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Col. Norman S. West, Air Force District of Washington command surgeon, left, jokes with Lt. Col. Charles Moniz, Air Force Element Defense Health Agency commander, and Col. J.T. Russell, U.S. Air Force chair and Chairman of the Joint Chiefs of Staff chair to Marine Corps University, during a break at the AFDW Commanders and Senior Enlisted Leaders Conference at Joint Base Andrews, Md., Nov. 15, 2018. (U.S. Air Force photo by Master Sgt. Michael B. Keller)