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The Vets First podcast is a research-based podcast that focuses on the VA healthcare system and its patients. Instead of being just another research podcast, the Vets First podcast was created with a primary focus on the Veterans and their stories. The hosts, Levi Sowers PhD, and Brandon Rea work to bridge the gap between the state-of-the-art research being performed at Veterans Affairs and the Veterans themselves in an easy-to-understand manner. Importantly, Levi and Brandon want to assist researchers around the country to better understand the needs of Veterans. In this podcast you will hear interviews from Veterans with specific conditions and then hear from VA funded researchers who are studying those very topics as well as other highlighted services the VA provides.
The Department of Veterans Affairs does not endorse or officially sanction any entities that may be discussed in this podcast, nor any media, products or services they may provide.
Announcer: Welcome to the Vets First Podcast, a research-based conversation centered around the VA health care system, its services, and patients. From Iowa city, Iowa, here's your hosts: Dr. Levi Sowers and Brandon Rea.
Levi Sowers: Welcome back to the Vets First podcast. Today we have Thomas Zampieri. He is the past president of the Blinded Veterans Association of America. He serves on multiple DOD grant review panels and has recently been appointed to the VA National Research Advisory Council, which is a congressional mandated council to advise research at the VA. He's a former Army veteran and who served during the Vietnam era and he was an Army medic. Welcome to the Vets First Podcast, Tom. It's really great to have you.
Thomas Zampieri: Yeah, thank you for the invitation to be on the podcast. And just so you know, it's Blinded Veterans Association. It's you know, some of our members get all like perturbed. I- you know, I when I've testified in front of Congress and they say, “Blind Veterans of America.” I just smile and say, “Okay.”
[laughter]
Levi Sowers: My apologies. You know, I- looking at your history here a little bit before we got on. You're like a Renaissance man. You've done everything. You've got a PhD. You served in the Army. You have continued to advocate for veterans in multiple ways. How did you get to this point? Where did you come from?
Thomas Zampieri: Oh, yeah, that's a great question. I started out with an interest in and I started actually as an emergency medical technician working on ambulances up in very rural parts of New Hampshire, in Vermont. And I was only 17 years old and I basically.
Levi Sowers: Is that where you grew up at?
Thomas Zampieri: Yeah. Yeah. So I was- I grew up in an area where there was a very, you know, big rural area where there was a lot of shortages of physicians in, especially specialists. And so that had an impact on me in any way after I had worked for a year as it emergency medical technician, I volunteered to join the Army because I wanted to be able to be a medic and get that training. And then I oh, I had met a individual who was a physician assistant who had a profound impact on me, and I thought, what a great career. And so I went into the Army, served three years as an Army medic at different hospitals. I worked in an emergency room at one military hospital in New Jersey. After I finished my three years, I applied to physician assistant program in Philadelphia and started the VA program there at Hahnemann Medical College in 1976 and completed the program and then went on to work for 20, 25 years as a physician assistant. And so that was my, you know, life plan. And then retinitis pigmentosa. My vision kept getting worse. And worse is, as you're aware, my peripheral vision kept constricting. And so all of a sudden, at the age of 46, I no longer so I could safely practice as a physician assistant. My visual fields were down like 10 to less than 20 degrees.
Levi Sowers: What kind of like, if I can ask a more personal question here?
Thomas Zampieri: Yeah.
Levi Sowers: What kind of impact did that have on your life when you came to that realization that you couldn't do what you wanted to do?
Thomas Zampieri: Huge. You know, it's interesting, you know, speaking as a person wearing a white coat and a stethoscope. I did surgery for over 20 years and I did emergency room trauma. I did orthopedic injury trauma for a whole year. I did neurosurgery. So I was sort of a type-A personnel allergy. And all of a sudden, the surgeons that I worked with were aware that my vision was getting worse. But they wanted me to be able to continue to work. So I stopped actually going into the operating room and I spent all my time in the clinic, but I was even having trouble eventually just going into the patient rooms and not seeing people in the hallway and in some, you know, all of a sudden I realized this is getting dangerous. I'm going to, you know, not see something. And so I went down and visited with the VA's visual impairment service team coordinator at the V.A. where I was working. And I went down there and I sat down in the chair and I talked and he knew me and knew my RPE was getting worse and suddenly he said to me, “Sit, Tom.” You know, “Let's get visual fields.” And we scheduled that. And I came back afterwards, a couple of weeks later and sat down and he said, “You know, you're legally blind.” And it just hit me, you know, suddenly you're confronted with that. And he said, you know, “What are you going to do?” And I just broke down in tears. I since- I've spent, you know, from the time I was 17 to 47 years old, taking care of people and taking care of patients, and now I can't- what am I going to, you know, and I'll never forget this. He says, “Well, back backup, Tom, if if you hadn't gone into the medical field and become a P.A. and all that stuff, what else would you have done in life? What were you what other interests did you have?” And I said, “Well, I've always been interested in history. And I thought once of of, you know, being a history teacher. And I have a real, real big interest in politics.” So he said to me as I stopped to tears, he said, “Well, why don't you go back to college and get a degree at, you know, get your master's degree?” So that's what I did. I went back and got a- I left the VA in July, medically retired after 20 years and the end of August, I started in a master's program in political science and a minor in history.
Levi Sowers: Wasted no time there.
Thomas Zampieri: Yeah, I mean, you know, I think it was looking back a good thing because if I had just retreated like a lot of people do when they get they realize that they're blind, you know, a lot of bad things start to happen. But instead, I got I got thrown into, you know, a university campus and going to classes. And and it was weird because, of course, I was the 47 year old and all my classmates were 23 or 24 year old graduate students. Anyway, I so I finished my master's degree in political science, and I just couldn't stop because some of my professors said, Tom, you've got a real passion for politics. And when we when we had class debates and stuff. So why don't you get your Ph.D. and then you can teach you can teach in a university or something.
Levi Sowers: Education is slippery. So you were like you were like 47 starting a Ph.D.. Yeah. Yeah. Oh, gosh. I can't imagine. I'm 37 and I can't imagine doing that school. It's just like, Oh, Lord.
Thomas Zampieri: Oh, no. So I had a lot of when I was an employee backtrack a little bit. I was also the national president of the Physician Assistant Association. And so I did a lot of congressional visits and I worked with a lot of the veterans service organizations. And so if there's another little piece to this whole life story, I ended up I used to go to Washington, D.C., about three or four times a year, and I would meet with members of the House and Senate, but I would also go on in network with the different veterans organizations. So I went into the Blind Veterans Association to talk to their executive director about some policy issues in regards to employment in the VA for physicians assistants. And so we talked about that for about ten, 15 minutes, and he was very supportive. And then he said to me, Tom, what are you doing? And I said, Well, I'm finishing up a Ph.D. in political science. And he said, So you're an Army medic. Yeah. And you serve three years. Yeah. And you work for the VA for almost 20 years. And he said, Yeah, And you know, all the different veterans service organizations. Yeah, I know. American Legion, VFW, too. You know, Purple Heart, all those different organizations. I know most of the members of Congress and the House and Senate Veterans Affairs Committee. And Tom Miller was executive director and he says, you're hired. And I said, look, what are you talking about? He said, Well, we have an opening for the director of government relations for the VA here in Washington, DC. And I said, I don't have my resume with me. And he says, You don't need to. You're hired. So I went to work in April of 2005 and I worked through till November 22nd of 2013. For nine years I was the director of government relations representing the Blind Veterans. So association with the V.A. in Congress and the other federal agencies and so I actually finished my Ph.D. that first year that I was still, you know, trying to finish the program while I was working full time for VA. And so that's kind of, you know, the nut shells, how Tom's injury ended up where I where I did. And currently I live in Houston. We moved back to Houston, Texas in 2013 because of family. And so I continued to serve on the VA's border. I got elected to the Bbva's Board of Directors in 2014 and served in a variety of officer positions. And for the last two years I was the national president of the VA until August of 2021.
Levi Sowers: Great. So, so down with your involvement at the Blinded Veterans Association, can you tell us a little more about the Association? Like what kind of sets them apart from the other groups, aside from the vision aspect?
Thomas Zampieri: Well, you know, the history of the VA, you know, goes back to actually its 77th anniversary, goes back to March 28th, 1945. And I think what's always been unique about the VA is the fact that the organization was started by World War Two combat blinded veterans, and they were concerned about the Department of Defense, had a couple hospitals for rehabilitation. But once you're discharged from the military medically, there was you couldn't there was no other follow up, you know, for rehabilitation. So our founding members worked passionately to get the VA to establish the first of the blind rehab centers in at Hines in Chicago, of course. And now there's 13 blind rehab centers. So over the 70 years, I think, you know, BVA has played an integral role in improving different types of veterans benefits programs in services. And they've also worked very closely with the VA on both low vision and blind rehab services. And so now, of course, it's, you know, pretty large. You know, there's the visor programs, there's the 13 blind rehab centers, there's the victor's programs for low vision optometry. And so on. When you look back at just how everything is is grown, you know, the VA has always worked closely with the other veterans service organizations in order to get those types of advances made.
Levi Sowers: So one thing I really want to ask you is what kind of unique perspective did serving in the military give you and why did you end up at the V.A., in particular? Europea You could have gone anywhere. Was it the service that you did that wanted you to go that made you go to the VA, that kind of work?
Thomas Zampieri: Oh, yeah. Boy, that's a great question, too. I was I you know, the first five years I was a physician assistant, I actually worked in the private sector. I worked at a university hospital. I worked at a private hospital. I did you know, I actually worked for the state of New York for a year as a P.A. But then I missed that connection with other veterans. And so in 1983, a really good friend of mine who had been a Navy corpsman said, you know, there's some pay openings at the hospital in Canandaigua in New York. And if you want to apply, we'll go down and, you know, and one thing led to another. And so I they hired me. And it was in the 1980s. You can imagine I was meeting World War One veterans who are elderly, but they were in, you know, and of course, you know, thousands of World War Two veterans, Korean War veterans. And I just felt like I could relate to them, you know, as a as a veteran to another veteran in the fact that I was their clinical provider. And I- when they knew that I was a veteran, they just- the trust seemed to go way up. Yeah. Even though, you know, my colleagues were- who had never served were, you know, extremely, you know, talented, you know, clinicians. There's that bond, you know, the band of brothers. And I think it veterans speaking as a veteran when I go in the VA in a it sounds biased but if I'm able to see another veteran you just know that they understand what you know, what you've been exposed to in both environmentally and physically. And I think there's also the automatic connection with those with those providers. Mm hmm.
Levi Sowers: Yeah, that's that's great. That's a great answer. Oh, one thing that I've noticed about the VA is it's very interested in research and promoting research. Uh, why, What's the importance to you for research? And what, what role does it play in a veteran's life, do you think?
Thomas Zampieri: Yeah, I, I'm certainly unique, I guess in the sense that because of my medical past background and then as I sort of helped actually drive the the VA towards being a stronger advocate organization for research because also I was heavily influenced from 2005 to 2013 in Washington DC. You can imagine all of the casualties that were coming back from Iraq and Afghanistan that were going to Walter Reed Army Medical Center in Bethesda, National Navy Medical Center. Back then, the two hospitals were just full of wounded, and I recognized that the Department of Defense probably didn't have as much funding for ocular trauma research as we felt was necessary, considering that 14% of all of the wounded that were evacuated had sustained some type of eye injuries. And so be the representing the V.A., I felt that we needed to advocate for more research funding, both in DOD and in the Department of Veterans Affairs and even I helped advocate for National Eye Institute because a lot of the members of the BVA have age related degenerative eye conditions. And so I think from the perspective that you want to have research that's going to hopefully find new treatments for the young soldiers or Marines who come back with a penetrating eye injury or traumatic brain injury with vision dysfunction. Those service members, you hope that the research for acute trauma will help prevent complications. And then for other veterans in the system who have already developed complications, retinal detachments or corneal problems or traumatic cataracts or they've got age related degenerative conditions, you know, the research that the VA does is critical to finding new treatments for those those types of problems. And so we I'm proud of the fact BVA is, you know, through their advocacy has seen you know, the budgets increase from Congress for the different agencies and in the I and IHS and in VA's research budgets have gone up and in DOD, the Vision research program is $20 million a year and so the you know, there's actually an organization called Friends of the Research that we participate with. It's all the different veterans service organizations that advocate for the research together.
Levi Sowers: So the time, given the prevalence of vision problems that you're talking about, TBI related vision problems like penetrating eye vision problems, what would you say are the vision problems or that you would attribute to being unique to vets versus civilian population?
Thomas Zampieri: You know, we got a lot of blast related traumatic brain injuries with vision dysfunction. That is the published papers in research journals show that, you know, the public thinks concussions like from football players is a good example causes you know different types of you know, problems. But veterans who've been exposed to blast their degenerative sensory problems are much worse than the civilians who have concussions like from a car accident or something from blunt trauma. And so I've actually, you know, when you look at NFL players or NHL players in hockey, you know, their complications are usually in their late thirties and forties. Veterans exposed to the shock waves from blast pressures have almost immediate complications that result in vision loss. So it's a markedly different type of a concussion than, you know, someone who falls down stairs or somebody like I said, been in a car accident and had blunt trauma. There's an awful lot about blast energy, pressure waves to the brain in the visual pathways. Yeah. We're just now discovering in fact through the research that you all are doing there at the VA in Iowa City. It's really critical because the importance of this research is, you know, is the sooner you can diagnose that there's actually been a traumatic brain injury from a blast, then of course, the earlier you intervene with hopefully new medications and new treatments or surgery surgically, the better your outcomes will be. And so I think it's important. I, you know, serve on international veterans research organization and Bravo, Victor, in what we're trying to do is compare the British service members that were exposed to two blasts in Iraq and Afghanistan with our American culture of veterans to see if there's any differences in different age groups and also between male and female veterans. So about 14% of-
Levi Sowers: Good questions, yeah.
Thomas Zampieri: Yeah, of American veterans are female and the BVA has you know female members that were exposed to blast that are blind and the UK, it's interesting, about 10% of their military are females. And so what we're hoping to do in our research data analysis is to see, you know, are there similarities and also, of course, looking at what types of complications occur in those populations. And so the frightening thing that they found in England with the veterans over there exposed to blast is they tend to develop early onset dementia type symptoms. And so that complements the research that's been done at the VA in Boston with the brain injury research. Yeah, you know, and so it really starts to tie TBI also into the symptoms of PTSD. Yeah, Yeah.
Levi Sowers: And so there's a high correlation between TBI or exposure to TBI in veterans and PTSD.
Thomas Zampieri: Right? And so the the neurological complications of the brain injury present often, as you know, I can't concentrate or a patient will say I can't remember, so they can't work because they get frustrated or they also in the research that Bravo Victor is doing, we're actually doing clinical studies in England with the sleep disorders. Interestingly, or a lot of the traumatic brain injury veterans complain that they can't sleep at night and then during the day, they know they're drowsy. And again, it complicates everything, whether you're trying to go back to college or whether you're trying to have a job, you know, And so we're looking at the sleep circadian cycles and how we could possibly try to, you know, come up with new treatments for that.
Levi Sowers: So just a couple more questions for you. Yeah. One, I think is a bit sensitive and what would you tell a veteran that was previously had an 100% vision and then loses their vision. It to me being naive to it, to be quite honest with you being ignorant it it would seem quite traumatic to go from 100% vision to no vision. Yeah you know, you, you've had a unique experience where you've you still I don't know your, your individual case, but I think you still have some vision then and you know, while that is traumatic, what would you tell a veteran that experiences this or is beginning to lose their vision? You know what would you tell them? How what should they should obviously they should seek care for that. But what would you say to them coming from their perspective?
Thomas Zampieri: So I dealt with both the older veterans who had age related degenerative early onset vision loss. And I think the key is in then I've dealt with, of course, out at Walter Reed Army Medical Center and at Bethesda Naval Medical Center. I had a peer visits because I think, you know, being able as a blind veteran to go in and talk to an individual who's had a sudden traumatic injury and they wake up and suddenly, you know, the ophthalmologists have done maybe three or four or five surgeries, and after a couple of weeks, they're told we just can't restore the vision because there's just been so much damage, you know, And in the reaction that they have is their life is over. And so in those peer visits that the I did on, you know, Blinded Veterans Association and even in England when I we had an exchange program where we would go over once a year and meet with the Burgess blind veterans if you can connect with them and let them know that there's rehabilitation training and that you can learn orientation, mobility skills, you can learn, you know, living skills, how to cook, how to how to do things in your house, computer access, training and the technologies have evolved so that people can. I got one Army blind veteran who's climb mountains all around the world. He's climbed five of the tallest mountains on five different continents. And he said to me, Tom, if I've got my Visa card and my iPhone, I could go anywhere in the world.
Levi Sowers:
Not because of any function.
Thomas Zampieri: It's incredible. But I think getting back to the you know, your question, what's important is that they providers will often make the mistake of telling a patient who's got vision loss, whether it's acute or whether it's a degenerative condition. They'll say, we're sorry. There isn't anything more that I can do for you. Meaning I can't give you a pill that will restore your vision. Or they it comes across, though, as there's no hope. So what I try to do and other blinded veterans try to do is convince that individual that once you've been introduced to two vision rehabilitation rehabilitative specialists and you've actually first time picked up a white cane with that orientation mobility specialist and you learn how to navigate, then you suddenly start to check off the things that you thought you'd never be able to do again in in. So I had a marine who was 22 years old who came back from Afghanistan and I went out to visit him. You know, maybe that's a good way to kind of in the stories and the doctors out there at Walter Reed asked me to mountain visit him because he was just profoundly depressed after they told him that there wasn't anything else surgically that they could do to restore his vision is right. I was on his left. I had two degrees of central vision. So he tells the story to two individuals still today. I walked in his room and 2000 2011. It was like in January. And I went and he said, I'll never forget I heard the tap, tap, tap. You know, I didn't know what it was. And you come in my room and you introduce yourself and you say, Hi, I'm Tom Zamperini. I was an army major. I, I, I'm blind and I'm here to visit you in. And so I talked to Tim about what I went through with rehabilitative training and computer training and orientation, living skills, all that stuff. And did I participate in recreational events and kayaking and all that stuff. And so after 15 minutes, Tim says, How did you get here? And he says, What? And he said, How did you get here to the hospital? And I said, Well, I work in the city in Washington, DC, and I took the bus and went over to the metro subway system, got on the train, came out Georgia Avenue, exit, and then I walked four blocks over to the hospital to Walter Reed to come see you. And he stood up a side of the bed and he said, You did all that just to come visit me. Why would work? That's incredible, you know, and you're by yourself. And I said, Yeah, yeah, yeah. You know, you learn, you learn certain routes, you learn certain bus schedules, you learn, you know, things to get around and you can do it. And so he said, I had never met a blind person before. I'd never had a family member who was blind. I never had any friends who were blind. So Tim was the first blind person I ever knew. And Tom, you're the second blind person I've ever known. And you can do all this. I guess I could learn to do it all. Yeah, that's all. Well.
Levi Sowers: That's a good story. You know, it just takes sometimes it just takes one thing to trigger their. Their mind. Yeah, I know. To give them hope. And I think that's really important. And I think to follow up with our fun questions. Oh, yeah. That. That very poignant story. Well done. We always, always got to ask, what do you do for fun?
Thomas Zampieri: Oh, actually, I'm kind of one of these crazy walkers. I used to run in and I was pretty good. I could do for miles and 27 minutes. But as you get older, you realize that's not an easy thing for your knees and joints.
Levi Sowers: So I just. I just realized I'm old.
Thomas Zampieri: Yeah, but I do a lot of walking and my physician primary care doctors, I was joking because I do on average eight miles a day. And I joke that when you deal with Congress a lot, you need a stress relief. And so it's a lot. I used to walk a lot in Washington, D.C., too. So I would, you know, the old Fitbit thing, everybody tries to get 10,000 steps a day.
Thomas Zampieri: Well, I average 24,000. So I'm doing probably eight miles a day. And so, you know, but I, I like to kayak, you know, and oh, you know, I, you know, obviously spend an awful lot of time looking at research articles and stuff in order to try to keep up with the different things, you know? And so I serve on the, you know, the congressionally directed medical research, vision research, programmatic peer review committee. I'm the only veteran representative on there.
Levi Sowers: And you're veering off the path of fun into that.
Thomas Zampieri: So yeah, you know, reviewing research grants is something that most people would run away from. But for me, the interest is I'm, you know, I'm going to be voting on obviously whether to fund or not fund something, but to to review, you know, 20 different 30 different research proposals, you begin to see advances that are being made and they may be in mice or in rabbits or in, you know, monkeys. But you're starting to see some phenomenal breakthroughs, especially with, as you guys know, with the retinal chips and the neuro neuro sensory advances.
Levi Sowers: Yeah. This stuff is like science fiction to me. It's pretty amazing.
Thomas Zampieri: I read a lot of the NEA stuff that comes out and kinds of things.
Levi Sowers: Well, yeah, you're a dedicated man, and I like it. Thank you so much for the great interview, and we really appreciate it.
Thomas Zampieri: Okay. Yeah. Thanks, guys.
Announcer: This concludes today's Vets First Podcast. For questions or comments relating to the program, please direct email correspondence to vetsfirstpodcast@gmail.com. Thanks for listening!