USPHS uniforms reflect this venerable service’s nautical origins. Paynesville’s Lt. Tom Miller shows off his tan dress uniform for warmer months. This attire elicited a variety of responses—good, bad and otherwise. Contributed photo
Cold War memories of a Paynesville native
Pitching and rolling, the fishing trawler fought through a storm between two immense land masses. A heavy pulley swung like a pendulum, seriously injuring a Russian sailor. Lacking a doctor, the skipper sought help from the Soviet Union’s Cold War rival, the U.S.A. He radioed the nearest U. S. Coast Guard cutter and transferred the injured man for passage to Anchorage. In 1967, however, Alaska’s infrastructure was austere and not many medical specialists practiced there. As a result, a young intern of dentistry from Minnesota would treat the Russian’s trauma.
Born in 1942, Thomas Miller grew up near Paynesville and graduated from its high school in 1960. Majoring in pre-med at the University of Minnesota, he took two years of Army ROTC courses. In 1964, he completed his B.A. and studied dentistry at the “U.” He also married Judith from Rollingstone, 32 miles east of Rochester. She worked at the U’s hospital while Tom was in dental school, and during their first two years of marriage they did not own a car.
In 1967, Tom added DDS to his name and looked into serving in the Air Force or the Navy, but both had enough dentists. Undaunted, he joined the Commissioned Corps of the U.S. Public Health Service, one of the nation’s seven uniformed services. The USPHS traces its origins back to 1798, when the government taxed merchant sailors 1 percent of their pay to operate hospitals for them on the East Coast, notably a large facility in Boston. Ultimately, the service expanded to the Great Lakes, inland waterways, and other coastal areas. In 1889, the government established the USPHS Commissioned Corps and charged it with preventing and controlling disease in disadvantaged and at-risk populations. Owing to their maritime origins, commissioned USPHS personnel wore nautical uniforms. When Tom joined, he wore a U.S. Coast Guard uniform with a USPHS insignia, to include the two stripes of a full lieutenant (O-3).
Needing to complete an internship, Tom prepared to go north to Anchorage, Alaska. He sold his VW to a Paynesville neighbor for $200.
In June 1967, Tom and his family, which now included Angela, boarded a Seattle-bound 707 in Minneapolis. USPHS personnel wore uniforms while traveling, so a child sitting near Tom mistook him for an aviator and thought he should be flying the plane rather than sitting with the passengers. During a five-hour layover in Seattle, Tom was walking about in the terminal when a young man who surely opposed the Vietnam War saluted the mild-mannered Minnesotan with one finger.
Many Vietnam-era vets suffered such indignities, but when the Millers got to their temporary quarters in Anchorage, their volunteer sponsors were helpful. During their first month, they in-processed at Fort Richardson and Elmendorf Air Force Base, where busy interns practiced under prosthodontists, periodontists and oral surgeons. The USPHS assigned them to its Alaska Native Medical Center (ANMC), a modern facility that served the Inuit, culturally similar indigenous people inhabiting the Arctic regions of Greenland, Canada and the U.S.
In 1968, Lieutenant Miller spotted this Fletcher class destroyer, USS Marshall at Anchorage during a training cruise for naval reservists. This may be one of the last pictures of this “tin-can” in US Navy service.
To make the most of limited medical capabilities, Fort Richardson had a medical service reciprocity agreement with Elmendorf AFB. When Tom wasn’t cleaning and examining teeth, he made dentures for career military officers at a 300-bed hospital that the Army shared with the U.S. Coast Guard, which delivered injured Russian fishermen for treatment. Many Slavs abused alcohol even more than citizens of western nations, and the Russians were no exception. Alcohol took a huge toll on the Soviet Union’s populace, but it generated revenue that propped up its faltering command economy. Moreover, drunkenness distracted Russians and other ethnic groups within the USSR from substandard services and consumer goods, so the government accepted the abuse. Tom experienced this firsthand when “Coasties” delivered seriously injured Russians, many of whom had been drinking and failed to dodge swinging hooks, pulleys, and other gear while at sea. U.S. medicos removed skull fragments from Russian brains, but Anchorage lacked neurologists who should have performed such delicate operations. Americans did what they could, and the Russians, understanding frontier life, never complained.
Other satisfied patients included nomadic natives who, like many others, ingested sugar, candy and soda pop which damaged teeth. Meanwhile, Inuit women softened seal hides by chewing them, and the silica therein wore teeth down to the gums. Someone would pull infected teeth out with pliers until missionaries learned the Inuit could soften hides with those same tools. Alaska did not fluoridate water, and USPHS patients generally lived far away and and could not return for the sequential treatment that dental schools like the U of M’s had stressed. Given the circumstances, Anchorage port hospital dentists often pulled badly decayed teeth. They also prescribed liquid vitamins with fluoride for infants and applied enamel restorer on children’s teeth.
Alaska was, and still is, America’s last frontier. Locals kicked up their heels, especially on Saturday nights. Helmeted law enforcement officers in the hospital’s emergency room coped with drunken revelers, and patients came in with broken jaws once or twice a month. Drunkenness was involved in many injuries, and it even replaced tuberculosis as the main Inuit health problem.
Lacking an oral surgeon, ANMC relied on one from Elmendorf AFB to fix jaws. When Tom served, that oral surgeon was gifted but arrogant; he expected special treatment, and rarely lingered after surgery, an operation the interns arranged. Tom and his colleague planned for pre- and post-operative care, handled complications, problems, and took the blame if anything went wrong. The first weekend Tom was on call, two helmeted Anchorage police officers delivered an intoxicated native with a broken jaw to the ER. Having admitted the patient, Tom X-rayed the man, called key staff members, reserved an operating room and filled out forms. That Monday morning the dental department director called him into his office and briefed him on what the USAF oral surgeon expected when he operated at ANMC. Among other things, the surgeon was a stickler on the informed consent form; if it failed to meet his standards the prima donna raged, and an intern had to rewrite it before the patient and nurse-witness signed it. To define the type of surgery, Tom was to write “open reduction and fixation of a broken right mandible using general anesthesia,” list common complications, and verify that he had addressed the patient’s questions and concerns.
Later that morning Tom went to the patient’s ward, introduced himself to the head nurse and asked for the informed consent form. Condescendingly, she gave him the form but filled out another, entering “fix broken jaw.” She then paged the patient, who came down the hall with Ace bandages wrapped around his head and face to stabilize the jaw, and had him sign on the line. She then intimated “That is how easy it is,” and that it should “cover us” in case Tom didn’t have time to get back or forgot to get it done. Tom returned that afternoon, but with a detailed informed consent form that the dental director had vetted. It described all the complications from pain, swelling, bleeding, and infection, including permanent brain damage and death.
The next morning Tom was in the lounge/changing room awaiting the oral surgeon when he arrived with his sergeant, a dental assistant. Having changed into scrubs, the surgeon studied the chart, X-rays and documents, and when he saw the informed consent form, he slammed the chart on the table and kicked a chair. Neck veins ballooned, and his face burned bright red as he heaped scorn on the lack of complications noted and the nurse’s entry of “fix broken jaw.” Throwing chairs, the surgeon hurled expletives at Tom, saying he was a disgrace and an insult to the dental profession. Announcing he’d “had enough” and would not operate, he changed back into his blues. Tom stammered that this was not the form he had the patient and a nurse sign; the surgeon then turned the page in the chart to Tom’s consent form. He sat down, read the form aloud twice, donned his scrubs and operated uneventfully. During his internship, Tom assisted the skilled surgeon. Once, a ligature wire poked through the surgeon’s glove, which he removed to see a bleeding finger. Having washed his hands, he double-gloved and finished the operation. This occurred before Hepatitis B vaccines were available, so the surgeon said he wouldn’t sleep well that night and that few people appreciated such workplace hazards.
Surgeons were not the only volatile aspect of Alaska. In 1964, an earthquake devastated much of the new state. A walk through Earthquake Park revealed ripples and ridges. While on his hospital’s third floor, Tom felt at least one aftershock. In 1967, crews were still demolishing condemned buildings. Reminders of another cataclysm, WWII, sat near an abandoned military airstrip. B-25s (Mitchell) and other war birds, some cannibalized, rested in the boneyard.
History was fascinating, but Tom needed wheels, so he visited a sparsely stocked dealership, but all its cars had block heaters. Tom bought a Chevy Malibu, but when he tried to drive it to work one cold morning, its battery was gone. The police did not even dispatch an officer to file a report, so common was that crime. Another Alaskan peril before ethanol was condensation in gas tanks. Tom’s Tlinglit (a tribe of the Inuit) dental assistant returned from a trip and didn’t top off her Mustang’s gas tank—nor had she added Heet. She was late for work the next morning.
Locals told Tom to get an Alaska driver’s license, so he drove to the Department of Motor Vehicles. Once inside the small building, Tom had to stand in line, show his Minnesota driver’s license, pay a fee, decipher a blurry mimeographed test and use a # 2 pencil to fill answer sheet ovals. He wanted to peruse a state driver’s manual but the official winked and said that was a waste of time so he just took the test. If the test-taker failed the first attempt, he’d persist until he got a passing grade.
Their TV received just two stations, and TV logs did not always conform to published schedules. TV hosts ran shows informally, presenting news and returning to movies. Two weeks after the 1967 World Series, game reels made it to Anchorage, and the network crowed about broadcasting the games much earlier than in previous years. Limited TV programming had a silver lining, since it encouraged Tom to take retired radio personality J. J. Stoddard’s course on Alaska’s history at Alaska Methodist University. When time allowed, the young interns attended dental meetings, journal clubs, and round tables at base officer clubs. Tom’s executive officer, Commander Dowd (3 stripes), had been a Navy pilot before he went to dental school, thus he wore “wings.” Affable Com. Dowd hoped to make the USPHS a career, thereby avoiding lengthy voyages that might have ruined his marriage. During one of Tom’s first meetings at the O-Club, Dowd offered to buy the young intern a drink. He had never been in a bar before (during seven years at the “U” he drank fewer than five beers) and could not even think of names for cocktails, but he’d overheard someone ordering a martini and that sounded good. The nice, clear mini-ice cubes chilled the concoction, and he drank it rapidly on an empty stomach. The cordial commander ordered him another drink, and for the first time in his life, Tom got drunk! A healer rather than a pugilist, he avoided a broken jaw. Officers also hosted social events at their homes, where liquor cabinets became status symbols. Yes, the AA group on base was active.
Tom’s internship had been hectic, but the time flew, and his proficiency had increased considerably. The Millers returned via the Al-Can Highway, built in WWII by U.S. troops and civilians. In 1968, it was mostly gravel, thus authorities recommended protective shields on headlights, used water trucks to reduce dust, and advised a top speed of 30 to 35 mph to avoid flats. A soldier in a packed VW Microbus with a snowmobile lashed to the roof repeatedly passed the homebound Minnesotans at about 45 mph, and then Tom and Judi would see him changing tires.
B-25 bombers such as this one served far and wide during WWII and postwar years. The twin-engine “Mitchell” bomber gained fame from the April 1942 Doolittle Raid, payback for the surprise Japanese attack on Pearl Harbor. Dr. Miller found this war-bird not far from his clinic at Anchorage.
Tom accepted a USPHS slot as the service unit dental officer at the White Earth Indian Reservation near Mahnomen. Dental practice priorities then emphasized treating children and young adults with preventive and restorative care and to provide mainly emergency care to the older adults. The main dental office was at White Earth and satellite offices operated at Nay-Tah-Waush and Ponsford. They also used portable/mobile dental equipment at schools at Waubun and Mahnomen. Equipment, supplies and instruments were not as good as in Alaska. In 1969, the USPHS promoted Tom to Lieutenant Commander, and Judi gave birth to Donna in Detroit Lakes. A motivated healer, Tom became disenchanted when the Indian Health Service expected its dental offices to meet quotas every month to complete a set number of acceptable procedures. Thus, each office had to do a specified number of exams, prophys, topical fluoride treatments, restorations, extractions, etc. The bureaucracy’s “one size fits all” approach did not sit well with Tom, and ever-present alcoholism and petty juvenile crime made private practice appealing. Tom could have pursued a master’s degree in public health in Michigan, but that would have led to a research or administrative position rather than a dental practice.
After three years, Tom left the USPHS in July of 1970. That same month, he opened his practice at Buffalo Lake, filling a post vacated by Dr. Wagner. During his 33-year tenure in the town of 700-plus, he served countless patients (but only worked on one broken jaw) until June 2003, when a tornado struck his office, and the community. He then practiced at the Willmar Regional Treatment Center one or two days a week. Most patients were passive and appreciative, but a patient with HIV once bit through Tom’s gloves and down to the bone. The venerable dentist dodged a bullet and did not become HIV positive.
After he turned 64 in 2006, Tom fully retired. Hearing loss in his left ear forced Tom to give up his private pilot’s license (he had logged 200 hours in the air). Tom maintains some acreage near Paynesville, and he and Judi have cruised the Caribbean and travelled extensively in the U.S., to including Hawaii, the national parks, and the Badlands. Both enjoy hiking, especially at the Crazy Horse monument. On a trip to Branson, Tom was pleased to see an exhibit honoring the USPHS at a memorial to veterans. An avid reader, the retired dentist enjoys history, especially military narratives. In so doing, he no doubt ponders his own Cold War experiences on our nation’s last frontier.