Some coins are worth more than money.

The value is measured, not in monetary worth, but with professional significance, personal sentiment and, at times, historical relevance.

Lt. Cmdr. Carmelo Ayala, department head, Naval Hospital Bremerton (NHB) Internal Medicine, started his Navy career as an undesignated seaman assigned to the Cimarron-class fleet oiler USS Cimarron (AO 177), from 1987 to 1990. He said that the coin of the 25th Chief of Naval Operations, Adm. Jeremy Michael Boorda, is one he will always display proudly.

Ayala said the coin has significant value because Boorda was the first Sailor to rise up from the ranks - from enlisted to officer - to become the top Navy officer. Like the admiral, Ayala also started out as an enlisted Sailor and has found his niche in the Navy Nurse Corps.

"I just love getting and also giving coins. I have received a few over the years from mentors, hospital corpsmen, IDCs (independent duty corpsmen), Navy Nurse Corps officers and others," said Ayala, a Camden, New Jersey, native, with over 28 years of naval service under his belt. "I am a firm believer that a coin is just a great way to say thank you to someone for going that extra mile to help out."

He noted that his personal collection has grown to include more than 3,000 coins.

"I haven't actually counted them in a while," he said. "I get coins all the time from friends, co-workers and beneficiaries from everywhere. Just this week there's 13 new ones."

That baker's dozen of new coins included a very special addition, which came about by happenstance. Ayala struck up a conversation with a beneficiary on the elevator ride to work. They exchanged small talk about their military service.

"The gentleman shared that he had been in some wrong places at the wrong time,s because at some of those places, people didn't return," Ayala related.

The gentleman Ayala conversed with said he appreciated the care and concern the lieutenant commander expressed. At that point, a very distinctive coin was presented to Ayala as a thank you.

The coin came from Lt. Col. Bruce P. Crandall, who received the Medal of Honor in 2007 for his heroic actions in the Battle of Ia Drang in 1965 with A Company, 1, 229th Assault Helicopter Battalion, 1st Cavalry Division (Airmobile).

"Just goes to show you that if you treat others the way you want to be treated, that they will appreciate it," Ayala stated. "What an honor! How often does one get a coin from a Medal of Honor recipient? The least I could do is return the favor and give him one of mine."

The origin of the military (or challenge) coin goes back to the days of the early Roman Empire. Militaries throughout history have presented such a token with the unit's logo or insignia on it to someone deemed worthy by a special achievement on their part. The practice also includes exchanging coins during exercises, collaborations and assignments.

Yufeng Miller, of NHB's Internal Medicine department, had witnessed active duty personnel accept a coin but never thought that she would receive one, until Ayala presented his coin to her last month.

"I never thought that I'd get one. It's great. It makes me feel more appreciated in our department," she said. "I now have a few more and I even have a little display that was made for me on my work desk."

Ayala attests that the best thing about any coin, for both the recipient and the presenter, is that the simple gesture is a morale builder and is all about service. He said his philosophy centers on treating someone the way you want to be treated, and that they will return the favor.

"If you tell someone you got their back, they will remember that," he added. "Whether it's helping with paperwork, getting an appointment, conducting a diagnosis, whatever the case may be, people can tell when someone cares. As a part of Navy Medicine, and as a Navy Nurse Corps officer, I'm in the caring business. It's what I do. It's what we do."

Ayala recalled several years earlier when he helped an aviation maintenance administrationman get into the Medical Enlisted Commissioning Program (MECP) for nursing.

"We needed her commanding officer's endorsement on her submission package, but he was on leave with explicit instructions not to be disturbed unless for an emergency," Ayala recounted. "Since I had helped her put her package together at the branch health clinic I was at, I took the liberty of phoning him and respectively explained why his assistance was needed as soon as possible due to the deadline. He asked if she was qualified as a candidate for our Nurse Corps and after ensuring him she was, he readily came in to give his endorsement. That AZ1 later on sent me a coin as a way of saying thank you after being accepted. That made my day, knowing that I could help her get where she wanted her career to go and then have her share that she made it."

There is also power in a coin, says Ayala. A coin can spark motivation, along with boosting morale.

"It's a small gesture but it goes a long ways," he said. "The only thing better than getting a coin is giving one."

The most recent coin that Ayala presented was to Personnel Specialist Seaman Josephine Fabia, in NHB's Human Resource Department, for her work in expediting needed paperwork for Ayala and his wife, Michele. He was anticipating that it would take several days to complete the necessary administration requirements. Twenty minutes later, Fabia contacted him to say his documents were ready.

"That service was so professionally prompt and courteous that I immediately tracked her down to say 'thank you' and present her with a coin," Ayala added.

For Fabia, it was her first.

"It was awesome to receive my first! I keep it in my car. It's good luck," she said.

Ayala's self-designed coin has embossed raised lettering around the edges on one side that states, "I did it the hard way. I earned it," and "The price of greatest is integrity." The middle portion revolves on two hinges, with one side showcasing the Navy Nurse Corps emblem surrounded by the words, "Nursing Excellence Up Through the Ranks." The flip side of the middle features a mustang horse, the icon representing a commissioned officer who started out in the enlisted ranks, along with the caduceus, the symbol of the Navy hospital corpsmen.

Despite all the coins he currently has, there is one that has at least so far eluded him; one from USS Cimarron. He had the opportunity, but as a young Sailor he could not justify the expense of purchasing the coin from the ship's store.

"I remember back then thinking, 'Why would anyone want to buy this little piece of brass?' But as I've gotten older I realize that there is such a connection to history and camaraderie," he said. "For the past 20 years I've been trying to locate one. But what's really cool is someone, and I don't know who, made this wood carving replica of the Cimarron coin for me. No one is taking credit for it and it's great."

Just as Ayala has been persistent in collecting coins, his career has also been an study in perseverance. After high school, he wanted to get into the state's Licensed Practical Nursing school but due to fiscal uncertainty in the program he decided to join the Navy.

Ayala then set his sights on becoming a corpsman. On the Cimarron he logged hours under instruction in the ship's small medical bay. Then, after a freak accident while conducting preventive maintenance, he was transferred to a base clinic. Fate intervened, as his skill was noted by an admiral being seen, who helped get him selected for corpsman school, where he excelled.

After reaching the rank of senior chief hospital corpsman, he then decided to continue his Navy service in the Nurse Corps.

"Although nursing was my original goal, the main reason why I went the commissioning program was to be able to better provide for Michele," Ayala noted. "The added schooling and training has increased my knowledge and allowed me to be better able to care for her and care for my patients."

As his career winds down, Ayala said he feels he has made an impact not only in the field of medicine, but as a caring coin giver and receiver, which in some ways is just as priceless.

For more news from Naval Hospital Bremerton, visit www.navy.mil/