Interview with Fred Downs, Prosthetics Consultant

Hello, and thank you for taking the time to check out PVA’s monthly newsletter. I’m Vance Padmore, and today, I have the pleasure of speaking with Fred Downs.

Nothing in this great world has been accomplished without passion. And it’s clear that Fred Downs is passionate. After losing an arm after serving in Vietnam and beating cancer, Fred has made it his mission to help other Veterans enjoy life to the fullest, even if that meant ruffling some feathers.

Today, we have Fred Downs, combat Veteran, author and PVA staff member. We’re here to sit down and get a better idea of where you came from, your role at PVA and what’s next. I would like to kick this off by just telling us a little bit about where you’re from.

Starting at the beginning, I grew up in a farm in Western Indiana.

How was farm life?

I love farm life. I thought I’d always be a farmer. I would never, ever live in a city. But then I joined the Army and then all kinds of things changed in my life. I went to Vietnam after I went through Army training in OCS (Officer Candidate School). I was the second Lieutenant Platoon Leader in combat, first with Fourteenth Infantry, fourth division. About five and a half months after I was in country, I stepped on a “Bouncing Betty” land mine, which blew up my left arm and did severe damage to my body and legs. But they saved my right arm and leg, so I feel fortunate.

The most shocking anti-personnel mine of the war was undoubtedly the German-S mine, known as the shrapnel mine, also known as “the Bouncing Betty” to American troops. The mine was set off by a trip wire, but instead of exploding from beneath, a small charge of black powder shot the mine belly high. The main charge then exploded, scattering 350 steel balls in all directions. The Bouncing Betty accounted for over 64,000 deaths during the Vietnam War.

Then, in 1974, I joined the VA and Benefits in Denver, CO. I had been sent to the Army hospital after I got wounded. I stayed on there and met a woman who became my wife (this was our 55^th year of being married). So anyway, I could tell you stories…

Before you get into the stories, I really wanted to know, what inspired you to pursue a military career and make your way into the Army?

I’ve always been fascinated about the military. My dad was in WW2, as well as my uncles and all my dad’s friends. I grew up in the American Legion of VFW Halls on Friday and Saturday nights. As a kid, my dad and mom would be there with all their friends and they would be playing country music and drinking, having a great time and telling stories.

So I always wanted to get into the military. I wanted to actually become a pilot, but I didn’t have a college degree and, in those days, you had to have a college degree to be a jet pilot in the Air Force. But in the Army, you could fly helicopters with just a high school degree. I had gone to college for three years and then I was asked to leave and think about what I really wanted to do with my life to get my grades up. I thought that that would be a good time in my life to join the Army and I’ll fly helicopters. So that’s what I did. I was snatched away in basic training. I qualified for OCS. They offered me an OCS slot, so I could become an officer. I thought, “well, I’ve been enlisted long enough, I’m going to try being an officer.”

How long were you enlisted? Just from basic?

Basic from February of 1966, I think it was. Whatever year it was, I went to OCS. I wanted to go into infantry then. Actually, I still wanted to fly helicopters. So I qualified and went to all the prelims that you do in the military. I got my physical, and I got my pre-flight orientation. Everything looked good. When I graduated from OCS, I was going to be transferred to Ft. Rutger for helicopter training. But when I graduated, it turned out somebody lost my physical. They said, “well then, you’ll be in the infantry training and you can apply for it when you get your new training station.” In those days, fresh new lieutenants were given two or three months of what they call command time and, during that period, I got my physical again and reapplied. And then, on a fateful day, I got a set of orders saying that I could go to flight school. I was thrilled. This was one of those things in life. It wasn’t one, two hours later, I’ve got a call to show up at battalion headquarters, because a colonel wanted to talk to me. I was like, “uh oh”. So I reported, and the colonel said, “Well, you have orders for Vietnam, Lieutenant Downs.” I said, “I just got orders for helicopter school.” He said, “Lieutenant Downs, you have orders for Vietnam. They supersede all other orders.” He said, “you can apply to flight school when you’re over there.” So that’s what I did. I reapplied for flight school. And I was told in December that when I finished my term in Vietnam, I would be sent to flight school. That was in December. On January 11, I stepped on a Bouncing Betty land mine. So that ruined my Army career. I spent a year in the hospital at Fitzsimmons Army Hospital where they put me back together again, and then I met my wife during that period.

Was this the end? Of course not. The journey doesn’t end here. It’s just another path, a path that Fred had to take.

I worked for private industry for a little bit, but I didn’t care for it. I wanted to serve my country in some way.

So that’s what led you to PVA?

No, not yet. That led to me to the VA. So I started working for the VA, and after working there in 1980, the Undersecretary of Health asked me to take over the Prosthetics and Sensory Aids Service because it was in such terrible shape. It was an embarrassment to the VA. I took the job, and I figured I would work there for a couple of years before going back to the management track that I was in. It turned out, I just loved that job. So I was there for thirty years. I was able to make a lot of major changes. In 2009, I was diagnosed with cancer and I stayed in the VA a little longer until I reached stage 4. So I had to retire (against my will, because I loved that job as Director of Prosthetics). I was able to make changes, and I had to fight every day with the budget to make things happen. I was sent to NIH for a new clinical program. They wanted to try a new drug on me, since I was stage 4. I said “sure”, and it turns out it saved my life. I went down from stage 4 to less than 1.

What kind of cancer was this?

Chronic lymphocytic leukemia (CLL). There’s different types and they move at different speeds. Mine was at a medium speed and then it started speeding up. That’s when I got to stage 4. But it hangs on you forever, and then you die, like most cancers. So it was a big change in my life, as you can well imagine, but the NIH trial turned out to be very successful. I got healthy and I wanted to do something again.

The PVA President and Executive Director called me into their office to work with them. I had worked with the VSOs (Veterans Service Organizations) for years as the Director of Prosthetics at the VA. PVA was always one of those strong advocates, always on my butt to do this or do that. I got chewed out many times. They were dead serious, since nothing had been done in prosthetics for so long. I was making a lot of changes and they didn’t want me to back off. I didn’t want to, either. I enjoyed doing what I was doing to get things correct, because these are disabled vets. These are guys that should be getting first in line for everything and they hadn’t been. I always saw the VSOs as compadres. My staff was mostly Vietnam vets. I had another arm amputee working for me, as well as a double leg amputee and a blinded Vet. So we were all focused on getting things to Vets, and the Secretary and Undersecretary backed us up. They wanted us to make changes.

What are some of the changes that you helped implement?

Just about everything that’s in place today. In other words, whatever is in the marketplace today is available for our Veterans. The VA had a very, very conservative outlook in 1980. You got one wheelchair, that’s it. You got one leg, that’s it. I said, “no, there’s lots of different types of wheelchairs out there.”

One of my favorite stories is about a young lady out in the Midwest who was a paraplegic. At that time, the local facilities did not want to spend any money or make any noise. There was a form called 2641, and when they didn’t want to make a decision, they sent it to Washington to make the decision. So they sent the decision back to me, because she wanted a hot pink sports wheelchair. Of course, they only wanted to give out black and very basic wheelchairs. I was changing that, saying “whatever is out there on the marketplace, you can prescribe it. Whatever is best for the Veteran.” It came back to Washington, since they didn’t want to sign off on it. I signed off on it, took it down to SCI Service, discussed it with the SCI Director, and we said, “sure, why not?” The local facility had a heart attack. This thing cost more money than a regular old cheap wheelchair. The Director of the hospital called me and the finance officer in Washington, who then went to the Secretary. I got called up to the Secretary’s office. They had the finance officer up there and the Assistant Director of this and the Assistant Director of that. They’re all sitting around this table.

The Secretary said, “Downs, we understand you approved this wheelchair and it was a hot pink wheelchair. Is that true?”

I said, “Yes, it is.”

He said, “Do you know how much that costs?”

By that time, though, I was one of those angry Vietnam Veterans. I took my hook, slammed my hook on the table, and said, “You know, when I was a Lieutenant, I was spending hundreds of thousands of dollars a day to kill people, blow things up, call in airstrikes, call in artillery. But we’re going to deny a Veteran a $3,000 wheelchair? Is that what you’re telling me?” I was pissed.

They said, “Oh no, we didn’t really mean that. We just wanted to confirm that you really approved it.”

Nothing in this great world has been accomplished without passion. And it’s quite clear that Fred has a passion for those he served.

So yes, I made changes. Whatever was available on the marketplace, our Veterans could get it if it was prescribed to them. We had to change the way people thought about prescribing. Before, they looked at the price tag first. I said, “no, no, look at what the patient needs first.” I worried about the price, and the budget. At that time, we were working with PVA, the VFW (Veterans of Foreign Wars) and DAV (Disabled American Veterans) and gotten something called “centralized funding” confirmed for prosthetics. So whatever money was needed for prosthetics, we got that off the top.

What does the VA count as prosthetics? We typically think of limbs when it comes to prosthetics, but can it be more?

The VA counts a prosthetic as anything that is inorganic that goes to replace a body function or part. That’s oxygen equipment, hospital beds, lifts into your cars, improvements in your home to make it wheelchair accessible, artificial knees and hips, eyeballs, glasses, hearing aids…

What steps should a Veteran take if they want to receive prosthetics?

Their clinical team will prescribe it.

So they’ll go to the VA and speak to the clinical team and they’ll provide them with the necessary information and guides for prosthetics?

That’s correct. Think of it this way. Prosthetics is like a pharmacy. The pharmacist doesn’t prescribe it, but the doctor prescribes it and the pharmacist provides it. They go out and they purchase it, store it and distribute it. Prosthetics does the same thing. We get a prescription, and our job is to purchase it, fill it, teach the individual how to use it and then let them go. And of course that’s for the rest of their lives. I’ve been getting an arm from the VA for over 55 years now. That’s something that doesn’t exist in the private world, let me tell you.

For newly separated Veterans now dealing with disabilities, do you have any advice or words of encouragement for those particular Veterans?

Yes, the first thing they need to do is go to the VA and get their disability rating and physical. Because then the VA will kick itself into gear and whatever your requirements are, it’ll say if you’re newly discharged and you have your medical records in the military, so whatever you have in the military, whether it’s a sprained back or a disease that’s service connected, so the VA then, the baton is passed to them. Technically, a Veteran can continue to get care from their military service, but they rarely do that and if they do do it, they don’t do it for very long unless they’re close to a military hospital, because the VA cares, it’s universal, it’s across the system and it’s quite good. All you hear about is the negative stories, but on the other hand, those six or seven million Veterans make fifty million visits to the VA medical center every year and they receive excellent care. And if they don’t, they can bring it to a Veterans’ service organization and that brings them to PVA.

After Fred retired from the VA and got better from cancer, he was eager to get back into work doing something he was passionate about. This is where PVA comes into his story. 

After I retired, the VA didn’t fill my position for five or six years. You need to bring focus every day to central office VA among the issues that you are responsible for. So SCI has their issues. They were always meeting with the Deputy Undersecretary for Health. I did the same thing. That was my job, to talk about the Prosthetics and what we needed there. That continued to happen. Once you’re no longer in a leadership position and the position is not filled by an acting person, it just starts declining. At that time, the Secretary and Executive Director of PVA called me into PVA headquarters. Since I was feeling pretty healthy by then, I signed the contract to become a Prosthetics consultant for PVA and that was eleven years ago now. And I’ve been with PVA ever since. I love it.  I work cases. I work with the Vets, I work with National Service Officers, and of course, I help advise any time the Executive Director or anyone of the Executive Committee or any of the chapter presidents, with anything that they need concerning prosthetics. What I started to do when I started working for PVA was starting raising Cain with the VA. You have to know who to call and you have to know how to get results and you have to know how to work with people. It’s a people business. So we’re dealing with Vets, service connected or not, but whatever’s wrong with them, they need help and the VA is supposed to provide that help.

As we wind down this wonderful chat, I’m not sure if your era ever had MREs…

What’s an MRE?

Meals ready to eat.

Oh. [laughs]. We had “c-rats” or “c-rations”.

Well, in that case, what was your favorite c-ration, least favorite c-ration and why?

Those c-rations were something else. When they came out there with them when we were out there in the jungle, guys fought over them. Well, they would have fought over them. What we did was open up the case of c-rats, turn them upside down so you couldn’t read what it was and it was luck whether you got the good ones or not. My worst one was ham & lima beans. I hated those. God, they were the worst. My family today knows not to serve me lima beans. My best one, though, what was that? I don’t know.

It all tastes the same after a while. When you’re hungry, it’s all delicious.

Exactly. Every meal was packaged in a little box, and in that box, you got a package of four cigarettes, toilet paper, sugar, salt and pepper.

It’s a different time when you’re getting cigarettes in ration boxes.

They even flew beer out to us sometimes. You get one beer, but in the jungle, you sweat that beer out so fast. Now you can’t even drink in the service anymore. I don’t know how I would have survived without that.

Any favorite military movies? Anything that sticks out to you where you’re like, “Wow, that’s a very accurate portrayal.”

Two of them come to mind right away. One was very realistic, Once We Were Soldiers and Young. Outstanding book and movie. Hand Over Hill, another movie I thought was very realistic. Flight of the Intruder, that was a good one.

Who’s playing Fred Downs in the next Vietnam movie?

I wrote three books on Vietnam, a trilogy: when I was in combat, the aftermath of that, the year when I got into the hospital, and then twenty years later, No Longer Enemies, Not Yet Friends, and that was my first four or five trips to Vietnam as part of General Vessey’s MIA/POW group. In 1987 and 1988, America and Vietnam were not speaking to each other. Then you had the MIA/POW issue, and the families of those MIA/POWs. There was a lot of pressure brought on Washington to account for those individuals, and this was one way of doing that. Vessey went to Hanoi, and he came back and divided it into two issues: the political issue, and the humanitarian issue. The humanitarian issue was the issue of their amputees and ours was POWs/MIAs. We would address those issues in that regard, and that was how we got the Vietnamese to speak to America. They allowed us, finally, over a period of time to go in and recover bodies from crash sites. My job was to review the Vietnamese for prosthetics, write a report on that and report back. Then Vessey would report to the President (Reagan had reported him to that position). Those were very, very interesting trips.

So who’s going to play me in a movie like that? I don’t know. No one’s ever approached me about making a movie. But if you haven’t read my book, you should. It’s called The Killing Zone.

Definitely. Everyone out there, if you haven’t read those books, you should. We’ll get Tom Cruise to play Fred. Fred, I really appreciate your time, and thank you for sitting down with me and having this conversation.