Veterans of any war have long struggled with injuries and illnesses resulting from active military service, whether mental or physical. As such, the U.S. Department of Veterans Affairs receives many different types of compensation claims — sometimes more than its designated teams can handle.
Enter Paul Smith, an Air Force veteran who has worked on one of those teams at the VA as a senior veteran service representative for the last 15 years. Smith deals with claims involving the PACT Act — a 2022 law that expands VA healthcare and benefits for veterans exposed to burn pits, agent orange and other toxic substances like asbestos.
Smith said he reviews personal records to see if claimants were stationed in areas with known exposure, and if there was a medical diagnosis of related conditions post-service.
“Then we can go ahead and connect veterans for compensation,” he explained. “We order exams, we review medical evidence and just try to make sure that the veterans are eligible for benefits that they deserve.”
Unlike most cancers that have two or three big tumors, Smith explained, mesothelioma is like bad acne and has hundreds of tiny tumors and cancer cells.
“A lot of times when these ships were being manufactured, or even buildings, manufacturers would use a fibrous asbestos material in the construction of these,” Smith said. “These products were breathed in by many people and with asbestos exposure, usually, it takes years to manifest.”
Smith’s father died from mesothelioma just four years later.
Unfortunately, that is not where the irony ended for Smith as on Dec. 5, 2022, his 36-year-old son Paul Smith III was diagnosed with peritoneal mesothelioma.
“He never worked in the Navy. He was never in the military, never had an active service and he never had a job that exposed him to asbestos,” Smith said. “When he got that diagnosis, I went into research mode to learn more about this disease. And I think working at the VA and doing what I do with my job helped me to search certain databases and different resources to try to get a grip on this very deadly disease.”
Smith leveraged his research to advocate for his son, who was seeking chemotherapy, immunotherapy and a procedure called HIPEC at the Mayo Clinic in Phoenix.
HIPEC, or heated intraperitoneal chemotherapy, is a two-step process. First, doctors open the patient’s abdomen and use surgical instruments to scrape as many physical tumors as they can from the peritoneum. Second, doctors heat liquid chemo to 102 degrees and pump it into the patient’s stomach to penetrate the folds of the stomach, killing underlying tumors.
While the Mayo Clinic agreed to immunotherapy, it refused to do the HIPEC as it only had a 20% chance of extending his son’s life. Successful treatments can add five to seven years.
Refusing to quit after a single opinion, Smith contacted the National Institutes of Health in Bethesda, Md.
“I sent all of my son’s records there, and they were very interested in Paul’s condition because of his young age and because of my father’s diagnosis and death,” Smith said. “They brought him out for a screening, and they concluded they could do the HIPEC, but wanted him to do a few more rounds of immunotherapy.”
That was February of 2023, nine months before Smith III passed away. In May that year, the family moved to Maryland for three months to be there for the 15-hour procedure where the doctors ended up taking out 30% of the cancer.
“My son he was doing good,” Smith said. “And he said, ‘When I beat this cancer, I’m going to go ahead and buy food truck,’ and he wanted to sell coffee. That was his goal.”
NIH recommended the younger Smith go into a nursing home, but the 36-year-old didn’t want to do that. So, Smith and his wife during their three months in Maryland quickly learned how to become full-time caretakers for their son — give him his medicine, change his wounds and administer IV bags.
Tragically, Smith’s son developed a related infection, which took his life.
“I wanted to keep his legacy alive,” Smith said. “My wife came up with this idea: Why not sell coffee online? So, I studied coffee, and I came up with this website because his nickname was ‘Bubba’ ever since he was born. The website was Bubba Brewing Company.”
After finding a local roaster in Scottsdale and navigating all the logistics, Bubba Brewing Company just went live Nov. 27.
“We’re not trying to become Starbucks or anything. That’s not the goal — the goal is that my son wanted to do this, and I want to keep his legacy alive,” Smith said. “The second thing is to bring awareness to mesothelioma. On the website I have an FAQ where I talk about mesothelioma, what you can do and a bunch of resources. That’s how the coffee company ties into helping veterans because veterans are the No. 1 demographic that gets this terrible disease.”
Even before losing his father, and well before losing his son, Smith was committed to helping veterans, he said.
But witnessing firsthand the toll of the disease — and the grueling process of filing claims for compensation against manufacturers such as Johnson & Johnson — gave him a renewed desire to help.
“I’ve always felt that let me do what I can to help veterans get the maximum benefit that they can,” Smith said. “When it pertains to mesotheliomas or certain cancers, I don’t want to say I work harder — but I kind of feel the intensity of what the veterans are going through. I know personally having to witness my dad and my son going through cancer treatment … I can understand what they’re going through.”
Smith advocates for civilians and veterans alike to “go beyond the thank you.”
“You always hear people say to veterans, ‘Thank you for your service.’ And I know people are sincere when they say that, but a lot of times there’s a great deal of veterans that need a lot more than a thank you,” Smith said. “A thank you is not going to cover them. It’s not going to make them feel safe and it’s not going to feed them.”
Smith said the best way to help is by giving money, food or water to veterans’ charities or cancer research. He’ll keep advocating from inside the VA.
“What I try to do is go beyond the thank you,” he said. “Go beyond the thank you and provide a resource.”
To learn more about qualifying for benefits, Smith points veterans to the VA national hotline number: 800-827-1000 or 800-698-2411.
“Knowledge is power,” Smith said. “The most important thing is to get help … and get yourself fixed so maybe you can become whole again.”
