UNIVERSITY OF SAN DIEGO / Summer 2006
Common Ground

[healing touch]
THE PATIENT PERSON

by Thomas Larson photography by Fred Greaves


Lt. Cmdr. Lavencion Starks, who heads the Naval Medical Center San Diego’s emergency room, spends most of his time behind a desk but he loves to lend a hand on the floor.

Elaine Allen, a 66-year-old retired Navy captain, is being wheeled into the emergency room at the Naval Medical Center San Diego. Her body and head are strapped to a backboard and her neck is collared; she blinks at the fluorescent ceiling lights whizzing by above her. It’s not clear yet how serious her injuries are — 15 minutes ago, she was hit from behind by a driver doing 80 mph. Allen asked to be brought here because she’s Navy and she knows the hospital’s reputation. She’s rushed into a curtained bay where a nurse leans over her and makes eye contact. He tells Allen that he’s here to take care of her. She’s frightened, disoriented. He says he knows how uncomfortable she must be with her head pinned. The nurse, an open-faced man with a satiny shaved head, says he and his team are going to move her: she may feel a jolt.

”Are you ready?”

She responds with a question. “You military or civilian?”

“Military.”

“What’s your rank?”

“I’m Lt. Cmdr. Starks, U.S. Navy, head of nursing.”

“That’s good,” says Allen. “A lot of my Navy friends are nurses.” She reaches her hand up to Starks’ rubber-gloved hand, and he takes it. They squeeze, and he counts, “One, two, three.” She’s lifted from the paramedic’s gurney onto an ER bed.

Soon Starks stands aside for Dr. John W. Love, one of two physicians on the floor today. Love begins the medical exam, telling Allen that he’s concerned about internal bleeding, broken ribs, the pain in her back she’s already noted. Allen is now relaxed and joking with the attendants; X-rays will later show her injuries are minor.

Providing this critical initial connection to patients is something Lavencion Starks would like to do more of. But his days bulge with duty; he’s in charge of the emergency room’s 35 nurses and 40 enlisted staff. He’s also fresh out of the University of San Diego’s graduate nursing program, with a master’s in executive nurse leadership. Prior to that he served at the White House under President Clinton. As an executive, he chairs meetings, whiteboards the schedule and chooses who will be deployed to Iraq, his toughest call. All of that can be taxing. Which is why several times a month the 39-year-old loves to don turquoise scrubs and work a 12-hour shift. It’s not only that he likes being reminded what “my people are going through.” It’s that administrating can drive him loco. “You might say getting out here to care for patients keeps me sane.”

To be a nurse and a male is not as incongruent to Starks as it may seem to some of us. The trade runs in his family. His mother, a single parent for several years, was a nurse in Chicago, where Starks was born and raised.

“We didn’t have a baby sitter, so when the pager went off, we’d get in the car and take off. I would travel with her to Cook County Hospital. I’d sleep on the gurneys in the hallways while she worked in surgery. Then, in the morning, if she was still busy, one of the nurses would take me to the cafeteria for breakfast, and if she was still busy, somebody would take me to school.” He says the bond between nurses and their families is special. “It’s the best part of the nursing culture.”

At 15, Starks took advantage of one hospital’s summer program and worked as an intern beside his mother. “I was an orderly, helping transport patients, empty bedpans, take bodies to the morgue.” When he was trying to decide on a career when starting college, his mother put the nursing bee in his bonnet: “‘You’ll always have a job,’” he recalls her saying. “‘You’ll always be able to take care of yourself. It’ll offer you diversity if you decide you want to go into anesthesia or the operating room; it offers you dynamics and range.’”

Central to his decision was the glowing example of his mother. “Doctors historically get all the credit,” he says. “But I saw things from the nurse’s perspective. My mother was my idol. I saw her in a position of authority, (having) a great deal of control. Wow! She was saving lives. I wanted to emulate that.”

When he enrolled in the nursing program at Delaware State University, Starks was the only man in a class of 40 women. “I feel like I’m a pioneer in the field. The percentage of males has grown; that’s a very good thing for the profession. But yes, then, I was a minority of minorities.”

Rather than face gender discrimination as a nurse, Starks says that “many of the guys on campus were envious of me, being around women.”

The question Starks usually gets when people find out he’s a nurse is, ‘Didn’t you want to be a doctor?’ As if men would only see nursing as a rung on the ladder to physician. His answer is straightforward: “I’ve had no desire to be a physician. I like what I do. Nursing, because of my mother, is a very comfortable and natural position.”

In 1989, during his senior year of college, the Navy recruited him. “They offered me the opportunity to come to California. I grew up in Chicago; I went to college on the East Coast. I was young. I wanted some adventure.” He signed a three-year contract and was sent to officer training school. From there, he got his first command at Naval Medical Center San Diego, a facility that today employs 6,000 military and civilian personnel.

He first shipped out on the USS New Orleans, a small helicopter carrier ship. Duty also took him for eight months to Saudi Arabia and Kuwait during the Persian Gulf War. There, with a mobile medical group, he provided care to Marines. Starks is still struck by the daunting challenge of fighting a war on the other side of the globe. “America basically takes a big shovel, scoops up our armed services and transports them halfway around the world. They must sustain themselves with food, tents, vehicles, weapons, everything. My unit was attached to a major re-supply detachment that carried the beans, the bullets, the water, the fuel for the soldiers. As the fighting forces went forward, we were 20 miles behind them.”

Starks’ unit stabilized the wounded and sent them back to larger facilities. “Those injuries were nothing like the high-intensity combat injuries we’re seeing now in Iraq,” he says. “We did see limb injuries, and unfortunately, almost as many friendly fire incidents.” He particularly remembers the fear of massive casualties at the war’s inception — and the widespread relief when doomsday scenarios failed to materialize. “For the first three days, people were saying, ‘3,000 casualties, man, it’s going to be horrible.’ But the Iraqis didn’t want to fight. They were surrendering to everybody, even to medical people. We spent a lot of time feeding them, seeing to their malnutrition, dehydration and infections.”

In 1996, three years into his stint in the intensive care unit at the Naval Medical Center, Starks got word about an opening for a nurse at the White House. He fit the criteria, was selected as a finalist along with six others (3,000 applied), flew to Washington for interviews and landed the position. Starks worked for three years as part of a 20-person team in the Old Executive Office Building next door to the White House. He cared for President Clinton and Vice President Gore, as well as their families. When Clinton traveled abroad on Air Force One, Starks was sent ahead to survey hospitals and clinics where — in case of an emergency — his boss might have to go.

In his office, three candid photos of Clinton and a beaming Starks line the wall. In one, Starks is cutting a cake on Air Force One and celebrating the end of his White House tenure. Clinton, Diet Coke in hand, is making Starks laugh. “He was commenting on not missing some of the exams we used to give him.” Because of patient privacy, Starks can’t share certain specifics, but he does recall President Clinton with affection.

“What I learned in the political arena is that generally there’s a certain person you see when the camera and the lights are on, and there’s a different person when the camera and the lights are off. Clinton was always the same person. He was the kind who would walk through the aircraft and find the guy handling the trash and talk sports with him.

I was a low-ranking military officer, and he still took time out to say, ‘Thank you very much for everything you do. I appreciate it.’” On his right shirt pocket, whether it’s his khaki or bright white uniform, Starks wears a Presidential Support Badge, the seal of the president — an eagle whose talons grasp an olive branch and a cluster of arrows.

After his time at the White House, Starks was assigned for three years to a small U.S. base in Atsugi, Japan. He lived in the city and met his future wife; they now have a 2-year-old daughter. But then, in 2003, he decided that “for my professional growth, I needed a master’s degree.” Starks applied to the University of San Diego as part of a Navy program that would pay for his two-year grad-school education and continue his salary as long as he stayed in the Navy for four years following graduation. Fifty percent of the nurses in the program were men: “Times have changed.”

Starks put on his civvies and spent his first year in class and writing papers. His second year was devoted to clinical work at hospitals in Escondido. On campus, he says, “I was a little lost. There’s a different thought process for those of us who’ve been out on the grindstone.” Then, he met two women who were major influences. Clinical professor Linda Urden was one of them. “She was the first one who helped me develop direction, tunnel my focus. She’s an incredibly smart lady, a visionary.”

Urden remembers Starks as having a “big-picture approach” to health-care systems. “He’s inquisitive and questioning; he’s very articulate, very well-read. He quickly synthesized information and came to conclusions.”

From professor Jane Georges, Starks learned grant-writing, information-gathering and the fundamentals of research. “I enjoyed her coursework the most.

She showed me how to find the science behind any particular problem in health care for which you need money to solve.”

Starks beams, recalling the school’s esprit de corps. “I loved it,” he says. “It was an incredible, remarkable, wonderful experience. I was always happy on that campus. It’s beautiful. If anyone wants to provide

Lt. Cmdr. Starks a scholarship so he can get his Ph.D.,” he jokes, “he’d be more than happy to take them up on it.”

Doctorate or no, he’s delighted to be working at the Naval Medical Center again. Nursing will always demand long hours and emotional strain. He’s got to be ready, he says — reviving a shipboard metaphor — for “whatever falls on the deck plates.” But to continue to be stationed in San Diego? “I’ll sign any contract.”

In January, Starks chose four nurses from his staff for deployment to Iraq. He’s sent others before, but this group is new to war. He says it’s always a tough decision. “I won’t send a brand-new nurse. But I will make sure they have the skill sets and the experience to do the job.” How did they take the news? “They know they may have to go to war when they sign up,” Starks says. “They will be forward deployed, which means wherever the Marines are — even on the front lines — that’s where they’ll go.”

About the conflict, Starks says, “I look at CNN just as you do. You could be driving down the street in a Humvee and be hit by a roadside bomb, or they could lob missiles into the chow halls. Everyone is at risk.”

Back in the ER, Starks is assessing a procedural change he has just implemented. One day last October, every ER in San Diego was overwhelmed. Full moon or freakish fate, all day long the waiting room at the Naval Medical Center was clogged. Ambulances arrived hourly. “It was a hospital traffic jam,” Starks recalls. “In America, people want high-quality health care, and they want it right away. We had to make changes.” Starks focused on triage time. “There’s no reason we shouldn’t be getting to patients in the first five minutes.”

It’s later in the day now, when the critical-care volume picks up. A boy with a bruised face goes by in a wheelchair. At the bedside of a sleeping woman, a soldier in camouflage and tall black boots stares at a monitor, its electro-luminescent waveforms tracking to the right. The manic pulse of television’s “ER” is rare, though it does happen. Most people who come through the door need non-urgent care. But that doesn’t keep Starks from innovating: “You never know when we’re going to be bursting at the seams again. I want my people to make quicker decisions.”

In the waiting room, a big sigh comes from a frazzled, bed-headed man in a T-shirt, shorts and sandals, his legs ghostly white. It’s a sigh of relief: a corpsman is cradling his arm and pumping up the blood pressure cuff.

Soon, the man is on his feet and shuffling into the ER, holding out an elbow for Starks, who, taking it, greets him. “Good afternoon, sir.”

His touch is gentle, affirming.

“You a doctor?”

“No sir. I am a nurse.”

[defender]
THE TOUGH COOKIE
No-nonsense style helps Frances Fragos Townsend get the job done.

By Kelly Knufken photography by Brendan Smialowski


Frances Fragos Townsend speaks to the press outside the White House, alongside Secretary of Homeland Security Michael Chertoff (center) and U.S. Secretary of Health and Human Services Michael Leavitt (left).

It was Christmas 2003 and Frances Fragos Townsend was worrying. Anxious. She wasn’t alone. All of America was on edge. Every day dawned with unease: Would this be the day terrorists picked to attack us again? But that weighty dread wasn’t Townsend’s only concern. Tomorrow was Christmas Day, and Condoleezza Rice — then national security adviser and Townsend’s boss at the time — had just asked President George W. Bush via videoconference what time he wanted his morning briefing. Townsend braced herself, but could say nothing. How could she leave her kids on Christmas morning? She waited for the bad news. Rice waited. Finally, the president responded. “I want to be briefed after the Townsend children open their Christmas presents.”

“Sure enough, the president of the United States got his briefing after I had Christmas morning with my kids,” she recalls.

This is the life of Fran Townsend ‘84 (J.D.), now assistant to the president for homeland security and counterterrorism. She has a family. She also has a responsibility to serve the country and the president. “I take the job very seriously,” she says. While the power level of her duties may be high, the ceilings are low in her West Wing office, just 6-and-a-half feet. That makes the huge 3-foot by 4-foot image of the mountain of debris containing what had been the World Trade Center at New York’s Ground Zero all the more imposing. It’s an emotional gut-punch that provokes comment from every visitor.

The aftermath of 9/11 has transformed Townsend’s world view. “I know very well that our enemies not only want to attack us, but plan to attack us,” she says. “I worry about that every day. I do think I see the world differently. Part of my job is to worry and ask, ‘Are we doing everything we can so the American public can go about their day without it having to be a constant worry?’”

Townsend is well aware that she’s viewed as hard-charging, independent and focused. “Do I think people would describe me as very intense and committed to the mission? Yes. I take that as a compliment,” she says. Her reputation as being smart and tough no doubt helped earn her a spot on a White House team that tends to choose staffers who are known quantities. At a time when the country is extremely divided over its leadership, Townsend has gained the trust of Bush, even though she served a role in the Justice Department during the Clinton Administration, where she had the ear of Janet Reno. It’s a shift seen as somewhat remarkable.

“It’s funny because I came to the White House as a career public servant. And at this level that’s unusual,” she admits. “Most people who’ve been part of the president’s team have either a personal or a political relationship with him. I came here a different way.”

Briefing the president carries a certain level of intimidation. “You realize how important it is when you walk in there to be well prepared, and make sure you’re giving him only those facts you know are accurate,” she says. “Every time you go in, you feel the burden of responsibility and an enormous sense of pride when you feel you’ve served him well.” She says that Bush is “enormously empowering” of his staff, with high expectations for every assignment. Indeed, he tapped Townsend to lead the inquiry into the federal government’s response to Hurricane Katrina, which was widely deemed inadequate. “The report focuses on what steps we can take at the policy level and where improvements can be made to help us be more prepared in advance and more efficient in response — for natural disaster or terrorist attacks,” she says.

But while she says the effort expended by the federal government “wasn’t enough,” she did observe “extraordinary lessons of courage and compassion” in the aftermath of the disaster. She notes the Coast Guard — where she once served as assistant commander for intelligence — saved more than 30,000 lives, and she admires the faith-based groups and private citizens who put themselves in danger to help others.

With responsibilities like the Katrina inquiry, it’s not surprising that Townsend’s job comes with long and unpredictable hours. Consequently, her husband and two sons are called upon to be extremely supportive. “The burden placed upon them and the sacrifices they make for the country — I couldn’t do it without that.” The other person who helps her achieve a home life and a White House life is perhaps an unlikely character: “When I hired my nanny, of course I wanted her to be loving and keep my children safe,” she says. “The fact is, she’s as much a mother to me as she is to my children.” Townsend is struck by the unlikelihood of her own road to the White House. “Nobody could have been more surprised than me by the opportunity.” After all, she was the first person in her family to graduate high school, and had to take out loans to pay for her graduate school tuition at USD. “I’ve always taken particular pride that I attended a Catholic university.” She plans to express that pride by speaking at the School of Law commencement ceremony on May 27. These days, her 4-year-old son, Patrick, wants to be president when he grows up. A lofty goal, but Townsend was almost sorry when she asked him why. “Because then we’ll get to be together all the time,” he told his mom. The comment “took my breath away,” she says. But Townsend remains committed to the mission. After all, she’s from New York and lost a good friend in the World Trade Center on that terrible day in 2001. “This job,” she says, “is really an opportunity to give back.

[poli-sci guy]
THE ROLE MODE
Patrick Drinan’s passions range from academic integrity to politics and beyond.

By Kelly Knufken photography by Tim Mantoani


When the talk turns to political science, Patrick Drinan leans back, puts his feet on his desk and settles into conversation. He talks politics with his wife for a few hours every day, even on vacation.

He’s proud of the faculty he’s built. He’s proud that the Donald P. Shiley Center for Science and Technology was built under his watch. He’s proud of USD’s advances in academic integrity. And he’s proud of his filing system. Huh? Well, outgoing College of Arts and Sciences Dean Patrick Drinan’s filing system may not be in the same lofty category as his other achievements, but it’s impressive nonetheless.

“One of my passions is information,” Drinan says. “I have one of the best filing systems on campus. Sister Furay, for years the provost, used to come down here when she’d lose things. And she was pretty darned good about that kind of thing.”

With a filing system that’s numbered and cataloged and meticulously ordered — his most current curricula vitae can be found right where it belongs, in the file marked 7.01 — all the information he’s gathered since becoming dean in 1989 is at his fingertips.

Now, after a 16-year stint, Drinan has decided to leave the dean’s position at the end of the spring semester, though he’ll teach at USD as a full-time professor. “Whether he is the dean or not, Dr. Drinan will remain one of the important leaders of this university,” says USD President Mary Lyons. “Among the most significant legacies of Dean Drinan’s leadership is the quality of faculty he hired during his tenure.”

It’s also one of Drinan’s proudest accomplishments. He took the number of tenure-track faculty from about 115 when he started, to some 190 —130 of whom he hired — by the fall of 2005.

And along the way, he’s kept the liberal arts character of the college front and center, while seeking “excellent faculty who know that most of their career success is going to come from teaching undergraduates successfully.” At the same time, he brought the average teaching load down from 24 units annually to 18 units now. “That gives faculty time to pursue excellence in both teaching and research,” Drinan says.

He may have well-developed ideas about the importance of a strong faculty, but it doesn’t take long to discover Drinan’s true passion. It’s when he starts talking political science that he puts his foot up on his desk and settles into the conversation. He reads four newspapers a day and talks politics with his wife, Mary Ann, also a political scientist, a few hours “every single day, even on vacation,” he enthuses.

He’s made a point of keeping his hand in the classroom by teaching a course a year as dean, usually an international relations seminar. “It keeps me abreast of the entire field of international politics. I love teaching it. It’s analytical, historical.” When it comes to how USD history will look at his years here, the completion of the Donald P. Shiley Center for Science and Technology is likely his splashiest achievement. The feat took “a lot of time and a lot of people working on it together.”

Among his many accomplishments, he points to increasing faculty diversity, earning Phi Beta Kappa status, strengthening academic integrity and developing a Master of Fine Arts program that has earned a national reputation among his successes. And he strongly believes that the school is strengthened by an increased discourse about the Catholic identity of USD.

But now he’s reinventing his role on campus. He says that the culmination of several long projects — including the general education renewal, the completion of the Donald P. Shiley Center for Science and Technology and Camino Hall’s renovations of art studios and classroom space — helped him realize it was time to move on.

Besides, he didn’t want to find himself staying in the same post for too long. “The college needed new blood,” he says. “My successor is going to be a marvelous dean. He’s a fine man.” That fine man is Nicholas Healy, previously associate dean at St. John’s College of Liberal Arts and Sciences in New York, who is scheduled to start July 1.

When he thinks about his own legacy, Drinan comes back to his work as a political scientist. “I really like to think about the political culture in the very best sense of the term,” he says. “I’m not one of these people who wants to lead by surprise or be unpredictable. I like to court predictability.

You should expect people to do their best. You have to model that for others.”

But the truth is that there will be some poignancy in vacating the dean’s office. “When you leave a position like this, you miss the dedicated staff. We’ve built a great staff here. It’s hard to think of doing something else. It’s the people you’re going to miss more than anything.” That said, he’s looking forward to having more time to spend with his seven grandchildren and to getting back to teaching full time before taking a sabbatical next spring. One project he’s planning to dig into is his research into the organization Opus Dei’s relationship to the democratization of Spain. With the attention The DaVinci Code has drawn to Opus Dei, Drinan finds himself in demand on the lecture circuit.

“I’m having a lot of fun with that,” he says. “The intellectual life ought to be playful. You ought to work hard — and it ought to be playful and enjoyable.”

[free bird]
THE BOUNDARY BUST
What a long, increasingly strange trip it’s been for musical innovator Marcos Fernandes.

By Julene Snyder photography by Tim Mantoani

It’s a safe bet that when Marcos Fernandes gets into a groove on stage — say at last December’s “Festival Beyond Innocence,” in Osaka, Japan — no one in the audience yells out, “Free Bird!” This is a good thing: When you’re a solo-improviser/sound artist/percussionist who’s built a career out of exploring the outer limits of the experimental music scene, you’re pretty much past dealing with exhortations by audience members to rock out. Of course, Fernandes wasn’t born yearning to break musical boundaries. That part came later. But as a child he did revel in the joy of the jam, especially when it came to watching his extended family get together, break out the instruments and play together into the wee hours. “It was before home entertainment,” he says. “I’d watch them get together, get drunk, have a good time. I miss those days.” Born in Yokohama, Japan, Fernandes — the son of a Portuguese/Japanese father and a Japanese mother — started taking drum lessons at age 12, then formed a band with his parochial school classmates. After high school, Fernandes told his dad that he wanted to hit the road and play music. Not surprisingly, that wasn’t seen as a viable career choice. “He told me, ‘No, you’re going to college.’” So the teen left Japan to attend USD, where he started out as a biology major.

“I thought I’d save the seals,” he says. “But it turned out I had a little problem with math. Also chemistry.” So he switched his major to literature, and immediately started having more fun. “I started meeting other musicians. We’d play at parties, do a little jazz, some Grateful Dead.” Any “Free Bird?” “Sure, we played that song,” he admits, perhaps just a bit sheepish. “We played casual gigs, you know, like weddings, bar mitzvahs.”

And his education in the avant-garde jumped into high gear. “I was heavily into progressive rock back then. King Crimson, Tangerine Dream.

Then I got exposed to a lot of 20th-century music, stuff like Stravinsky, John Cage. That just opened up a whole different world for me.”

By his junior year, he felt like his education was really starting to gel. “It all came together. My interest in drama, art, music, it was all on a parallel track. I got a good historical perspective on all of this stuff. It started to make sense to me.” He also got involved with the drama department, playing in the pit orchestra and doing theatrical lighting for plays on campus.

When he graduated in 1978, Fernandes was more into music than ever, and played in a variety of different bands. One of them was with fellow USD alumnus Scott Himelstein, who’s now California’s deputy secretary of education. “We’d play rock, new wave, some blues,” Fernandes recalls. In the mid-’80s, he hooked up with the players in the worldbeat band Burning Bridges. It was that group that provided the impetus to take him to the next level: founding an artist-based independent record label.

Not that it was wholly a noble cause, at least at first. “Of course, I founded Accretions so we could release our own stuff,” he explains. “While there were some people in the band who had notions of being discovered, I was already in indie-mode. Getting signed wasn’t a priority for me. I wanted to do it myself.” Meanwhile, he served as curator/concert promoter for San Diego’s now-defunct Wikiup Cafe and Intersection Gallery, which gave him access to the very few local experimental musicians and artists he hadn’t met yet. When he decided to release a solo CD by multi-instrumentalist Marcelo Radulovich in 1994, in Fernandes’ mind, “that made the label official. Putting out Marcelo’s record made us a real label, and not just a vehicle for our own stuff.”

His involvement with the Wikiup whetted his appetite for boundary pushing even more. “I’d been immersed in world music for so long,” he recalls. “But the Wikiup opened me up to non-commercial, non-mainstream fringe art. I was happy to go back to it, especially after 10 years of world music; now there was this whole different language that I’d acquired.”

Fernandes formed the Trummerflora collective in 2000 as a way to hook up with other musicians who shared a similar sensibility. “We had a mission statement: To produce, promote and help distribute improvised or experimental music in Southern California.” The players involved were disparate in origin: “Some were academics, some had a rock background, some played jazz, there were new music composition-type people. But the collective really focused our energy: A lot of music was made, we got a lot of gigs and got connected with all sorts of organizations and festivals.” So what kind of music does Fernandes make, exactly?

Well … that’s a little difficult to describe. Short answer: Whatever kind of music he feels like playing at the time.

“Some musicians have a hard time playing this sort of thing,” he explains. “When there’s no rhythm, no tempo, no parameters, no beat to follow …” his voice trails off. “It’s all about listening, really. Making split-second decisions. There’s a collective consciousness that happens when you’re improvising with a room full of people. You can tell when they’re there, really there, with you.”

He leans back, satisfied. “That’s what I enjoy most. Being in that moment.” And as far as the path he’s chosen? “If I’d have known as a teen-ager that you could go to a college and study the kind of music I actually liked, I may have become a music major.” He laughs out loud. “And then I probably would have wound up an accountant.”