On Christmas Day 2006, US Navy Corpsman Dustin Kirby was standing watch on the roof of an outpost in Iraq as the Marines in his unit called home for the holiday.
After three quiet hours, it was his turn to call home.
“I was the first one to walk out and,” as if holding onto every word like someone bracing before a hit, he said, “I got shot.”
This was the small town Georgia boy’s second tour in Iraq and, by then, was known as “Doc.” The trauma medic for the Second Battalion, Eighth Marines had saved a lot of lives, including that of his friend and turret gunner Colin Smith.
“The sniper shot impacted him around his right temple and blew out his entire frontal lobe,” he said. “We’re taught to make em comfortable. But, he was my friend and up until that point I had never lost a Marine that I had the opportunity to treat and I wasn’t going to give that up.”
Like that October day, Doc’s medic skills saved another life on Dec. 25 – his own.
“Bandaging myself; giving myself a trach so I could breathe,” Doc said, running his thumb against the circular indent left at the base of his neck where he inserted the endotracheal tube. “I tried to give myself an IV, but ended up having to get help from a Marine because my fingers stopped working.”
The sniper shot ripped through his face, taking a chunk of his tongue and seven teeth with it, while destroying 13 centimeters of his jaw and causing a skull fracture on its way out.
“I had no idea how bad it was,” said Doc, who refused the gurney and instead walked to the helipad, hoping to show his Marines they weren’t losing yet another brother. “In my mind I really thought that I was just going to get bandaged up and I’d be right back.”
Doc would not return to the battle field.
He required more than 30 surgeries to repair all of the damage and, still, he was left with chronic pain for the next 10 years.
“It hurts to talk. It hurts to eat. It hurts to even look around sometimes,” Doc said.
Doc grew tired of surgeries, tired of doctors and, eventually, tired of trying.
He used alcohol to cope with the pain from his injuries and post-traumatic stress disorder (PTSD). He put on weight and grew a beard to hide the scars on his jaw. His teeth were deteriorating and, coming up on a decade after he was shot, the metal plates that held his reconstructed jaw in place were failing.
“Every time he looks in the mirror he has to see what the war did to him physically,” said Doc’s mother, Gail Kirby. “And enough times of that and he remembers what it did to him emotionally.”
Mrs. Kirby hadn’t seen Doc smile in nearly 10 years. What she did see was a man, her oldest child disfigured from war nearing the end of his rope. She reached out for help. With the support of an entire community – both at home and among veterans – she was connected with a team of doctors, led by David Hirsch, MD, director of maxillofacial surgery at Lenox Hill Hospital.
“While [the prior surgeries] saved his life, I don’t think it put the jaws in the best possible position,” Dr. Hirsch said. “[And his teeth] are being traumatized every time he talks or eats.”
The pioneer in virtual surgical planning came up with a plan to ease Doc’s decade-long pain and give him a new set of teeth.
“I removed all the old hardware after the 30 surgeries that was in there and then we added new hardware to keep the bones together and allow them to heal after they were surgically broken,” said Dr. Hirsch, who performed two surgeries pro-bono.
The new hardware was a custom-fitted titanium plate, which Dr. Hirsch added after repositioning Doc’s mandible bone to better align with his teeth. By moving it forward, up and to the right, Kirby would now be able to talk, eat and, yes, finally smile with no pain.
“I went from being in pain all the time, sometimes debilitating pain, to feeling ok,” he said, five months after his surgery. “And then I went from feeling OK to feeling great.”
Mrs. Kirby, who had fought, as her son would say, like a bulldog to get Doc this far, waited in the hospital with family, friends and tempered excitement for some good news that day.
“It went good?” she asked the doctor.
“It’s exactly the outcome we wanted,” Dr. Hirsch replied, seconds before a Kirby family friend placed an American flag scarf, matching her own, around his neck.
The Kirby family had a lot to smile about that day and in the months to come. But, Mrs. Kirby still hadn’t seen her son “completely smile.” That would happen on Sept. 14.
“They removed all my old teeth and then they spent all day making me a wonderful set of teeth,” Doc said.
Two days prior, Dr. Hirsch put in dental implants in the jaw to act as the “root of the tooth.” Then, on Sept. 14 a team of dentists fashioned a set of teeth – although a temporary set – that would attach to those implants. They will build a second temporary set before the final porcelain set is made.
With his mother in tears and his teeth in place, Doc said, “I’m definitely going to have to learn how to smile again.” He chuckled, then looked in the mirror and, for the first time since walking out that outpost door to call home for Christmas in 2006, Doc saw himself – “completely smile.”
“Ya know, I spent a long time looking in the mirror and not seeing me,” he said. “Seeing kind of what was left after the fact.”
Like everyone that met Doc after his injury, his daughters had never seen him really smile. So, when he returned home, he drove straight from Atlanta airport to their elementary school to surprise them.
“Lylah stops dead in her tracks, like 30 feet away,” Doc said. “She drops her bag and her jacket and says, ‘Daddy, your teeth.’ So, then she starts crying and I hug her, and I start crying. And then my 10-year-old, Bella, she rounds a different corner, sees us crying and just starts crying all over the place.”
The Kirby kids had many more firsts when they joined their dad on another trip to New York City in December. But, this time it was not for a surgery or an appointment.
“We brought Dusty and his four daughters to New York so that they can experience Christmas in New York, and try to bring his Christmas spirit back to life,” said Juan Serrano, US Marine Corps veteran and director of Military and Veteran Liaison Services for Northwell Health.
Christmas is a hard day for Doc, especially on the tenth anniversary of his injury. The memories, he says, will never go away. But, watching his daughters take their first plane ride, see Rockefeller Center, the Rockettes Christmas Spectacular and a world of new experiences this year made it easy to smile and mean it.
“You just learn how to carry it better and better as you go,” he said. “But, this up here, being in a different place, keeping my mind occupied, it’s really helping me to stay away from negativity and really thrusting some positivity on my thought process.”
Now Dusty is looking forward to taking family photos and actually smiling in them.
“Since these operations there’s been a whole lot of much better days,” he said. “I can’t say it enough, all of ya’ll along the way have change my life for the better, and I don’t know where I’d be without ya.”