A Tale of Two Pandemics: The 1918 Flu and COVID-19

**By Chris Baliga, MD, and David Wilma**

“We’re in unprecedented times.” During the COVID-19 pandemic, we hear variations of this statement on repeat. While current times are heartbreaking and incredibly trying, there is, in fact, a precedent.

As an infectious disease specialist here at Virginia Mason, I was curious about historical similarities and differences between the 1918 influenza pandemic and the current COVID-19 pandemic.

I checked in with David Wilma, author and historian, to help answer some questions many people have related to what we are experiencing now compared to what happened more than a century ago.

Chris Baliga, MD (CB): What did the early days of the 1918 influenza pandemic look like?

David Wilma (DW): First, let’s discuss the 1918 pandemic’s commonly used name, the “Spanish flu.” It’s entirely a misnomer. The name “Spanish flu” mainly spread far and wide because Spanish public health officials were the first to report an influenza epidemic in 1918. But the virus did not originate in Spain.

Due to wartime censorship during World War I, reports of severe influenza-like illnesses from several years earlier in army camps in France were suppressed. Because Spain had been the first to publicly declare an epidemic of influenza, the world latched onto that association.

CB: So, if not Spain, where did the influenza of 1918 originate?

DW: There are a few theories. One posits the virus transferred to humans from birds in China. Thousands of Chinese people were recruited by the British Army as laborers, sailed across the Pacific Ocean and were transported by trains across Canada, where the first known infections were recorded. Then, these recruits and additional passengers boarded ships and returned back across the Atlantic Ocean, subsequently infecting armies in France.

Another theory places the first outbreak in Kansas in February 1918. But, it’s possible that outbreak was the result of the virus returning with travelers from France. An unfortunate reality is that the likely origin and means of transmission have never been established and will never be known.

CB: What did the influenza pandemic of 1918 look like in Seattle and our region?

DW: The first influenza infections in Seattle occurred aboard a trainload of Navy recruits arriving from Philadelphia in early October 1918. Statewide containment measures were not rolled out until Nov. 3, 1918. Still, there was no state authority over local governments, and bans on public gatherings were spotty and irregular.

Hospital 1920

Virginia Mason Hospital in 1920

In Seattle, public gatherings resumed on Nov. 11, 1918, to celebrate Armistice Day, only to prove that the city was not ready to return to “normal.” Infections increased again, resulting in a total of 1,441 deaths in Seattle and more than 5,000 deaths across Washington state, of which more than half of victims were between 20 and 39 years of age.

At the time, Seattle had a population of three hundred thousand, making it the largest city in the state. Inadequate hospital beds in the city forced a dormitory at the University of Washington to be pressed into service for the sick and dying.

The shortage of good hospital care in Seattle prompted the Virginia Mason founders to consider a new hospital built around a team of specialists. As a result, Virginia Mason Hospital opened in 1920 in direct response to the 1918 flu pandemic.

CB: What are we seeing with COVID-19 that is similar to the influenza pandemic in 1918?

 DW: First, both the 1918 flu and COVID-19 are caused by a virus. Both highly contagious, the viruses also share similar transmission between humans by contact with infected air particles. Transmission is exacerbated by travel. Though ships and trains back then were physically slower than airplanes travelling internationally today, they were still just as effective in moving passengers around and contributing to disease spread. During both pandemics, seaport and airport cities were home to the earliest infections, largely due to the volume of travelers through the area. For many people in 1918, the notion that influenza came from “somewhere else” outside their own country in combination with wartime tensions contributed to harmful xenophobic, racist ideas and scapegoating of foreign populations. We’ve unfortunately seen similar reactions to the coronavirus.

And as influenza and COVID-19 arrived in and spread throughout cities, they’ve affected Native, Hispanic and African-American populations more than other populations.

In both pandemics, the virus alone is not the sole cause of fatalities. Rather, it’s the escalation of symptom severity that can become a problem. Influenza and the coronavirus can rapidly contribute to severe, often fatal complications like pneumonia.

As we analyze various government responses and containment efforts directed at COVID-19, it’s important to remember what we saw during the 1918 influenza pandemic. Intentional, thorough and well-implemented containment measures are likely to be most effective in virus control. In fact, during the 1918 pandemic and COVID-19 today, countries and cities that imposed contact restriction measures early and kept those measures in place experience fewer fatalities overall. Acting early is an important lesson for all of us to learn, as well as ensuring a thorough response and not returning to normal operations too quickly.

CB: How is our current response to COVID-19 different from how we experienced and handled the influenza pandemic in 1918?

DW: Perhaps the most significant determinant of the 1918 influenza response was the limited medical understanding and technology at the time.

Our lack of understanding of viruses and their behavior meant we were never able to respond to the 1918 influenza pandemic properly. The particular strain of influenza was not even identified as a virus until 1930, and no vaccine was ever developed to combat the disease. The pandemic only really calmed down after infection rates declined in waves in the late winter of 1918. Wartime censorship limited our understanding of the ongoing pandemic and early outbreaks on the battlefields. Potential drug treatments like Tamiflu simply did not exist at the time.

Recordkeeping practices in 1918 also posed a challenge, and reports of influenza were likely overlooked. We know that the 1918 flu infected populations across the board – hitting the youngest, the oldest, men and women. But contact tracing and tracking the disease’s spread in real time was minimal. Wartime record suppression, lack of reporting requirements and health authorities’ conflation of data among deaths from influenza and pneumonia all contributed to inaccurate data.

Around 100 years later, we have a much greater understanding of viruses, their behavior, effective treatments and the capabilities of health care workers and medical systems overall. We’ve been here before, and we’ll get through this now, by all working together.


Baliga, ChrisChristopher Baliga, M.D. is board-certified by the American Academy of Internal Medicine in infectious diseases and internal medicine. He practices at Virginia Mason Seattle Medical Center. Dr. Baliga specializes in infectious diseases, HIV/AIDS care and travel health issues.


David WilmaDavid Wilma is a writer and author of history books and historical fiction. He is based in the Pacific Northwest.

 

A Message from Gary S. Kaplan, MD, Chairman and CEO

To Our Community:

I am writing with a heavy heart, and I’m sure many in our community share my feelings. The senseless deaths of Ahmaud Arbery in Georgia, Breonna Taylor in Kentucky and George Floyd in Minnesota are tragic. These events shine yet another spotlight on the longstanding systemic racism and injustices in our country — at a time when we are already in crisis with the continuing COVID-19 pandemic. Americans are hurting and the ongoing protests and recent events only begin to illustrate the deeply rooted pain and frustrations felt by so many.

At Virginia Mason, we believe in equity, inclusion and respect for people. We have a duty to ensure all individuals in our community can thrive, which is why we say, Black Lives Matter. We stand together in solidarity with our African American and minority colleagues, patients, and community members.

Virginia Mason CEO addresses racism and injustice in open letter. We also believe change can happen when we come together to take a stand and raise our voices. Our nation is not equal, and for far too many of our most vulnerable citizens, the inequities in this country are fatal. As long as this statement stands true, our communities cannot truly be healthy or well. Our country must right these wrongs so we can build a more just society where every individual has the opportunity to achieve success and live their healthiest life.

Each day that we interact with our communities, we have an opportunity to model change as we go. At Virginia Mason this work can begin in the exam room. It can begin in the emergency room or the operating room. Anywhere we may have an interpersonal encounter, our team members have an opportunity to demonstrate respect. Respected populations are healthier populations.

At Virginia Mason, we chose health care as our profession because we have a common purpose to help others, our broader communities, and to keep each other safe and healthy.

Kaplan3MBVirginia Mason stands with our entire community in the fight against racism and injustice.

Thank you,

Gary S. Kaplan, MD
Chairman and CEO
Virginia Mason Health System

 

Donated Supplies Help Deliver Care in East Africa

Last summer, Phoebe Wright completed her third volunteer mission to the Elimlim Community Health Center in Kitale, Kenya. It was the second year the University of Washington biology major took medical supplies donated by Virginia Mason; basic items to support health services for some of the poorest people in the region, including many young children.

Africa.Phoebe.photo.1 (002)

Left to right: Phoebe Wright; Evelyn, clinic nurse; Samantha, ICU nurse volunteer. 

Phoebe, who plans to attend medical school, describes the extraordinary education of assisting in a clinic where easily preventable conditions are a constant risk to life. Simple things like sanitary linens, packaged gauze and aspirin create treatment options and help promote healing. Sharing knowledge and techniques – Phoebe remembers a health worker intrigued to learn that silicon bandages could reduce burn scars – is another form of exchange desperately needed in remote areas.

“I now have a genuine compassion for the people part of medicine,” writes Phoebe about her months spent at Elimlim, which offers everything from wound care, family planning and eye glasses to treatment for HIV. “I’ve seen first-hand how completely preventable diseases and conditions affect mothers, children and people living on the streets. Improving basic education of medicine and the human body would prevent many deaths and needless suffering.”

Africa.bed.photo.2

Multipurpose patient room with donated bed linens.

Kenya’s patchwork health care system stems in part from the lack of a long-term commitment by the government. State-run clinics, even when accessible, often fail to provide the consistent, reliable care needed to prevent or treat chronic illness. Access to free, donor-funded clinics like Elimlim is critical, says Phoebe, to fill gaps in care and for treating the whole patient.

Elimlim currently employs a Kenyan medical staff of four, with rotating volunteer physicians, nurses and clinicians, serving more than 350 patients per month. A mobile clinic brings health care to remote villages as resources will allow, a schedule the clinic hopes to increase.

In her post-trip letter to Virginia Mason, Phoebe wrote: “I am very thankful for the opportunity to partner with Elimlim as well as Virginia Mason to serve the people of Kitale, Kenya. I was able to spend quality time building relationships with the staff, following up with returning patients, learning about tropical medicine and not being afraid to say yes to unique learning opportunities. I cannot emphasize enough my gratefulness for the support and generosity of the team at Virginia Mason.”

Africa.pharmacy.photo.5

New supplies for Elimlim’s pharmacy. 

Protect Loved Ones and the Community by Safely Tossing Prescription Drugs

National Prescription Drug Take Back Day at
Virginia Mason Federal Way Medical Center

Saturday, Oct. 26, 10 a.m. – 2 p.m.

Prescription medications play an important role in the health of millions of Americans.

But some prescribed medications become a danger when they sit unused in peoples’ home medicine cabinets. According to the 2018 National Survey on Drug Use and Health, nearly 10 million Americans misused prescription drugs. The study shows that a majority of abused prescriptions were obtained from family and friends, which is how most children and teens access the drugs.

“Prescription drugs ending up in the wrong hands is dangerous and can lead to tragedy,” says anesthesiologist Julie Vath, MD. “That’s why Virginia Mason is again participating in National Prescription Drug Take Back Day. At last year’s event we collected 17 boxes of medications totaling 408 pounds.”

drugtakebackcrop

The Virginia Mason team on Take Back Day, Oct. 2018

Members of the public are invited to anonymously dispose of unused and expired medications on Saturday, Oct. 26, 10 a.m. – 2 p.m., at Virginia Mason Federal Way Medical Center (33501 First Way S., Federal Way, WA). Medical professionals will be on site to answer questions about the Drug Take Back program.

Accepted items include all over-the-counter or prescribed pills, capsules or liquids, including:

  • ADHD medications
  • Ambien
  • Antidepressants
  • Codeine
  • Fentanyl
  • Hydrocodone (Norco, Vicodin)
  • Klonopin
  • Morphine
  • Muscle relaxants
  • Oxycodone (OxyContin, Percocet)
  • Tramadol (Ultram)
  • Valium
  • Xanax

Items not accepted include:

  • Chemotherapy medications
  • Illegal drugs
  • Intravenous solutions
  • Syringes
  • Epinephrine injectors

For those who can’t make the take back event, Virginia Mason Federal Way provides a permanent medication drop box, located in the pharmacy. Find additional drop boxes located at Virginia Mason Hospital and Seattle Medical Center, in the Buck and Lindeman pavilion pharmacies.

For more information, including a collection site locator, visit the official Take Back Day website.

Peer Partners Offer Encouragement and Support to Joint Replacement Patients

When it comes to innovation and improvement, Virginia Mason recognizes that patients are a valuable resource. This is especially true in the Peer Partners program. When former joint replacement patients were asked what could be done to improve their experience, many said they wished they’d been able to talk with someone who had recently gone through a hip or knee replacement.

Patient peer partner volunteer speaks with orthopedics patient.

A Virginia Mason patient learns his Peer Partner, Kent Smith (right), also looked forward to playing tennis again after joint replacement.

Patient Relations Program Manager Ann Hagensen, RN, realized the value of that suggestion. She and her team worked with patients to design the Peer Partners program. Now in its third year, the program trains former patients to become volunteer peer partners. The volunteers round on the orthopedics unit, visiting patients. They also attend pre-surgical classes to reinforce the knee and hip surgery protocols. In an orientation session, peer partners are prepared to visit with patients by learning communication techniques that help them listen for topics that matter most to the patient. Often patients are excited to talk about activities they plan to get back to with a newly functional joint.

Following their training, peer partners move through the orthopedics unit, introducing themselves to patients who are scheduled for surgery or are in recovery. Volunteer Kent Smith, who has been a peer partner for two years, found the program to be very helpful to him when he underwent his own hip replacement. “I wanted to find a way to pay back for the great care I’ve received at Virginia Mason,” he says. “The caregivers here have wonderful hearts. They give the kind of care you always want to receive.”

Kent credits the Patient Relations training with transforming the way he communicates in all aspects of his life.

“It’s all about listening and letting people know you’re there for them,” Kent says. “The conversation may begin with a focus on their surgery, but often expands to include their personal lives. Patients want someone to listen to them. Our goal is to be a source of encouragement and motivation, to help them get the hard work of recovery done.”

Kent is not alone in his enthusiasm for the Peer Partners program. Ann says the one-on-one experience is so positive that many patients decide to volunteer before they leave the hospital, returning six months later for their training.

“This program is a win-win,” says Ann. “It’s a win for our patient partners who have this opportunity to help others and see their ideas become reality, and it’s a win for Virginia Mason, helping us create the perfect patient experience.”


A version of this story also appears in the Virginia Mason Health System 2017 Annual Report. 

Breaking the Cycle of Homelessness with the Housing Stability Project

In a weekly skill-building class at Bailey-Boushay House, outpatient program clients are quietly finishing a journal entry. Group leaders Angela Brock, occupational therapist, and Billy Burton, clinical case manager, assure the group that sharing their writing is strictly optional: the real purpose is to help them manage feelings jumbled by transition.

Each client in the group has reached milestones in Bailey-Boushay’s Housing Stability Project. With support from the program, some are now in housing, and others are nearly there. Reading from loose journal pages, Antonio recounts a difficult moving day and facing the fortress of boxes in his new apartment. It’s this class, he says, that got him out of the house and talking about unpacking.

Annual Report - BBH

Angela Brock, occupational therapist, guides a group session.

Another client, Robert, says his entries are too personal to share aloud but he’s amazed by the relief writing brings. Next, Jeffrey reads from his last entry: “I have an apartment in my immediate future.” Words on a page have power, Angela tells the group, and she pledges to get everyone new notebooks by the next class.

About half of Bailey-Boushay’s outpatient program clients are homeless, many struggling with a history of substance abuse and mental health problems, while managing daily treatment for HIV. In 2016, outpatient program efforts to broaden support for both homeless and newly housed clients included:

Extended hours. Bailey-Boushay moved its opening time up 90 minutes to 6:30 a.m., accommodating clients displaced by shelters closing at 6 a.m. Executive Director Brian Knowles says not only are clients glad to get out of the cold and rain, but they have more time to shower, do their laundry and get services like therapeutic foot care. Because foot health is crucial for overall well-being, new socks are provided daily.

An onsite food bank. Often items available at regular food banks require cooking facilities or refrigeration, leading to waste. Because many client medications must be taken with food, hunger is not the only danger when food supplies and money are gone at month’s end.

A monthly food bank offered at Bailey-Boushay is designed around the wants and needs of clients. Single servings mean no spoilage; cans with pop-tops are in, as are foods known to taste OK cold. The onsite food bank eliminates another problem linked to food insecurity: chronic anxiety. No lines, no empty shelves, no being rushed to shop and enough choices to help clients feel empowered.

More life skills classes. The Housing Stability Project maintains a class lineup to meet clients where they are, with weekly drop-in groups for self-care, stress management, conflict resolution and relationship skills. Clients who excel are invited to join the Phase Two class (the journaling session above is an example), bringing together the same group each week to build relationships as they work toward setting longer term goals for a future taking shape.

Glenda, a client in the Phase Two class and an avid journal writer, told the group about making new choices and what it means when her doctors say she’s doing well. “It’s lifted my self-esteem,” says Glenda. “I’ve climbed the ladder of recovery for three years and I like what I see. I have more to do, but I know I can do it.”


A version of this story originally appeared in the Virginia Mason Health System’s 2016 Annual Report. Bailey-Boushay House, a skilled nursing and day health facility serving people living with HIV/AIDS and other life-threatening conditions, is owned and operated by Virginia Mason. 

Eye Safety Reminders for the Solar Eclipse

On Monday, Aug. 21, the Seattle area will experience a partial solar eclipse, where the moon covers part of the sun’s disk. When the moon covers the entire solar disk it is called a total eclipse. While Seattle is not in the “path of totality,” or where the total eclipse will be visible, the last time anyone saw a total eclipse from the mainland United States was 1979!

employee eclipse article

First-person account from a 1979 Virginia Mason newsletter.

As we prepare for one of nature’s most exciting sights, ophthalmologist Connie Chen, MD, a retina specialist, offers these reminders about eye safety:

  • Looking at the sun without appropriate eye protection is dangerous for the eyes, and sunglasses are not effective for viewing the solar eclipse. Even the darkest sunglasses don’t reduce the amount of light hitting the back of your eye (the retina) by that much.
  • The optics of our eyes leave us vulnerable – think of them as magnifying glasses focusing the sun’s energy on the retinas – potentially causing permanent vision damage. Because the retinas don’t have pain receptors, you won’t feel the damage being done.
  • Since the Seattle area will only be experiencing a partial eclipse, you must always use solar filters to view the eclipse (such as those found in certified viewing glasses) when viewing the sun directly.
  • Information about certified eclipse glasses with solar filters, labeled with the ISO 12312-12 international safety standard, can be found here.
  • Children viewing the eclipse are particularly susceptible to retinal damage as glasses are not typically fitted for smaller faces, not to mention a stronger temptation to peek around the glasses. Children must be supervised carefully.

For more information, please visit the American Academy of Ophthalmology website.

Virginia Mason Physicians Volunteer at Kenya Hospital

Leveque

Dr. Leveque discusses a patient’s condition with a resident at Kenyatta National Hospital.

Last September at the Kenyatta National Hospital in Nairobi, Kenya, residents in orthopedic surgery and neurosurgery got a sense of what their U.S. counterparts experience. Virginia Mason complex spine fellow Vijay Yanamadala, MD, traded information with the young doctors as part of his volunteer surgery work at the massive 3,000-bed hospital. Creating a learning environment with the residents – some inspired to further their education in the U.S. – was an important cohort in the week-long mission.

Virginia Mason neurosurgeon Jean-Christophe Leveque, MD, who also volunteered in Nairobi, works through the NuVasive Spine Foundation, a nonprofit organization providing surgery and advanced training to disadvantaged communities in Africa. Dr. Leveque praises the shift he sees in the medical missions from simply performing a series of surgeries to partnering with the resident surgeons for training opportunities.

“When you interact with the residents on the surgical cases, not only are they getting instruction from the experienced surgeons, but they do the follow-up care with patients and keep in touch with us on their progress,” says Dr. Leveque.

Of the 18 surgical cases completed during the mission, the majority were to correct spine deformities caused by long-term tuberculosis (TB) infection. If the infection spreads from the lungs to the spine, a severe form of arthritis can develop. Eventual collapse of the vertebrae can lead to deformities, nerve damage and paralysis. Spinal TB is an ongoing threat in underdeveloped countries, where access to anti-TB drugs and public health care is scarce.

Despite having nearly 10 times the beds of Virginia Mason Hospital, Kenyatta National Hospital is challenged to serve all patients, with hundreds doubling up in single beds or sleeping on the floor. The power can be fickle, as can the running water: scrubbing before surgery was sometimes a dousing with an alcohol-based solution. Yet there were surprising things Virginia Mason shared with this hospital across the world.

“We asked the hospital’s chief quality officer what kind of quality improvement projects they were working on,” remembers Dr. Yanamadala. “She said ‘5S kaizen.’ Even in a resource poor environment, their priority was an efficient, productive hospital. I realized there is no setting where these principles can’t apply.”

Only about 12 neurosurgeons and 60 orthopedic surgeons practice in Kenya, serving a population of 64 million. There are no complex spine fellowships because there’s no one to teach them. Missions like the one Dr. Leveque and Dr. Yanamadala completed are first steps toward growing programs to advance patient care around the world.

“There is no way we can treat all the patients who need surgery the week we are there,” says Dr. Yanamadala. “But we can help train and inspire new doctors to continue the work going forward.”

physician volunteers

Pictured from left: Vijay Yanamadala, MD; Jean-Christophe Leveque, MD; W. Blake Rogers, MD, director, NuVasive Spine Foundation; Hunter Volk, market development manager, NuVasive


A version of this story previously appeared on Virginia Mason’s internal news site.  

 

Virginia Mason Surgeons Treat Spine Disease in Sri Lanka

A 16-year-old girl with severe scoliosis traveled to the National Hospital of Sri Lanka for a chance at a new life. An international volunteer medical team had arrived to perform Volunteer%20Spotlight%20-%20Dr_%20Sethicomplex spine surgeries alongside a few of the local surgeons, while dozens more would participate virtually by live video. Two members of that visiting team were from Virginia Mason: Rajiv Sethi, MD, director, Neuroscience Institute, and Vijay Yanamadala, MD, complex spine fellow.

Many years of performing volunteer surgery to treat scoliosis, a spine deformity that affects 3 percent of the world’s population, have sent Dr. Sethi to Asia, the Middle East, Africa and South America. With the support of a team and donated spinal implants, spinal diseases brought on by tumors, infection and congenital deformities can be treated, restoring function and relieving crippling pain. For the young girl in Sri Lanka, a spinal curvature of 90 degrees would be made nearly straight again.

“Without our intervention this girl would progress to a 130 or 140 degree curve, have difficulty breathing, horrible pain and likely an early death,” says Dr. Sethi. “Now everything will improve, and it will be hard for anyone to tell she had scoliosis.”

Dr. Yanamadala had just begun his fellowship at Virginia Mason when he heard about the mission. Then came an invitation from Dr. Sethi: Would he like to join the team in Sri Lanka?

“It seemed like a great opportunity to see what surgery is like in that part of the world,” says Dr. Yanamadala. “I expected to do surgery and help some people, but I found it changed my entire perspective as a surgeon. I was struck by how we could accomplish everything we wanted with a fraction of the resources we have in the U.S.”

Dr. Yanamadala says a typical lumbar fusion surgery here might utilize four or more trays of equipment, whereas only one tray supplied everything the team needed in Sri Lanka. A conserving strategy must be applied, however, for the use of spinal implants. Each donated implant is just one piece of a “scaffolding” applied to strengthen and reshape the spine — a typical surgery could require 20 or more – at a cost of about $2,000 apiece. With the mission’s limited supply of implants, Dr. Sethi modified his approach, spacing them out to use fewer implants while maintaining a good surgical result.

Besides equipment, what the volunteer surgeons bring is more hands to carry out the complex surgeries, and the expertise to empower a small but dedicated group of surgeons. Dr. Sethi notes a senior surgeon in Sri Lanka may only take on three scoliosis cases a year, procedures that can last 12 hours or more, simply because there’s no one available to assist. “Doing surgery in these places is a personal challenge I don’t find anywhere else,” says Dr. Sethi.  “I’ve operated in stifling heat, with bugs flying around, lights that go out and very limited equipment. It’s easy to complain about things at home until you see what they have to deal with. You come back with a much more positive outlook.”

On the last day of the mission, Dr. Yanamadala remembers checking on one of the team’s patients who had traveled many days to reach the hospital. A senior surgeon from Sri Lanka was there, and mentioned he would drive the patient home himself, since the ambulance service ran only once every three weeks.

“My time in Sri Lanka emphasized the humanitarian side of medicine, and the reasons I became a physician in the first place,” says Dr. Yanamadala. “Seeing all they accomplish with few resources makes you rethink what’s truly valuable for patients.”

 


A version of this article was originally published on Virginia Mason’s internal news site.

 

Celebrating National Nurses Week: A Nurse Volunteer Helps Military Families Feel at Home

Sherry Taylor is a busy registered nurse, but she makes time every week to help support a unique program that is close to her heart.

Sherry Taylor RN Federal Way (002)

Sherry Taylor, RN

Sherry volunteers at the United Service Organization (USO) center at Seattle-Tacoma International Airport. There, military members and their families receive travel assistance and enjoy access to the comforts of home 24 hours a day, every day of the year. Each month it serves more than 8,000 service members and their families, reservists and retired military.

“The USO has served military families for 75 years, but my reason for becoming a volunteer is very personal,” said Sherry, an oncology-infusion nurse at Virginia Mason Federal Way Medical Center. “The USO has been so helpful to my son, a U.S. Navy pilot and his family when they have been traveling. Volunteering is my way of saying ‘thank you’ to the USO.”

The USO center provides around-the-clock meals and snacks, five big screen TVs, a bunk room and lounge, showers, free Internet access and a separate family-friendly room. (Learn more about the USO-NW SeaTac Center at www.usonw.org/seatac.php.)

National Nurses Week is May 6 through May 12, when businesses, organizations and communities across the country are encouraged to celebrate nurses. As Sherry exemplifies, the contributions of nurses often extend beyond the walls of hospitals and medical clinics.

A nurse for about 44 years who has also been a practicing psychologist, Sherry’s support of others in difficult times is a calling as much as it is a career. “I have the privilege of being there for others during their time of need. I just love people,” she said.

The USO works in partnership with the U.S. Department of Defense but relies on private contributions and on funds, goods and services from corporate and individual donors. The USO, which is not a government agency, operates 160 centers worldwide.

“It is rewarding and fulfilling to support a program that benefits military members when they are far from home and their loved ones,” said Sherry.