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The photo caption for this story was updated on Feb. 23, 2011. An explanation follows the story.

Since President Franklin D. Roosevelt opened its gates in 1942, the National Naval Medical Center's mission has been to serve the men and women who serve their country, providing them with cutting-edge medical treatment at the world-class facility in the heart of Bethesda.

Although its mission remains the same, the hospital has grown from the hospital tower that is still the architectural centerpiece of the hospital to a full-fledged medical campus and adapted its equipment and staff not only to medical advancements, but also to accommodate diverse injuries that result from shifting war strategies and locales.

Among the biggest changes in Navy Med's 69 years comes in September, when the hospital merges with Walter Reed Army Medical Center under the 2005 federal Base Realignment and Closure mandate. The merger will add 2,500 employees, twice as many patients and a fuller medical repertoire to the hospital.

Navy Med has been long recognized as a premiere brain trauma center, while Walter Reed's modus operandi is amputee care. Come September, Walter Reed National Military Medical Center will have it all.

"It exemplifies what the goal of the BRAC was," said Capt. David Bitonti, the hospital's chief of staff for integration and transition. "To focus the unique capacity of the two separate facilities and bring them together on one campus as the future."

What's coming up

More than five years of planning have gone into preparing the 245-acre campus on Rockville Pike for the merger. This year that change takes shape: Slightly less than half of the building renovations and new construction planned for the merger are scheduled to be completed between now and September.

Melding two of the nation's largest military hospitals required developers to multitask.

"We were planning the buildings literally as we were building them because of the tight BRAC times," said Capt. Steve Hamer, of the Naval Facilities Engineering Command, who is overseeing the $1.3 billion construction project.

Construction began in 2008 and is expected to continue to late summer, just weeks before the hospital's mandated September opening. At least four projects are each less than half done and scheduled to be finished by the end of August, Hamer said.

The main projects at the hospital include four new structures: an outpatient care center and an accompanying 950 space parking garage, a 1,200 space multiuse garage and a 153 suite barracks. A 162,000-square-foot addition has been added to an existing medical building for emergency services and another building is being renovated, to protect its historic façade, and will include a fitness center, administrative offices and parking garage.

The campus also will renovate its entry gates, to move them farther from the road, in an effort to improve traffic congestion, Hamer said. That project should be done this summer.

What's new

The two medical building additions and the accompanying parking garage are the only projects to date that are complete.

Among the largest and most clinically important additions to the campus is the America Building, a 550,000-square-foot facility that houses most of the hospital's outpatient clinics, including women's health services, pediatric care and an amputee center in its basement.

Many of the additions at the hospital are intended to round out the center's services, most notably amputee services, which Walter Reed thrived in and were lacking at Navy Med.

In the basement of the America Building is an open, echoing room that more closely resembles a warehouse than a hospital. The room, called the Gait Lab, is intended to re-teach patients how to use their limbs, or the prosthetics that have replaced them.

David Oliveria, the BRAC program manager for Navy Med, compared the space to a Disney Pixar animation lab, where doctors cover patients in pingpong ball-sized dots to record how they move with video cameras that slide along tracks bolted around the perimeter of the room's walls. The floor is made of blocks that are sensitive to weight and can show on a computer screen whether a walker is favoring one foot or the other.

Next door is a Computer Assisted Rehabilitation Environment lab. The lab is similar to a virtual reality game that simulates real-life activities, such as waterskiing or bike riding. Navy Med needed one because Walter Reed has it, Oliveria said.

The hospital also has added the Arrowhead Building, a 162,000-square-foot addition to an existing medical building, which will primarily house the emergency room. The addition also includes other emergency services, such as intensive care units.

In advance of the merger, the campus also has seen additions that were not called for in the federal BRAC mandate, but have been contributed by outside donors. The Fisher House Foundation added to the campus three Fisher Houses, which provide free housing to families of service men and women who are being treated at the hospital. The Intrepid Fallen Heroes Fund used $65 million of public donations to pay for a center for traumatic brain injury and psychological health, the National Intrepid Center of Excellence, which opened last year.

Other changes

on the horizon

In addition to the new features to the hospital's physical structure, the staff also will change when the new hospital opens.

The hospital will gain about 2,500 employees, a majority of whom will come from Walter Reed — representing close to half that hospital's staff — as well as some staffers from Andrews Air Force Base. Walter Reed currently employs about 6,000 people.

The remainder of Walter Reed's staff will be reassigned to Fort Belvoir, Va., where a hospital will open as part of the same federal mandate.

Navy Med currently employs about 8,000 people. Between 500 and 600 people currently employed at Navy Med also will move to Fort Belvoir.

A new beginning

What stands out to most people who live near or drive past the hospital is the impact an additional 2,500 employees and double the number of visitors, to about 1 million per year, will have on the roads surrounding the campus — and the minimal funding the federal government has fronted to help the community cope with such a large-scale change.

Maryland and Montgomery County officials have plans for renovations at four intersections surrounding the campus and a Metro access project, but can not carry out the work without money to pay for it. The entire project is estimated at $165.4 million; to date, a fraction of that, about $69.4 million, has been secured.

The state will use $39 million available for the intersections project to begin work, but with construction still months away, none of the intersection upgrades will be complete when the hospital opens. Late 2012 is the earliest any of the intersections could be complete, according to the project's schedule. A $58 million Metro project that calls for a pedestrian tunnel under Rockville Pike and high speed elevators is even further away.

Despite the strife the new hospital has caused, hospital officials insist the quality of the hospital that will come out of the merger will be a positive and equally grandiose change to the Bethesda and military community.

"I don't know how the average taxpayer would feel about how we've used their money, but I'm very proud," Oliveria said. "America should be very proud of what we've built."

About this report

This is the first in a series of monthly reports leading up to the September merger of Walter Reed Army Medical Center at National Naval Medical Center in Bethesda. The merger will create Walter Reed National Military Medical Center

on the Rockville Pike campus.

sgantz@gazette.net

The photo caption in the original version of this story said that David Oliveria is in the Gait Lab. He is in the Linear Accelerator Suite, which contains a high-tech radiology machine that can pinpoint a location to administer radiology.