Frederick Downs Jr.: A Life of Service

By Clayton Moore

Some men are naturally born to serve. Others do their duty to their country despite seemingly insurmountable challenges. Frederick Downs Jr., retired national director of the U.S. Department of Veterans Affairs (VA) Prosthetic and Sensory Aids Service (PSAS), represents both of these ideals.

Downs, who served as a combat platoon leader in the Vietnam War, went on to serve 38 years in the VA. He began his career with the VA as a management analyst in Denver, Colorado, in the early 1970s and became director of PSAS in 1980. He also served as chief procurement and logistics officer and chief consultant of PSAS for the VA's Veterans Health Administration (VHA).

During his leadership, PSAS became the largest and most comprehensive provider of prosthetic devices and sensory aids in the world.

When Downs first started at the VA, there were still dependents on the rolls from the Civil War and veterans from the Spanish-American War. When he became director of PSAS, the program budget was approximately $140,000. Today, the program is budgeted at well over $2 billion and provides assistive aids to 1.9 million veterans with disabilities.

"I saw the whole sweep of America's wars in my job-the 19th century, the 20th, and the 21st century," he says. "I was amazed at the range of veterans and their dependents that we served, and the work was so interesting. When I started, I had no idea of the vast scope and depth of the VA's involvement with three centuries of history."

Downs, as director of PSAS, looks on as Gulf War veteran Paul Yarbrough demonstrates hand dexterity with an articulating upperlimb prosthesis at a VA event. Photograph courtesy of the U.S. Army.

Today, Downs continues to advocate for the VA and its services. He is also a highly regarded subject-matter expert who advises on healthcare administration, financial management, logistics, procurement, and supply-chain management. His company, Fred Downs, Fort Washington, Maryland, recently received its certification as a service-disabled veteran-owned business.

"I'm still very passionate about the VA, and I love the organization," he says. "I would love to use my experience to help organizations and the VA continue to make improvements in the areas of prosthetics and sensory aids."

The Road to the VA

Downs grew up in Kingman, Indiana, a small town in the western part of the state, among a large family that included five brothers and a sister. But the formative events of his life happened 9,000 miles away, in the jungles of Vietnam. He enlisted in the U.S. Army in 1966 and graduated from Officer Candidate School at Fort Benning, Georgia, in March 1967. In September of that year, he landed at Pleiku Air Base in central Vietnam.

Outside of his VA career, Downs has been a prolific writer.

Downs became the leader of First Platoon, Delta Company, in the Army's Third Brigade, Fourth Division when he was 23 years old. Downs, a prolific author, recounts his experiences in his 1978 memoir, The Killing Zone: My Life in the Vietnam War. After just four months in country, Downs was leading an ambush when he triggered a "Bouncing Betty," or a bounding antipersonnel mine.

He was severely wounded and underwent a transhumeral amputation of his left arm. He subsequently spent more than a year recovering at Fitzsimons General Hospital, Aurora, Colorado, which he writes about in his second book, Aftermath: A Soldier's Return from Vietnam. He was awarded the Silver Star, the Bronze Star with "V" Device for valor, the Vietnam Cross of Gallantry with Gold Star, the Combat Infantryman's Badge, and four Purple Hearts for his service in Vietnam.

In an interview with C-SPAN in 2008, he also discussed the trauma that led to his divorce from his first wife, mother of his oldest daughter. "She came out to see me, walked into the hospital and there were more than a thousand of us wounded... with all kinds of grievous injuries.... I think the shock was great for her, and so our marriage dissolved over a short period of time."

But his personal life improved: about six months later, he met a woman at the local officer's club, Mary, who remains his wife more than 40 years later. She is also the mother of his youngest two daughters, one of whom enlisted in the U.S. Marine Corps.

He remembers asking himself, "Are women going to be interested in me? What will people think of me?" Today, he uses his experience with those doubts when he talks to others. "As I tell new amputees, if you're comfortable with yourself, then people will be comfortable with you. So I was comfortable with myself, and it just didn't bother [Mary] at all."

While recovering in Aurora, he earned an undergraduate degree and a master of business administration degree from the University of Denver, and subsequently went to work in the private sector. "I was making good money, but I just wasn't getting the right satisfaction out of it," he says. "People kept telling me I should go to work for the VA. [The VA] was looking for young Vietnam vets to get into their programs, and they put me on the fast track."

Eventually, Downs was offered the directorship of PSAS. He recalls his impression upon joining PSAS: "When I took over the job in 1980, the condition of the service was terrible. The degree to which veterans were not able to get what they needed and the lack of training for the people working in the service was awful. So I proceeded to upgrade everything."

Modernizing the Service

Downs' personal experience was instrumental in his advocacy for improvements in services offered by PSAS. "Because I was wearing a prosthesis, I understood its importance," he says. "The upper-limb prosthesis allows you to regain your independence and the lower-limb prosthesis allows you to regain your mobility. Both of these elements are critical to one's self-esteem. I pushed hard to start improving services for everyone-those veterans who needed prosthetics, sure, but also those with spinal cord injuries, or the hearing impaired, or the blind. We worked to provide better training for those working in the field. I raised a lot of hell, and I spoke out because it was needed."

Downs gives the "thumbs up" while wearing the DEKA arm. Photograph courtesy of the U.S. Army.

One of the foundations of Downs' philosophy toward services for veterans is embracing innovation. "If it's available in the marketplace, it should be available for our disabled veterans," he says. "We needed to always be the vanguard for new prosthetic devices and to be the advocates for vets within the VA."

With firm support from his chain of command and strong relationships with veterans' service organizations, Downs created a sea change in PSAS by securing centralized funding for prosthetic devices and sensory aids. "That meant we got dollars for prosthetics, period," Downs explains. "I controlled those dollars at headquarters, which is also unique. Usually the money was sent to the field, where others decided how to spend it. With centralized funding, they had to spend the money for prosthetics on prosthetics. No one could siphon off the money to other areas."

Downs believes that anything that replaces a bodily function or action is a prosthetic device. This belief allowed him to expand services to include funds for such items as eyeglasses, hearing aids, and implants. He also advocated for "extra" devices and specialized prostheses, such as running legs. "When I first took over, it was taboo to let anyone have an extra arm or leg," he says. "Wearing a device myself, I knew that when it broke down, I felt disabled. If I had a spare, it made my life easier. People said the vets would just stick these devices in the corner and they wouldn't be used. That's just not true. These changes gave veterans choices they didn't have before."

With more funding in place, Downs and his team were able to spark development in the O&P industry. When Ernest M. Burgess, MD, PhD, introduced the Seattle Foot in 1985, Downs and his team helped bring it to veterans. "We called it priming the pump," Downs says. "We bought 500 of these things and distributed them to our clinical staff and the amputee clinic teams. The vets loved that foot. It was the breakthrough in the industry to kick-start devices to compete with it. It was all about staying on top of everything happening in research and development, and being at the front of the wave."

Downs has also been a lifelong advocate for veterans on the policy front, testifying regularly to the House Committee on Veterans' Affairs and other influential government entities. "The VA prided itself on what it provided to veterans, but supporting the budget was a constant battle," Downs says. "When I would go before budget committees or the VA or the Hill, my position was this: when I was a second lieutenant, I spent hundreds of thousands of dollars a day blowing things up, calling in artillery, and expending ammunition, not to mention men's lives. Now that we're back here in the States, why can't we spend a few thousand dollars to provide a veteran with the device that he needs?"

Downs also serves as a volunteer peer counselor at Walter Reed National Military Medical Center, Bethesda, Maryland, to soldiers undergoing rehabilitation after amputations.

A Legacy of Innovation

Downs continues to live on the edge of innovation. He returned to VA headquarters in April to participate in a forum during National VA Research Week. Downs is a participant in the testing phase of an advanced prosthetic arm developed by DEKA Integrated Solutions, Manchester, New Hampshire, based on funding from the Defense Advanced Research Projects Agency (DARPA). He also recently returned to New York to show the third-generation device-known affectionately by its creators and users as the "Luke Arm," after the futuristic appendage worn by Luke Skywalker in Return of the Jedi-to 60 Minutes for a second time.

"I was in the first generation of testers," Downs says. "It's a really neat device that I control using sensors in my feet. It is still a research project, so the FDA [U.S. Food and Drug Administration] will have to approve it. It's a Class III device, so it has to go through a lot of evaluation."

The DEKA Arm allows for six pre-programmed grasps and ten powered degrees of freedom: users can raise, twist, and bend the arm, and Downs demonstrated on television how he can pick up a screw or grasp a soda bottle without crushing it. He can even give a "thumbs up" to fellow veterans.

A man of strong opinions, Downs has advice for those who follow him at PSAS. "I would tell that person to fight hard to maintain their status within the agency. They need to meet with the budget office constantly to maintain control of centralized funding, and they need to be on the leading edge of developments in the industry."

Downs voiced concerns about recent efforts to reorganize the procurement process at PSAS. "There are changes occurring now that I don't believe are good," Downs says. "I would allow the PSAS to continue purchasing whatever they need to provide prosthetic devices for veterans. There are provisions in the law to allow that to happen, but there are internal arguments about doing big projects with the lowest bidder. That's going to send things backward."

He also has counsel for the leadership of the VA. "The PSAS is one of the jewels of the administration. People need to understand why it's important for prosthetics to remain an independent service. It's a very visual part of what the VA provides."

Outside of the O&P industry, Downs is well known for his curious mind and creative endeavors. He is a member of the Screen Actors Guild and has appeared in movies and television, most recently on 60 Minutes. He has also been profiled on the television show Impact: Stories of Survival. In addition, he continues to be a prolific writer with three books and numerous magazine features to his credit. He recently joined Sinclair Advisory Group, Herndon, Virginia, a veteran-owned firm that provides strategic planning, leadership training, and specialized consulting services.

Downs reflects with pride on the work done during his time with PSAS. "We pushed the envelope as hard as we could. We had a very active group, and we took things as seriously as we did because we knew from personal experience how important these devices are to individuals." He describes how he sees the interplay between O&P services provided at VA facilities and those provided at private facilities contracted with the VA. "There was always angst among [private providers] because we had our own labs and we did some of our own work in [O&P]." But Downs maintains that what VA provides internally each year is a small percentage of O&P provided to veterans by the VA every year. He continues, "We are very dependent on private industry being able to provide us with the devices that are prescribed. And they are staying on top of things because they recognize that's where all the interest lies."

Downs continues to admire his colleagues working in the O&P sector. "I still enjoy working with the people in [O&P]," he says. "I always sensed a lot of passion in the people who work in this field. I so admire what they've done over the years and the progress they've brought forward in prosthetics. I always advocated that we would not be successful at the VA without the people in the industry."

Clayton Moore is a freelance writer based in Boulder, Colorado. He specializes in many subjects including medical technology, aviation, business, and entertainment features. Clayton can be reached at