle, and I liked wearing the uniform."

Oliver said he helped establish the TBI Clinic in 2009, when then 673d Medical Group commander, Air Force Col. Paul Friedrichs, asked him to institute the clinic with a holistic approach. This methodology contrasted with other TBI clinics, which are run by neurologists.

Oliver was the right doctor for the job.

He said he had a predominately primary care background, working in Indian Health Service hospitals in Oklahoma before transferring to the Alaska Native Medical Center in Anchorage.

It wasn't long before Oliver put his stamp on the fledgling TBI clinic.
"The first day I was here, I wrote on the white board, 'The patient is the mission.'" he said. "Of course, to the military, mission means something specific. It's your assignment, and you never quit on a mission. You go until the mission is completed."

As part of the holistic approach, Oliver said he and his staff see patients as complex people with varying backgrounds and challenges.

"From the very beginning, everyone who has been a part of this clinic has had the mindset of 'Let's find out what this patient needs and help them get it, even if it's really not in our court,'" he said.

Oliver offered the example of a TBI patient suffering from severe back pain. Such a patient won't get much out of cognitive rehabilitation until the back pain is cured or managed. Likewise, if a patient has debilitating post-traumatic stress disorder, treatment for TBI-related headaches may not be as effective. These considerations have prompted TBI clinic caregivers to work closely with their behavioral health and primary care colleagues to ensure treatment is administered in an effective, holistic manner.

"We look at the patient as a whole," the doctor said. "We don't treat traumatic brain injury, we treat people who have traumatic brain injuries."

Oliver said he was specially suited to help stand up and run the TBI clinic because of his status as a PHS officer, which made possible the continuity the clinic needed.

"When we are assigned to the Department of Defense, we are in essence functioning just like a military officer," he said. "But there are a couple of differences that make us desirable for certain types of positions - one of those is that we're not going to be transferred out from under them."

Oliver said that - while assigned to the JBER hospital - he can perform any function an Air Force doctor can, and he has worked in family medicine when the TBI caseload was slow.
The doctor said he is encouraged when patients benefit from the services provided at the TBI clinic.

"Because the patient is the mission, I feel that I have accomplished the mission when the patient recovers," he said. "That's the part that's really rewarding.

"These men and women, they've been through things," Oliver continued. "They put everything on the line because they were asked to, and they deserve nothing less than the very best we have. They deserve our very best effort. And because they deserve our very best effort, it feels so good when they get better."