Posts Tagged ‘Deployed Dentist’

Now that I am home from Afghanistan and the dust has settled, I have decided to come out of hiding for the sake of this blog. I still want to work toward sharing my experience as an army dentist with those out there who are interested in reading.

My year in Afghanistan was long. I deployed as the dentist for an Infantry Brigade Combat Team. My brigade was deployed to a remote and violent part of Afghanistan along the Pakistani border. I was the officer in charge of a small expeditionary dental clinic that supported approximately 8,000 US and Coalition forces throughout our Area of Operations, and I was the only dentist in the AO.  The majority of my time was spent seeing dental patients at my clinic. Over the year I saw approximately 1,300 patients whose problems ranged from infected wisdom teeth to trauma from IED blasts.

My dental clinic was at a larger sized FOB and co-located with a physical therapist, a team of physicians, nurses, and PAs, a preventive medicine officer, and a Forward Surgical Team (FST). As expected, the surgeons handled quite a bit of war-related trauma throughout the year. Since there was no oral and maxillofacial surgery support in all of RC-East, I had the opportunity to go into the operating room to help the surgeons repair some maxillofacial trauma. I remember assisting two of the general surgeons on a neck dissection after a guy took several AK-47 rounds to the head and neck. A bullet went in through neck and came out through his left parotid gland (one of the major salivary glands). They wanted my assistance dissecting and exploring the parotid and its duct into the oral cavity. I also had several opportunities to handle facial lacerations, and even remove shrapnel from a soldiers face after he was wounded by a mortar round.

Part of my job as the brigade dentist was to “flex forward” and support our more remote soldiers in more than twenty outposts throughout the mountains and valleys of Nangarhar, Nuristan, Kunar, and Laghman provinces. Throughout the year I traveled on 18 “battlefield circulation” trips throughout this AO. During these missions I would travel forward with my assistant to provide evaluations and preventive care to our most remotely deployed combat soldiers. My assistant and I would fly to some small observation post or outpost up in the mountains for a day or two. While my resources limited me to very basic procedures while on a mission, these trips proved to be a very valued service to the war fighter and much appreciated by their commanders. Life on these small outposts was very different from life back at my larger base. The movie Restrepo did a pretty good job detailing what life is like for these guys out at these small outposts and I would highly suggest it as a primer to what life has been like for the infantry in this war.

Life on my FOB was pretty good and relatively safe. It made me appreciate the little things we had (like flushing toilets).  Although we got mortared somewhat often during certain months, I never really felt like I was living in a dangerous place. However, towards the end of the deployment  a small group of insurgents did successfully mount a VBIED attack against my FOB that resulted in 9 deaths and approximately 20 wounded Afghan Forces. We took enough casualties that morning that I actually had to act as the triage officer for a short while because all of the physicians and surgeons were busy inside.

Looking back on the deployment I am glad that I was there. I’m proud to have served as an army dentist in a time of war and I am immensely honored to have deployed with an infantry brigade. I witnessed many events and ventured to many places that I will never forget. The deployment was more difficult on me and my family that we had anticipated. The year-long separation was very challenging and stressful on my marriage and my relationship with my young son. I feel we are stronger for it, but I wonder if there will be lingering effects of this separation for some time. The professional isolation was overwhelming at times, but I have no doubt it has made me a better dentist.

While my future in military dentistry is dubious, I hope that I can continue to serve as a reference to any dentist who is deploying with a brigade in the future. I hope this blog continues to serve as a source of information to all those who read it.

No Squatting For the past year I have had to share toilet facilities with hundreds of other US military personnel as well as a host of Third Country Nationals and Afghans. By now I have pretty much gotten used to the odd hygiene and toilet practices of our non western partners.  I was recently thinking back to when I first arrived in country almost a year ago and was exposed to the oddities of third world defecation for the first time.

I remember seeing signs “Do Not Leave Water Bottles in Here” in all the port-a-johns. Why would people bring water bottles into the port-a-shitter? Probably because there is nowhere to wash their hands. It didnt take long to figure out what was going on.

I had put these odd defecation practices out of my mind until yesterday when I was out on a mission to Laghman Province. I saw the above photo plastered to all the US toilets. I simply had to capture it and share it with America.

My favorite part of sharing toilets with Afghans and TCNs isn’t the un-flushed mounds of feces. It isn’t the piles of brown paper towels that are literally piled into miniature mountains on top of their poo. My absolute favorite part is the muddy footprints that they leave on the toilet seat after squatting on the john. It really accentuates the polarity between our cultures.

For more information on pooping in Afghanistan, please check out Tom Ricks blog here.

I haven’t written much in a while. I’m still here in Afghanistan. Still living in a 8×8 plywood room. Why haven’t I written? Because pretty much every day is the same. Every once in a while there are spurts of excitement but for the most part the winter isn’t the fighting season.

Last week I watched the movie Office Space and couldn’t help but see the similarities between the main character Peter Gibbons’ life and life on a FOB in Afghanistan. There was a scene in which Peter was in therapy because he hates his job. The conversation went something like this:

Peter: “So I was sitting in my cubicle today and I realized that ever since I started working, every day of my life has been worse than the day before it. So that means that every single day that you see me, that’s on the worst day of my life.”

Therapist: “What about today? Is today the worst day of your life?”

Peter: “Yeah.”

Therapist: “That’s messed up.”

That scene pretty much sums up my life right about now. Being here for this damn long is really messing with my head. I’m moody. I’m angry. I lose my patience quickly. I get frustrated over the littlest things. Why the hell can’t I get any sunflower seeds? (Damn you Pakistan!) Every day seems worse than the day before.

I wake up every morning pissed off. I’m angry at myself. I’m angry at the people around me. I’m angry at the Army. It is mostly misdirected anger and it usually subsides after morning sick call. But it is no way to start the day.

My only consolation is my amazingly upbeat wife who reassures me that This Too Shall Pass and that once I return to America my life will improve. She’s probably right. She has to be right. Right?

I still love what I do. I absolutely love being a dentist. I even enjoy being in the Army. I’m just tired of being at work 24/7 I guess. I miss my family. I’m ready to come home.