Army Dentistry

I don’t enjoy having conversations about Afghanistan with people who haven’t been there. It is not that I don’t want to share or help others understand the conflict or my experiences. My issue is that the stories I truly want people to understand are so visceral that words rarely due them justice. Especially when my words fall upon ears that don’t already have some basic connection to this conflict: the ears of someone who has never served in the armed forces, who has no relatives who have been to Afghanistan, who couldn’t find Afghanistan on a map.

The majority of my time in Afghanistan was divided between working hard and doing absolutely nothing. There would be days at a time where I did not see a single patient. Being frustratingly bored is what I hated the most about my deployment, but being bored is not what has affected me. Being bored is not what inspired me to start sharing my experience on my blog.

My clinic in Afghanistan was in a small concrete building near the runway on a small base close to the Pakistan border. In this building were other medical assets, to include two operating rooms and a team of surgeons. As such, the majority of seriously wounded Soldiers in our area of operations came to us for surgery. I got quite a bit of experience that year treating maxillofacial battle wounds, but unfortunately along with the split lips, broken teeth, and facial lacerations came the double amputations, exsanguinations, and other variations of modern battle-wounds that the American public has yet to see the long term effects of.

As a dentist I see bleeding and pain on a routine basis, but I am not accustomed to the level of violence and trauma that a general surgeon is. To me the images of wounded American Soldiers stand out profoundly, while to a surgeon they are likely routine and unmemorable. I hope to never again see the effects of such violence again in my lifetime, but those wounded and dying men and women that I saw will forever be etched in my memory. It is these memories that I want to share with the American public, and it is these memories that churn my stomach when I recall them.

My first exposure to the violence of this war was in the first 24 hours after arriving in Afghanistan. A suicide bomber walked onto a nearby base and the wounded were evacuated to our facility. Still, this trauma was distant, new, confusing, and as such did not yet seem real. Nine days later was when it became real to me. It was a Sunday morning and I had been called in to the clinic to see two emergency dental patients. As I was finishing, we got word that we would be receiving five incoming wounded patients. I remember feeling naively excited as our new battalion surgeon and I propped open the doors to the clinic to prepare to receive the casualties. He wanted me to stick around to triage — to sort the patients based on severity — since that was technically an additional duty of the dentist.

I recall it was a very warm April day. The sun was beating down on us while we joked, getting to know each other better. Then the first ambulance rolled up and the medics threw open the back door to get the patients out. The mood quickly changed. I ran up to the vehicle to assess the patients and to begin sorting. Thankfully there were not enough patients to really triage. There was only one that really needed surgery and a few others who were minimally wounded. But at this moment the war became real to me. I looked up and saw a man about my age with red all over his uniform, blood streaming from his face. He was shaking and violently vomiting into a plastic baggie. His left eye was ripped out.

As the year progressed and casualties mounted, I developed a bad habit of internet-searching the names of the Soldiers who died. I wanted to learn a little bit about them out of respect; and in the age of social media and online hometown newspapers, it was easy to do. Unfortunately this made the emotional burden somewhat more personal. I could no longer separate them simply as patients. They now had first names and families. Lives they had lived before the military. Wives and kids whose lives would be forever changed by their death.

One particular death bothered me more than others, probably because it was my first. He was a young Soldier whom I did not know. To this day I do not know what happened to him, but when I came around the corner of our building I saw the team unloading him from the ambulance. His uniform had been cut off by the flight medics so I could see his pale yellow skin under the hot Afghanistan sun. There was a small amount of blood on his chest but no visible trauma. Our Brigade Nurse was barking orders while doing chest compressions on him. His eyes were open but vacant. Each time she compressed his chest I could see his lips moving, un-naturally expelling air. He was dying right there before our eyes. I knew from the color of his skin that he was already gone.

He died that hot summer day in Afghanistan.

Something odd happened to me every time I saw a Soldier in the grips of death. Time slowed down and all of my senses heightened. Colors became more vivid, smells and sounds more defined. Details became more pronounced. I will never forget the smell of blood evaporating into the air under the hot sun. It is the smell of life being carried away by the wind.

Later that day I searched his name on the internet and quickly found a picture of him and his wife and children. He looked very different in life. I realized that in a few short hours that woman in the photo would get a knock on the door that would change her life forever. Her husband had been Killed In Action. Those children’s father would never kiss them good night again. A knot formed in my stomach. I thought about my own family: my wife and son, my parents. I prayed they would never get that knock.

I couldn’t get the images of his death out of my mind for days. I had a hard time sleeping at night. Every time I closed my eyes I could see his face. I can still remember his face but it doesn’t bother me as much anymore. I’m not sure if that is good or bad. I like to think that for me it is a good thing. But for history’s sake, forgetting his face is wrong.

Now that I have been home seven months, I find my mind wandering back to Afghanistan less and less often. In the fast-paced, cushioned lifestyle we enjoy in our country it is easy to forget how many are still serving in Operation Enduring Freedom. As Thanksgiving approaches this week I will take a few extra moments to thank God for bringing me home safely and pray for those who are still downrange. And I will remember to ask God to bless the families of the fallen who celebrate the holidays this year for the first time without their loved one.