Timothy A. Miller, MD, FACS, a recently retired plastic and reconstructive surgeon, and professor emeritus and former chief, division of plastic surgery, University of California-Los Angeles (UCLA), finished his career with many notable accomplishments, including a Bronze Star for his service in the Vietnam War, directorship of the American Board of Plastic Surgery, and authoring a number of fiction and nonfiction books, among other achievements. But there is one role of which Dr. Miller, a Fellow of the American College of Surgeons since 1976, is particularly proud—cofounder, chief reconstructive surgeon, and executive director for Operation Mend. Founded in 2007, Operation Mend is a program that provides reconstructive surgery services as well as other medical and psychological counseling services at no cost to severely wounded and disfigured veterans of the recent conflicts in Afghanistan and Iraq.
“I’m wrapping up my practice,” Dr. Miller said, “and to end in this way, doing this type of surgery, has been an honor and a privilege.”
Vietnam and establishing a career
Working with Operation Mend held particular significance because of Dr. Miller’s early years of service in the U.S. Army at the Brooke Army Medical Center’s Burn Center, Fort Sam Houston, San Antonio, TX, and, some months later, in the Vietnam War. After completing medical school at UCLA and a surgical internship at Vanderbilt University Medical Center, Nashville, TN, Dr. Miller joined the Army and was assigned to the Brooke Army burn unit. It was an exceptionally educational experience, he said, noting that although he had no training beyond a surgical internship, he “learned a tremendous amount by taking care of burns from the other surgeons in the faculty, all of whom were board-certified general surgeons.”
Soon afterward, Dr. Miller was called into service in Vietnam. The conflict was in its early stages, with fewer than 20,000 U.S. troops in the war zone, but medical and surgical services were already needed.
“I went with Special Forces, who were in need of physicians,” he said. “We went to villages that were in the middle of nowhere. I would take care of small, and sometimes larger, medical or surgical issues. I was young at the time, and being in a war was a valuable experience. Before, at Brooke, I was taking care of burn patients in a controlled setting. This was a war, and that changes your point of view.”
That new perspective would stay with Dr. Miller after he returned home and began building his career. He completed a general and thoracic surgery residency at UCLA, and then pursued a fellowship in plastic and reconstructive surgery at the University of Pittsburgh, PA. He returned to UCLA, where he would teach and practice plastic surgery for 42 years. Through this time, Dr. Miller remained involved with veterans’ health care and surgery, including being named chief of plastic surgery at the Veterans Affairs (VA) West Los Angeles Medical Center, one of the largest VA hospitals in the U.S.
Experiences in Operation Mend
When Dr. Miller was offered a chance to perform the facial reconstruction on a U.S. Marine who would become the first patient served by Operation Mend, he didn’t hesitate. Ronald A. Katz, a member of the Ronald Reagan UCLA Medical Center board and executive committee, saw a television program that described the massive burns and scarring of the Marine, and it compelled him to act. “[Mr. Katz] called the dean of UCLA Medical School, and the dean called me and asked if I would be interested in operating on this young man. I said, ‘How about tomorrow?’” Dr. Miller recalled.
The immediacy of his response was drawn from the connection he felt to these veterans. “I knew what it was like to be in the military, I knew what it was like to be in a war and to be shot at. I could relate to their experiences,” he added.
Operation Mend started with that first case in 2007 and became a formal program through a partnership between UCLA, the VA Greater Los Angeles Healthcare System, and Brooke Army Medical Center. The program is supported entirely by private donations. “I gave presentations to potential donors almost every two week when we began,” Dr. Miller recalled.
The veterans on whom Dr. Miller operated were all severely burned, in almost all cases by roadside bombs—improvised explosive devices [IEDs] triggered to detonate by cell phones, wires, or lasers. Some patients had also lost hands and sustained significant burn deformities, but the commonality in his patients was severe scarring of the face, which often included a missing nose or ear or an absent lip. The magnitude of their injuries was such that the reconstruction process required an average of 15 operations, often spread over a period as long as two years. And the number of operations was growing.
“I asked for help from Chris Crisera [MD, FACS], a superb plastic surgeon, to help with a number of patients,” Dr. Miller said. “Soon after, because the hands were often exposed and injured, I asked Kodi Azari [MD, FACS], an excellent hand surgeon, to address these problems and to provide additional improvement so these men could return to a normal life after the war.” Drs. Crisera and Azari are now co-directors for Operation Mend.
Dr. Miller’s implicit purpose in these operations was to restore the appearance of the veterans, but, as time went on, he realized the procedures were having a profoundly significant mental effect as well. “My initial focus, of course, was if they didn’t have a nose, I wanted to build a nose that looked just like a nose,” he explained. “And as they were reconstructed, their personalities changed. In their initial consultations, most of them were quiet, sometimes extremely withdrawn. But after the surgeries, their confidence began to reappear. A sense of humor appeared in men that didn’t at first talk. They could look in a mirror and see that there was a real improvement. Psychologically, that progression was very evident.”
He recalled the case of a U.S. Marine Corps Staff Sergeant who was badly wounded from a roadside bomb in Iraq. He wanted to be able to take his kids to a soccer game, but when he did, everyone stared. Perhaps the best compliment he offered to Dr. Miller after his reconstructive surgery was complete was, “I’d really like to thank you. You took the stares off me.” Dr. Miller conveys this story and others like it in his book, The Surgical Reconstruction of War: Operation Mend, released earlier this year and available on Amazon. “Certainly they still have scars, but their faces, I’m happy to say, have normal features,” Dr. Miller said.
Operation Mend provides the veterans not only with surgical and medical services, but, perhaps as importantly, with a sense of community. Dr. Miller is particularly attuned to the significance of a supportive network for returning veterans, injured or otherwise, because of some of the negative reactions and hostility he and other soldiers experienced when they returned from Vietnam.
“I’m so happy these young men and women were really accepted and welcomed,” he said. “Operation Mend was designed to care for them in a truly holistic fashion. We flew them to Los Angeles, we met them at the airport, we housed them, and we had families in the community who made contact with them when they were recovering.” As of October, 135 men and women from the U.S. Army, Marine Corps, Navy, and Air Force had been treated through the program.
More information on Operation Mend can be found at the Operation Mend website.
A lasting connection
After performing his final Operation Mend case in July, Dr. Miller decided it was time to retire from practice. He and his wife, Mia, are contemplating a move to Sun Valley, ID, where he plans to work on writing his third novel about this experience and to fish. Although retirement represents a less demanding lifestyle, “It’s difficult to transition away from being a surgeon for so many years,” Dr. Miller said.
The reluctance to leave surgery behind is understandable, though, considering Dr. Miller’s connection to Operation Mend. His work with the program bridged his service in the military, his skill as a plastic and reconstructive surgeon, and his dedication to wounded veterans into work that is a fitting capstone to a long and accomplished career. “These soldiers had been through a tremendous amount, and the fact that I had the experience of being in war helped a lot. This was an opportunity to give back to these guys for what they’ve done,” Dr. Miller said. “It was the most satisfying effort of my entire career, and the most important accomplishment I ever made.”