Posts Tagged ‘forward surgical team’

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.

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Back in June my buddies and I decided to spice up life at JAF by growing mustaches. Combat Staches if you will. Our mission was simple, but dangerous: To grown the most combat effective lip sweaters allowable within regulation 670-1. We had no idea how far this would go.

It started out small. Me and about three other guys in the clinic just stopped shaving our upper lips. After a few days the sprouts were visible and growing. A week later we all had acceptable staches. A few days later and the male medics in our Aid Station started growing them too. Then the orthopedic surgeon in the FST. Then the veterinarian. When it was all said and done, the Aid Station looked like a scene from a movie from the 1970s.

The fallout was pretty minimal. We were all prepared to be accosted by a whole host of First Sergeants demanding to know what we thought we were doing. As a precaution, we began carrying a copy of the regulation in our pockets “just in case.” Suprisingly, no one said anything disparaging about them. That’s not entirely true. No one officially reprimanded us for growing them. A lot of individuals in our brigade made disparaging comments about our appearance daily. I just got used to it, but the pressure was too much for some.

Our physical therapist lasted a week. The medics didn’t last much longer. The preventive medicine officer held on for a good month but punched out after he started skyping his wife and son more often. The surgeon and the veterinarian held on until the forward surgical team re-deployed. After almost three months, it was down to me and our battalion surgeon.

It was just the two of us. Isolated from society, we continued mission undeterred. End of Mission occurred the day before I left on R&R. Sadly it was me who decided to bail out. I had originally intended to proudly wear this new accoutrement home but after discussing it with my wife, I realized it was in my best interest to have it completely removed before I got there.

It was a sad day in the aid station. It was time for it to go. We gathered the last few surviving members of the mustache clan and videotaped its farewell. Goodbye old friend. Until we meet again…