Six months after the Feb. 13 shooting that sent at least 26 rounds through the wall of his Virginia Beach townhouse, Landyn sat propped up on a couch still pocked with bullet holes and watched videos of himself posted last fall to his YouTube channel. His dad, Steven Davis, scooped a handful of popcorn into his son’s mouth as the boy in the videos windmilled his arms, tried dance moves and offered his pipe cleaner creations for sale.

The self-acknowledged baby of the family laughed and flashed his trademark smile that lights up brighter than the neon colors of his favorite video games.

But the emotion changed when the shooting came up. He described the feeling, with his mother’s permission for the language, as “pissed off.”

“I’m angry at the people who shoot,” he said haltingly, the words hard-won through months of physical therapy. “Don’t buy guns. Don’t sell guns.”

Last year, 21 children and adolescents died as a result of gunshot wounds in Hampton Roads, making up more than a third of the state’s child deaths due to gun violence, according to preliminary data from the Virginia Department of Health. Almost four times that number, 82, were treated for firearm injuries in Hampton Roads emergency departments.

In June, U.S. Surgeon General Dr. Vivek Murthy declared firearm violence to be a public health crisis, joining the American Academy of Pediatrics and other advocates who have considered it an epidemic for well over a decade. This push comes nearly 30 years after the 1996 Dickey Amendment froze any government funding for research into gun violence, six years after Congress allowed the Centers for Disease Control and Prevention to fund research as long as it did not advocate for gun control and four years after it became the leading cause of death for children in Virginia and nationally.

From June to August, The Virginian-Pilot followed Landyn and his family at community events, through grueling rehabilitation appointments and at home for an in-depth look at what it’s like for a child to live through gun violence.

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‘We all looked’

The family’s front porch lightbulb camera captured the moments that changed their lives forever.

Landyn’s parents had left on a chilly, dark Tuesday evening with his 13-year-old brother, Breland Barksdale, for a wrestling team meeting. Landyn was supposed to go, but he’d been begging to play video games. Sister Briyah Barksdale, 15, was staying home, so his parents agreed to let him use the computer in their room on the second floor at the front of the house.

Just after 6 p.m., Briyah was sitting outside with her friends, listening to music. Video footage showed teenagers swaying and singing along before they suddenly looked around, then relaxed.

“I took off the headphones,” she said, “and then we heard the pop, and we all looked.”

It seemed like the sound had come from far away, so they weren’t worried — at first.

“The next thing you know, it was like you kind of saw the shots coming, but you really heard them too,” she said. “It’s like they whistle when they go by. So like, you could tell that the house was getting hit. We were getting hit.”

One bullet whizzed past her head. Another grazed her leg.

On video, the kids whirled away, then dropped out of sight as dozens of flashes erupted from the darkness. They ducked inside the house, and Briyah ran upstairs to check on Landyn.

“I didn’t see him in the chair. So I’m like, ‘Did he run in the bathroom?’ But then I didn’t know if they were going to start hitting at the house again, so I sort of army crawled on the floor,” she said.

That’s when she saw her brother lying still.

Landyn doesn’t like to talk about the shooting. He remembers it and its aftermath, although he seems to have forgotten some things over time and recalled others, said his mom, Emily Rigsby.

Something hit the computer screen, and as he lifted his headphones and turned to see what was going on, he was struck and collapsed to the floor, Rigsby said he later told her. A bullet had rammed through his skull, just behind his left ear.

Dr. Adam Conley, the pediatric neurosurgeon who operated on Landyn that night at Children’s Hospital of The King’s Daughters in Norfolk, said he has treated 40 to 50 children for gunshot wounds in his roughly 13-year career.

“The mortality of the gun violence is much higher,” Conley said. “We may see it less often, but when we do, the injuries uniformly are much more severe and life-altering — or life-ending.”

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Grueling recovery and family stress

In Landyn’s case, he had an entry but not an exit wound, which is somewhat uncommon because usually the force of the bullet has enough energy to go through, Conley said. The bullet went through the protective membrane, called the dura, causing significant damage to the left side of Landyn’s brain, but then came to rest on the right side without nearly as much injury.

Objects in the brain don’t typically migrate to new locations, and removing the bullet, which was sterile due to the friction generated by the gunshot, would have destroyed healthy tissue.

“Quite honestly, that’s the last thing in the world I want to do, is to inflict any more brain damage on him,” Conley said. “You try to get a seal on the brain again and that allows the healing process to start.”

The hours immediately after the shooting are a blur for Landyn’s family. Rigsby said she didn’t sleep for the next four days while detectives repeatedly interviewed her, Briyah, and other family members. She recalled noticing mud on her husband’s shoes after he stopped by their house, only to realize it was their son’s blood.

“I’m just grateful he’s still here,” his mom said. “They didn’t think he was going to make it the first 96 hours. And once it got closer to the 96 hours, your heart starts pumping, because you’re like, oh my gosh, this is Day 3. Tomorrow’s Day 4. Is he going to make it?”

“You’re just worried to death,” she continued. “And they’re like, ‘If he does make it, he won’t be able to do anything.’ And I told them, ‘I don’t care. As long as I’ve got him, I would take him any way I could get him.’”

Landyn was released from the hospital after 91 days, just before his ninth birthday in May. He’s defied the odds, but every tiny improvement comes at a cost.

“Younger children have an increased potential for neurological recovery,” Conley said. “But you have the physical damage to the brain and how that relates to the immediate and long-lasting physical therapy. Then, of course, you have the emotional component. You have the stress it puts on the family.”

On a Monday morning not long after the Fourth of July, which left Landyn sleepless and anxious among the jarring noise of fireworks, he prepared for his regular slate of rehab: speech, occupational and physical therapy, four days a week.

At home, before being loaded into his mom’s SUV, he laughed and joked with his brother. He showed off his favorite plush toys, the fancy Lego sets his parents are saving in hopes he can one day assemble them himself, and his cat, Coco — short for Cocomelon — who sleeps by his head every night. But by the time he arrived in the waiting room, his head hung low and his eyes were distant.

For the next four hours, Landyn trained as hard as any athlete. In speech, he practiced controlling his head to swallow safely — one of his most important goals so he can get his feeding tube removed.

In occupational therapy, it took almost 30 minutes to strap Landyn into a functional electrical stimulation therapy bike, a machine that sends small pulses to muscles to improve their function. Then he spent another half-hour straining his arms and legs to improve grip strength, motor control and coordination — the areas most affected by the damage to his brain.

A screen on the bike showed a driving course, similar to a video game. But Landyn rarely looked at it, instead focusing with grim determination on the effort needed for the task.

“Do you remember what you could do when you left the hospital?” occupational therapist Kelly Allen asked Landyn.

“Wave,” he murmured.

“Yeah, I think you could wave,” she said. “What kinds of things can you do with your hands now? You can wave. You can pick things up.”

“Click buttons,” Landyn contributed.

“Oh, like on a game, like on a device? Or a remote, yeah,” she said.

Finally, it was time for physical therapy. After a short break, Kelly Crombie led Landyn through exercises designed to build the muscles he’ll need to sit on his own, stand and eventually walk.

The demanding exercise took its toll, leaving Landyn exhausted. And he would have to do it again the next day because he was in the wrong place at the wrong time when someone decided to fire a gun.

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‘So many other Landyns out there’

Landyn isn’t the only child at CHKD recovering from a gunshot wound.

The health system, which provides the region’s only freestanding Level 1 pediatric trauma center, reported treating 22 patients under 18 for gunfire injuries last year. Of the 82 children and adolescents treated for firearm injuries in Hampton Roads emergency departments last year, 25 were under age 15, according to state data.

For many, physical rehab is only the beginning of the arduous journey to recovery, said Kristina Golden, a licensed clinical psychologist with CHKD’s Child Advocacy Center, where Landyn, Briyah and Breland all engage in therapy.

Being injured, suffering a “near miss” or simply witnessing gun violence all qualify as potentially traumatic experiences, she said, that can lead to post-traumatic stress disorder.

“There can be a significant psychological effect,” Golden said.

Symptoms can include difficulty sleeping, hypervigilance, flashbacks, feeling on edge, school absenteeism and risky behavior.

A landmark study published last November in Health Affairs, a health policy research journal, showed that in the year after a gunshot wound, child and adolescent survivors experienced a 117% increase in pain disorders, a 68% increase in psychiatric disorders and a 144% increase in substance use disorders. The study found their health care spending increased by an average of $34,884, with 95% of costs paid by insurers or parents’ employers.

The good news, Golden said, is that studies done on children who have experienced traumatic stress show that with evidence-based interventions, such as trauma-focused cognitive behavioral therapy, they can go on to lead normal lives and remain in remission from their symptoms.

“A lot of these symptoms, we can’t tell by looking at a child,” Golden said. “It’s so important to go to a professional, get that mental health evaluation, just to see how the child is doing because a lot of these things … we wouldn’t know if we don’t ask.”

Survivors aren’t the only casualties, according to the Health Affairs study. Parents of survivors experienced a roughly 30% increase in psychiatric disorders, and routine medical care for mothers and siblings decreased by 5% to 14%, which suggests families’ needs are pushed aside in the wake of a shooting, researchers said.

Helping families meet immediate needs is one of the most important and effective actions taken by a violence intervention program called Safer Futures, which CHKD started three years ago, said Kamron Blue, a medical social worker and the program’s coordinator.

Bags of groceries line a table in the small room on the ground floor of CHKD where Blue meets with families to talk about what kind of support they need to find a new normal, whether that’s going home with food or getting legal help in the aftermath of a shooting.

“I think gun violence is rooted in systemic issues, and poverty is one of those,” Blue said.

People become desperate when jobs are limited and scarce, health care and other services aren’t easily accessible and they struggle to afford housing, he said. Those factors don’t cause gun violence, but they affect people’s ability to take care of themselves and their families — and that contributes to it, Blue said. But the problem isn’t confined to any one type of neighborhood or lifestyle.

“We know that people who live in these marginalized communities are at increased risk,” he said. “But gun violence has happened everywhere. So while it may not happen to them in their neighborhood, I think every parent worries about getting a phone call from their school. Let’s look at Landyn. He was playing video games. And there’s so many other Landyns out there that were just doing kid things.”

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Living a new normal

Rigsby and Davis attended the first hearing in the case against their son’s accused shooters in early August, even though they were alerted it would be continued. They’re determined to show up for every court date. Once the case moves past preliminary stages, Landyn will join them in the courtroom. His parents estimate he could be a teenager before it’s resolved.

“It’s unfair for the people who have to suffer,” said Davis, who holds a concealed carry permit and keeps his firearms locked up. “People don’t think about their actions. They want to be like the gangsters they see in the movies, or their favorite rappers.”

Police have said the violence was gang-related and someone standing outside their home was likely the target. Police told Rigsby that someone who went live on Facebook unintentionally showed their house number in the background, but was already gone by the time the shooters opened fire, she said. A Commonwealth Attorney’s Office spokesperson declined to confirm any details, citing the ongoing investigation.

It’s too easy for people to get their hands on guns, Rigsby said.

“They’re not thinking about the people or the children or families or anybody else that it affects,” Rigsby said.

A 10-year Army veteran, Rigsby thinks the barrage of bullets that invaded both floors of her home shows just how little many perpetrators of gun violence understand about firearms.

“A bullet doesn’t have a gender or an age or a race,” Rigsby said. “You never know where they’re going. You might think that it’s going to the intended target, but that’s not always the case. And it’s turned our lives completely upside down.”

Landyn’s dad returned to work driving trucks full-time in June. He spends weekends building Legos next to his son, an activity he regrets often turning down before the shooting because he was too tired.

“I had all the time in the world before Feb. 13 to build Legos with Landyn,” said Davis, who has also raised Briyah and Breland for the last 12 years along with his oldest, Brielle Davis, 16. “I almost lost that chance.”

He finds himself noticing things they’ve never done and making plans to do them, like watching the sun rise over the beach.

“He was 8 years old,” Davis said. “All that could have been over with.”

Last year, Landyn’s mom took three back-to-school pictures. This year, there was only one.

Breland was the only one who got on the bus this year. An outgoing, charming teen in constant motion, he still faces challenges at school — like the time he told his mom that at first he didn’t hear someone talking to him because he was wearing headphones, and then the kid said that’s how his brother got shot.

Briyah, who hasn’t returned to school since the shooting and participates in an online program, will continue to stay home and help her mom take care of her baby brother.

Instead of starting fourth grade with the classmates who sent him dozens of cards and Lego structures in the spring, Landyn will continue to work on learning to sit, stand and walk again.

While he can’t go back to school yet, one of his favorite teachers gifted him a keyboard and piano lessons at home. Almost 200 days after the shooting, Landyn beamed that trademark smile as his teacher placed his hands on the keys, and he played his first note.

“They have to take all these radiation sources out, put the new ones in. They have to be stored safely, transported safely. We have to have the government involved. It’s all very finely regulated,” said Dr. William McAllister IV, a neurosurgeon with Riverside in Newport News.

This year’s recharge to the radioactive cobalt-60 fuel that powers the gamma knife, which Riverside has had since about 2005, coincided with the release of the Elekta Esprit, the newest version of the machine made by Leksell. Riverside was the first health system in Virginia to make the upgrade, which significantly increases treatment options, medical practitioners said.

That’s because for almost 20 years, patients’ heads had to be immobilized in a lightweight aluminum frame with four tiny pins screwed into their skull, requiring local anesthetic.

“It’s not the most pleasant thing in the world, but it isn’t like cutting someone’s head open and barreling through their brain,” McAllister said.

Patients generally could only be treated once, staff said, because doctors had to balance the need for radiosurgery against the difficulty of the frame fitting.

But now, the development of a custom-fit mask allows medical staff to “fractionate,” or provide repeated treatments in shorter intervals. The machine went from treating one or two patients in a day to five or six, said Lee Miller, the radiosurgery center manager, who has worked with the gamma knife for almost as long as it’s been at Riverside. Some patients don’t have to use the frame at all, but most still need it for the initial session for high-quality imaging, she said.

A new mask is made for each patient from two pieces of specialized material. One piece is fitted to the back of the head to isolate the curve of the neck, Miller said, and the other is heated in a special oven until it becomes soft and moldable. It takes about 15 minutes to cool before it’s ready.

Patients lie back on a cushioned table that slides their head into position. The machine is nearly silent, Miller said.

The technology uses 192 lasers concentrated at a single point to break up, shrink and destroy tumors that spread to the brain, or metastasize from tumors elsewhere, such as lung or breast cancer, McAllister said. He added that melanomas, in particular, are increasing in frequency and have a tendency to spread to the brain.

“We can treat bigger tumors than what we’ve ever been able to treat before. We can treat more tumors,” McAllister said.

Invasive surgery usually isn’t an option for these tumors, because patients generally are undergoing chemotherapy, which would have to be stopped to allow them to heal from surgery, and because there are often multiple small tumors to target, McAllister said.

Whole-brain radiation is another option for people with tumors too large to be treated in one session or many small tumors, said Dr. Harry Lomas, a radiation oncologist with Riverside.

“There’s stuff that we couldn’t treat before,” Lomas said. “Something that was too big to give a big dose to, we’d just give a lower dose and they would often recur. Now, we can treat those tumors in five treatments. We spare more normal brain and that leaves more real estate for us to come after the remainders.”

While Riverside has the only Leksell Gamma Knife in the region, Bon Secours and Sentara Health also offer forms of stereotactic radiosurgery in Hampton Roads, spokespeople for the health networks said.

Bon Secours has a Varian TrueBeam linear accelerator at Harbour View in Suffolk. Sentara has a Varian Edge Radiosurgery Unit at Sentara Norfolk General Hospital and two Varian SRS TrueBeam units at Sentara Careplex in Hampton. The linear accelerator systems work by speeding up electrons to produce radiation, rather than using radioactive fuel.

The number of tumors treated with stereotactic radiosurgery, versus whole-brain radiation, is a function of clinical judgment by the physician, not a function or limitation of the type of machine used, said Dr. Song Kang with Virginia Oncology Associates.

“Overall, technology has advanced for all systems from different companies, which in turn has improved the experience for patients receiving this type of treatment,” Kang said in an emailed statement. “We are fortunate to practice in a time where hospitals and radiation centers have several choices of advanced technology to offer the same treatment.”

The different systems have passionate advocates when it comes to their advantages and drawbacks, but the addition of the mask option for the gamma knife addresses its most significant negative, which was the requirement to use the frame, Riverside staff said.

Over time, Miller said the improvements she’s seen in survival and quality of life for patients with metastatic brain tumors has been astonishing.

“What amazes me the most my whole time here, since the inception, is just how far we’ve come in terms of the options we have,” she said.

Katrina Dix, 757-222-5155, katrina.dix@virginiamedia.com

They ask what that means, because they thought the diagnosis was definite, said Okhravi, medical director of the memory consultation clinic at Eastern Virginia Medical School, now part of Old Dominion University. But he said Alzheimer’s, the most common cause of dementia, can’t be diagnosed definitively without a brain biopsy — which typically only happens after death.

Almost 120 years after Dr. Alois Alzheimer first identified, via autopsy, the characteristic ways Alzheimer’s changes the brain, many aspects of the disease remain a mystery. But Okhravi hopes to find a few more clues in a study of whether a common diabetes drug can help prevent dementia due to Alzheimer’s. EVMS recently joined the nationwide research effort, which is recruiting participants in Hampton Roads.

The study, led by Columbia University and sponsored by the National Institutes on Aging, attempts to determine whether metformin, the most common drug prescribed for diabetes, could help prevent early memory loss. Researchers believe there is a potential link between insulin resistance and neurodegenerative disorders. Metformin lowers glucose, the main blood sugar found in the human body, and increases sensitivity to insulin, a hormone that regulates blood sugar levels.

Those effects may help prevent mild cognitive impairment, Okhravi said.

“MCI is really a stage between normal age-related memory loss you see in people when they get older and the serious decline of dementia,” he said. “About 1 to 2 out of 10 people with MCI probably progress to a stage of dementia in a one-year period. But this number actually goes up to 60% five years after developing mild cognitive impairment.”

Mild cognitive impairment can be hard to recognize. In an Alzheimer’s Association survey, more than 50% of Americans thought a description of it sounded like “normal aging.”

Symptoms include losing things like eyeglasses, keys, cell phones and remote controls, forgetting to go to important appointments and events and having more trouble coming up with names and phrases than other people the same age, Okhravi said. Diagnosis usually requires separate clinical interviews with the patient and with a spouse or close family member and a standardized memory test.

“Essentially, we can figure out if this is a different trajectory from age-related memory issues,” Okhravi said.

The earlier Alzheimer’s is caught, the better the chances of delaying the progression of the disease, he said, and in some cases, it can be caught very early — up to 20 years before any symptoms develop.

That information comes from a separate research effort in which Okhravi participates, called the Ahead Study, run by a consortium of leading academic Alzheimer’s research centers. It has found that a buildup of amyloids, a protein in the brain, may begin up to two decades before people notice symptoms like memory impairment.

This kind of study is particularly important because although mild cognitive impairment can be determined clinically fairly well, Alzheimer’s is very hard to diagnose based on clinical evaluation alone.

“Even the best people in the field, there is a 36% chance that we may make a mistake or a not accurate diagnosis,” Okhravi said. “When we think a person has Alzheimer’s, 36% of the time they did not have Alzheimer’s.”

PET scans, imaging used to build 3D images of internal tissue, can accurately diagnose Alzheimer’s over 90% of the time, he added.

Given a potential two-decade window of time to fight progression of the disease, the opportunity to slow it down with metformin — which is widely available and inexpensive —  could present a major breakthrough.

“Right now, there aren’t many options for preventing Alzheimer’s,” he said. “This study could lead to new ways to keep people healthy and improve quality of life as they age.”

Learn more about the study at evms.edu/research/current_clinical_trials/.

Have a health care or science story, question or concern? Contact Katrina Dix, 757-222-5155, katrina.dix@virginiamedia.com.

Nieces Nataleigh Goodwin, 6, and Emileigh Griffith, 2, loved him back, especially when he took them outside to draw with sidewalk chalk or to search for worms.

“That’s me and Emileigh and Aunt Ashleigh and Uncle Zack,” Nataleigh said, showing off a picture she drew while Ashleigh Blankenship spoke about the historic donation of her brother’s heart. “I miss him very much.”

Pate, who died July 9, made just the third HIV-positive-to-HIV-positive heart donation in the U.S. this month at Sentara Norfolk General Hospital, Sentara spokesperson Dale Gauding said.

Blankenship knew her 29-year-old brother, who lived with her in Portsmouth for most of the past two years, was an organ donor, but she and Pate’s two other sisters, Taylor Goodwin and Madison Tye, were stunned to learn the donation was possible a decade after he was diagnosed with HIV.

“I know my brother would have wanted that,” she said. “I feel like the HOPE Act needs more recognition.”

The HIV Organ Policy Equity Act, passed in 2013, established a research program that made liver and kidney transplants legal for people with HIV. In May 2020, the act was expanded to include all organs, and the first HIV-positive heart transplant took place in 2022.

This was the first HIV-positive organ donation for Sentara Health, Gauding confirmed, and for Virginia Beach-based LifeNet Health, the federally designated organ management organization for most of Virginia, said Douglas Wilson, its executive vice president. Pate’s organs were transported to recipients out of state.

As of Dec. 31, 2023, 377 HIV-positive kidney donations and 93 HIV-positive liver donations had taken place, according to UNOS, the United Network for Organ Sharing, which manages the United States’ organ transplant system.

The HOPE Act allows for living organ donations, but so far, only three have taken place. The second was a kidney donation in 2019 by Karl Neumann, a transplant registered nurse at Sentara Norfolk.

“Working in the profession for 20-some years at that point, I always wanted to be a donor, but once I was HIV-positive it was illegal for me to do that until the HOPE Act passed,” Neumann said Friday.

There are a few reasons donations remain rare, Neumann said, including the limited number of centers that can transplant HIV-positive organs and the comparatively small group of eligible donors.

Recipients of HIV-positive organs can only get their transplants at the roughly 35 centers that participate in the HOPE Act research study, Neumann said, and other transplant centers may refuse to accommodate HIV-positive patients even if they are receiving HIV-negative organs. Generally, donations can happen from anywhere.

Neumann’s donation took place at Duke University Hospital in North Carolina because Norfolk General is not part of the study, but his team in Norfolk works with HIV-positive patients, including a few who have received HIV-negative kidney transplants.

More complicated infection protocols are part of why so few transplant centers work with HIV-positive patients, but Neumann said he feels the persistent stigma surrounding HIV also contributes to the limited numbers.

“People live very normal lives with HIV at this point, but there’s still a social stigma,” Neumann said. “My doctors hated it when I said that I would rather have HIV than diabetes — but I think it’s easier to manage.”

Improvements in medication have helped make living donation possible without risk to the donor, Neumann said. The health, future health and rights of the donor are the most important factors in the process.

In the past, HIV medication sometimes caused kidney or liver failure, he said, but now, organ damage in most patients is caused by other health problems.

“If HIV directly related to needing a kidney or liver or something in the future, they would never even have proposed living donation,” Neumann said. “I always tell potential living donors that you’re getting the best health screening that you’re ever going to get.”

One of the biggest reasons donations remain rare, though, is the lack of awareness that they’re possible.

“I give a lot of gratitude to any of these people who have donated their organs and signed up ahead and registered, but also to those donor families — his family who is sharing his story,” Neumann said, referring to Pate.

Blankenship said her brother, who died as the result of a suicide attempt after battling mental illness for most of his life, was obsessed with his health, following strict routines and rules for everything from his diet to skincare. Even through the tumultuous times since their mother’s death in 2021, he kept up with managing HIV.

“He always thought he was unhealthy,” she said. “And look what happened. He was able to save lives.”

Have a health care or science story, question or concern? Contact Katrina Dix, 757-222-5155, katrina.dix@virginiamedia.com

Mixon, a member of the Tohono O’odham Nation, has lived in Hampton Roads for almost 50 years. But when her husband retired, she wasn’t old enough for Medicare and developed a severe case of vasculitis, a blood vessel inflammation. Finding and affording treatment was so difficult, she opted to stay with family and reestablish Arizona residency.

While attending the Nansemond Indian Nation’s powwow last fall, she learned about its new initiative, Fishing Point Healthcare, a network intended to provide state-of-the-art care to members of any Indigenous tribes as well as all Virginia Medicaid recipients. The clinic is also open to people without insurance who meet Medicaid criteria.

“I’m just glad that they’re here — not just for myself, but for everyone,” Mixon, 65, said Saturday at a community day to celebrate the completion of Fishing Point’s flagship clinic at 2929 London Blvd. in Portsmouth.

Behind her, dozens enjoyed the block party vibe as they danced in front of a DJ stand, stood in line at several food trucks or supervised their children in a bounce house.

The facility, including its in-house pharmacy, opened on a limited basis in February. Recently, providers there have been treating about 20 patients a day, said David “Black Feather” Darling, Fishing Point’s board chairman. Now, the rest of the facility has been fully renovated to offer dentistry, physical therapy, radiology and a lab.

A similar clinic is under construction in Newport News, with a third planned for Norfolk.

“We have a strong tradition of really being stewards of the land,” Darling said. “That’s not just the ecosystem. It’s the people who inhabit it, too.”

The Nansemond Nation finally secured federal recognition in 2018, more than 30 years after its recognition in Virginia and following almost a century of erasure. That recognition ultimately made it easier for the tribe to manage Medicaid patients than most other providers, who are in many ways disincentivized to accept them, Darling said.

The federal government makes some basic guarantees to Indigenous nations, Darling said, but under the Indian Self-Determination and Education Assistance Act passed in 1975, those nations have the sovereign right to take responsibility for those services themselves and become federal contractors.

“We enjoy a different rate than a private provider would as an extension of the federal government,” Darling said.

Fishing Point Healthcare started in 2023 with a home health care service, which generated enough capital to move forward with the clinics, Darling said. He declined to provide further details about cost because Fishing Point is privately held.

Providing health care only to the Nansemond people would have been cost-prohibitive because of their low numbers, Darling said. Opening care to Medicaid recipients generates revenue, giving the Nansemond Nation a path to financial security.

Providing preventive and follow-up care to people who often have little to no other access to it should help relieve strain on local emergency departments and lower public costs, Darling said.

Visitors to Saturday’s event, from some of the clinic’s first patients to its employees and neighbors in the community, overwhelmingly agreed.

“We need this so, so bad,” said Mary Sherrod, a nurse with Sentara Health. “I see so many people that need the help.”

For more information on the Portsmouth clinic, call 757-891-9010 or visit fishingpointhc.com.

Have a health care or science story, question or concern? Contact Katrina Dix, 757-222-5155, katrina.dix@virginiamedia.com

Now, artificial intelligence writes visit notes for him before he can walk the 20 feet from an exam room to his office.

“AI is actually bringing back the human component,” Wallace said. “Now, I can actually put the phone down and, getting the history, I can look at you. I don’t have to sit here and type and try to keep up.”

Wallace is one of about 200 Sentara primary care physicians testing DAX Copilot, a generative AI program that can filter through conversations with patients to compose a narrative summary of their visits. Health system administrators hope the technology can help address problems from provider burnout to a massive physician shortage.

“It’s the ‘pajama time,’ as they say,” Wallace said. “If my notes aren’t finished, I either stay after work and finish up my notes, or now I’ve got to go home and take time away from my family to finish up my notes or I come back into work on the weekends. I think that can increase burnout for providers.”

An app on providers’ phones records the session, then automatically writes the visit note. Doctors who are part of the pilot program disclose the technology’s use to patients, who are able to opt out, said Stephen Payne, Sentara’s regional director of operations.

In over 20,000 visits, only one patient has objected, he said.

Payne has been looking for ways to reduce the paperwork burden on Sentara’s providers for years, he said. The health care network first experimented with using human medical scribes, hiring extra medical assistants to fill the roles, but had trouble keeping the positions staffed, he said.

Sentara then considered remote human scribe services, like one Wallace used in private practice before coming to Sentara. The former Army doctor’s scribe was based in India and attended his appointments virtually. But those programs didn’t meet Sentara’s privacy standards, Payne said.

Next, Sentara tried a full-service transcription program from Nuance Communications, the Microsoft-owned company behind DAX Copilot. That program involved having a human review transcriptions, then compose the notes from the visit, which Wallace and other providers didn’t like because it put them about a day behind on their paperwork.

Information technology staff, Sentara’s legal team and a dedicated working group are among those that reviewed the AI program, especially in regard to privacy concerns, Payne said. Although a secure app on doctors’ phones records the visit, that recording bypasses phone storage and goes directly to Nuance’s servers.

“Physicians aren’t walking around with patient information on their phones,” Payne said.

Depersonalized data is used to continue to train Nuance’s AI programs, and uses may grow to provide highlights to doctors before a patient’s visit, suggesting what they should follow up on. The program may be able to write prescriptions and labs orders, too, Sentara leaders said. In all cases, though, the provider’s review and signature is vital.

Doctors may need to make small edits before signing off on the AI note, just as they might when reviewing a human scribe’s documentation, said Dr. Steven Pearman, Sentara’s vice president and chief medical officer for primary care. But AI may also catch things mentioned in passing that a doctor could miss.

“AI is augmenting humans, not replacing them,” Pearman said. “You should never take the human out of the delivery care model.”

Pearman also doesn’t feel AI in medicine is likely to replace humans anytime soon because of the existing primary care crisis. The Health Resources and Services Administration estimates that the U.S. needs more than 17,000 primary care physicians to fill current gaps and will need more than 68,000 by 2036.

“There’s going to be a huge shortage of primary care physicians, and if we don’t do something different, there’s going to be a large percentage of Americans who don’t have any primary care at all,” Pearman said. “Part of the solution is to produce more doctors. Part of it is to pay primary care better … and part of it is to make the work more manageable.”

DAX Copilot can have a “phenomenal” impact in that regard, Wallace, Payne and Pearman said.

After it became available last fall, Payne said, the support and excitement from doctors was immediate.

“The feedback from our providers, it’s been unbelievable,” he said. “I’ve never worked on a project and seen results like this, where you’re changing the lives of people you’re working with.”

Have a health care or science story, question or concern? Contact Katrina Dix, 757-222-5155, katrina.dix@virginiamedia.com.

Their invention, MindBot, is a semi-autonomous countertop greenhouse now in use at the Williamsburg Landing retirement community. An interdisciplinary undergraduate team of four women created it under the tutelage of professor Ran Yang, a physicist and inventor.

Three were in Yang’s department, the university’s engineering physics and applied design program, where there’s one main idea the professor tries to get across to her students.

“Make something that people want — not just a flying coffee machine,” she said. “What problem are you solving?”

A student who graduated in 2023 originally came up with the idea as a way to care for houseplants, recent graduate and team member Anna McNally said. But when McNally inherited the project and made it the subject of scholarship-supported research last summer, it put down roots as something entirely different.

People with Alzheimer’s disease and other neurodegenerative conditions that affect their ability to think, learn and remember are encouraged to stay engaged, but there’s a lack of interactive options, said recent graduate Emma Stiller, the team’s sole neuroscientist.

Stiller worked with McNally on the real secret to MindBot: a research-backed curriculum of activities that stimulates memory through all the senses from sight — with green as the color that remains detectable the longest — through the powerful properties of scent.

“I was really looking at what activities I could create that would engage certain cortical areas of the brain that are specifically used for memory, cognition and overall function,” Stiller said.

In one study, she said, people with Alzheimer’s who were provided with essential oils for 45 minutes a day for six months showed less cognitive decline than patients not given the oils.

“That is actually the first sense that Alzheimer’s patients lose, and that’s a lot of times how it’s diagnosed,” Stiller said. “If you can keep the olfactory sense functioning, then it prevents the cognitive decline.”

One of the activities the team devised involves taking cuttings from the greenhouse plants and putting them in sensory bags to smell and touch. The team selected common cooking herbs such as basil and mint, stimulating taste as well as smell, and other activities that target dexterity by caring for and touching the plants.

Gardening is often recommended as an activity, but it’s seasonal and not accessible for people with more severe memory care needs. The countertop greenhouse addresses those issues, said Emily Morris, a team member who graduated from the applied physics program this spring. Morris constructed much of the final product, including a light sensor that adjusts the intensity of the greenhouse’s light in response to ambient light in the room where it’s kept.

The three recent graduates knew each other well, having lived in the same dorm as freshmen in William & Mary’s Botetourt Complex — partial inspiration for MindBot’s name, along with “robot” and “botany.” Still, first-year international student Trinny Xu said they made it easy for her to join as the fourth team member.

Freshmen rarely have the opportunity to participate in higher-level projects, Yang said, but Xu’s prior work, which included a project to calculate a function that could predict the path of space capsule parachutes, was impressive enough to earn a spot on the team. Xu created a 3D rendering of the greenhouse design and 3D printed many of the elements used in the final iteration, team members said.

When the team presented its research at Williamsburg Landing in May as part of the facility’s “Let’s Talk Science” discussion series, it caught the eye of staff and residents, including Leslie Bowie. After coordinating care for years for her mother, who had dementia, Bowie moved into Williamsburg Landing when her husband started showing signs of neurodegeneration about seven years ago. He died in December.

Bowie, recently appointed to a four-year term with the state’s Alzheimer’s Disease and Related Disorders Commission, said she agrees with the design team that the activities available to individuals with memory care issues are too limited.

“Every individual living with Alzheimer’s is very different, and so there’s the need to know what they’re interested in, what they’ve been interested in in the past, what their physical limitations are. All that has to be taken into consideration in developing activities,” Bowie said. “So, I think the more options, the better for those being cared for.”

Have a health care or science story, question or concern? Contact Katrina Dix, 757-222-5155, katrina.dix@virginiamedia.com

People who have the human immunodeficiency virus have years of life to gain if they start treatment before developing symptoms, according to information shared from the CDC for this year’s National HIV Testing Day. Not knowing they’re HIV-positive prevents people from getting treatment and leads to increased spread.

As of this week, Walmart is one of the many Hampton Roads organizations to offer free HIV testing, according to a news release. Free tests are available at seven local stores: two in Chesapeake, one in Gloucester, one in Hampton, one in Norfolk and two in Virginia Beach.

“We remain on a dedicated journey to broaden access to HIV care while also doing our part to reduce the stigma associated with HIV,” Kevin Host, Walmart’s senior vice president of pharmacy, said in the release.

Walmart pharmacists will administer the test, a finger prick that takes less than 30 minutes to return results. The participating stores are part of Walmart’s Specialty Pharmacies of the Community program, which provide customized care recommendations, including help navigating insurance options.

The CDC recommends that everyone between the ages of 13 and 64 should get tested for HIV at least once. Most tests are available free or at a reduced cost, and testing locations can be found at gettested.cdc.gov.

Hampton Roads Walmart locations now offering free tests:

• 6819 Walton Lane, Gloucester
• 1900 Cunningham Drive, Hampton
• 632 Grassfield Parkway, Chesapeake
• 201 Hillcrest Parkway, Chesapeake
• 1170 N. Military Highway, Norfolk
• 657 Phoenix Drive Virginia Beach
• 2021 Lynnhaven Parkway, Virginia Beach

Have a health care or science story, question or concern? Call, text or email Katrina Dix, 757-222-5155, katrina.dix@virginiamedia.com

“It’s not that I didn’t want them,” Jones said as she cradled one of her sons in the neonatal intensive care unit at Sentara Norfolk General Hospital, where she gave birth in May at just 29 weeks’ gestation. “I just didn’t want to be struggling.”

Jones, 33, already had been a single mother of two for almost a decade before finding her “person,” Johnny Burden, about two years ago. Burden wanted kids, and Jones loves babies. But after delivering their son, Burden’s firstborn, in July, she was shocked to learn just a few months later that three more were on their way. Burden, though, had no hesitation, and they decided they would be a family of eight.

Then Burden was killed in January when shots were fired into a car in which he was a passenger. Jones, a private person with a small circle of family and friends, was more isolated than ever.

Multiples often arrive before nine months, but 29 weeks, almost three months shy of full-term, is dangerously early.

“I think it’s because I was grieving,” she said.

While Jones held her babies — Kaisyn, Karsyn and Kisyn — in the Family Maternity Center on Monday, just a few hallways away, Sentara hosted a roundtable discussion with community organizations on improving maternal health outcomes and connecting mothers with support before, during and after birth.

Melissa Herd, the acting U.S. Department of Health and Human Services director for District 3, which includes Virginia, participated remotely. The federal government, Sentara and other organizations have been working to address disparities in Black maternal health, which Herd has said is in a state of crisis across the country.

“What we’ve found is that the resources are likely there. The problem is they’re not connecting,” said Dr. Francine Pearce, Sentara’s medical director of health equity.

That can mean community organizations may have difficulty connecting with individuals who need them, with each other to provide wraparound care or with traditional health institutions such as hospitals and obstetricians.

“There’s a whole hidden system of care that people don’t know about,” participant Stephanie Spencer said after the roundtable.

In 2015, Spencer founded Urban Baby Beginnings, an outgrowth of the Capital Center of Virginia. She said her nonprofit and other community organizations are “reaching in” to systems like Sentara to make resources more visible and to get to pregnant women and mothers sooner.

For the past three years, Urban Baby Beginnings, or UBB, has maintained an office in the Family Maternity Center at Sentara Norfolk. It connects with mothers right after delivery.

“We try to find our moms where they are, because we realize the barriers are too great for them,” Spencer said.

Spencer doesn’t know Jones, but thanks to that outreach, Jones knows UBB. A representative helped her sign up for the organization’s services, Jones said, and a postpartum doula visited her at home and is trying to connect her with other resources.

UBB often refers to its doulas as “birth sisters,” Spencer said, because not everyone is familiar with the work of doulas. They’re trained to provide physical and emotional support to expecting women through the birth of their child and the postpartum period. Their assistance can help to reduce the length of labor by 25% as well as the use of pain medication by 30%, according to the nonprofit’s website.

Jones recalled how Burden, a deeply involved father, was willing to reach out for support, including making the rounds of organizations that offered diapers and other necessities.

“He wasn’t ashamed. He would go for help,” Jones said. “I’m prideful.”

She’s been a painter in the apprentice program at Norfolk Naval Shipyard in Portsmouth for the past four years, and still hopes to walk in her October graduation, but for now, her benefits have run out. Since the boys came so early, she wasn’t able to work long enough to get the last of the three car seats she needs — a special kind for triplets that cost $300 apiece — much less a car big enough to fit all six kids or a place to live, after her Portsmouth home sustained recent water damage. She and her kids have been staying with various family and friends for a few days at a time.

“I always thought I could do it all my own,” Jones said. “I need to get out of that mindset.”

Spencer said that “superwoman syndrome” is one of the cultural barriers her nonprofit and similar organizations try to address.

“No one has a cape here,” Spencer said. “I especially think for women, women of color as well, we tend to just say, ‘No, we can do this ourselves,’ because everyone’s doubting us. That is common, and I think that’s a barrier that we’re constantly fighting.”

On the other hand, that persistence contributes to a remarkable ability to move forward through hard times, she said.

“It really shows the resilience of women,” Spencer said.

Jones said faith and prayer are what’s gotten her this far. Burden is gone, but he left a legacy he never got to know: his four sons. They hadn’t yet learned the triplets’ gender when Burden died.

“I knew I was strong, but I didn’t know I was this strong,” Jones said. “Lord, please don’t give me another test.”

Have a health care or science story, question or concern? Text, call or email Katrina Dix, 757-222-5155, katrina.dix@virginiamedia.com.

Police say the teen boy was arrested on second-degree murder charges and weapons offenses for the Oct. 14, 2022 shooting, according to a release.

Officers were called to the 800 block of Walden Pond Court for a report of a shooting. When officers arrived, they found the boy suffering from a gunshot wound. He was taken to a hospital, where he died shortly after.

Police didn’t release the name of the shooter or the victim due to their ages.

Katrina Dix, 757-222-5155, katrina.dix@virginiamedia.com