DURHAM — The procedure that could, in a way, make Master Sgt. Clarence Gray immortal was quick, simple and mundane.
The 59-year-old Sanford resident walked into a small, windowless room in the Durham VA Medical Center, filled out a survey, signed consent forms and held out his arm for the needle.
In minutes, it was done.
Gray plans to retire from the Army in September after more than 32 years of serving his country. But the two teaspoons of blood he gave last week will continue to serve indefinitely as part of a vast collection of genetic material that the Veterans Administration is building for research.
The Million Veteran Program could help transform healthcare for veterans - and everyone else - by leading to new ways of predicting, preventing and treating illness.
The goal is to find 1 million veterans who agree to allow their genetic material, medical records and information about their lifestyle and military service to be used for research.
This broad combination of different kinds of data will let researchers study complex interactions between the genetic material and, say, exposure to certain vaccines, alcohol use and exercise.
Some of the patterns that researchers will be looking for are subtle. That means the huge number of samples available could vastly increase the confidence in the results.
The national program started modestly last year, with just one medical center enrolling volunteers. Then seven more were added, including the Durham VA.
Now with 40 sites involved, including the Salisbury VA Medical Center, the program is starting to hit its stride; about 23,000 veterans have already been processed, and about 30,000 more have agreed.
By combining the vast number of genetic samples and the VA's high-quality electronic medical records, the program is expected to become one of the most important repositories of data for healthcare research in history.
"I think about it as a bridge to the future of medicine," Dr. Joel Kupersmith, chief research and development officer for the Veterans Health Administration, said in a telephone interview from Washington, D.C. "... Not only will we be able to use it to understand diseases better, and who will get them, and be able to predict things, but also to have new ways of designing treatments."
Research in the works
Given the huge number of subjects, their diversity, and massive amount of detailed healthcare and genetic information on each, inevitably much of the research that will be done with the data hasn't even been dreamed up yet.
But researchers already are making plans. A look at what may predispose someone to suffer post-traumatic stress disorder - or conversely to avoid it - is among the research already being planned, said Kupersmith.
Another priority is getting a better sense of why some people need smaller doses of certain drugs or are more vulnerable to a specific disease such as diabetes.
The VA recruits veterans by periodically mailing out fliers. At the Durham VAMC, the program team periodically distributes information in clinic waiting areas.
Between them, the Salisbury and Durham sites can mine a rich ground for enrollees: North Carolina is home to more than 760,000 veterans.
The Durham branch of the program has a processing goal of 20 volunteers a day, and at midday Friday was at 1,235 and counting.
A key to recruiting volunteers, said VA officials, is assuring them that their medical records and genetic material will be carefully protected for privacy. The medical records will be connected with genetic information only after patient names are stripped from the records.
Volunteers can back out any time they wish, even years later, without stating a reason, and the VA will destroy the genetic material.
Occasionally the local program team gets skeptical questions from veterans who worry that their DNA might be taken and used by someone other than authorized researchers.
"One guy said, 'Oh, someone's going to clone me,'" said Nancy Steward, the research assistant for the Durham program site. "We said, 'No, no, that's not the case at all.' We're just going to do research on this vast number of samples, and we're going to get research done a lot more quickly because we have so much to choose from."
Mostly, though, the veterans are receptive, since the basic idea is helping other veterans, said Dr. William Yancy, the local site investigator for the project at the Durham VA and a researcher at Duke University's medical school.
"I think that people understand that we still have a lot to learn about genes and how they interact with our health and how they predict disease down the road and how they interact with our treatment," he said. "We don't even know exactly the questions we're going to ask, and I think they understand that."
Another way to serve
Gray said that when he saw an advertisement for the program that he knew immediately that he had to volunteer.
With the program just getting started, Gray said that he doesn't expect to reap any benefits from it.
"Oh, this isn't about me," he said.
"It's just one more way to serve my country."
Army veteran Dan Ocheltree, 42, of Roxboro, who had his blood drawn last week, said there didn't seem to be any reason not to volunteer.
"It's a perfect way for me as a veteran to give back to fellow veterans," he said. "A study like this, to be able to perhaps come up with new ways to treat and prevent illnesses with veterans and Americans generally, just seems to be a great program to be involved in."
The program isn't perfect. Veterans are much more likely to be men, for example.
The sheer number of people being enrolled, though, and the extraordinary quality of the medical records will easily offset any concerns about the demographics, said Dr. Jim Evans, a professor of genetics and medicine at UNC-Chapel Hill, who is not involved with the VA's program.
The promise of the database is substantial, Evans said.
"I think this will really help with figuring out the genetic and environmental underpinnings of health and disease," Evans said.
"We have huge problems in sorting out what genetics and environment mean for human health, and the only way of doing it is with programs of this scale."