Hines VA Blind Center is vision of hope for 75 years

Robert Smith is a former Marine Corps scout sniper trying to relearn his entire way of life—today’s lesson, crossing the street by himself.

“The first time I tried this on my own, it was terrifying,” the 55-year-old said while navigating a curb. “It’s these little things we take for granted.”

Smith is legally blind following a stroke in February 2023 while sleeping in his Kansas City, Missouri, home. 

Now he is completing a six-week inpatient program at Edward Hines Jr. VA Hospital’s Central Blind Rehabilitation Center. 

Approximately 130,000 American Veterans are legally blind, and over one million have significantly limited vision, according to the Department of Veterans Affairs. Like Smith, thousands are referred to one of 13 VA Blind Rehabilitation Centers annually.

Hines VA’s center is VA’s oldest, founded 75 years ago by Russell C. Williams. 

The birth of VA blind care

“Russell C. Williams has an unquestionable lasting impact on the rehabilitation and training of the entire visually impaired community,” said James Doelling, Hines VA hospital director. “As a visually impaired Veteran, Williams brought a personal connection and real-world experiences to his patients.”

Williams grew up in Indiana and originally hoped to be a schoolteacher before joining the U.S. Army in 1941.

Soon after landing on the beaches of Normandy in 1944, he was blinded during a German artillery attack. 

After rehabilitation and eventually instructing at the Army’s now-closed blind treatment center in Valley Forge, Pennsylvania, Williams was selected to serve as the Hines center’s first chief, according to hospital records. 

“The idea underlying the Hines program is that one must change certain ways of performing and thinking when sight is gone,” Williams was noted to say to new patients. “Hines provides the opportunity for learning these changed ways and making them a habit.” 

Treating the whole person

Williams believed a visually impaired person could continue an independent life by combining new and old medical practices and training techniques to treat a person’s whole health.

Seventy-five years later, Smith credited this pioneering approach with saving his life. 

“Overnight, I lost everything,” Smith said. “I lost my vision; I lost the way I supported myself. I woke up, and it was all just gone.”

Feeling helpless, Smith attempted suicide in March 2023. 

“I think a lot of Vets out there who have lost their sight, especially if they recently lost it, probably experience the same thing,” he shared. “They may not gravitate toward suicide, but I know they feel like things are out of control, and they don’t know to fix it.”

Smith said that for months his visual impairment service team coordinator from VA's Eastern Kansas Health Care System called him to enroll Smith in the Hines program, but he refused. 

“Finally, just to get her to quit calling, I said, ‘Yes, I will go,’” Smith recalled. 

He arrived on May 23 but didn’t expect his life to change. Smith said he spent the first two weeks arguing with his instructors until his second weekend when staff took him to a shooting range.

Smith, an avid marksman, shot 25 out of 30 bullseyes in his first attempt using assistance devices that play sound to help the visually impaired sight a weapon. 

“Not just the target, the bullseye,” he said, smiling. “That was the beginning of me realizing that my life can go on.”

Smith’s initial hesitation is not uncommon, according to Anthony Cleveland, orientation and mobility supervisor.

“We see a lot of people come in through the admission process really unsure of what we can do for them, and really what’s left for them to do?” said Cleveland.

Maggie Elgersma, the center’s current chief, described the importance of teaching Veterans to continue their passions after losing vision.

“It’s a huge motivator toward goals and remaining independent after vision loss and reintegrating into their community,” said Elgersma, who has worked at the center for 14 years.

The practice dates to the founding of the center. Early photographs showed Hines patients learning skills now common in modern blind rehabilitation, including woodworking, cooking, golfing and walking in the community.

Patients also learned to use a long white cane to scan their environment, the center’s most well-known contribution to visual impairment rehabilitation.

Perfecting the long white cane

The long white cane was developed by Richard Hover in the Army’s Valley Forge hospital in 1944, an offshoot of shorter canes used for several decades, according to the American Foundation for the Blind. 

Williams would learn and then work for Hover before coming to Hines and considered the cane a critical component of training, the foundation explained.

However, the canes were still new and considered novelty items by many. Early designs were difficult to use, recounted Stephen Miyagawa, a blinded Korean War Veteran and Hines patient in 1952 who later wrote of his experiences. 

Through careful observation, Williams and his team modified the long cane into the tool used today, including sizing to each person, using a plastic tip for sensitivity, and including a grip for better control in any weather, Williams recounted to Miyagawa.

They also improved navigating techniques and using sound to understand their surroundings, leveraging their real-world experiences to build a new curriculum, according to Miyagawa.

Today millions of people worldwide have used the long white cane, including Smith, who practiced different cane techniques while walking through Hines VA Hospital. 

“Before coming here, my only reference to using a cane was from watching Al Pacino in ‘Scent of a Woman,’” Smith joked while showing different methods he learned at Hines. 

However, the cane is only one part of rehabilitation for Smith and the more than 10,000 Veterans who have stayed at the Hines center since 1948. 

Becoming independent

Hines opened its new Central Blind Rehabilitation Center in 2005, replacing the old-World War II-era buildings with a modern facility able to treat up to 34 patients for typically four- to six-week programs with the help of about 50 staff, according to Elgersma.

The modern facility focuses on five rehabilitation programs tailored to each Veteran’s needs – living skills, computer access training, visual skills, manual skills, and mobility and orientation.

“The goal is community reintegration, homelife reintegration, increasing independence and maintaining that independence,” said Elgersma. “They really take into consideration all aspects of their life. Like, how can Veterans stay in communication? How do they travel?”

Smith moved to one of two apartments in the rehabilitation center toward the end of his stay to better his independent living. While in the apartments, Veterans are responsible for all their day-to-day needs, including cooking and cleaning.

“It’s kind of a trial run to see how they’d do if they’re trying to get their own apartment or move out on their own,” said Sarah Milledge, blind rehabilitation specialist.

Veterans also learn how to operate various specific technology to aid their needs, such as assisted reading devices, braille reading and writing aids, voice-activated technology and GPS devices.  

Once a Veteran finds a device that works, they take it home for free.

Smith mentioned his difficulties writing in braille and was quickly shown an aid. After he practiced, the staff asked if Smith wanted one, and he quickly replied, “Yes, please!”

However, Smith counted learning to play the guitar and crafting his own leather guitar strap in manual skills training as a personal triumph during the program.

“It’s something I always wanted to learn, but I always thought my fingers were too short,” he joked. “It’s funny how I had to lose my vision to finally do it.”

Learning skills, like the guitar, have deeper meanings, according to Ernest Staines, Blind Rehabilitation Specialist for manual skills.

“It’s something that helps them to be more confident and capable in their daily independence while they’re here and once they return home,” said Staines.

Smith graduated on July 14 and planned to golf with his brother for the first time since losing his vision.

“I think once he learned what we had to offer, he really embraced the program and what he could gain from it. He really thrived,” said Elgersma. “Mr. Smith is a success story of what we do at the blind center and why we do what we continue to do it after 75 years.”

Veterans can be referred to any of the VA’s 13 centers by contacting a visual impairment service team coordinator available at every VA medical center or through a VA eye clinic for low-vision Veterans.