Story – How one encounter changed a Veteran’s life
VA HPACT primary care provider Dr. Cody Gehring first met Veteran Tom in the parking lot of the Everett VA Community Clinic, where his HPACT team serves homeless and housing-insecure Veterans. Tom, in his 60s, was lying on the ground in tears beside his prosthetic limb.
“You gotta help me, doc,” he said. “My prosthetic doesn’t fit right.”
Tom had a below-knee amputation and a chronic wound on his stump that made it unsafe to wear his prosthetic. He needed specialty care, but access was difficult. He had no phone, was living in a car in the woods, and his PTSD worsened when travelling into the city.
When Dr. Gehring’s encouraged him to visit the local ER, Tom declined and left.
This type of situation is common for the population HPACT serves. “Anything that requires scheduled appointments falls apart quickly,” said Dr. Gehring. “We have to meet Veterans where they are, finding creative, flexible ways to meet their needs.”
Before Tom disappeared, Dr. Gehring convinced him to return to the clinic on a day when Nathan Dooley, a certified prosthetist/orthotist (CPO) for the local VA Mobile Prosthetic and Orthotic Care (MoPOC) program, would be onsite. “We’ll have someone here who can help you,” promised Dr. Gehring.
Weeks later, Tom returned asking for help.
Although same-day visits are difficult in a busy clinic, Dr. Gehring and Mr. Dooley prioritized his care. Each time Tom showed up, they adjusted their schedules to treat him.
“We asked, ‘What can we do right now that will help?’” said Dr. Gehring.
Tom’s goal was simple: to walk again. Over the next few months, he returned multiple times. While addressing his prosthetic needs, the team also used these visits to broaden his care — managing his blood pressure, connecting him with mental health and psychosocial services, and addressing his other unmet needs.
Fixing the prosthetic became the entry point. "Alleviating their knee pain, making their prosthetic fit, is often the reason they show up,” explained Dr. Gehring. “But it also gives us the opportunity to build trust and address everything else.”
After several months, Tom was walking again. His wound had healed, and he received a proper prosthetic fit. For the first time in years, his blood pressure was under control, he was engaged in mental health care and had moved into VA-supported permanent housing.
Today, Mr. Dooley provides home-based care using the mobile prosthetic lab, ensuring Tom can continue treatment without barriers.
“The Veteran would have not kept engaging with VA if it wasn’t for MoPOC,” said Dr. Gehring. “Despite ongoing challenges, he knows he can always turn to us.”
Note: the Veteran’s name was changed for privacy
VA Puget Sound providers Nathan Dooley, CPO, and Dr. Cody Gehring sit in the mobile prosthetic lab, which expands access to prosthetic care for Veterans in rural areas.