A Surgeon Recalling the Past
Dr. Bob Christensen
With Contributions by
Captain Dale Black
Randolph C. Robinson, MD, DDS
My Days with Dr. Christensen…
Not long ago while working at a store, a customer named Dr. Christensen wearing a yellow polo shirt sat patiently waiting on a printing job. He was twirling gently in a swivel chair in his own little world when he smiled at me kindly. From that day on, he became my friend…it was that simple.
Over the next few months I would go see Dr. Christensen at his office three to four time a week to help him with a bit of a project. He had asked me as a medical transcriptionist to proofread a manuscript he was preparing about a battle with the FDA. At first, he was very serious and told me all about the situation in which he was writing. Appalled at the treatment and unjust outcome of his battle, I became drawn in this whirlpool to help him in any way I could.
Over time, he became more comfortable with sharing stories about his life and his profession. Some of the stories would make me laugh and some would bring tears to my eyes. I knew quickly, that he was unique. God had used him in many various ways to heal people with the gifts He had given him.
Having entered my life only a short time ago, I am still uncertain of all the wonderful things others must know him for/as. Yet after hearing and reading much about his life, his successes and losses, I know him as many things beautiful; a tremendous doctor, innovator, fighter, adventurer, writer, dear friend, God’s warrior, and even a teacher. Some of the stories he has shared with me are in this book. In all hopes, it will bring to you, the reader, the same emotion and conclusion that knowing Dr. Christensen has brought to me. He has left an indelible mark upon my life and God has gifted me and all who have ever met Dr. Christensen with his smile and kindness. He has trusted me with many of his projects since we have met and all have been a pleasure working on with him. Not many people can say they have led or could keep track of such a full life, although I am quite certain that I could write my own book about his incredible journey…from just the (hundreds of) emails alone!
Randolph C. Robinson, MD, DDS
Many men elect to go through life never asking the hard questions of “why” and “why not” because they are afraid of offending or learning what might be demanded of them in response to the answers, but not Dr. Bob Christensen. For the short twenty five years I have known him, he has challenged the status quo in surgical innovation and challenged us all to live our lives with a greater commitment to Jesus Christ. I am proud to call him a friend and appreciate all he has done to teach me about surgery and life.
His innovation, creativity, and tenacity have contributed immensely to our specialty of oral and maxillofacial surgery. I met Dr. Christensen at Truman Medical Center in about 1986 or 1987 when I was a third year resident in oral and maxillofacial surgery. Dr. Ed Mosby was a leader in the field of TMJ total joint replacement surgery using the Vitek prosthesis. This prosthesis was later pulled from the market and it left a black eye on TMJ surgery which even to this day shows some lingering bruising.
Dr. Christensen had developed a new joint which was better and safer and Dr. Moses wanted us to learn about it. What I learned was that a man with an idea could build a company and help many more patients than he could by operating on them one at a time. After all, so I thought, this is America, entrepreneurs welcome. His work was an example to me that a person could take his ideas to market to help others.
I don’t remember a lot about the lecture other than a few slides but I remember the enthusiasm of the speaker and his little side jokes which seemed to entertain him sometimes more than the audience. He did not display any tone of arrogance and was approachable with questions, rare qualities among us surgeons.
As an inventor and one who has dealt with the vicissitudes of the Food and Drug Administration, I always looked up to Dr. Christensen for trying to keep his work moving forward for the sake of those patients in need. I know the hurt and burden this struggle has been for him and have the highest respect for him as a result. He did everything he could for as long as he could.
Over the years he has helped me with many of my joint patients along with Dr. James Curry. At one point we even seriously tried to merge our two companies together. I enjoyed reading Just Remembering-- A Surgeon Recalling the Past because it gave me a greater understanding of the adventures of a man who has made a difference for others. The surgical stories are entertaining from his first patient as a dentist in Chester, California to performing a tracheostomy on a calf. The amazing stories of his various endeavors include operating a Cat-9 bulldozer in a river to flying a Citation jet make one think, on one hand, this guy is crazy but, on the other hand, gee I’d like to do that, too.
The central focus of the book is: how does a guy like Dr. Bob Christensen become a born again Christian willing to serve the Lord Jesus for others? The story, Bob’s life story, shows that Proverbs 19:6 is true, “The mind of man plans his way but the Lord directs his steps.” His story shows that adversity can mean opportunity and that no one escapes adversity. The adversity comes unfairly sometimes from friends, colleagues and government regulators causing frustration and anger. But the key is how that adversity is used for advancement in deepening a relationship to God. I hope you will find his story fun to read and inspiring as I did to ask the hard questions ”why” and “why not”.
A Surgeon Recalling the Past
Dr. Bob Christensen and others
For a number of years I had thought about writing about some of the things that have transpired as I travelled through all of my years as an oral and maxillofacial surgeon. I have previously written several books about my earlier life as a young cowboy growing up in Julian, California. I really felt that some of my children might enjoy knowing some of the history which I had travelled through, especially in the years of the Great Depression, and perhaps the little I might remember of earlier generations. I really feel everyone has a story to tell and for some later generations it might be fun to compare to the time they might be living. I know I would have been most appreciative of my grandparents or great grandparents if they could have found time and energy to put together such a history of their own lives.
I kept thinking there are some things which happened as I travelled down my path as a surgeon which might be of interest to some later on. I kept getting that thought and even mentioned it to three ladies who a half century or more ago were my assistants in my surgery practice and in many of the surgeries that I encountered along the way. I knew they too might remember things which happened that I didn’t remember or that they looked at it from a different vantage point than mine. It has been such a blessing to be able to reunite with these three women, all of whom played a substantial part in the story which we will tell. Their names are Linda Chubb, Nancy Mills and Carol Ginther-Land although we worked together in the 1950s and early 1960s, our respect and friendship through all of these years has never diminished. Linda and I have stayed closely in touch through all of these subsequent years while Nancy and Carol and I have found each other many years later. Though the years have elapsed and the gray hairs and wrinkles may have come, the love and friendship has survived intact. I owe a great deal of appreciation to these three helpers who allowed me to accomplish some of the things which I was called to accomplish.
More recently a young Christian woman and friend of mine, Lenaya Casados, has encouraged me to write this book which will be about some of the interesting or funny things which have happened as I have travelled down the road of my life as an oral and maxillofacial surgeon. This road started some 64 years ago so it will take some ability of mine to possibly recall. My ability to remember all of the details may be difficult since I am in my 87th year on this planet. Lenaya has been most helpful in helping me prepare another 20 books for publication and I am most grateful. She truly is a Gem, but I will add, “She made me do it.”
Some of the things in this book will likely be just stories and others will have a funny side or twist. They will not be written to mock anybody that might have been a patient, but at times may mock me as the “professional”.
As I write some of these stories I am attempting to give a picture of portions of the life of an oral and maxillofacial surgeon who lived in a particular time so that some who come later will know of some of the better things we might have done but also some of the mistakes we may have made. As the word somewhere says, to err is human. This book is not intended to portray a surgeon any different than his colleagues, but just another of God’s people attempting to use his God given abilities to help some part of humanity.
I have written this book to encourage others to do whatever he or she has been ordained to do to improve and relieve those whose care is placed, for a moment, in their hands. Although I may tell the story as though I had individually performed all of the surgeries alone, I am forever grateful to the men and women who walked with me to accomplish whatever we accomplished in the medical and surgical realm. It is a walk which I have enjoyed and a walk that I am grateful to our Creator for allowing me to walk and to play a small part in a few others lives.
Table of Contents
Being primarily a Christian author I adhere to the banner which we had on the wall of our medical device company for the better part of a quarter century. The banner, in 9 inch stainless steel letters, made the following statement for all to see; “To Know Him and To Make Him Known.” That refers to our Lord and Savior, Jesus Christ, Thus, this book is dedicated to Jesus the author and finisher of our faith and certainly the One, who with the Holy Spirit, not only ordains each one of us for whatever we are called to do, but who guides us daily. I am forever grateful.
But to so many others whose lives touched mine in so many ways from those early years of growing up and finding which path to take, such as Eva and Lee Christensen, my parents who showed me the way. But I also am grateful for my deceased brother, Charles, and deceased sister, Shirley, both of whom were there to help mentor and love me as their young sibling.
Certainly, I am most appreciative, too, of my biologic father, Dr. Charles J. Brophy and then years after his death to his brother, Dr. Frederick H. Brophy and his wife Muriel who took me into their home in Pelham, NY during my training at NYU. My father was an extraordinary dentist in his short life having brought forth an innovation for new toothpaste. It never quite got off the ground because of his death in 1927 at age 41.
To my wife, Lynne, for the forty years she has walked with me through some interesting moments and to all of my 10 children who have been there to teach me some important lessons.
Then, to all of my colleagues in the field of oral and maxillofacial surgery who have mentored and walked with me through some interesting moments. To mention just a few, Drs. Curry, Jim Latta, Ric Alexander, Don Chase, D. Lamar Byrd, Anthony Urbanek, Pat Abbey, Crayton Walker, Randy Robinson and too many others to mention. There were some 700 or more excellent oral and maxillofacial surgeons across America who I was able to get to include the Christensen TMJ hemiarthroplasty surgery in their surgical armamentarium, for which I am most grateful. There is no question that these men and women will carry this type of surgery to new heights for the good of the patients who rely on their expertise.
My earlier general and orthopedic surgical friends like Drs. Douglas Donath, Fred Turnbull, Bob Mueller and Jack Paschall and many others were always there to assist and to counsel me in those most interesting times. Another friend I enjoyed working with, cinematographer, Bob Chapin who masterfully recorded, on film, many of those very spectacular surgeries. There was another brilliant scientist named Dr. Bryan Starling, of Golden Colorado, who helped me by pointing me toward an advertisement about stereolithography. It was a new entity in the medical field, in about 1991-92, which might be useful in the conversion of CT scan data to plastic models for study of anatomic features in patients with pathology and with the preparation of acrylic models from that data for use in preparing custom implants for a patient. This find became the basis of our patient-specific or customized implants for any bony portion of a patient’s anatomy, from hip, knee, shoulder, spine, foot, hand, cranium or mandible.
I can’t forget the people who walked with me each day, for over forty years (elapsed timeframe), in my surgical practice. Nell Firner RN, Karen Burnquist RN, Linda Hadley Chubb, Nancy Mills, Carol Land, Aina Barry, Beverly Fredland and a host of others whose names I may have temporarily forgotten. To them all I say thank you, as a grateful partner in the work we were called to do.
Then, years later, as we founded our medical device company, TMJ Implants, Inc. I would be remiss if I didn’t mention and thank my attorneys, Larry Pilot in Washington DC and Lynn Watwood here in Golden for their masterful work in protecting us through some trying legal battles with the FDA. I would like also to express my gratitude to all of my staff at TMJ Implants, Inc. and Medical Modeling, Inc. who worked so very hard to make both companies viable companies with excellent products to further the science of medicine and surgery. The TMJ implants are excellent implants which have been implanted in tens of thousands of patients over a 52 year period with excellent success. I am indebted to all of my co-workers, but also to all of the more than 700 surgeons whom I had the opportunity and pleasure to mentor and teach this variety of TMJ surgery.
I am most grateful to my dear friend and photographer, Michelle Pesce who prepared the cover of this book, for her talent and expertise. I, also, do not want to forget two special women who always joined me in prayer for some of the recent battles we have fought to keep these spectacular implants available for the millions of patients who require them. That would be Lynne Pilot, Esq. of Virginia and Helga Phillips of Texas.
There are certainly many others who walked with us through these interesting times and for which we are so grateful. There was no way I could have accomplished all of the book writing and preparation if it hadn’t been for the kindness, generosity and unbelievable talent of a young working mother named, Lenaya Casados. We met by accident, or better yet, by the arranged hand of God. I am most grateful.
The Time of My Graduation from NYU
My story starts back some 64 years ago, even before I entered my specialty practice as an oral and maxillofacial surgeon. I will take the story right back to when I finished my course at NYU College of Dentistry in 1948. Some stories may be sort of tangentially related to the subject, but are being incorporated for their perceived interest value. There may be some stories that will seem to be totally unrelated, that will be true, but they will still bring some laughs.
As I start this story I remember well that when my graduation from the Dental School at NYU was scheduled for June 7, 1948, my folks who lived in San Diego decided to attend. They had not seen me for probably three years, out of the four years I was stationed as a U.S. Navy midshipman at New York University. I had been able to travel to San Diego in December of 1944. Having no money, I had hitched ride on a Navy plane leaving from Brooklyn’s Floyd Bennett Field, and traveling via Florida to Norman, Oklahoma where it would be placed in the junk yard for old, retired airplanes. It was an equivalent to a DC 3. The seats and all of the radios had been removed with exception of the Pilot and Co-pilot’s seats. It was a stripped down plane. Without radios, all navigation had been done with VFR, or visual flight rules. The pilot flew the plane about 700 feet above the ground all the way, from NY to FL to OK. There were about 8-10 of us military members as passengers hitching a ride west. We were all sitting on the floor or on “bucket” seats along the side of the fuselage.
It took me three days to get to San Diego. In El Paso, I had gotten out and started the rest of the flight to Los Angeles on commercial airlines. From LAX to San Diego, I hitch-hiked a ride, starting at 1:00 AM and sitting on the back of some young man’s motorcycle, holding my suitcase off to the side, throughout the 125 mile ride back to my former home. What a trip that was. My visit was too short, but that was a snapshot of how things were for many during those WWII years. For many of us, our transportation was in hitching rides usually in cars, but at times it could be anything from a military plane, or on someone’s horse or boat or whatever. That was the way life was in those Depression and post-Depression days.
So now, the story I was going to start with, was the trip in my folk’s car after my graduation from New York University. I had married Ann Forsyth the year before and now my folks were getting a first chance to meet the bride. As we were spending some 5 or 6 days to drive back to San Diego, I will not quickly forget the time somewhere along Route 66 we had been in the car for a whole long day. That particular night we had stopped at some Midwestern town along the path at about 10:00 PM. Ann and I headed for our room a couple of doors away from the folks room, in a very average, one story motel. We quickly went to bed. At about midnight, after probably 60 minutes of sound sleep, we felt we heard a knock on the wall or door and felt that was our wakeup call, but wrong, it wasn’t. We got up and got dressed and loaded our bag into the car and knocked on the folk’s door, only to find out it was only a little after midnight. We had goofed, but of course as I tell you more about my life, you will see I made a few more goofs along the way.
My First Practice and Life in the Mountains of California
We ended up finally starting a general dental practice in a small lumber town in Northern California. This small town had a single physician, in a new medical-dental ranch style building, in a town with a lumber mill and a population of about 1500 people. The town was Chester, California and the main employer was the Collins-Pine Lumber Company which hired most of the people in that town. That was the headquarters for the Company. As a brand new dentist, in a town that had never had a dentist before, and a County that now had their second dentist, this was going to be an experience for me and for the townspeople. The physician was a Dr. Bill Greenman who owned the very nice building, on the main highway into town. The building had been financed and built by the Collins-Pine Lumber Company. The only other dentist in that whole Lassen County was probably about 40 miles away, in Greenville, and he was older, and certainly more experienced.
Being a physician or dentist in a small town in the High Sierra’s was going to offer some challenges to any who might wish to practice there. Dr. Bill was seasoned in this type of practice having probably spent some 20 plus years practicing in either this town or a similar type of location. The small town practitioners in either medicine or dentistry are faced with some very unusual challenges as they have to meet many emergency type needs that are not the same for those practicing in the larger cities with all of their medical and dental specialization. Bill was fortunate to have his wife, Mildred, as his sole helper. She was trained as a Registered Nurse and was a very friendly and hospitable partner in his marriage, family and medical practice.
They both accepted both Ann and me with open arms and made us feel quite welcome. I had acquired enough dental equipment from the Bank of America in Chico, California where some dental practice had closed. That was most helpful since they financed the $4000 that I offered for the two room dental office equipment. We didn’t have any money, but Nana Hart had loaned us $1000, for a year, to get us in a rented log cabin and somewhat settled. You see, Ann was now about 7 months pregnant with our first child.
Well we got all of the equipment placed in the three room office and were about ready to start my first practice in the town of Chester, California, but then I came down with a rather severe cold and was lying in bed at home in the two bedroom log cabin when some young woman knocked on our door. We let her in. She had a noticeably swollen one side of her face and looked like she felt miserable. Ann and I let her know I hadn’t as yet opened the office, but it was ready to be opened, but I was sick. Well she wanted help so we drove the three blocks to the office and welcomed her in as our first patient.
I was asking her some questions about her name; where she lived, did she work, age etc. I had been filled in by Bill Greenman somewhat about the town of Chester. He had described it as the end of the road for many. They might have lost their homes and fortunes and even families in some larger town or city somewhere distant, but now were sort of hiding out, or starting over, in this one horse town.
The new dental office had been built a year earlier and set back from the main highway or two lane road coming into Chester from the valley town of Red Bluff some 75 miles due West. In Chester’s back yard was the beautiful Mt Lassen about 15 miles away, but fully in view. The town of Chester was situated on a small fork of the Feather River dumping into the adjacent Lake Almanor here in Lassen County.
Across the road from the office building was a realty office and within a block was a small café known as the Green Pine Café. I had eaten there a few times. It was always an experience for this just out of Manhattan, young dentist to mingle with the locals at the Green Pine Café. It wasn’t that I felt superior, just different, even though I was raised on a cattle ranch in the back mountain town of Julian, in San Diego County. After all, Julian had many less people than Chester, but it had been some 6 or more years since I had lived there. I had also been told by Dr. Bill that he treats a lot of the “gals” at the Lone Pine Inn which was a brothel or whorehouse situated just a few miles out of town.
Now back to my first patient whose name I can’t seem to remember. I now asked her where she worked. I was later almost sorry I had asked the question. Her answer was the Lone Pine Inn. I mixed up and thought that was the Green Pine Café, but I was wrong. My next dumb question made me blush when I asked her if that was the café and did she wait tables there? Standing in front of me with my 7 month pregnant wife, Ann, standing alongside me, she came back with, “Oh, you know where it is”. It was said as though I might have already visited the brothel, which of course I had not. I must say that exchange was one I have remembered all these 64 years later. Despite being able to recall the lady’s name, I do remember her thoughtless and embarrassing remark. I was able to reduce the infection with penicillin injections to the point I could later remove the impacted lower wisdom tooth (third molar). I don’t ever recall seeing that first patient again and certainly not at her domicile. That was the beginning of a host of experiences.
Another interesting thing happened that sort of went along the same line. When time came on November 11th for Ann to give birth of our first baby, Dr. Bill would be the obstetrician and we would have to travel the 15 miles to the town of Westwood where the only small wooden hospital was located. Basically, this distance would offer no difficulty as the labor and delivery would take about 20-24 hours. We had arrived at the hospital on the evening of the 10th.The hospital was a two story, unpainted wooden building that really looked more like an Army barracks. All of the older appearing wooden houses had no paint on them because the Westwood Box Factory who owned the town of Westwood felt wood was cheaper than paint, thus the town was rather drab.
We spent the entire night with Ann in labor and certainly not enjoying the whole situation because Dr. Bill was not willing to give her anything for pain or relaxation. He and I were having a bit of a discord over that whole situation. I was thinking we might need to forget about any practice in Chester. I felt with my training in pharmacology and anesthesia I could have kept Ann much more comfortable. As years have gone by that feeling has increased in me. But during these long hours I held her hand, massaged her legs and encouraged her. At the same time I was attempting to stay awake, while at some few moments she might close her eyes.
To add a bit of humor, another young woman was brought into the hospital as an emergency, because she had been shot, at a distance with a 12 gauge shotgun. It turns “Ginger” worked at the same brothel as the lady who’s name I can’t remember in Chester, and some irate “client” had gotten mad and plastered her and the refrigerator behind her (I am told) with the 12 gauge pellets. Fortunately, Ginger was not badly hurt and recovered to I guess continue in her profession. Finally, after about 24 hours, Ann, with a little help from Dr. Bill, delivered a 7pound 12 ounce baby boy whom we named Robert Jr. We really should have named him Ann Jr. because it seems to me after watching the whole labor and the whole birth, that all the effort was Ann’s. My contribution to this whole episode was rather small and certainly more enjoyable. Meantime, back at the ranch…
Starting a dental practice in this small of a town was certainly an interesting experience. I had one young man who had been slugged by some co-worker at the mill and his lower jaw was totally broken. In these situations I would admit the patient to Westwood Hospital and now with Dr. Bill’s help I would perform my earliest open reduction surgery of a fractured mandible with practically my other hand holding a good text on this phase of oral surgery. Actually, I would be studying the how-to for this kind of surgery right out in the parking area at the hospital. The patient fortunately did very well. I have always said that the young practitioners in medicine and dentistry would do well to spend a few years in these back woods locations. You don’t have other specialists to send a patient to, unless it is way too complicated to do in this type of location. The patients expect you to know everything. I was attempting to oblige them, but certainly had a long way to go. My medical and surgical library kept growing at a feverish pace, because I needed that extra education.
In this fractured mandible case, I remember, the hospital had no drill which I might use, with the bone burs I possessed, to drill the bone in order to place a wire to hold the fragments together. I had to purchase a hand held drill at Young’s Hardware Store to then allow me to use one of my straight bone burs to penetrate the entire mandible for the wires which I would use to immobilize the fragments.
These times became a bit more common as I was faced with everything from being asked to deliver an Indian woman’s baby in the medical office to treating gunshot wounds to the abdomen or face. Fortunately, I was able to get Dr. Bill’s help for many of these, but not all, as he and Mildred would take an annual 2 week vacation and get out of town.
One of the emergencies arrived when I was at the Lion’s Club Wednesday noon meeting in the Bear Club in the center of the town. I admitted the patient to Westwood Hospital and went into surgery where I repaired the soft palate and tonsillar region in which the out of town skier had penetrated the region when on a downhill ski route he fell and jammed his ski pole into his mouth and structures. The surgery went well and the patient was able to return to Chico after I released him from the hospital
Sometime that same winter I had a similar emergency to treat in a man who rammed his ski pole to just above his left eye. Talk about hemorrhage. He was really gushing but I took care of him in the office... Fortunately, he just missed his left eye. Again this patient also did well.
One funny thing happened that has caused me to remember it all these 64 years. I had performed some simple oral surgical treatment for a young lady named Eulita Plaskit. I commented about her rather uncommon or unusual name. She came back with, “You should see my sister’s name.” Which brought my immediate question, “What is her name?” She answered, “Zenobia Ephelda.”After being a bit stunned by her answer, I foolishly asked another question. “Where did your folks come up with that name?” Her answer was absolutely amazing. She calmly replied, “That this was her dad’s girlfriend’s name before he and her mother were married.” That ended my questions, at least where they might be heard.
Ann’s and my time in Chester was very interesting and rather enjoyable. We were becoming part of the community and we were enjoying the three of us living in this rather cold in the winter County. We were about 4300 feet in altitude but with Mt Lassen going up to about 10,000 feet ASL. The snow would be several feet deep in much of the winter, but in the center one block of the so-called downtown, they would plow the snow into the center of the street, thus allowing it to get to be 6-10 feet or higher, with walk paths made in a few areas for the foot traffic.
The log cabin had been built by a young couple named Jack and Betty Farrar. If I recall correctly, they built much of it with their own hands and then for some reason, maybe running out of cash, caused them to have to leave the area, thus giving us the opportunity of renting it. It was a nice home for us to start in but only had a floor diesel fueled heater on one hallway of the house, which in winter allowed our bedroom to be about 15 degrees and Chris’s bedroom to be about freezing. We kept a small electric heater in his room which helped slightly. The icicles would reach from the roof top to the ground.
We stayed there through two winters which were most interesting. The snow would pile up to several feet deep generally but in the one block of downtown Chester, they would plow the snow in the center of the road causing it to at times be 8-12 feet high with tunnels or always cut through for the foot traffic. It was a sight to behold.
I’ll never forget a couple of weeks before Christmas in 1948, I was leaving the office at about 6:00 PM and looked across what was in summer times the long expanse of lawn, and out at the roadside some men whom I knew, were loading Christmas trees onto a tall truck. The sun was down and it was dark and it was snowing. These men were lifting the trees to be hauled to the city and sold for Christmas, onto the truck, under a street light and with the snow falling. What a beautiful sight that was. It truly was a picture Christmas Card. I’ll never forget.
It was in the summertime when cattle drives would be coming forth down that same highway reminding me of the days of my cattle drives from the Warner Ranch and then down to Imperial Valley. Sometimes along that highway into Chester they would drive large herds of sheep.
It was an interesting time that we lived in the small town of Chester, California. I began to learn of some of the complexities of helping people with their dental and oral surgical needs as well as a number of purely medical needs. It was a time of learning for this young cowboy from the gold mining town of Julian, California.
I found my dental practice was booming and when we had a need to put someone to sleep for some fairly minor procedure, Dr. Bill and I would bring them into his side of the office on a Wednesday night and work for a couple of more hours, or more, maybe putting 3-5 people to sleep for their surgery. What an experience for this new graduate from NYU.
Occasionally I might get out to fish in some stream or in Lake Almanor. One interesting thing happened when Al Dorio, the local Game Warden and I went out on the peninsula portion of Lake Almanor to go duck hunting. The peninsula in those days was completely free of any settlement. That has completely changed at this period of time. A flock of ducks approached Al and I had a 12 gauge shot gun all set to shoot at them. There was a rule that you could only shoot 3 shots at one time with a time to reload and shoot at some more. Well, my shotgun had five rounds in it and when those Teal came flying over I let all five bursts ring forth, not even giving that a thought. After all there was no one around. Wrong! Just as that burst was exploding across the Lake unseen by me, were two duck hunters in a small motor boat approaching our position. Al spotted them just before I did and he quickly started walking away with only his backside visible. I got one duck, but I got slightly chewed out by my friend; the embarrassed Game Warden,
Life went on as we settled in to the back country life in Northern California. Young Robert, who we nicknamed Chris, was growing up and a year later Ann was expecting our 2nd child; more about that later. All of a sudden something got in my bonnet that I felt I should strive toward possibly becoming an oral surgeon and limiting my practice. That would mean a move to some city, if that direction was to be pursued. So I spoke with an old time and much respected oral and maxillofacial surgeon named Dr. O.K. “Pete” Bullard in San Diego. He advised I go to either the Los Angeles County General Hospital or the Mayo Clinic in Rochester, MN. He leaned a bit toward LACGH as it would give a great opportunity to be involved in a lot of surgeries. I finally made the decision to go to the Los Angeles hospital, if I could be accepted there. Only time and an interview with the administrator of the program would tell me if that was even possible.
A Slight Change of Direction
I well remember the time in my life when I was changing the direction in my life’s work. I believe now it was the Lord that was pointing me in a different direction, to somehow fulfill the plan and destiny He had for my life in the work which only He could have directed me. It started in a most unusual way and I feel in looking back on that time and moment that the devil had a plan to stop what God was orchestrating in my life. Let me tell you a most interesting and scary story which started just after Christmas Day in 1949.
It was midnight, January 3, 1950, when I left our home in Chester, California, to head for Los Angeles to be interviewed by the director of oral and maxillofacial surgery at Los Angeles County General Hospital.
My wife and I had been at a Lion’s Club dinner meeting, earlier that evening in another small town, when I heard of a serious storm approaching the area we lived in and the path that I would have to travel. Thus, I decided to be ahead of the storm, I would drive the 75 miles over the High Sierras, from Chester to Red Bluff during this very evening, but hopefully before the storm would approach the area.
So much for the wisdom of men. The roads were perfectly dry as I got in my newly purchased, but used, 1948 Buick Roadmaster sedan and started driving from the Chester altitude of 4300 feet to elevations over 8500 feet and then back down to an elevation of less than 200 feet at my destination in Red Bluff. It sounded simple. Just precede any storm, and the roads would be dry all of the way. What could be easier?
So, at 10:00 PM, I started my journey. The roads were dry and I had a certain degree of excitement for being permitted to meet with the hospital division director. I would drive to Red Bluff, take a hotel room for a few hours and then drive on to San Francisco and then fly on to Los Angeles later.
I drove happily down the road thinking of the possible life-changing direction of leaving my dental practice in Chester where I was being called on to care for a number of serious medical and surgical problems in patients who had no other medical assistance. The only medical doctor was absent because of his family’s annual vacation. If I got accepted for the training at LACGH, I would be furthering my education in the area of oral and maxillofacial surgery. That would be a new direction for me, but one I felt I would enjoy and excel in. Both were true.
I possibly should have been more tired as I had worked all day in my dental practice, attended the Lion’s Club meeting in the town of Mineral, and then drove 30 miles home, and then started my drive back over the mountains.
Happily, the roads were dry, but within 20 miles I was heading into the largest, most challenging experience of my life to that point.
The road was beginning to be fully covered with snow. I had not attempted to place chains on the car and by the time I realized I should have, it was too impossible. Before 40 minutes had elapsed, I had only travelled less than 25 miles up the hill. The roadway was beginning to be obscured, and it was most difficult to actually see where the road was going. I had the wipers going but they could not remove the amount of snow accumulating on the windshield.
I would look to see where the trees were separated, hoping that was where the road was going. At times it would appear the road might be going in two different directions. The shorter snow markers along any normal mountain road were now covered and of no value. The smoothness of the apparent road was evident. But was it really the road?
As I attempted to move along the road at a low speed, the snow would come across the hood of the massive Buick totally blocking my vision. At one point that mass of snow was so fierce that it ripped off the metal visor which was like an eyebrow over the windshield of that light green Buick Roadmaster. I had to stop and break the opposite end visor attachment off of the car. That allowed me to place the broken visor on the floor of the back seat.
In the next half hour I had only gone another 5 miles and found myself stuck against the right road embankment. The car motor had not stopped, but I was completely stuck as I attempted to get out of the ditch. I had not seen a fellow traveler since I started in the snow. By this time it was almost impossible to get out of the car as the snow was nearly up to my window.
All of a sudden I saw some headlights approaching me. It appeared some kind of vehicle was coming down the mountain in my direction. We were perhaps at the 6000 foot level, and I still had to eventually get over the road summit of approximately 8500 feet.
Only God could have delivered me out of that predicament that evening. A truck with four young men came along and rather quickly pushed me out of that awful mess. I thanked them profusely. I could easily see me trapped in a hidden vehicle, covered with at least ten feet of snow in a hidden road bank somewhere along the mountain road, that night in 1950. I could see a massive, snow-throwing vehicle, used in the High Sierras to clear to highways coming along and gobbling me and the car up, if these young men had not come to my rescue.
I’ll never forget on the previous July 4, 1948, the road was just being opened from Mt Lassen to Mineral and there was still 14 feet of snow on that road. So, it was very easy for me to see myself frozen and being gobbled up by one of those large snow plows. Not a pretty picture for a 25 year old, young husband and father of one child, to contemplate.
For the next few hours I plodded along in my powerful green Buick Roadmaster up the hill to the top, and then I started downhill. The road was much more difficult to locate and to navigate as the snow was getting very deep. I felt little comfort in the fact that I had made it over the higher altitude and was now part way down the mountains heading for Red Bluff, which lay in the valley below, and rarely ever sees winter snow.
Whoops, not only was I out of brakes on my car due to the actual snow, but I was now against another bank, and this time there was absolutely no way I could get out. The outside temperature was low enough that I would freeze unless somehow I was rescued. I went backward and forward against the bank where snow was built up to 6 feet high, ten feet behind me and a few feet ahead of me as I attempted to get free. I was stuck. It had to be at least 3:00 AM at this point.
After reviewing the impossible circumstance for some half hour, I was amazed to see lights coming up the hill in front of me and in my direction. What a welcome I gave those basketball players in that bus as they were heading home, somewhere in those majestic and, at times, frightful mountains. They were able to push me out of the predicament I found myself in, and now I could start down the hill once more, watching out all the way for the cliff on one side which could take me down some 200 to 1500 feet, in a split second. That would not be a good ending for this young and aspiring surgeon.
Six hours after I started my 75 mile trip, I pulled into Red Bluff where the snow was now over one foot in depth and my brakes were totally demolished. I parked in front of the hotel, got a room and slept until I needed to continue my journey to San Francisco.
What is the point of this story? I believe when God has a purpose for your life and journey, he will move mountains to accomplish it. No hardship, no snowstorm, no lack of car brakes, nor any lack of provision will prevent God’s plan being fulfilled in your life. The Lord knew I was to be an innovative surgeon who would bring forth the first artificial replacement for the ailing temporomandibular joint in thousands of patients in the United States and even more in the World. This God-given innovation of how we could restore function to an ailing or missing temporomandibular joint would someday bring pain-free jaw function to hundreds of thousands of patients.
When I met with Dr. Paul Hamilton who was the director of the oral and maxillofacial training program at LACGH, I found him to be most hospitable and warm and truly interested in seeing that I might get trained for this specialty. I was flabbergasted when he told me I could start right away, that there was an opening. Remembering that Dr. Bullard, one of the five founders of the American Board of Oral and Maxillofacial Surgery had suggested I go to this institution to be trained, made me feel this was a real opportunity and I had better not pass it up. I let Ann know what had been offered and she concurred with my thought and plan.
Boy, this would change our plans drastically. I accepted the challenge and now had to go home to Chester and see how I might get out of that practice and in a hurry. That wasn’t the biggest thing to consider as Ann was about 8 months along in her 2nd pregnancy. Her delivery would be a bit of a challenge in the midst of the move. What should we do? After some phone conversation with Ann’s folks who lived in Scarsdale, NY, we decided the best thing to do will be having Ann move back to her home in Scarsdale and stay there until after the delivery. For a month or so, until our new baby might be able to travel and hopefully I would have found a new residence in the greater Los Angeles region. Boy, that all sounded pretty tricky, but when you are 25 or so, anything is possible. On February 21st, Ann gave birth to a beautiful baby girl whom we named Joan Brophy Christensen, who was 8 pounds 6 ounces at birth.
Well, surprisingly, it all worked like clockwork. Ann travelled back to Scarsdale and I began to disassemble house and office and move us to a new apartment in the bayside area of Long Beach, California. This was really going to be a new start for our family, but I believe we both felt up to the job at hand. Our young son was walking and in diapers. Our apartment had one side that was like a second story and our basement garage opened out just below the only bathroom for this two bedroom apartment. My schedule at the hospital was pretty much around the clock. Before we had gotten settled in our new apartment, and when Ann was in the East, I stayed in the Residents Quarters at the LACGH. My pay during that time was $50 a month, total. The Resident’s Quarters was just a bedroom with absolutely no frills.
Back to the apartment in Long Beach…One Saturday when I was home, “Chris” locked himself in the only bathroom, which was over the garage area. We could not get him to unlock the door and finally had to get the Fire Department to send a truck out with a ladder and they entered the bathroom window and got ‘Chris’ free and Mom and I relieved. I guess you could say Chris had a mind of his own.
My training at LACGH, with Howard Davis, Lou Hanson, and Lyle Larsen, went well. We certainly got involved in a lot of trauma cases, some tumor cases, a lot of dento-alveolar surgery and then service on other departments other than the Oral surgery department, such as Anesthesia, ENT, Plastic and Reconstructive surgery, and Pathology.
I spent a lot of additional time at the Tumor Board meeting days as I wanted to learn all I could about diseases and tumor pathology particularly. That fact held me in good stead later as I headed the Tumor Board at St Luke Hospital for a year.
The anesthesia service was a particularly valuable training for all of the Oral Surgery doctors. Much of the time was spent on the OB-GYN floor giving short general anesthesia to women going through a D&C procedure for either spontaneous miscarriages or incomplete abortions. This training would be most valuable as most all of these trainees in oral surgery would be giving their own out-patient anesthesia in their own offices for many office type procedures.
The set up for these OB-GYN anesthesia procedures was quite interesting. Two operating tables were in a single room with the foot of the table facing the entrance door. A gurney would bring the patient into the room and then the surgical nurse in attendance for that table and that procedure would help the usually younger woman on to the operating table and then to get her feet in the stirrups. We as the anesthesia doctors, under the supervision of an anesthesia staff doctor, would take the patient’s arm, usually the left arm and would start either an IV or just start with the 20 cc syringe which was filled with the correct percentage of 5% Sodium Pentothal anesthesia solution. We would explain the action to the somewhat frightened patient and then as she began to get sleepy we would place a face mask on and administer a combination of N2O2 and O2. We two OMS trainees in anesthesia would perform the anesthesia for from 20 to 40 such procedures in a two or three hour session each day.
It was interesting, if the resident surgeon doing the D&C was very experienced he could accomplish his task in usually about 2.5 minutes. Occasionally some really speedy OB-GYN resident could accomplish the procedure in as little as 20 seconds. Most of these residents were male but a smaller portion, at that time were female. The female residents on this department showed compassion, for the most part, but there was one female doctor who would become so nasty and nervous in all that she did that none of us wanted to be working with her. Her D&Cs would take up to 20 minutes and for the person administering the anesthetics, that wasn’t necessarily a good thing.
The atmosphere in those rooms at that time was not a quiet, gentle and compassionate one. Bodies were being put on and taken off operating tables and gurneys somewhat like one hundred pound sacks of sugar being off-loaded from a truck and un-ceremonially thrown onto the loading dock. I may have never described it that way before, and certainly it was no fault of the young women patients, but I have always felt that we as the medical staff could have taken a bit more time to be genuinely interested and compassionate in caring for these hurting and often fearful young women. It certainly wasn’t that we really didn’t care but the system of training, the level of staff and the tremendous need of the public, in this government run hospital was such that it could make for a pretty hectic atmosphere. It all seemed to come to a head for these most unfortunate women.
In later years when my wife Lynne and I founded and led a marriage ministry, Covenant Marriages Ministry, I would frequently relate how the attorneys and Judges involved in the divorce courts were treating those hurting people just as we were in the D&C operating rooms at the LACGH in the 1950’s. Neither was a pleasant sight and both caused some un-needed angst in all present.
My rotation on all of the other services was somewhat unremarkable. My co-trainee from Alhambra, Lyle Larsen, and I would at times see as many as 100 oral surgery patients for follow-up, or exam or treatment in a morning and then we would tackle a number of jaw fractures in the afternoon, usually under local anesthesia. Lyle was a talented surgeon but a quiet man, but one that I was pleased to call a friend and a colleague. He later settled in Alhambra and developed a very nice oral surgery practice.
My friend, Captain Lou Hanson, who was training at the Los Angeles County General Hospital, was sent by the Navy to train with us. He later became the Chief of the Dental and Oral Pathology Section of the Armed Forces Institute of Pathology. I was later instrumental in presenting Captain Louis S. Hansen the first honorary membership in the Southern California Association of Oral Surgeons. This occurred some 13 years later when I was practicing in Pasadena.
I’ll never forget the day that I spent with Captain Hanson. It was the time of the beginning of the Cuban Missile Crisis in 1962. Lou and I were scheduled to be at the American dental Association Annual Convention in Miami. I was presenting a surgical motion picture film on my innovation in the field of dental implantogy. Lou was schedule to speak about some aspect of his work at the Armed Forces Institute of Pathology. Lou spent much of those years bringing a clearer picture of some of the salivary gland tumors which were being seen in various institutions and hospital across the Nation. Captain Hanson was not allowed to leave his battle station to attend the ADA Convention in Miami because of the acute Cuban missile crisis. I was free to attend, which I did.
Meanwhile, back at the home front…Ann was doing well with our two young and beautiful children. The second child was our daughter, Joan, who was really a beautiful baby. We had moved into a small rented house on the more Eastern side of Long Beach which made my commute easier. There is one more interesting moment that I well remember at that location. There was a flat roofed one story garage. It was white stucco and the perimeter of the walled up roof went about 12 inches above the top of the roof. On the backside of the garage I had placed a ladder for some reason and at one point I had driven down the block to a mail box to send something. I left Chris in the enclosed back yard. Ann was in the house. Everything seemed safe for that one or two minutes which I might be gone. But as I drove back onto the driveway in front of the garage, I looked up and here is Chris, in his diapers up on the roof. I couldn’t believe what I was seeing. How could this little boy climb up a metal ladder, then hoist himself over the one foot ledge and be able to walk around on this tar paper roof? It seemed impossible. I rushed through the gate of the fenced yard and around to the back of the garage to where the ladder was propped up. Quickly I ascended the ladder in hopes that Chris wouldn’t have attempted to jump off of the garage roof.
When I reached the top I beckoned a rather frightened looking 2 year old Chris to come to me and then I reached for him and brought him down from his perilous perch. It was just one more lesson for a new father. Always expect the impossible. Both Ann and I were so relieved to have our two children safely by our sides. Over the years hence, there would be more challenging moments.
Back In the Navy Again
My training at the LACGH was going well and when my year was nearing an end I got a letter from the U. S. Navy telling me I was being called back into active duty and to report to the 11th District Navy Headquarters in San Diego on some special date. The Korean War had just begun and the Armed Services was about to activate tens of thousands of new Soldiers, Sailors and Marines. As it turned out I would have a part to play in that activity with the U.S. Marines at the Marine Corps Recruit Depot where I would be in charge of the Oral Surgery service at that base as 18,000 new recruits would be entering the Marine Corps every 13 weeks.
This time was a real challenge as well as a great opportunity for me. It would mean Ann, I, Chris and Joan would move to San Diego and eventually purchase a brand new home there in East San Diego not far from where I had grown up before originally entering the Navy when I was 17 years old. This was an exciting time for us in many ways. Our new home cost us $14,000 and was a brand new, three bedrooms, and one story home sitting on the edge of a small canyon, in a brand new development area. And now my income has risen to $600 per month. Whoopee!
I met a lot of nice young professionals while I was stationed there at MCRD. I was a Navy Lieutenant, but could also wear the Marine Corps officers’ uniform if I wished. The Navy Medical and Dental corps took care of all of the medical needs of the Marines. My experience grew dramatically in the oral surgery field because of all of the surgery I was required to perform. I am most grateful for all of that experience, and was fortunate to have been needed more here at the Marine Recruit Depot than I might have been need in the fields in Korea. It also allowed me to be home every evening with my family and to be here when our third child, Elizabeth Ann was born in 1951 at the U.S. Naval Hospital in San Diego.
It was during this same period that my 19 month old daughter Joan developed a small umbilical hernia just above her navel. It was definitely obvious while she was awake and moving around. Ann and I decided to have her seen by one of the general surgeons at the San Diego Naval Hospital. On the day of consultation, the chief of surgery kindly examined her and concluded as we had earlier, that she had an umbilical hernia and it probably should be repaired. It measured less than an inch in length and was about ¾ inch above her navel.
An appointment was made for surgery with my friend and USC classmate, Dr. Bob Mueller doing the anesthesia. On the day of surgery I brought Joan to the surgery area at about 7:00 AM without any food or water after midnight. A Commander would be doing the surgery. I elected to wait in the hallway outside of the surgery. It was about 3:00PM when she was rolled away from me in the pediatric room and toward the surgery. The day had been long already and I was very concerned for this 19 month old daughter and her not having any fluids or nourishment for such a long period.
She and the surgeon and Bob Mueller all came out after the short procedure and confirmed that this was a diastema of the muscles which had allowed this to happen. Joan was asleep and had a small bandage over the area of surgery. It was later in the week that I had my first peek at the small, sutured horizontal incision line about one and one quarter inches above her navel. It was then that I determined they had operated ¾ inches too high and had missed the hernia as I could easily see its bulge. I was distraught about what they had put Joan through and I was mad at myself for not having gone in to observe the surgery. I was sure I could have prevented the mistake. She had been put through all of that and for nothing. I was to learn later in my own practice that things just always don’t go the way you hope or expect, even in a surgery practice.
So next I called to speak with the operating surgeon and told him politely my concern. We made an appointment for him to re-exam Joan and he had to agree, with Joan anesthetized with ether anesthesia, the relaxation of the abdominal wall had made visualization of the hernia impossible, and he had not been the one that had done the original examination. He agreed, we needed to have Joan re-operated. He asked me if I would want some other surgeon to operate on Joan and my answer was no, he now knew exactly what we were looking for, so another appointment was made for surgery and it was successfully accomplished. Joan now has two horizontal, supra-umbilical incision lines, but I won’t tell anybody.
It was during my stint as a Navy officer stationed at the Marine recruit depot that we had our third child, Elizabeth Ann, who was also another very beautiful daughter. She was born in the San Diego Naval hospital and the delivery was certainly much simpler than that first delivery in the small northern California town of Westwood. Ann and I felt blessed to have three healthy and beautiful children all close together so they could eventually enjoy one another. But there would be more.
I had a few interesting surgeries while I was in active Navy service. One was a rather unusual benign tumor of a tongue. It is a vascular tumor which is usually considered a developmental tumor in that is develops as the young baby is developing. It was also what is considered a vascular tumor. It was a rather large Lymphangioma of a recruit’s tongue and covered most of the dorsal surface. Sometimes these tumors are so large that the person’s tongue protrudes well out of the mouth. I performed an excision of much of the tongue’s dorsal surface to totally remove the Lymphangioma. The young Marine was very grateful and healed quickly and nicely. That surgical report was the subject of my first article in the Journal of Oral Surgery, Oral Medicine and Oral Pathology. Over the years I would publish many articles in that journal to where at one point of time, Dr. Kurt Thoma, the Editor, wrote in his editorial page, “Dr. Christensen is well known to our readers through his contributions to the JOURNAL.” I was later selected to be one of the Contributing Editors of that fine Journal. The photo of the tumor I removed from that Marine was later used by Dr. Kurt Thoma in his most recent edition of Oral Pathology which certainly was the tome on that subject at that time.
By the end of 1952 I was released from active duty in the U.S.N.R and allowed to pursue my life in the civilian realm and make a decision of where we might like to reside and to practice. One of my five corpsmen, who assisted me in surgery while there at the MCRD, was John Sundbye Jr. He was a very nice young man that would later go on to be a general dentist in San Marino, California. It just so happened that his father was an oral surgeon in Pasadena, and lo and behold he asked me to join him in that practice in Pasadena, which I did. So, Ann and the three children and I moved to an area on the eastside of Pasadena where we bought a small ranch style home in an area called Hastings Ranch. It was an unpretentious one story home, but one which worked well for us at that moment in time.
The Beginning of My Specialty Practice as an Associate
That first year of practice went pretty well with me getting on the St. Luke Hospital staff of oral and maxillofacial surgeons. The Sisters who administered and cared for patients at the hospital were very pleased to have me on staff. They did all could to increase my visibility and to send me many patients from their E.R. My association with Dr. Sundbye lasted about one year and then I was let go. It was rather devastating at the moment as we now were the proud parents of our fourth child, Peter Forsyth Christensen. But, we picked up the gauntlet and started our own solo practice in oral and maxillofacial surgery.
When I was associated with Dr. Sundbye he had a young RN, by the name of Nell Firner, who had just left her position on the surgery staff at Huntington Memorial Hospital. She was extremely talented and capable in the office and hospital oral surgery realm. When I was let go by Dr. Sundbye she decided to join me in my practice and her knowledge and connections with the medical staffs of Pasadena was most valuable. She worked with me for another 10 or 12 years. At that same time another young woman, named Carol Land, who was well trained as a dental assistant came aboard to join Nell and me in the oral and maxillofacial surgery care of many patients. Although she had recently finished her training, she was most interested to learn more and assist us in caring for our surgery patients. We were developing a very excellent surgical team, for which I was most grateful.
Some 60 years later Carol was able to find my location through the internet and contacted me and sent me a letter which I will include in this book a bit farther down the road. What a joy to hear from her after so many years. I have asked Carol to attempt recall any interesting times with patients and their treatment which she might recall.
Carol’s letter of 60 years past will appear later in this story. It was most gracious and kind of her to write it and to send it to me. I know you will enjoy hearing what she had to say about her thoughts while being a part of our surgery office team.
Our Early Years in the Solo Practice in Pasadena
It took a short while to get established in a solo practice having spent a year, following my military service as an associate to a surgeon in an established practice. It was a little scary knowing we had three children and the fourth was on the way, to realize all the effort to receive patients in our office would be on my shoulders.
We had moved into a small medical building on Oakland Avenue one block away from Fuller Seminary. I had to hire a staff and I really was always able to get a good group of young women to want to come on board and help me with the task at hand. Patients began to fill our appointment times with a number of emergencies occurring at St Luke Hospital that required my care. My college friend and Navy colleague, Dr. Bob Mueller, had been hired on to the anesthesia staff at St. Luke Hospital. His presence was always a welcome sight as we would schedule surgeries at that hospital.
One of my earliest surgeries was referred to me from a physician in town. She was a 60 year old woman whose lower jaw was totally fused to the base of her skull. This would be a major surgical fete, if I could figure out what I might do to help Marie Appel, from Sierra Madre. I wasn’t sure I had the answer, but I sure didn’t want to leave Marie where she couldn’t open her mouth and chew and talk like normal people. I consulted with an old time surgeon in Los Angeles who had taken care of most of the movie stars of the past. His name was Arthur Smith, MD, DDS. I appreciated all he had accomplished in this field. His first book on removal of the impacted third molar was published in about 1913.
He was a very learned and talented surgeon. And his words were to me were, “you’ll kill her, Dr. C”. With that word of encouragement, I returned to my office in Pasadena to ponder. I just didn’t feel that was the correct answer. Somehow we could find a way to get Marie where she could open her mouth, brush her teeth and chew some normal foods. I can only imagine the horror of being not able to open your mouth and jaws. I took it as a bit of a crusade from that time on to see if I couldn’t find some way to help these poor unfortunate individuals.
I next met with Dr. Douglas Donath who was a respected general surgeon in Pasadena and a surgeon with whom I had operated some of my earlier patients. Dr. Donath had been the President of the Pasadena Medical Society and was a very, respected surgeon. We both enjoyed our times in surgery helping each other. Well, mostly, he, helping me. I reviewed the entire case of Marie with him and when I finished he asked me if I felt I could operate on her fused jaws and help her and I answered, yes. He was confident that if I felt I could accomplish a particular surgery, then he would be in agreement. He agreed to join me for that special surgery at St Luke Hospital in 1953.
We started the left TMJ surgery through a routine pre-auricular incision first as it was the more fused appearing joint on the skull radiograph. It certainly was totally fused to the skull base but with care we did an osteotomy just below where the normal joint space would be, being extremely careful to not penetrate the base of the temporal bone and thus enter the middle cranial fossa. When that osteotomy was accomplished we carefully removed and recontoured the skull base to resemble the normal glenoid fossa of the temporomandibular joint. Now we removed another small amount of bone on the proximal segment of the mandible, and when this was done we closed the left side in the usual manner. When we had accomplished a similar surgery on her right temporomandibular joint we were now ready to see if we had improved her ability to open her jaw.
Since she was totally under general anesthesia we could now entered the oral cavity and be able to force her jaw open using the bite opening device, known as the mouth gag. Although her jaw could now be forced open to about 25 mm we felt that could be improved if we did a bilateral coronoidectomy, thus relieving the adhesions in the temporal muscle attachment to that jaw process. These procedures were accomplished intra-orally. When we were done we could now force her jaw open to about 37mm, which was more than we expected. We were most pleased with the procedure and so was the patient. I watched her over the next 10 years to a time when she passed away of natural causes, but still had a reasonable amount of jaw mobility, for which she was most grateful.
It was about this same time, when one work day at about noon, I got a call from my wife at our home in Hastings Ranch. She informed me that we had just had garage fire and had lost all of our stored items from the past. I went home to find all my family was safe, but our garage was a total loss. Fortunately the garage was a detached building laying some 30 -40 feet behind the house. The fire department had been there to extinguish the fire, but all inside the structure was lost. All of my Navy mementos and high school materials were lost, but thankfully the children and Ann were all OK. When I asked what happened it seemed that Chris (Bob Jr.) had used a cigarette lighter to ignite some shingles which I was using to construct a pretty good sized doll house for Joan and her sister, Beth.
About this next year I had been referred a woman in her 40s who had a malignant tumor invading the floor of her mouth and one half of her mandible. This would be a problem. We could remove her jaw and perform a radical neck dissection, but without replacing the mandible, she will be greatly harmed and disfigured for the rest of her life. She would not be able to use the other half of her mandible and teeth to be able to chew anything and esthetically she would be a sad appearing individual. I decided to take a long-bone metal plate, known as a Sherman Plate used for fractures of tibia and humerus and to bend it and use it to replace the resected portion of the lower jaw. The surgery went well and we used the bent Sherman plate to replace the resected portion. In time I figured I could place a bone graft to totally replace the missing bone section thus giving the patient a near normal face.
The surgery went very well and the recontoured bone plate appeared to do the job. Unfortunately, within about 1 month the facial tissues got pulled back through the bone plate allowing the plate to protrude in part through the tissues of the face. This was not a good ending and would allow for focal infection to occur. We must do something to cover the bone plate so with a consultation with another general surgeon we decided the raise a facial skin and muscle flap and to rotate it over the area of bone plate exposure. This seemed to take care of the problem for this patient, but as I had other similar surgeries I would need to develop a different and more successful surgery.
Again I consulted with Dr. Arthur Smith in Los Angeles and this time he was most helpful. He had been working on a novel way of creating an implant which might be used to replace a section of a patient’s missing or resected lower jaw. The concept was rather simple and would allow the surgeon to literally make an implant to be constructed from a thin plate of 316 L stainless steel, and to make it in his own garage with tin sheers and drill bits and jeweler files.
So on another similar patient I was able to make an implant, in my own garage in one evening after I had gotten proper skull x-rays which would allow me to make an implant to the correct proportion. This technique worked quite well if one was very careful to have the skull x-rays taken at a reasonable distance allowing for parallel x-ray beams to penetrate the bone and leave a most accurate image on the film. It was all cutting edge technology at that moment in time and would require diligence and perfection in whoever attempted to accomplish such a surgery. For the most part the so-called “tumor” surgeons were less interested in restoring form, function and esthetics in these hurting patients. Their only interest was in excising the tumor, not necessarily in restoring esthetics or function.
When I prepared this new implant for the restoration of the mandible I placed a curved Lucite rod, in the area of resected bone, which would easily maintain the space for a later replacement by a bone graft. In that way if, by any chance there had been some residual tumor left, it could more easily be visualized by an x-ray. That plating system worked quite well for me and began to prepare me for my later innovations in the dental and cranio-facial implant field.
A number of years later I was consulted regarding a malignant tumor in a 17 month old baby boy’s left mandible. I was now able to construct an implant to replace his jaw by using as a pattern one of some 65 human skulls I had purchased from all over the world for just a time as this. The patient and his mother had also been referred for consultation with another oncology medical group who advised the same jaw resection but they had no plan to restore his mandible. I really did not feel good about that suggestion. I did know they were most talented surgeons, but that one thing was missing, which I felt I could supply. I evaluated the situation and decided to not only resect the quickly growing tumor but to definitely replace the resected mandible with a Co-Cr, cast metal implant.
The design and shape of the implant would be gained from my taking accurate x-rays of Baby T’s mandible and then searching in my 65 human skulls and another 50 separate mandibles for one whose size would seem similar. I then would perform a mock surgery on the mandible and would then have waxed up a pattern which could then be cast in the prescribed metal. The pictures of the mandible and cast metal jaw implant are seen in the following pictures. In the picture I show a bone graft. Let me tell you about that particular bone graft. This will be a most interesting and innovative ways to secure such a graft. In the 1960s I was able to do what I did here, but today things would be much different.
At about the time I was getting ready to schedule the actual surgery, a very interesting thing occurred. I had planned that we would do an elective tracheotomy on this young 17 month old boy, but I was contemplating taking a rib out of the young patient to be used as a bone graft to replace the missing mandible. I was very concerned about that procedure and the possibility of a pneumothorax. I began thinking way out of the box when I heard of a dentist in town dying that week and that an autopsy was scheduled at Huntington Memorial Hospital. I asked my friend the pathologist if he would be kind enough to remove a good sized block of the deceased dentist’s iliac crest which I might then take home and freeze in my freezer and then sculpt it at the time of surgery to fit. As shown in the picture the implant housing a bone graft replacing the young boys jaw. That is what I did and the results were spectacular. Today, with all of the safeguards and regulations and litigations, this would not be possible. But for this young patient, it was a lifesaver.
Nancy Mills Recalls
I had asked Nancy Mills to see if she remembered anything which might be of interest from that time period as she had worked with me, in surgery, back in the 1950-1960s. She wrote me the following letter.
Hi Bob, It seems my mind keeps going back to the Oakland office. I remember the teenage boy who came in for his third molar removals without his parents. We got him back to the surgery room and everything was ready to go but when you got the needle out to put in his vein, he started uproar. We couldn't settle him down, no way, no how. You were getting more exasperated by the minute. The next thing we know, this kid hopped off the table, darted for the side door in the surgery room and took off. The last we saw of him he was bookin' up Oakland Avenue looking like Carl Lewis. However we had the last laugh. His dad (or it might have been his mom) brought him back that afternoon, very subdued. He didn't give us another minute’s trouble.
Another time (I was very new to the job and I might add, very young) we had a new patient coming in whose name I can't remember. What really impressed me was on his new patient form his occupation was owner of Hutch's BBQ rest. That impressed me for some reason probably because I always liked that place. Anyway it flitted through my mind to be careful I didn't call him Mr. Hutch. So when the time came, I opened the waiting room door, smiled and in my best professional voice said, “Would you like to come in Mr. Hutch”?? As I remember, he took it very well.
Then there was the face mask which was my personal favorite because I was probably the only one who got so cracked up I couldn't stand it. We had this gal on the surgery table with straws up her nose and you were merrily patting on the Jeltrate used to make an actual replica of her face, later in stone. The more you put on her face, the funnier she looked. It covered every inch of her face all the way to her ears and chin line. For some reason I got looking at her and it dawned on me that she looked just like a Baked Alaska. I got the giggles but had to hold it in because the patient had no idea what was going on. I told you what I was thinking but by that time I was totally out of control. I don't even remember if you thought it was funny or not. (Actually, I did)
Most likely you wanted to strangle me. I take that back...you were always patient and had a great sense of humor; except when you were getting ready for a TMJ surgery in the hospital. You were relentless about the instruments, having everything ready and there. You'd go over it twenty times until I could have strangled you. I lived in mortal fear that you'd get to the hospital some time and not have everything you needed. Luckily I don't remember that ever happening.
One other, what I considered CRAZY at the time was again at the Oakland office. You were doing a lot of work on your early implants and the veterinarian, Dr. Ray Weitcamp, was donating the head of a stray dog he had put down. You elected me to go to the vet’s office and pick up the dog head. I remember driving back to the office with a bucket and this head all wrapped up in a towel beside me on the front seat. I kept thinking about Frankenstein and Dracula stories and wondering what kind of job I had gotten myself into.
(Another story about a dog was one that I had placed some Transosseous dental implants, invented by me, in that dog’s jaw as a research project. When the time came that Dr. Ray Weitkamp was going to euthanize this dog, which had been his blood donor for some 9 years, I had suggested I take the live dog at the time he was to be euthanized, and send the live dog over to Dr. Phil Boyne at UCLA so they can do a post- operative histologic study to show how well the implants had done. The implants had done well but I didn’t get the report from Dr. Boyne until 32 years later when I was addressing the faculty at Loma Linda University, School of Medicine where I had been appointed as a consultant in R&D in the Orthopedic Dept. When I said hello to Dr. Boyne when I asked him about the histology slide he took me to his office and the exact slide I had been waiting for those 32 years was on his desk. We became good friends after that.
Dr. Boyne was an extraordinary man who was most proficient in the oral pathology sphere. All who had the privilege of knowing Phil Boyne had to have been richer for that opportunity. His last half dozen years he was confined to a wheel chair, but that never hampered him from attending the Annual American Association of Oral and Maxillofacial Surgeons meetings, wherever they were being held. He always made it a point to come by my TMJ Implants, Inc.’s booth to give me a warm greeting, for which I will always be grateful. He has since passed on but he like a number of other earlier surgeons were giants in the field, for which we all owe a debt of gratitude.
Nancy Mills and her husband Ed became good friends during those early days of establishing an oral and maxillofacial surgery practice, for which I will always be grateful. No matter how hectic a day might have become, Nancy always had a cheerful and encouraging word and a smile on her face. In the lower picture she is seen having a few days of leisure in Palm Springs. All of these years later, she still brings a smile to my face.
Nancy’s comments in her email continue:
Well, my well has kind of run dry. But I know you were always a down to earth wonderful man to work for. Do you remember letting me keep your very new Chevy Impala when you had your back surgery? I have always loved to drive and I thought I'd died and gone to heaven with that new car. It even had a BIG old Motorola phone in it. Boy did that car spoil me. You introduced me to the best Mexican restaurant in Pasadena, Majares. Ed and I still love to go there when we go back to Pasadena. All in all, my years with you and all my co-workers were the best working years of my life. You were generous, fun, kind and so darn smart it's scary. Well, more may come to me, probably will, but that's all for now.
By the way, the other story you mentioned of the wrong kid whose thirds we took out by mistake was also a classic memory of mine. I'll keep thinking and see if I come up with any others.
Bye for now, Nancy
Nancy, your letter reminded me of another couple of things to do with animals. Way back in early 1953 I was asked by an orthopedic surgeon to help him pin a fractured femur in a race horse which he owned. The surgery was in the stable out at Santa Anita where the horse was given a general anesthetic and placed on the straw in the stable where the orthopedic surgeon with my help and that of another surgical specialist plated a fractured femur, at night. It was a sight. But then another time a few years later my friend Dr. Ray Wietkamp was brought a young Siamese kitten that had a prognathism (protrusion) of its lower jaw. He asked if I could help fix it and I said yes. So under general anesthetic I opened the two areas below the cat’s mental nerve areas and with a small scissors I sectioned about 3/8 inch on mandible through one of two mental foramen areas on either side of the jaw, removed the segment of bone between the two osteotomies and then brought the chin back the 3/8th inch, on either side and placed a small household pin to hole the anterior and posterior segments of bone together. It worked well. Only the cat and I realized she had a numb lower lip, but she went on to win first prize in her particular show.
Another time a large German Shepard was brought into Dr. Ray’s clinic-hospital with a crushing fracture of his right mandibular ramus. In that case we performed an open reduction of the fractured ramus and placed the various pieces where they belonged and placed a small finger bone plate in three areas to repair and reposition the bone and then placed a circum-zygomatic-mandibular wire on each side of the dogs jaw to immobilize the mandible for 4 weeks. The dog did fine and the owner was most pleased.
I just remembered a couple of weird, but interesting things which happened in that Oakland Avenue office. On one Saturday there were two young boys from two different families in our office for a consultation regarding having their retained deciduous teeth removed. The consultation proceeded with the patients, and x-rays and the parents. One boy I believe was named John and the other named Bill. Both names are likely incorrect, but will be OK for this story. The consultation appointments were completed and John was appointed to be given a general anesthetic and have his 6 deciduous teeth removed the following Thursday morning. On that Thursday morning the nurse went out to the reception room where John was sitting and called out his name and he followed her back to the surgery. We placed him on the operating table and prepared him for the necessary extractions. I always took special effort to see that the x-rays and the patient’s actual dentition were the same. Everything appeared correct so we went ahead with the extractions.
Just after that, my receptionist came back and informed me this wasn’t John, but it was Bill. Oh my, what a revolting discovery. The actual John was now in the waiting room and was scheduled to be operated next. So after a few moments recovering, we then went ahead and removed the same six deciduous teeth on the real John. No harm was done but it can surely show you how easy these kinds of mistakes can happen.
Another time an even more unusual thing happened. This one really shook this young surgeon to the bones. One day I walk out to the waiting room, myself, and call a specific young man by name. He answers correctly then he follows me back to the surgery. He was a bright appearing 17 year old boy we’ll call Tom Jones. He had apparently been in for his consultation appointment some while back, regarding his impacted four third molars. Again, I reviewed the x-rays and all looked just right for this young man. He was a rather quiet person so other than my reassuring him that these third molars needed to be surgically removed, there was no other conversation.
I had no more than finished removing these impacted teeth with the patient fully asleep when either Nancy or Linda, came back to the surgery and informed me this was not Tom Jones. But who was he? This was probably the greatest screw up of my 40 years in the active practice of oral and maxillofacial surgery.
We had to get the patient awake and then had him fill out a patient information form. Remember on this patient I did not even have the correct x-rays. His teeth matched, however, what I was seeing in this patient, to a T, but it was not his x-ray. So when he was awake I had to get the correct information about this fine young man. I was surprised to learn that his mother was one of the surgery nurses whom I worked with at St Luke Hospital. I gave her a call and explained that these teeth really needed to be removed and that we had gone ahead and removed them. She was so relieved and appreciative, Trust me, she wasn’t as relieved as I was. It just goes to show that no matter how careful one might be, in whatever field of employment one is in, accidents do or can occur.
Fortunately, in today’s medical and surgical world many safeguards have now been installed to prevent some of the things like the amputation of the wrong leg, or the extraction of the incorrect teeth on an incorrect patient. There are a number of double checks and the actual labeling of the right leg or correct side of the face by actually writing in red ink on the patient’s skin will help to prevent any misapplication of surgical intervention.
I’ll never forget another young female patient. She as a redheaded girl of about 13 years of age, but somehow looked older. This happened again in that first year of my solo surgery practice there on Oakland Avenue in Pasadena, California. I didn’t yet have the full staff that I needed so I employed my good anesthesiologist friend, Dr. Bob Mueller to come to my office and administer the Sodium Pentothal anesthetic to this lovely young woman. Her father had brought her to the office and would be giving her a ride home.
We had no more than gotten her on the table when she got up and bolted from the operating room and ran down the hallway half way and the took a right turn and went down a short flight of stairs to the bathroom and locked herself in. I went to the waiting room and explained, to her father, what had happened to his daughter and where she was now hiding. He goes down to the small bathroom and gets her to come out from there, but she was putting up a fight so I entered the fray and we carried her up and placed her screaming and kicking on the operating table.
Her father was holding her feet, Dr. Bob was attempting to get a needle in her left arm vein and I was lying across her legs trying to keep her from ruining the leather cover on the new operating table. My original charge for the anesthesia and extraction of her four first bicuspids was quoted at the usual $45, but at this moment I rather loudly said to the father, Mr. whomever, there will be a slight increase in fee. I’ll never forget that rather embarrassing moment. Can you imagine today having four teeth removed under a general anesthetic administered by an MD anesthesiologist all for $45? What a bargain, even if it did cost the father $65.
Somewhere in those early years of my practice a young Indian boy of about 12 years of age was brought to my office for me to exam regarding a malignant tumor in the anterior maxilla. His name was Charlie Smith. It was rather imperative that I get him admitted to the hospital as soon as possible, but one problem was that his family was indigent and that might make hospitalization a bit more difficult. I had first examined him in a free medical clinic that I volunteered at on a weekly basis. I made the arrangement to get him admitted to Huntington Memorial Hospital in Pasadena. There would be no fee for my services and I’m not sure whether the hospital might collect some government fee, but it certainly would be minimal, if any.
The day of surgery arrived and all went well with my excising the anterior third of Charlie’s upper jaw, which involved about 6 permanent, anterior teeth. I kept Charlie in the hospital for about 3 post-surgical days and every time I came in to do rounds, Charlie was in the bathroom and in the bathtub. The nurses told me he spends some hour or more in the bathtub daily. When I asked Charlie about why he spends so much time in the bathtub, he informed me they had no bathroom facility in his house. I found that very hard to believe that any house in Pasadena might not have bathroom facilities.
Charlie recovered quickly so I discharged him on the third post-op day. His family was glad to get him home. I guess they did not have a car so I travelled over to his house on one occasion to see how he was doing. I could hardly believe what I was seeing. His wooden house was two rooms which looked like they could have been converted from a two car garage. There was not only no bathroom but no running water either. No wonder Charlie was so anxious to bathe at least once a day while he was in the hospital. I went home that night feeling particularly bad for Charlie and his family, but also recognizing and being grateful for the nice home and furnishings my wife, I and the children enjoyed.
The story didn’t quite stop there as on one post-op visit to my office, Charlie had decided he needed to go to the bathroom in the office. It was a very small room, down a number of stairs. It had a potty and a small sink and a light bulb in the rather tall ceilinged room. After about five minutes I heard a commotion from the bathroom and out Charlie came calling “doctor, doctor”. I ran down the stairs meeting Charlie half way and heard this rushing of water.
What happened was that Charlie had wanted to turn off the light bulb in the ceiling, so he got up on the sink to attempt to unscrew the light bulb, not recognizing the fact that there was a light switch on the wall. His weight caused the sink to fall off of the wall and now the water was gushing from the injured pipes. I got the supply turned off and just shook my head. I would now have to get a plumber in to re-install the sink, at my expense. But, hopefully, Charlie learned a lesson. Dear Charlie was one of my pro-bono patients that cost me more than I wished to think about, but I still thanked God for not only what I had, but for the privilege of helping Charlie, in his time of need. He was later able to get a partial, acrylic denture to replace his missing permanent teeth so that talking eating and esthetics was all quite good.
Somewhere back in this time frame I met Carl Bailey and Bob Chapin. I guess I met Bob and his wife Jane before I met Carl and his wife Lea. All four of these people had a great deal of talent and in their own ways the two men helped me greatly in producing about 25 fine surgical 35 mm motion picture films. Bob was the cinematographer and Carl was the narrator. Bob and Jane worked out of their rented duplex in Pasadena and were instrumental in capturing on film many very interesting, and at times, novel surgeries which I and others were involved in. I spent many a night until one or two AM editing surgical films which were later presented in the surgical film sessions in about 15 consecutive American Dental Association Annual meetings in various cities across America. All of those films were placed in the film libraries of not only the ADA but also at the National Naval Hospital at Bethesda. They were also requested at many of the country’s oral and maxillofacial training centers and at other University hospitals.
The films not only showed some of my most complicated and at times innovative orthognathic surgical cases, but also showed my first innovations of the original TMJ implants in many patients, but also of the various dental implants innovations which I had received original U.S. Patents for. One of the films, Endosseous Dental Implants, The New Way received the Golden Eagle Award for film excellence, thanks to Bob Chapin’s excellent work.
Carl Bailey was an act all by himself. He was the radio narrator for the KBIG radio station in Los Angeles. He was about 6’10” or 7’ tall and was known as Mr. K BIG. He was on the boat and narrated for KBIG, which travelled daily between L.A. Harbor and Catalina Island. Carl had a great voice and a great following of fans. He was a really talented narrator and one who made our films very professionally done. I will always be very grateful for the many nights he, Bob and I stayed up working on these films together. We three enjoyed each other and each one was using his God-given talents to further the medical-surgical cause. I later had the opportunity of correcting surgically, Lea Baileys retruded mandible by doing bilateral vertical osteotomies of the rami of the mandible and placing bone grafts from her iliac crests into the rami to allow the mandible to move forward about 3/4ths of an inch. It made a great improvement not only esthetically but in Lea’s ability to masticate. She and Carl were most grateful. We did film that surgery as the technique I used was developed by me.
Another interesting patient and surgery was one I later wrote an article about called The Complex Composite Odontoma and was published in Oral Surgery, Oral Medicine and Oral Pathology.
A dentist in Sierra Madre had a young 12 year old girl who was missing some right maxillary molar teeth. She had also noticed an elevation of her right eye so the white conjunctiva of the eye was more visible below the iris, meaning that tumor or antral cyst or developmental deformity was allowing this to happen. We got cephalometric lateral skull view plus Water’s P-A views of the skull which showed exactly what was happening.
The maxillary permanent first molar developmental tissues had developed an odontoma which now incorporated the 2nd permanent molar and even the early remnant of the 3rd molar. This now was a massive, benign hard tooth structured mass which had encompassed the entire normal maxillary sinus region and was elevating the entire eye ball. Otherwise this young lady was a very attractive and bright young lady. I had explained the entire situation to her mother who had come with her. I explained we would have to go in through an intra-oral flap extending from the maxillary midline back to behind the maxillary right 3rd molar region and then elevate that tissue flap up to the level of the right infra-orbital rim, being very careful to not injure the infra-orbital vessels and nerve.
There would be no way of removing this odontogenic tumor in one piece as it was the size of almost two golf balls hooked together. It would require painstakingly dividing the tumor mass in several hundred smaller pieces and then when totally removed to expect to see the elevated eyeball return to a more normal position. A lot would depend on whether there was any bony structure and support inferiorly for the eyeball, once the tumor was removed. This would be a tricky and time consuming surgery, but hopefully, if all went well would give an excellent result. Another concern was it would require removing all of the bone lateral and inferior to the tumor over to the midline of the hard palate and the laterally and superiorly up to the infra-orbital rim. When that was accomplished would the patient end up with a tissue opening from mid palate up to the orbit. I had hoped not.
The surgery was accomplished at St Luke hospital in Altadena where I was on staff. It took the better part of three hours carefully dissecting the hard tumor mass and the accomplishing what is called a Caldwell-Luc procedure where an opening is made from the antrum or sinus cavity into the nose, below the lower turbinate so that a 36 inch by 1 inch sterile, medicated gauze to be used to fill the antral void so it could be carefully extracted or removed later through the right nostril. The surgery went exactly as planned. Now we must see how the patient will recover and whether the eye ball would reposition itself downward. I had planned to keep her in the hospital at least 4 days and keep her on ample antibiotic therapy. The first post-op day this young patient appeared to be doing well. My biggest concern was that she did not develop a large oral-antral opening that would either require her later wearing an artificial obturator which would cover the defect, or require some secondary surgical, tissue graft procedure to close the defect.
I was elated that the orbit was assuming its normal position and there was no visible conjunctiva showing below the iris. Everything was going very well and the patient’s mother had been at her bedside throughout the hospital confinement. Now, a most unexpected thing occurred. The young girl’s 37 year old father was admitted to St Luke hospital with what was first determined to be pneumonia. We were very saddened by that development, but then the following day the father suffered a massive cardiac arrest and was not able to be resuscitated. The doctors had missed the fact that this was mainly a cardiac problem, thinking it was pneumonia. The mother was terribly distraught as we all can imagine. She and I consulted as to whether the young patient should be told her father had died and it was the mother’s thought we should not tell the daughter until after the funeral. I had to reluctantly concur, so we kept the daughter in the hospital an extra 3 days, allowing the poor wife to partially get her own breath and bearing. I can’t tell you how sad I was then, and even writing about it brings tears to my eyes.
We finally told the daughter what had happened and how important we felt it was to give her the undisturbed rest which she needed after her rather major surgery. She really healed like a champ. The eye returned to normal and the mouth healed in a spectacular way. Bone was able to grow back to form the oral structure which would be needed for a partial denture later to replace those three missing molars. Thank you Lord. I was able to follow this young 12 year old until she finally moved away to college. She turned out to be a very lovely young woman that her father would have been so proud of.
I guess it adds a bit of sorrow to my thinking when I realize my Mother lost her 41 year old husband of 6 years, with very young children, just as suddenly and unexpectedly. In my Dad’s case he was buried on my brother, Charles’ fourth birthday.
I later published an article about that unusual tumor in this young woman and I later received a letter from a father/son surgery team in New Jersey. They had a discussion and argument about whether they would have attempted that surgery without having a double degree, i.e. MD, DDS, and what was my thought on that issue? I came back with a little humor saying I might have preferred having a DD degree, meaning I would like to have had a doctor of divinity so that I might offer prayers.
Another rather difficult situation arose as I got more involved in some pretty difficult elective surgeries and emergency surgeries at St. Luke Hospital. It probably was about 1955, although I can’t recall with accuracy at this time. I was doing about 95% of the emergency oral and maxillofacial surgeries being brought into the E.R. at the hospital even though there were 7 or 8 other qualified oral and maxillofacial surgeons on that staff at the time. I was favored by the Sisters and also by many of the physicians and surgeons, partly because I always made myself available, but also because I went out of my way to involve the other physicians and surgeons on that staff every time I could.
Consequently, if I was called to treat some difficult facial or maxillofacial problem I would frequently ask one of the general surgeons, ear nose and throat surgeons or orthopedic surgeons to assist me. That helped them learn more about what we oral and maxillofacial surgeons were faced with, but also was good mentoring for me. It was a very nice and comfortable situation for which I was always most grateful. There were times when the airway problems became so severe that I would suggest a tracheotomy was indicated and the anesthesiologist would be in agreement. On some of those early cases I would ask the orthopedic surgeon assisting me if he would want to do a tracheotomy and let me assist. Almost without exception they would ask me to do the tracheotomy and they would assist me. I was fine with that, and over a three or four year time span I had performed, maybe 4 such surgeries.
At one point, this Sister-administrator, wanted to know the hospitals malpractice risk, because of an oral and maxillofacial surgeons performing tracheotomies. She benignly asked a Dr. Kenneth Kipp who was on staff, but never operated there, if he knew any answer to that question. Well, he took it to the Southern California Society of Oral Surgeons for an answer. There was some outright jealousy present about this younger surgeon now doing so much of that hospital’s surgery, so they got involved and turned it all against me; even blocking my application for membership to the Southern California Society of Oral Surgeons. Later when I spoke to the Sister-administrator she informed me that she and the staff and nurses in no way wanted to harm me, but she was just asking a question. I just stopped doing the tracheotomies after that. Well, almost. I think I later did them on a calf or a deer that might need a tracheotomy, but for humans, I kind of let others worry about that.
Later on, about 25 other surgeons in Southern California who were also being mistreated by the Southern California Society, joined with me in founding the Southern California Association of Oral and Maxillofacial Surgeons. In some ways that battle never ended as the jealous surgeons also used that to block me from membership in the National Society, even though I invented the first implants for restoring the temporomandibular joint, and the first three dental implant inventions. One would have thought they would have been most pleased to have me in their society. Oh well, life goes on.
Back somewhere in this time frame, a young RN graduate came to me looking for a position in my practice. It was still at a time when Linda Hadley Chubb was working with me as an administrative assistant. The nurse’s name was Karen Burnquist. Her home town was up in the San Joachim Valley of California. Her parents had a ranch or farm in that area and I believe raised cotton. She was a very sweet and pretty young woman who developed into a very good surgical nurse. I believed she was trained at the nursing program at Huntington Memorial Hospital. She capably assisted me in many difficult hospital surgeries as well as in all office surgeries. I was always very grateful for her excellent assistance and her friendship.
Physically, she had what we term a retrognathia with an open bite deformity, of her mandible which allowed for her chin to be somewhat retruded so that her maxillary and mandibular anterior teeth did not come together. She had been under orthodontic care and it was decided that I should perform a surgery to correct the problem just as I had done on Lea Bailey. I just can’t remember whether Karen may well have assisted my for Lea Bailey’s jaw reconstructive surgery.
We had filmed that surgery and I had published an article depicting that innovative way that I had moved her jaw. Karen’s jaw surgery would be quite similar but we would use a smaller triangular shaped bone graft to fill in the gap in the area of the ramus osteotomies. Karen did very well and the surgery totally corrected the function component of the jaw relationship as well as the slight Andy Gump appearance present before surgery. She was most grateful for her corrective jaw surgery, but I was very grateful for her years of service and her friendship. I believe she later married and moved to Wyoming to live again on a ranch.
As my patient load began to increase I was invited to join a dental group who were in the midst of building their own building. They had been in the same rented building I was in and so I joined forces with them. That turned out to be a great move. I was almost across the street from Dr. Sundbye’s office which may have annoyed him a bit, but certainly didn’t bother me. It was on a beautiful corner of El Molino and Cordova avenues which was a great location. The building had been beautifully planned and the architecture was rather spectacular. It won a prize for its architectural beauty by one of the trade organizations.
It was about this same time that I was referred a young boy named Terry Boatman who was afflicted with a congenital deformity known as unilateral Golden-har Syndrome. Terry was about 15 or 16 when I first saw him. He was missing a left ear and the bones of the ear that were part of the temporal bone were missing. The left temporomandibular joint was missing and the mandible was under developed so that his chin was positioned to the left side and the ramus of the left mandible was severely shortened. This caused the maxilla to be under developed on that left side thus giving him a lopsided face. He was a delightful young man and had a very pleasant mother. There were no known others in the family with this syndrome.
I examined the patient preliminarily and decided we would have to order extensive cranial x-ray films, taken as accurately as possible, if I was going to be able to reposition both maxilla and mandible. I had never seen the maxilla fractured loose from the rest of the skull and positioned downward about 1 inch lower on the deficient side. It would first mean I would have to elongate that deficient side of the mandible 1 inch lower by splitting and extending the ramus as far as it would go then bone graft an addition to the mandible all the way to the chin in order to gain the esthetics desired. This would be a massive undertaking and I felt rather risky as I had not seen anyone attempt such a procedure at that time.
When I had the opportunity to review this with his orthodontist, I then asked for a consultation with my dear colleague and general surgeon, Dr. Douglas Donath. Following that I had another consultation with another dear colleague, Dr. Fred Turnbull. Doug and I had operated several difficult and complex cases at St. Luke Hospital and Fred and I had operated a case or two together at Hollywood Presbyterian Hospital. Fred later became Director of the Head and Neck Surgery Residency Program at the UC Irvine, College of Medicine and he asked me to join him as an Assistant Professor of Surgery in that same department; which I was pleased to do.
The plan was to first do a reconstruction and repositioning the mandible so it would be correct in its position to the entire cranial-facial structures. This would require the placement of an iliac bone graft along the left side of Terry’s mandible, after a sliding vertical osteotomy had been performed on his left ramus. The idea was to place his mandibular dentition in the new position with a straightening of the midline and a vertical displacement of his left mandibular teeth, from the maxillary teeth, a whole inch and retaining that position during a 9 week healing period by placing the mandible in a specially constructed dental splint.
The second surgery would be to do what later became known as a Le Forte I procedure where the entire maxilla is separated from the cranial structures, through the level of the antrum, and then it is to be repositioned into its new, more correct position in relation to the mandible with all the teeth in near perfect position and relationship.
The portion of the surgery which I was contemplating operating with Dr. Donath as the assisting surgeon had to do with the reconstruction of the mandible with the addition of an iliac bone graft. That would be the first surgery.
Whereas, the part of the surgical treatment of this patient that I wanted Dr. Turnbull to assist me on, had to do with the second surgery, known as the Le Forte I. To me this second portion of the surgical treatment was most scary. It meant that I would get the Stryker Orthopedic Company to make me some special reciprocating bone saw blades which would be very thin and only 1.5 inches in length attach to a small motor. This saw would be used to create an osteotomy just below the inferior turbinate of the nose. I would then use a few hand chisels to complete the separation of the maxilla and nasal septum through the nasal level and above all if the teeth roots.
The incisions and flaps for such a surgery seemed most critical and I had never seen anyone attempt such a surgery in its total. The left side of the maxilla would be dropped 1 inch and the bone separation space would be filled with another bone graft taken also taken by Dr. Donath from the left iliac crest of the patient. I had purchased a small tire iron instrument, which resembled a surgical periosteal elevator, but just the correct size. It would be used for separating the maxilla, after the osteotomy, from the cranial-nasal bone structures. It worked perfectly, with a loud snap, which I must say sent shivers through my bones. I can still hear that awful noise.
I was very concerned that we might get into some serious hemorrhaging that might be hard to control, but thankfully that didn’t happen. I had planned to leave all of the palatal tissues undisturbed, and I suspect that was a very wise plan as it allowed the maxilla to accept its new position and to retain much of the blood supply which would be needed for such a massive move of the maxilla.
As I mentioned, I went over all of the proposed surgeries with both surgeons and they, too, felt it was feasible. My real concern was whether this 15 year old might end up losing all of his maxilla and/or his maxillary permanent teeth. I was really very concerned with doing this surgery, not that I couldn’t perform it, but that results might be disastrous. My biggest concern was that the entire maxilla might be sequestered by what I was attempting; meaning that this fine, young, 15 year old man would be without an upper jaw. That was very heavy on my heart, but I had gotten all of the best counsel possible, plus the fact I had repositioned and secured many a fractured maxilla for motorcycle and car accidents, without ever seeing it fail. It was all in God’s hands, but I felt rather vulnerable, but I was still confident. Years later the Le Forte I, II and II procedures became routine, but when I was attempting it, it was frontline surgery.
The two surgeries were performed at Hollywood Presbyterian Hospital and all went just as planned. The time between the two surgeries was just over 2 months and during that time Terry’s jaws would be completely immobilized. Terry and his mother seemed confident that we three surgeons could accomplish what had been planned. At the end of the 9 week period, Terry would be allowed to open his mandible and we would then remove the acrylic intra-oral splint. We would now be ready to accomplish the surgery on the maxilla that I have just described.
The patient post-surgically couldn’t have done better. His occlusion appeared excellent and his facial asymmetry was totally gone. The rather lengthy submandibular incision healed very well and both Terry and his mother were most grateful. Of all of the surgeries which I was involved with during that first 20 years, this one seemed one of the most difficult and slightly questionable. But this is the life of surgeons in all specialties. Many times those who are attempting to bring the most significant improvement to a patient’s life will have to go beyond what might be a comfort zone. Fortunately, most all of those surgeries ended up being very successful.
The Letter by Carol Ginther-Land
Some 60 years after Carol Ginthr-Land had been a surgical assistant in my surgical practice, she came across my name on the internet and decided to write me a letter depicting her experience a young 19 year old woman work in in an oral and maxillofacial surgery office in Pasadena, California. Her letter was so remarkable in her feelings about that experience that I suggested we put it in this book. She titled it:
Dear Dr. Chris and Lynne,
In my previously mentioned letter of May 20th, I mentioned your standards, which became the basis of my evaluation for other professionals. I should have included a list of what some of those standards were:
Some of your patients were referred to you by other professionals.
Some were referred by other patients.
And yes, some even came in from the phone book.
ALL were treated in the same manner.
ALL were questioned about the state of their general health
ALL were examined carefully
A result for one young man was early treatment for Hodgkin’s disease.
Carefully done and carefully evaluated with many questions being asked.
Is it any wonder that your “standards” stayed with all of your staff? You gave of yourself to serve others. That is the expectation that was set for me to look for in other professionals.
My next employer, Dr. X in Lancaster, Ca. met those expectations, in a different manner, but with the same goals. Other employers in the professional field did not do so; poor choice on my part so I soon departed from that employment. Not poor dentistry, just poor Standards of giving.
Therefore when values and standards were previously mentioned, the above is what I was referring to.
It is quite apparent that you were unaware that your behavior was of such a high quality that all of the people, who worked with you, were usually improved just through association with you.
Be assured that it is apparent that God had been guiding you for a long time.
Certainly it is true that the short time I was privileged to work with you has had such a strong effect, for the better, that today your standards and values still are a measurement used to evaluate many others, including myself.
It is difficult to show enough appreciation for those values, but please know the time spent in your office has stood the test of time, over 50 years ago.
I am truly honored to have worked for you. Dr. Chris, I have searched my memory, which is not as complete as it should be, but I do have a question for you. I do not ever recall applying for a position in your office. I was on a short vacation after graduation when I received a call from my Mother that you had requested me to come in for an appointment regarding a position with you. How on earth did this come about? In fact Mom said it appeared to be a done deal that I would have a position with you. Do you recall why you hired me? Was my instructor in touch with you? It is not likely after all these years that you can remember why you hired me. I remember I was thrilled to be offered that position.
I also wish I could remember the author of the book on oral surgery, in your office, and written by a Navy surgeon. It was fascinating to read. Had you been stationed with him or did you know him?
Well, enough for the night. May God bless you and Lynne this Christmas season.
Carol and Jim
Many other interesting surgical patients and their surgeries occurred in those first ten years, but now let’s look at some other things which were about to occur in the life of this oral surgeon. I talk about those next ten years as my innovative years. Those years I had somewhat proved myself in the surgical realm. Does that mean everyone wanted to give me kudos? No, there was still some jealousy amongst the other oral and maxillo-facial surgeons in my city. I think the fact that I was making surgical films of many of my more complicated surgeries wasn’t appreciated by them, but the films were very well received by those surgeons and dentists in other parts of the Nation.
REMEMBERING ...By Linda Chubb
> > Early Spring 1960- Time to pursue a new job in the secretarial field - preferably medical/dental in nature. I was informed of an office position available in the Pasadena office of Robert W. Christensen, DDS. Called and an appointment was established. I met with Dr. Christensen who introduced me to Aina, the lady who was moving from the front office responsibilities to chair side assistant, and to Karen, RN. Good folks, one and all. I found Dr. C. to be outstandingly intelligent, accomplished and creative, very dedicated to his practice of Oral Surgery. His bright smile, alert personality and quick humor were evident. It was a good interview. They had others to interview and would be in touch with their final decision. I think I prayed all the way home to Monrovia; I would be the chosen one.
> > A few days later I received a call, informing me they had hired someone else, but would keep my resume for future openings.
> > Several days later, Dr. C. called asking if I was still available for the office position stating the candidate of choice did not work out and the position was mine if I was interested. INTERESTED? I couldn't get my positive response of YES out fast enough! I began work in his Oak Knoll (if I recall)
> > Dr. C. made each day of work most exciting offering learning experiences by sharing various cases with all of us.
> > Having been raised Protestant, I knew little about Catholicism. Dr. C., A devout Catholic, treated the Nuns and Priests of the Catholic Church at little or no cost. I remember one special Nun, Sister Lucille. She was tiny and dear, and had severe masticating problems. The pain she experienced was great and she came to Dr. C. for his expertise in correcting her problem. Some of the pre-operative work was done in the office, the major surgery at St. Luke's Hospital in Pasadena. Other Nuns would accompany her to the appointments and return upon completion of treatment. One day a Nun arrived to pick her up, pushed up her sleeve and loudly asked, "Where is the body of Sister Lucille!" We all laughed and in that one encounter I learned Nuns and Priests are human and do have a great sense of humor. Many others of the Church were treated throughout the years by Dr. C.
> > Harry Sachs was another patient that comes to mind. I would guess he was middle-aged when he met with Dr. C. His TMJ's were severely diseased by Arthritis. He had not eaten solid food for some twenty years! He had a good sense of humor, was a bright person, and very alert, although in constant pain. He and Dr. C. conferred, surgery was scheduled, and all went beautifully. When all appliances had been removed from his mouth, Mr. Sachs was most excited to be able to open his mouth fully. By his following visit to the office, he exclaimed the joy of eating a very large cheeseburger filled with delightful ingredients. A joy for him to experience; a joy for Dr. C. and the office staff to visualize. This was another very thankful patient with great respect for this Oral Surgeon.
> > Dr. C was and is a perfectionist in all ways. The staff all took pride in maintaining the office in top notch shape. At the end of each day our work stations, the lab, and all, were left in an orderly condition. However, one day when we entered the office, we each found individual notes "suggesting" we pay more attention to the condition of various areas/items in the office. We were so surprised we began to giggle, which is typical of three females who know no other way to act! It was not funny at all!!! Dr. C. wrote he would be in the office at whatever time, and expected to see perfection upon entry. Whow! We were blown away, but work and work rapidly and completely, we did.
> > One of Dr. C's complaints was the percolator coffee pot. It had residue in it and was to be cleaned completely. My job, right? There’s nothing difficult about cleaning the coffee pot. I looked for White Vinegar to no avail. There wasn't time to go to the market. I found bleach and that made the old pot shine like new. I ran water through it to rinse, many times, and with great pride prepared a pot of coffee to be ready when the boss arrived. When Dr. C. arrived at the office he was pleased with the work we had accomplished. He was poured a cup of coffee - and I was taught rather quickly to never again clean a coffee pot with bleach!
> > Dr. C. wanted to dictate a letter to William Buckley, one morning. I took my notepad to his office and we began. The letter stated Mr. Buckley had made a serious error in something he had written in his column that day. Dr. C. sent a letter of correction. The letter was typed, signed and mailed. A few days later, a letter addressed to Dr. C. arrived at the office from Mr. Buckley. I opened the letter and put it in the mail stack for Dr. C to read. Dr. C. called me to his office and read the letter to me. I had made a couple of errors in the letter sent to Mr. Buckley. His letter was thanking Dr. C. for correcting him, but suggesting it would be best to assure your secretary could spell correctly before signing and sending a letter!
> > Dr. & Mrs. Christensen were to attend a convention in support of Barry Goldwater with other friends. Two extra tickets became available. Dr. C. asked if my husband and I would like to use the tickets and go with them. We jumped at the opportunity and had a most enjoyable evening.
> > Once every month or so, Dr. C. would take the staff out for lunch. As I remember, he always drove a convertible. We would get into the car, the top down, the radio on, and off we would go. Where? Angel's Flight, Farmer's Market, some fun Pasadena restaurant, to Palos Verdes to see the new home he and his wife were building, to meet with the person who was filming surgeries for Dr. C., and many other places. What fun!
> > There were times Dr. C. would ask one of us to pick up his children from school and bring them to the office. How good that was! Off one went to gather Chris, Joan, Beth, Peter and Mary O. There was always a snack for them at the office and then they helped in the lab or the office, whatever they elected to do. They loved the electric typewriter, filing patient charts, polishing in the lab, and helping in every way. It was a joy to have them there; such bright, happy kids.
> > Spring of 1962 arrived. I was pregnant and it soon became time to give notice to Dr. C. We talked at length and his decision was there was no reason to resign early. The baby was due the end of May. I requested my last day to be late March. We talked about this as time got shorter. He suggested if I kept working until I went into labor, I could use the surgical or recovery room; he would be there to assist and if necessary, he would place a call to my OB/GYN, Dr. George Macer, a good friend of Dr. C's. It was then I called an employment agency and listed my job. My replacement was found and I left the end of April, I believe. Dr. C. asked me to return every couple of weeks to tend to the book work, which I was most happy to do. Dr. C. called the staff together on my last day as a permanent employee, and presented me with a lovely silver plate engraved
To Linda, "The Truest Mirror Nature Sends Are Honest Eyes of Faithful Friends" Dr. "C" 3-23-62
> > You will notice the date - He had planned to accept my resignation as first requested. I was thankful he had encouraged me to remain a bit longer.
> > When my baby Leisa was born, June 2, 1962, Dr. C. arrived in my hospital room, his dental bag in hand in case anyone questioned why he was there, held Leisa and visited with me. What a surprise. After a week or two at home, Dr. C. and his staff came to our little apartment in Arcadia for lunch and to check on the baby and me.
> > Five months after my daughter was born, my mother passed away. She and Dr. C. had met, and mutually respected one another. Mother's funeral was held at Forest Lawn, Glendale. At the graveside service, standing off to the side, was Dr. C. and two staff members. I couldn't have been more touched
> Dr. C. invited Jim and me to attend a Dental Conference in Bethesda, MD. Son Matthew presented new devices. Dr. C. was honored for his outstanding accomplishments and dedication to the field of Oral Surgery. It was most informative and we were, as always so proud of Matt and Dr. C. The next day Dr. C. took us by limousine to a tour of Washington, DC. I had never been there before, and my, how impressed I was. Jim had been there years ago, and found the Korean and Viet Nam War Memorials new and something never to forget. (See photo of us at the Korean Monument.)
> > As years passed, Dr. C. and I kept in touch. Times change, people come and go, but the friendship and respect Dr. C., my family and I shared, only grew. We were both divorced and remarried and that only made the bond greater. Bob, his wife Lynne, Jim, my children Leisa and David, and I have spent quality time together. Andy & Matt were born to Bob and Lynne. Many Christmas's and Thanksgivings were spent together in our home or in theirs. The time together is now in the form of phone calls and emails as time and distance between Colorado and California seem to leave something to be desired. The love and respect will always fill our hearts and keep the relationship strong.
> > Bob, there is so much more I could write, but a book is not my object. I have tried to pick some of the most meaningful "Rememberings" and hope this pleases you ... and, hopefully, I have not misspelled any words!! You, Lynne and all of the Christensen children, will forever be loved and cherished in our hearts.
> > God bless you, dear friend,
> > Linda
The Arrival of Mary O’Neill
This was a day I will always remember. It was May 10, 1955 and Ann was due to have our 5th child. She was large and right at the delivery date. We planned to rush her the 2 miles to St Luke Hospital, when labor commenced. It was a week day and I had just been called to the Emergency Room, St Luke Hospital, to evaluate an MVA patient who sustained very serious facial and jaw trauma.
As I rushed out the door, I made a call to my dear Navy and USC friend, Dr. Bob Mueller to ask if he was free from his anesthesia duties and if required could he transport Ann to St Luke in case labor began. He concurred.
After examining the 20 year old female in the E.R. we decided that she needed to be transported to surgery immediately for repair of some serious facial lacerations, reduce and immobilize the multiple bone fractures of the maxilla, zygoma and mandible. I had asked another orthopedic surgeon to assist me and he agreed. We must have worked on this rather attractive young woman for some 4-5 hours total. During that time, my friend Dr. Bob Mueller poked his head into the surgery on two occasions to see how we were doing. On one occasion he came up to the table to see what we were doing and then departed.
At the end of the surgery I felt that this patient was going to have an airway problem so I suggested we do an elective tracheotomy. I would always prefer doing the trach in a sterile and surgical setting rather than having to do it as an emergency in a hallway or patient bedroom. So, I asked the orthopedic surgeon if he would prefer his being the operating surgeon with me being the assistant, but he answered no, he would prefer just assisting me.
I was just finishing bandaging the head, face and neck when Bob Mueller came in again and said that he had brought Ann into the hospital and she was down in delivery. I couldn’t believe he had not told me that on two earlier visits, but I was most thankful that I was able to get through this poor girl’s surgery.
I changed out of my sterile gown, and removed my gloves and washed up. Then I proceeded down to the delivery room area on the OB-GYN floor at St. Luke hospital to be with Ann for probably 10 minutes before she and I were beckoned into the delivery room. Within an hour or much less, a beautiful 7.4 ounce baby girl was brought forth in a normal delivery. I was so glad that Bob M finally gave me the report that Ann was in the hospital and that I was there to observe the birth of our 5th child, whom we named Mary O’Neill. The O’Neill was a maternal grandmother’s name. She is now a married woman with children and grandchildren of her own.
The young woman I did the surgery on did very well. I was really concerned when I heard post-surgically that she was a female vocalist, but she appeared to do well after the trach tube was removed 10 days after surgery.
My Middle Years of Innovation
• The Circumferential Dental Implant
It was in those years between about my age of 35 and 45 years that seem to be my more innovative years. I suppose a person needs to get ample experience behind him so as to begin to know what works and where innovation and creativity are necessary. I had always felt there had to be some way to anchor teeth to the jaw bone as a permanent tooth replacement for improvement and substitution for the more cumbersome and awkward dentures which people without teeth were wearing. I had first given that some thought back in 1948 when I had just gotten out of dental School at New York University.
As the years went by it was even clearer that a simple method of attaching a single tooth or multiple teeth should be made available. The only technique which had come forth with any success was the so called sub-periosteal implant devised by Drs. Goldberg and Gerskoff in about 1950. It was a very cumbersome type of implant in which the surgeon had to take an impression of the mandible and have a laboratory design and cast a Cobalt-Chrome casting which was meant to cover the superior surface of an entire mandible and have four posts protrude through the mucosa on which to attach a lower denture. It was a remarkably complicated technique in which post-operative infection can torpedo the entire event to everyone’s dismay.
I sought after a simpler, single or multiple tooth replacement type implants, which required no earlier surgical technique or special laboratory procedures; something that would be pre-fabricated and useful in any patient at any instance.
My original dental implant I called a Circumferential Dental Implant and sought a U.S Patent for in the late 1958-1960 time frame. I placed them in dogs and cats as my own financed and accomplished research project with success, and then placed them in patients and made a motion picture film of the entire procedure.
The film was called “The Circumferential Dental Implant-The New Way” and appeared on the Annual Program for The American Dental Association occurring in Los Angeles in
October 1960. The L.A. Times wrote a medical story about my innovation and presentation at that same moment. It made quite a splash with the American Implant Society which was having their meeting in conjunction with the ADA meeting. No one was aware of any of my work.
That was the original, individual dental implant in the United States. Many more were to follow. Since then the dental implant sales in the United States and world has soared to over 2.6 billion dollars annually, yet almost no one today knows of my early work in this field. There were more innovations to follow.
• The Circumferential Dental Implant (Picture)
• The TMJ Implants
This next part of this chapter deals with my innovation of an implant to reconstruct the temporomandibular joint. It truly starts in the late 1950s and more specifically in 1960. As a successful oral and maxillofacial surgeon practicing alone in Pasadena California, I was being asked to treat many difficult and complex patient issues.
For some of the problems, there had been no effective treatment and I was attempting to think out of the box to be helpful to those patients. One area of surgical treatment in which there was no consensus and certainly no satisfactory treatment modality, had to do with the surgical TMJ problem. The problem could manifest itself in a host of ways from fractures of the joint all the way to agenesis or even tumors of the particular structures. But the most frequent was degenerative joint disease, just like we see in the hip and knee.
I had examined many patients, during my training at the Los Angeles County General Hospital, who had suffered trauma to the mandible and who then suffered fractures of the condylar neck, unilaterally or bilaterally. The usual treatment being recommended at that institution was the closed reduction with immobilization of the mandible, in occlusion, to allow the fractured condylar portions to heal in whatever position they found themselves in after the trauma. As I started my own specialty practice, after the Korean War period, I began to see a pretty significant number of similar patients. I wasn’t comfortable with not attempting to do what we now call an open reduction and skeletal fixation of the fragments.
As time went on I found I had a great deal of success. Was it a more risky procedure than the closed reduction? Yes, definitely. But I really did master that operation and in the next 8-10 years I had probably operated some 35-45 such patients with measurable success. With this background, it is easier to see why I began to operate on the degenerated TMJ, that didn’t have any fractures, but was deteriorating much like the degenerated hip or knee joint. The problem was there was no excellent surgical technique that gave any long term good or predictable results. We might do a disc removal procedure, but overtime that would cause more serious problems within the joint. Or, we might do what is called plication of the disc. In that instance, the displaced and somewhat degenerated disc was placed back over the condylar head, in hopes that it would stay in that position, and secondly that it wouldn’t repeat the dislocation or just plain wear out.
There were other procedures, and to be truthful the success rate was usually less than 20% in the first 5 years. Not a compelling reason for doing that procedure. Now came 1960 and Sister Lucille. Here was a young Catholic nun in her mid-thirties, who has had a prior discectomy seven years earlier, followed by a high condylectomy some 3-4 years later. Her condyle is now anchored (ankylosed) to the skull base with almost no jaw function.
Now what, Lord? “Physician, do no harm.” And yet both of the procedures accomplished on this young sister were accomplished by a very knowledgeable surgeon, who happened to be an orthopedic surgeon in the Central Valley of California. Was he negligent? No. He was doing the only treatment considered effective at that period of time. But how could I help this young Sister have proper, pain free joint function?
This was the challenge I was faced with that winter day in 1960.
Was I capable of improving the situation? I certainly had been recommended very highly by the surgeons at St. Luke Hospital as well as Huntington Memorial Hospital. But, would that be good enough? I certainly could operate on Sister Lucille and get an immediate relief from pain and a greater amount of jaw function, more than a few weeks to a few months. The problem which would occur after any surgery, normally accepted at that time by the medical community, would be that the bones would grow together and she or he would be worse off after another surgery than if we had performed no surgery at all. Only God could really make a difference.
Either the Lord would miraculously heal Sister Lucille, or He would show me how to operate on her TMJ and make it well. In 1960, as I was driving from Pasadena toward Santa Barbara, God placed an idea in my head which was so simple, so perfect and so just as easily condemned by the naysayers. He showed me that I could take the ten human skulls which I possessed and could fabricate a metal, S shaped implant to cover the bone at the base of the skull; which was the superior joint surface, and the one the degenerating condyle would normally attempt to attach to. Wow! So, it was December 1960 when I began to work on my new project.
It meant I would need to place all ten of my skulls on a laboratory table, unhinge the lower jaw (mandible) and make wax patterns to duplicate the base of the skull in the area of the TMJ. The implant would need to extend laterally over the rim of the zygomatic process and have 3-5 holes placed for the screws which would be required to hold the implant in place. Then it would take the shape of the glenoid fossa and cover even over the articular eminence so that basically all of the temporal bone surface of the joint will be covered. This was getting exciting, but could I pull it all together? If when I got the first wax patterns developed, what metal should I use to cast the final implants?
What made me think that I could make any of the ten implants which I would fashion to fit Sister Lucille’s skull base accurately enough? That was the biggest challenge. If, at surgery, I had her left TMJ fully exposed, and the new implant didn’t fit, what then? I would be no better than the earlier surgeon and she would have trusted me and we both failed.
Well it took me the next couple of months to fashion 15 implants for Sister’s left TMJ. I then had to do some corrective bone surgery which would allow the condylar neck to reside within the metal fossa portion of the implant. This would allow me to give Sister the best chance for proper jaw function after surgery. I decided to do all of this “mock” surgery on a skull, including the bone corrective surgery which would have the effect of lengthening that part of her left mandible and putting the articular portion back into the cup configuration of the new TMJ implant. It was all getting more complicated, but exciting.
I decided, with Sister’s permission, to make a surgical film of the entire surgery. I had fully explained the surgery to Sister Lucille and she and I explained it to the Mother Superior of her order of Dominican Sisters. We were now just three days before the surgery, when I made a costly mistake. There was an excellent general dentist, whose office was near mine, that I made the mistake of telling him about what I was contemplating. He taught at USC, and of course had many colleagues at that institution. It turns out they were having an office party that very evening, and my friend Dr. Ray Contino let his comrades know about what Dr. Christensen was doing the next Tuesday on a young Catholic nun named Sister Lucille.
There were a couple of dentists at that party who likely were not too friendly with anything I might be doing. Thus, on Monday early afternoon, one of those darling doctors took it upon himself to phone the Sister-administrator of St Luke Hospital to ask “if they allowed experimental surgery to be done in their hospital?”
The custard hit the fan. Sister Lucille had been admitted in the hospital and was awaiting surgery at 7:30 AM on Tuesday. She was unaware of what had transpired over the weekend and on Monday noon. Now, Sister-administrator found herself in a pickle. After all, Dr. Christensen had been on staff for about 8 years, had taken his rotation as head of the OMS department of the surgical staff, and was very well respected for doing a great deal of excellent surgery, and sometimes on the sisters, at no charge of course, but even the Catholic priest at the hospital.
She had to call me and explain I would not be allowed to do that “experimental” surgery in St. Luke Hospital and especially on a Catholic nun. That last part added by me. Won’t the devil attempt to stop God’s plan at every turn? After all it was God who showed me how we might effectively treat this type of problem; and now what? Only God could have orchestrated the next words out of my mouth. I said calmly to Sister, “I would like to go before the Executive Committee.” It just happens that they were meeting that very night.
Well, PTL. So they listened to me as I explained what I have just written, and long story short, they allowed me to operate Sister Lucille the next morning, and all went perfectly. The implant fit well and then it was secured with four screws. My assisting surgeon, Dr. Douglas Donath, and I accomplished the other bone corrective surgery and the patient was returned first to ICU then to her room on the surgery floor of St Luke’s Hospital of Pasadena, California where the first Christensen TMJ hemi-arthroplasty was accomplished this week in 1961. That was a momentous moment for future TMJ sufferers.
It was rather interesting that within a year or two of operating Sister Lucille I was referred another Sister who was on Staff at Santa Terrescita Hospital in Monrovia. I believe it was the Sister Superior and administrator who made the referral. She was a very young Sister who, during a hospital picnic, had fallen over a dry waterfall some 75 feet to land on a ledge below. She had some facial lacerations and compacted her mandibular condyles into the base of her cranial bones, bilaterally. I believe there had been bilateral condylar neck fractures and the Dr. Charles Petty, of Monrovia, immobilized her mandible to her maxilla with intermaxillary wire fixation for some 6 weeks. When she was seen by Dr. Petty some 6 weeks after the original fall, he removed the wire fixation and allowed the patient to mover her jaws. Over the next month or two her ability to open her jaws became very restricted to where only soft or liquid diet was possible. It was at that point, about four months after the fall that she was referred to me for relief of her ankylosis. After the proper imaging and pre-operative workup we decided that bilateral hemiarthroplasty was required, with the insertion of the Christensen Fossa-Eminence prostheses. The surgery was performed at Santa Terrescita Hospital and the patient had an uneventful and complete recovery.
Sometime near that same time period, maybe in the 1950s, the chaplain of St Luke Hospital required an orthognathic surgery to correct his congenital prognathism, or protruding jaw syndrome. I did an osteotomy in the rami of his mandible and pushed the mandible back about 5/8ths of an inch. It greatly approved his appearance but even more his dental occlusion and ability to masticate foods.
Over the next 15 years I had the opportunity of operating on hundreds of patients with a variety of TMJ problems. The surgery was proving to be more successful than I might have first imagined. I was on about 17 major hospital staffs in the greater Los Angeles
area and in 1964 we put on a teaching symposium on TMJ arthroplasty at Hollywood Presbyterian Hospital where I performed a live surgery which was televised to about 200 surgeons from across America who were present for the symposium.
The TMJ Symposium at Hollywood-Presbyterian Hospital, January 1964
The staff I had assembled for that symposium was spectacular. I had a leading neurosurgeon, the heads of otolaryngology at Loma Linda University Medical School and at USC, a lead general surgeon, the chief of orthopedic surgery at Los Angeles Orthopedic Hospital, the world’s leading anatomist for the head and neck, two leading oral surgeons and a gnathologist. It was a most remarkable gathering of scientists and surgeons for this type of surgery.
That TV program on TV 13 in Los Angeles brought a lot of attention to the work that I was doing and was featured as a news story in a number of papers across America. TV Channel13 in Los Angeles recorded the live surgery and it was shown a couple weeks later on a prime time, one hour program called, “Surgery 64” and narrated by Bill Burrud. It was seen by likely hundreds of thousands in the Southern California region.
The patients continued to be referred to me from across the country and many of them had severely arthritic TMJs to where they had not had any jaw function or mobility for over 20 years. The successes were phenomenal, and I give all of the glory to God. It was God who showed me very simply how to correct these problems. There were always the naysayers somewhere in the crowd of professional people, but the successes were so spectacular anybody really reviewing them couldn’t help be impressed.
I started a company called Implants Inc. back in the 1960s but I was just too far ahead of the curve. The public was much more attuned to why this technique would work, but the profession was cautious and at times mocked my attempt to correct the problem.
The TMJ Partial Joint Implant (picture)
• The Transosseous Dental Implant
My next innovation occurred about 1964 and was what I called the Transosseous Dental Implant. It was an implant for which I held the U.S. Patent and was a dental implant which traversed the mandible in the chin area. I had learned earlier that the “Implant-a-band”, also known as the “circumferential dental implant” was not the best approach. It allowed, at times, for an invasion of bacterial infection to occur along the band and around the mandible, especially on the lateral aspect. It was obvious that coming through the mandible would be more successful. I began to design various patterns with a couple of different heads to see what might be best.
I might say that tackling and accomplishing all that I was accomplishing was taking monetary resources from my family as well as time. It also required that I develop a working relationship with people in the metal fabrication business. I also had to determine which metals might be best and then to find where I could secure limited amounts of that metal or alloy. This was a more challenging accomplishment than one might think, but I truly was on a mission.
Since my thought was to come all the way through the mandible, forward of the mental foramen on either side of that. The length of the implant was important so that it would penetrate the entire mandible, and the screw thread area should be only long enough to stay within the variable bone heights, in the various patient subjects. The thread size would also be important as the bone density at the cortical margins would have a limiting constraint to the diameter of the actual threads on the implant. Too large and they couldn’t be screwed through the inferior cortical bone region or would cause a fracturing of the bone at that point.
I had placed several of these in dogs and cats and had the opportunity of observing some of them for as much as nine years with total success. Like with every other innovation I had accomplished, I made a surgical motion picture film of the procedures on patients and used those films at ADA and other national and even international meetings. Those films were very well attended, usually by some 1500 doctors viewing each session. This implant has remained very successful over many decades and could certainly still be used as an important implant in our armamentarium. Some years later a Dr. Irving Small copied my implant and with a slight variation he got a U.S. Patent sometime after mine.
• The Transosseous Dental (Implant picture)
• The Endosseous Implant
This was my most recent dental implant innovation in the middle 1960s. A very interesting thing was happening at this very moment. I had been referred a very interesting appearing gentleman by the name of John D’Costa. On the day of his first visit for the extraction of a single tooth, my folks were visiting my Pasadena office from their ranch in Julian. I had been sitting in my private office talking with them, when John was ushered into a treatment room to be examined by me and then to have this single bicuspid tooth removed.
After I had extracted the tooth, he and I got talking about how the tooth might be replaced. I was really at the point where I wanted to develop my third dental implant innovation and so I mentioned that to him. I let him know it would be fairly expensive to develop such an implant. Out of his mouth came the words, “How much would it cost, Doc?” I let him know, I really didn’t know but at least probably twenty thousand dollars. He asked how much I would need to get started to innovate such a tooth implant. I casually said probably $2000. He immediately reached in his pocket and began to pull out a wad of $5.00 bills.
I told him I would get my receptionist to come in and count the money, so I found my receptionist talking with my folks. So without any explanation to her, I just asked her to accept $2000 from John, then give him a receipt and have him back in a view days so I could see how the extraction site was doing. That was the beginning of my development of the third of my dental implants, which was the precursory of all future dental implants in the U.S. Today that dental industry brings in some 2.6 billion dollars, annually.
Another interesting part of the story was this. I learned later that John, a Belafonte appearing, young black man, was a very educated and charismatic person, but most importantly he was California’s most noted drug dealer in the 1960s. Before we got done, I had followed John from his being incarcerated in the downtown Los Angeles jail to several maximum enforcement prisons in the Central Valley of California.
Another patient, and a man I called a dear friend, was the Chief Justice of the California Supreme Court. Judge Donald Wright finally had John incarcerated. When Don came into my office sometime later, I said, “Don, you arrested and jailed one of my patients.” Don let me know this man was California’s biggest drug lord and one they had suspected earlier had killed his own father, a physician in San Diego. Before I got done treating John A. he had paid me $20,000 and I had been able to develop and implant the first of these implants in John’s jaw.
The Christensen Endosseous dental implant was designed and made like a sheet metal screw with large screw threads. I had my first ones fabricated in Ti Al V (known as 90-6-4 because of its metal concentrations) and this became the precursors of most of the more recent dental implants. I developed it in several lengths and widths and then I developed a screw driver in order to place them in bone very quickly after a pilot hole has been drilled in the bone. This implant could be used as an individual, single tooth implant or as a multiple tooth or full arch implant. I made a new surgical film titled, “The Endosseous Implant-The New Way”. This implant was a great success and we placed hundreds of them in patients over the next dozen years.
I required a couple of them a few years ago in my jaws and they have been so very successful. We have always been able to have the final crowns placed on them and they could be masticated on as soon as they were placed. These implants have started an industry that today in 2010 has a gross sale volume of approximately $2.6 billion annually.
• The Endosseous Dental Implant (picture)
• The Modular Mandibular Implant
This was my final implant to be developed by me in the mid-1960s. The cost of innovation and gaining U.S Patents was beginning to overcome my resources and so I decided to not attempt to patent anything after that. This implant was designed as a sectional or a modular way of replacing the actual mandible, or any part of it. Over all of my earliest years in practice if I were going to do an excision of a large portion of the tumor patient’s mandible I would either use a bone graft from the iliac crest of the hip, or a portion of the patient’s tibia or a rib graft. Then there would be times I would use some standard bone plate, like a Sherman Plate, and would mold it to make it fit the desired shape and proper length.
Later in the early 1950s I would take a thin sheet of stainless steel and use tin shears and drill bits to fashion a rather anatomically shaped implant to replace the patient’s missing mandibular section of bone. This technique worked very well but if for some reason one’s pre-surgically determined bone excision was incorrect, then you would be faced with a difficult way of replacing the missing bone, without going back to the laboratory to fashion an implant for later placement.
That is what I did and in the late 1960s. I submitted the drawings for a U.S. Patent approval and got it as the first U.S. Patent accepted for this type of device. It was about this same time that I was appointed to the position of assistant clinical professor of surgery, in the Head and Neck Surgery Department at the Medical School of the University of California at Irvine. This gave me the opportunity of placing the earliest of these modular mandibles in a cancer patient where half of her mandible was resected. In my years teaching of 4th and 5th year residents at that University, I had the opportunity of teaching TMJ reconstructive surgery and jaw replacement surgery to the benefit of these early surgeons.
• The Modular mandible (picture)
Gone Cattle Ranching
These years were interesting years but somewhat unremarkable. In the mid-1960s I required multiple laminectomy procedures in my lumbar spine, some of which likely related back to my early ranch experience, but then some of it due to my occupation as a surgeon leaning over a surgical table for so much of my life.
Ann and I and the children had moved our home to Palos Verdes which was some 50 miles from my office in Pasadena. With my back falling apart, that move was not the wisest thing we could have done. In the midst of that Ann and I ended in a divorce.
Some 8 or 10 years later I met and married a young woman named Lynne. She worked for an investment banker in Pasadena as an administrative assistant and happened to live in the same apartment house as did I.
Some year or two later, Lynne and I bought a beautiful 100 acre ranch in the Applegate Valley of southern Oregon. It was equal distance from Grants Pass to Medford. This was considered the banana belt of Oregon as it was sunny and dry.
It was a cattle and hay producing ranch which rested in a valley along the Williams Creek which eventually ended up going into the Rogue River. There were two pretty good sized ponds also on the property. It was surrounded by beautiful, snow covered peaks rising to about 6000 feet that gave an even more majestic and beautiful appearance to the ranch. Our nearest neighbor was a quarter of mile away and the nearest town of Grants Pass was about 16 miles away.
Lynne had never lived on a ranch or farm and knew nothing of cattle and horses. I had the benefit of living on a cattle ranch when I was a young boy so it was like going home for me. Since I had been compelled from 3rd grade until college and the WWII years to daily milk the Jersey milk cow, I felt I would never voluntarily do that again. When I saw a sign for a beautiful, five gallon a day, Jersey milk cow, just like Bossy, I succumbed and purchased her. We called her Josephine, after the county we were ranching in.
We started on the ranch by purchasing a herd of registered Black Angus cows and a bull. Now we had a Jersey milk cow and about 25 Black Angus, which were very nice appearing. Having been raised with the whiteface cattle with pretty lengthy horns, these polled Angus were an interesting change. I had forgotten to mention that Lynne and I had purchased two nice riding horses for us when we were living on our 1 ½ acre horse property in Palos Verdes. We brought the horses to our new “Little Creek Ranch”.
I suspect we felt we were in seventh heaven about this time. Lynne took to ranching like a duck to water. We made friends with several of the ranch people we had either done business with or had been introduced to. In a year or so we had our first child, Andrew and about three years later had his brother, Matthew. Andrew had been with us on the ranch and we felt so blessed to be able to have him beginning his early years enjoying the ranch life.
The ranch had about eighty acres of hay producing pasture land where we were able to grow about 400 tons of excellent grass hay which we could bale and sell or save some in our large barn to feed the cattle through the colder and rainier winter months. That grass hay would get so high that it would be over your head. It was beautiful.
We finally got to where we had about 80 head of Black Angus and we sold them at varying times, but the income was never equal to the outflow. There was a steady drain on our economics, especially after I had sold the practice and retired just to the ranch, but we really did enjoy that ranch life. It was hard work for both Lynne and me as we moved 300-400 tons of hay around each year, and I had three prior spine surgeries in which my 5 lumbar discs had been removed and I was told to not lift anything heavier than a phone book. Oh Yeah!
One interesting thing happened while we were ranching in Oregon. There were a number of interesting things which happened along the line of some animal requiring my surgical skills. One time we had a young heifer that developed a serious neck infection which was disturbing her ability to breathe. I finally decided the time had arrived for me to do a tracheotomy so I put the calf in the corral and tie him up on the ground and then give her a local anesthetic. After that I did a routine tracheostomy and placed a tracheotomy tube in her neck. Then I gave her several days of penicillin by injection and she recovered.
There were times where I was treating injured birds or an injured deer. It was all part of a surgeon being a rancher. I was glad to be able to be helpful to the hurting animals. Lynne and I were always interested in caring for animals.
Lynne just reminded me of a time when we took someone we had met in Oregon, in our car down to where we crossed the border into California so I could, under local anesthesia, extract a tooth for that person. That way I was legit as I was only licensed in California. These State licensing requirements are another political obstruction and really are detrimental and silly.
After about the 5th year we sold the Little Creek Ranch and moved onto a small 8 acre parcel half way to Grants Pass. We developed the land and had a big barn put on the property, then used our case 450 dozer to build a road into the pad we had bulldozed for the double wide T shaped mobile home. By this time I had gone into the land developing business with a backhoe, cat, dump truck and a few other smaller items. Again I was lifting a lot more than telephone books and wasn’t sure how long my ability or stamina would last. But, somehow, I had to make a living.
I would be contracting jobs to build a road into someone’s property, or dig the shape of a swimming pool, or dig septic test pits, and even occasionally putting in a whole septic system, etc. It was an interesting life, and certainly a challenge for this somewhat retired oral and maxillofacial surgeon. I suspected this life of a construction worker was not destined to last.
I used those talents and that equipment to develop small land parcels which I could purchase and sell after I had improved them a bit. It was an interesting adventure and we were able to keep eating and living and it was interesting for me to do. At times we would have a well drilled on the property. Since it was frequently me that had to select the area where a well might be drilled, it was always interesting to see how well we did in that selection.
In one instance in which we drilled a well in our own property, we instructed the well driller, whose name happened to be Bob Christensen, to drill at this spot to a depth of 200 feet. When he got to 190 feet he had hit zero water, but within 5 more feet he hit an artesian well producing some 100 gallons per minute. I plumbed that well and our house and even the pond without ever putting in any water pump. The natural pressure was more than enough. PTL
At some point in time, which is certainly getting harder for this 85 year old to remember, we bought a 20 acre parcel along the McKenzie River in Springfield Oregon. It was actually at Blue River. The new three story house was right in the flood plain, adjacent to the fast moving McKenzie River. Boy, it was beautiful, but when the rains came, it was most dangerous. One winter, we had nothing but water running on all sides of our home. It was treacherous, and may actually have been damaged by flood waters after we left that area. It was so beautiful, and the two boys were still very small, but I had a chain linked fence put around all of the living area and we felt remarkably safe as far as the children were concerned.
I would take the boys with me on the D-3 or even the backhoe when I would either go to do some job, or do some work on our own property. It was interesting in that Matt’s first words were “dum” and “doz” which stood for dump truck and dozer. We had kept our horses and we built a small barn on the new property. It was so beautiful and we felt so fortunate, mostly.
Actually, in Ed Werner’s design of the house he had made two roofed areas as sod covered roofs. Oh, Ed Werner would say, “and it was engineered to never leak.” Give me a break. We had so much rain water pouring through the roofs into our living room areas that the ceiling board panels began to actually fall into the living room. What a mess and what a job to attempt to replace with a normal tar paper and tar roof.
I used the 5 yard dump truck and backed it right up to the lower part of the building and then began an arduous hand shoveling of many yards of top soil on the roof, which covered the visqueen layers of “water barrier.” We did that on two separate roofs which had a third story peak rising between the two flat area garden roofs. When I got it all off then I had to lay down tar paper and begin to tar the entire roof, which I had learned to do in my youth during the Great Depression. I really felt more like tar and feathering Ed Werner, but he was a gentlemanly older gentleman, and that would not have been good.
After we had moved from there down to the Ukiah area we were still attempting to sell this property. One of the disadvantages of the property was that the house was definitely in the flood plain, which had been allowed by Ed’s persistence with the Springfield Planning Commission that this property and house were perfectly safe. It was just about as safe as that visqueen roof.
When we had left the area but were attempting to sell the property, I decided I should attempt to dam up a large area of the river bank of the McKenzie River as it swirled around the region of the house; lots of luck on that venture, Bob. I had gotten to know the gentleman that owned a large island, just downstream from us, but within the river. He had a D-9 Cat with a blade 8 feet high by 16 feet across and he went around that whole island pushing river rock up against the banks. I believe he owned the Coca Cola bottling company in Eugene, so as long as we all kept drinking, he kept pretty well off. The Fish and Game and State Troopers visited him frequently and undoubtedly fined him heavily, but he persisted until that island was much more protected for the golf course they had allowed him to place on it.
I somehow got in touch with him and asked if I could fly up from Ukiah, in my own P-210 Cessna airplane and bank up those pesky banks around the house area using his D-9. He was very kind, so I flew up for a weekend and took that D-9 right out in the fast flowing McKenzie River and began to bank up the banks with the large river rocks that made up the McKenzie River floor. In most areas the water would be about 4 feet deep, but there were areas along a section of our home where the water probably got nearer 15 feet deep.
And since I didn’t want the world to know what I was doing, I decided I would do much of it after dark, and there were no headlights on that D-9, at least which I could find. I got some poor soul sitting on the right fender area, with a flashlight in his hand, attempting to let me know if I was getting close to the abyss. It was a rather dangerous mission, and I well remember when I borrowed another contractors brand new D-4 to enter a smaller riverbed within my property to clean out some of the silt. That hadn’t worked out well as I buried that Cat in a 6 foot deep mass of silt, that I felt sure was only 2 feet deep. Anyway, I got through that late night adventure, but I had the feeling some eyes might have been watching me from the 80 foot high river bank, where the only other houses were located.
The next day was Sunday and I was doing some of the same, but in a more normal and less dangerous area, knowing I had to leave by about 3:00 PM and then fly back to Ukiah. Lynne was out watching me when a truck arrived with a State Trooper and a Fish and Game official approaching. I was below normal ground height as they approached, but I knew I was in trouble. It didn’t take a rocket scientist to figure that out as they got closer and asked if I was Dr. Christensen? I looked more like the wetback from some other planet in my old clothes and pretty much covered with dirt. Although they didn’t draw the heat on their hips, I just figured I’d better be straight with them because they certainly had the upper hand.
The Trooper seemed a bit friendlier than the Fish and Game fellow. If they gave me their names, I have forgotten them. I actually probably never remembered them, but who cares. They explained with some authority that to bank up your river banks this way was not lawful and that certainly a permit and hearing would be required to ever build a retaining wall. Yes Sir, I suspected that might be their position. I let them know I had flown up from Ukiah so I could do something to prevent all of my 20 acres and 1/3rd mile of river front from taking all of my property away, which certainly would not be good for the fish and plant life and certainly wouldn’t be good for my little bride and me. Right?
The Fish and Game fellow had no sense of humor. I thought I perceived a small smile from the Trooper’s mouth. I asked the question if they would be back anymore before 3:00 PM and the Trooper said, “No”. I was thrilled as that would allow me to finish and to give the Cat back to my neighbor across the McKenzie River. I felt very relieved, I had apparently not gotten a fine; maybe that is because I looked so poor. Just think if I had been there in a suit?
Sometime after that we apparently sold the 20 acre parcel with Ed’s home in the flood plain, with the new tar roofs and the newly banked riverbanks.
It became apparent that we were going to have to return to California for me to get back to my principle occupation as an oral and maxillofacial surgeon, in the State where I was licensed to practice. Now we would have to make a decision as to where we might go, and we opted for the Ukiah area as a nice place to live and raise our two sons.
We started an oral surgery practice in a small town near Ukiah and stayed there for 2 years until the Lord called us to start a medical device company alongside of a marriage ministry in Golden, Colorado. While we were there, a young assistant of mine raised horses and one of them got kicked in the head and received quite an injury. She had the local veterinarian examine the horse and he told her that the horse treated by the veterinarian department at UC Davis. The cost would be beyond what my young nurse could afford, so I agreed to examine the horse. When I did I found the horse’s eye had dropped down into the antrum and the supra-orbital rim had been seriously fractured. I suggested if I could get the local veterinarian to put the horse down with an anesthetic for 1 hour, then I felt I could repair the supra-orbital fracture. We got agreement with the Vet and so I began to prepare for doing this surgery at night, in the pasture under the headlights of my truck. This might be an interesting adventure but I had little concern that I could perform this surgery, but there was a bit to get prepared. I would need to prepare a surgical tray, then bring a Nitrogen tank to the field so that I could use my surgical drill and burrs to place wire or bone plate on the surgically reduced fracture, providing I could reduce the fracture.
The vet had given me a bit of a curve in that he could only give me 30 minutes of general anesthesia as he had to drive off to San Francisco. I accepted the challenge and so at night with my surgical trays set on bales of hay and the truck lights shining on the surgery scene. The minute that horse hit the ground, believe me I was injecting xylocaine and started my supra-orbital incision. It took me no time at all to expose a massive supra-orbital ridge on this animal, and it sure was fractured with part of this 1 inch wide bone impacted under the rest of it. I had to take a small tire iron retractor, used like a periosteal elevator to separate and position these two fragments of the supra-orbital rim. Then with my Hall drill I placed a hole in each segment and then fed a 24 gauge stainless steel wire through one hole and then the next and tightened the wire by twisting and the two fragments came back into their correct position and the eyeball, which had been depressed, now took its natural position in the orbit. Before I could begin the wound closure the vet was driving away and the horse was awakening. I was able to close the wound and give the horse some penicillin by injection and he recovered nicely and my nurse got it all done for zero cost to her. Praise the Lord for He is good.
It was sometime after we had started our surgery practice up north that Lynne felt she wanted a divorce, so unfortunately we divorced. I began to stand for healing of my marriage. It was sometime later that we all ended up in Southern California near the city of Pasadena. I had learned to fly an airplane some 20 years earlier and through the years we had several airplanes, such as a Cessna 182, a Cessna 206 and then a Cessna Citation P-210. I had picked up my private, my twin and my instrument license. When the divorce occurred, we lost all of our planes as well as a medical building, a new home and a ranch in Oregon.
While I was finishing my multiengine training in the Ukiah area, I kept hearing I was to learn to fly jet aircraft. But why? God had a plan which I was going to learn more about. As I moved down to the Southern California area to see if I couldn’t find some way to get my marriage back together again, I kept hearing the Lord tell me I was to learn to fly jet aircraft. So when I sought out where to go to learn to fly jets I was directed to a jet flying school on the Long Beach Airport, called Eagle Aviation. It was there that I met my instructor and the owner of the jet flying school, Captain Dale Black. Not only was I going to learn to fly jets but more importantly, I was going to become a born again Christian. God had to take me 600 miles to learn to fly jets, when in the middle of a most hurting situation I will finally be brought face to face with my need for salvation. I have asked Captain Dale Black to write a few words telling about what he saw God doing in my life and how he and his dear wife, Paula, would play such a pivotal spot. If this story doesn’t convince you that God moves on the heart of His people, then nothing likely will.
Captain Dale Black, God’s Aviator, My Mentor and My Friend
May 20, 2012.
Dear Dr. Bob,
I’ve tried to remember about our times together back in the early 80s. But since this will be a chapter about your life’s work, let me tell you what I do remember.
I distinctly remember Dr. Bob Christensen calling me on the telephone sometime in the early 80s, probably 1983 possibly 1984. Bob was eager to learn to fly a jet aircraft, his eagerness came through his voice on the phone. He had an extremely pleasing personality. I knew immediately that he and I would get along beautifully. He was already an accomplished pilot, so I thought it would be a wonderful opportunity to help an already professional pilot learn how to fly a jet. In this case it was a Cessna Citation jet airplane which I was a specialist on. At the time I owned a company that provided pilot and maintenance training for the citation jet and the Learjet.
Bob lived in Northern California. My wife, Paula, and I and our two kids lived in Garden Grove, California.
My first day of meeting Dr. Bob was just like I had expected because of our phone conversations. He was extremely outgoing and smiled a lot. He seemed to feel secure about himself, but he was clearly not arrogant. Immediately after talking with him, I knew he could lead … I wondered if he could follow. Some strong entrepreneurs that I’ve trained in the past had troubles in this area. Being such strong personalities and powerful people, is why they have risen to heights, but working with me, sometimes could be a challenge to some of these rare individuals. Within 10 minutes I realized Bob was the ideal balance of both leader and follower. When he needed to lead he led. When needed to follow, he could follow too. Our safety was at stake. I realized that he and I would be in the cockpit of a fast moving jet together, and that I would need to keep us safe, primarily with my words, as Bob would do the flying, I would do the instructing.
It was obvious he and I were going to get along very well. What I did not know is that we would get along in a way that both of our lives would be changed.
I don't actually remember the reason why he came to our house the first time, but I do remember that Dr. Bob was in our upstairs room in our house in Garden Grove. I cannot remember if we conducted our flight and ground school from our home or if we had an office nearby and we just invited into the house. Bob maybe you can remember that part? While talking about his medical practice, which was obviously flourishing, we learned a lot about the man. He was an extremely well-to-do, self-accomplished, millionaire who was used to having a very elaborate and successful lifestyle. He owned his own offices his own homes. He owned more than one airplane through his aviation career. He had many of the other conveniences that only a few successful American entrepreneurs can sometimes afford. He shared about his life with a kind and humble demeanor. He was amazingly humble throughout.
While we talked about his life and his training as a doctor…We also talked about his family. I should say that Dr. Bob not one time indicated in any way, to my wife Paula or to me, that he was arrogant, selfish or materialistic. Instead, he seemed to be a supercharged human being who wanted all that life had to offer. Underneath his words was a humble and extremely friendly individual.
That night, while in the bonus room, Bob eventually shared that he was going through divorce with his wife, Lynne, who he adored. His heart was hurting. He mentioned that his wife had run off with a good friend of his and without his permission or knowledge they had sold his airplane and used the money for their own personal purposes. The man that his wife had run off with, strangely, was someone I was somewhat acquainted with. It's not that he and I were friends, but I certainly knew who he was because he was a vital part of the aviation community in El Monte California.
I shared with Dr. Bob about the fact that God can heal a marriage just as easily as God can answer the most basic prayer and as He could do everything else too. Bob mentioned to me that his wife had already filed for divorce and that the papers were forthcoming. I told him that the divorce papers were certainly not the final answer nor were they the final result. I shared with him that the final result is what we believe God has promised us in His word, the Bible. It gradually became clear that Bob was a strong and respectful religious man. He had a huge respect for God and for the things of God as he knew them. But I had no sense in my heart that Bob had experienced the new birth, or the born-again experience.
I asked lots of different questions. One of those questions was do you believe you will be going to heaven? He said yes he did believe he would be going to heaven because he believed in God. I recall him explaining about his belief that God was the Creator, that Jesus was the son of God and that Mary was the mother of God. He went on to describe what sounded like a very devout Catholic background.
We talked for a good hour and in that discussion we had moved to our living room downstairs and I asked a final question, “Bob, are you 100% certain, without any doubt, for sure, that you will go to heaven when you die?” I explained that many people believe in God. But believing in God doesn't assure a person that they will go to heaven when they die. As an example, even Satan the devil believes in God, and Satan certainly will not be going to heaven. I learned growing up in business, particularly in sales, that the sale is often “made in the questions”. So I asked Bob lots of questions. My wife Paula was there too, and Paula, has a wonderful capacity to say the same thing that I’m trying to say, but in a more “user-friendly” way. So she and I tried to be as loving and kind as we could be to Bob. We repeatedly asked the Lord for his Holy Spirit to help along the way that entire evening with Bob. Paula and I tried to do our best to allow God to work in and throughout the conversation.
I remember seeing Bob's eyes sort of “click” when he heard me say that there will be hopefully, many Catholics and Protestants in heaven, yes, but some Catholics and Protestants, I have found, unfortunately do not seem to have a personal relationship with God through Jesus Christ. I asked Bob if he was willing to ask God to forgive him of sin, which is what I had done, what Paul had done, and it changed our lives completely. It turned our lives upside down so beautifully. I asked Bob if he would be willing to not just believe that Jesus is the son of God, but to go further, and invite Jesus into his heart and life as Savior and Lord.
Well, to make a long story short, I can’t recall anyone ever being as eager as Dr. Bob to become a Christian, and believer in the family of God. Bob repeated, what we call the sinners prayer, which was not some religious formula or some magical words. These words were simply spoken from the heart to God, asking His forgiveness and accepting the free gift of salvation paid for by the blood of Jesus.
Later that night we explained to Dr. Bob, (being a man with an extreme high intellect) that what happened in his heart was like planting a seed in a garden. You may not see the plant, not the next morning, but a seed has been planted. We explained how to water the seed by reading the Word of God, the bible with your heart, not just your mind. We taught Bob how to pray to God. It seemed very new to him. “You talk to God like a friend,” we told him. “You can articulate anything you want, Bob, and you obviously have a tremendous gift, so, use that gift and talk to God in the same way you talk to your patients, your family and friends”.
The next day I went and bought a Bible at the local Christian bookstore and had engraved on the Bible Bob's name and his wife's name. As I recall, the Bible said “Dr. Bob and Lynne Christensen”. Inside I wrote something similar to this, “Believing in faith for your family’s unity”, signed Dale and Paula Black.
Starting then it seemed likely that Bob was going to be an amazing, once-in-a-lifetime, powerful disciple of Jesus Christ. He also became like glue to my wife and me. We still laugh about this. He couldn't get enough talk about God, about Jesus, about what we had told him about the Holy Spirit. The next day we told him about the early disciples of Jesus. We described how and when they were filled with the Holy Spirit, by the laying on of hands. We explained that the Holy Spirit is the power of God to the Christian in today's life. I told Bob my own testimony how I have lived many years as a Christian but not with much power. The power came upon being filled with the Holy Spirit. Bob wanted this. So once again, like before, we laid hands on Bob and asked God to impart to Dr. Bob his precious and most wonderful gift - the Holy Spirit.
Throughout the rest of the time with Bob…He wanted to know both about the jet for that was the class he was actively enrolled in; and about the Bible, for he believed it was prayer to God and knowledge of the Bible that would save his family.
During the time he was in Garden Grove, without his family and while going through Cessna Citation jet pilot training, that I remember him being astonishingly interested and eager, almost desperate, to learn anything, and everything he could about being a Christian. Bob’s big challenge was that our pilot training school was highly advanced and extremely intense. We were teaching pilots, what normally took three months to learn, we were cramming into 2 1/2 weeks. So to say my class was total immersion is a gross understatement. But somehow Dr. Bob progressed right along with the class in every area just like everyone else. Somehow he was able to do this while his mind was on his family, his marriage crisis, and on his business which began struggling, once his wife left. She too was an integral part of the business success. I’ve since learned that Bob's brain doesn't work like the rest of the human race. To say that Dr. Bob is one in a-billion is quite accurate.
Because of the intensity and the shortness of this cram Cessna Citation Jet course, several students in the class were not quite ready for their check ride. This is not an indication that these pilots are substandard in any way, shape or form. It simply means that different people learn at different levels and it also means that certain persons have a background that requires a little more training before they can handle a complex jet aircraft - with perfect precision. In Dr. Bob's case, he was able to capture the didactic portion but also the flying, hands-on part of jet flying. He passed the oral exam and was ready to complete the test ride, when Lynne let him know she needed $1000 which meant, Bob had to make the decision to leave the $1000 on the test ride, or scrub his test ride and help Lynne.
He made the correct decision, to give the money to his dear wife.
Dr. Bob was a skilled surgeon, not a professional pilot who flies day after day throughout the year. His absolute need for this jet rating would not be essential. After all Dr. Bob was on a mission to serve the Lord, but at the same time to see his dear family and marriage restored. We decided to go on a flight to El Monte airport where Bob had gone through much of his flight training many years before, but also where his wife was now working. So, with Dr. Bob flying the Citation jet we left Long Beach airport and flew directly toward El Monte airport. He asked me to radio the tower to see if they allowed jets to land at the 4500 foot runway at El Monte. The tower operator came back that it wasn’t disallowed but it was frowned upon. Bob and I both smiled as Captain Dale announced we are on course to land at El Monte Airport. Bob was beaming as we moved along the path toward El Monte Airport. Bob asked me the question, “Is that field long enough to land this jet?” My answer was, “Yes, barely”
We both agreed that since the El Monte airport has a short runway, I would likely need to do the actual landing myself. He could fly to and from, even make the approach, yet I’d probably need to make the actual landing. He didn't hesitate. So Bob and I flew en-route VFR to the Almighty El Monte airport, as I used to call it.
Bob few flew beautifully all the way there. He made a beautiful takeoff, and he held altitude and headings really well on the way. Once near the airport, he entered downwind, adding flaps and landing gear at the appropriate times. His speed was maintained very well, which is as tricky as it is important. As we turned onto the final approach, I took over the controls with Bob “following me through”. I conducted the landing while he laid “fingertip pressure” on his flight controls. This way he could feel my inputs at this very short and challenging runway.
Upon landing, we, both lowered the nose of the jet, then quickly jumped on the brakes and placed the thrust reversers into maximum reverse. It was a beautiful landing on a very beautiful day. Bob was amazing. He could have just as easily been a professional pilot, college professor or brain surgeon. His intellect, his drive, his mature and calm nerves would allow him to become anything he wanted…even an astronaut if he wanted.
Every pilot and mechanic and observer on the airport wanted to see who was bringing this expensive corporate jet to the small little airport called El Monte. Bob had other things to do while there. I remember being concerned about the airplane and making sure we had fuel and the weather was good for our return flight, etc.
Bob, to Lynne’s surprise waltzed into the aircraft facility that she was working at. He had not announced the fact that he would be arriving there, and especially not in this brand new Citation II aircraft. To his delight, their two young sons would be arriving there to be with their mother after school. So Dr. Bob asked if any of them would like to go around the pattern with he and Dale. Lynne said No, but 7 year old Matthew beamed and said, yes. So with my following through on all of the maneuvers, Bob took off and made a loop around the airport and then landed again, just as before. Bob well remembered the massive drainage canal and highway at the far end of the runway and if a landing was not exactly as it should be, we would likely end up in a fiery crash in that ditch. Not a pretty thought, but the thrust reversers deployed perfectly allowing the aircraft to complete the landing, with the use of the foot brakes, some 300 feet short of that canal.
We said goodbye to Matt, Andy and Lynne and Bob took that beautiful aircraft off of the field at El Monte like a pro. To Bob it seemed like he was in the Blue Angels leaving some field or aircraft carrier. We both had a great feeling of success, but sadness Lynne and the boys weren’t with us.
But now, the flight got really interesting. Dr. Bob had no problem finding his way back to long Beach airport. He had flown this route many times in his other training and in his own aircraft. He was looking forward to landing on the 10,000 foot runway and he made a perfect approach and landing, but then something spectacular occurred. After touchdown Dr. Bob deployed the thrust reversers, but they did not deploy, allowing the plane to rush down this 10,000 foot runway, only to be stopped by Dr. Bob and me getting on the foot brakes and finally bringing the plane to a stop.
This was a situation that Bob was not expecting in any way. Had this same thing occurred at El Monte on the two different landings, likely we both would have ended in the storm canal? What a sight that would have been for Lynne and the others, eagerly watching, but what an ending to two dedicated Christians. That was just a bit scary, but PTL we came through very well.
After two and half weeks with this incredible man named Bob Christensen our paths parted – but only for a while. We were on the phone with him regularly teaching him the ways of God through the Word of God. Bob was the eager one. He was the one that kept drawing nearer to God. He was the one that was completely engrossed in learning all he could learn and being all he could to be a powerful Christian, dedicated to God. He was seemingly driven to be worthy of God's salvation and in doing all he could to allow God to save his family.
Bob saw God work in his life on many wonderful and in very diverse ways. I even remember at least 100 occasions where he would call or send a little card in the mail to us about a license plate that he had seen while he was driving in which God used to send a message to Bob. Each time the license plate was used by God to encourage, and in some cases, even direct my wonderful brother in Christ, Bob. One that I know he remembers very well was UZMEGD which he saw one evening when he was coming to see Paula and me. He confessed the same, Use Me God.
Months later I was, again, highly impressed to see that Bob was such a DOER of God's word. By that time in my own life, I had met countless Christians who “know” the word of God but don't “do” the word of God in their personal lives. I've known countless Christians who are more interested in searching for “knowledge” yet who don’t do much with that knowledge in their day-to-day lives. I have met and observed countless Christian leaders who know so much – yet who do so little. But Dr. Bob is an exception to these. Bob was and is the ideal example of learning something about God through His Word, and then doing what he just learned. In short, Bob is a doer. Bob Christensen is the real deal. He was the real deal from the very first day I met him. He was the real deal immediately after he became born-again. He was the real deal after he asked for the infilling of the Holy Spirit in his life. I've known Bob for close to 30 years and let me say very clearly, he is the real deal. I’LL SAY IT AGAIN; DR. BOB CHRISTENSEN IS THE REAL DEAL. He lives what he shares and writes about in his books. He lives out in his personal life what he has learned about God and His ways.
I never told Dr. Bob about a little joke that Paula and I have mentioned to each other throughout the years of knowing him. First you should know that Bob is without doubt the most persistent person I’ve met. And with his persistence in mind, my little joke goes something like this. It is a play-off of the Scripture that says, “draw near to God and He will draw near to you." Well, with that Scripture in mind, I have said on dozens of occasions, when referring to brother Bob, I speak as if I were God speaking, “You know, I told my children to draw near to Me, and I’d draw near to them. But, in Dr. Bob's case, this is ridiculous”. Of course my entire joke is a wonderful testament and a compliment to how much I respect Dr. Bob for being persistent in pursuing God…as well as pursuing the things of God.
We're told in the book of Matthew that in order to build our house on the rock, one must do the word of God in their lives. That scripture somehow really stuck with Dr. Bob, because he does what he learns, as soon as he learns it. What a wonderful and precious brother in the Lord, Bob Christensen is to me.
Months later Dr. Bob brought his wife Lynne over to our house for dinner. I remember we had Kentucky fried chicken. We were so busy at that time in our lives, that we didn't have time to cook so that was an awesome way to fill our busy schedules with wonderful friends. When Lynne came over, we tried to make her feel comfortable. She appeared to be completely on guard. We had already been told that she thought Christians were weird and therefore she expected us to be even weirder. We talked to her through the evening and she seemed to become increasingly more comfortable as we shared with her. We didn't condemn her. We didn't talk about her problems. We didn't mention her situation at all. We only tried to love her and be real. Of course we asked God's help during the entire evening. Apparently she went away comfortably, because Bob told us later that she didn't think we were that weird after all.
She did pursue the divorce, however, as she had planned. And this was another one of the many lessons that Bob handled amazingly well. He handed handled it perfectly, in fact.
We told Bob that he needed to stand on the word of God, on the promises of God and not to be moved by the circumstances. We didn’t mean this literally, just figuratively, but we meant it with all our hearts. We too had gone through a marriage crisis of our own, and the word of God was our answer. Apparently, when Bob was in court with his wife in front of the judge, Bob took his Bible with him - put it down on the floor in front of the judge and said, “I’m standing on the word of God. I am not for this divorce. I will not sign these divorce papers. I love my wife. I love my kids and I believe that God will answer my prayers and restore my marriage. Your Honor, I believe that God can answer prayer on anything and I believe God will put my marriage together again”. Bob later told me that He and a dear flying buddy, Jim Fry, had taken the divorce papers and put them on the floor and prayed and stomped over them.
Lastly, may I also tell of something I have learned? One of the clearest verifications that a person has truly dedicated his or her heart and life to God, through Jesus Christ, is what they do with their lives, outside of their vocation. Also what they do with material things. Through almost 30 years I've watched brother Bob live his life. And while watching, sometimes from afar, I've seen again and again a consistent track record in his life that seems to say, “May God's will be done - not my own”.
God has truly gifted Bob. But Bob has dedicated these gifts back to God. Something else, sometimes a real sign of a genuine minister is what they do with their nonprofit organization. Bob is again a wonderful and rare example of how to be a giver rather than a taker. For years I’ve watched Bob take less than his expenses. I know this for a fact. And he's done this for decades.
Many ministers, many ministries, who started out with very altruistic motives, over time have become not much more than religious businesses. And when economic times are tough being a minister is actually a pretty good job. But the word ministry is really meant to be a servant of God and a servant of the people. Bob is a servant of God and he is a servant of people. He doesn’t run his business or ministry for personal gain. Nor does he do this for fame or recognition. Bob is a driven man. He has passion in living. He wants to help others find this same Jesus that he found when his life was turned upside down a short time before we met, praise the Lord.
It's an honor and privilege - to have met Dr. Bob back in the early 1980s and it’s indeed a great pleasure to watch what God has done with him, his wife and kids and his businesses. To say that I respect Bob is not a strong enough word. I love, admire, and COMPLETELY respect Dr. Bob Christensen in more ways than my words can possibly depict. I thank God for the time that I had with this wonderful servant of God who I'm honored to call my dear friend and brother in Christ.
Sincerely and respectfully,
To not allow this story to get too elongated, Lynne and I got back together again and remarried at Jack Hayford’s Church on the Way, with Gavin MacLeod, the skipper on the TV production of The Love Boat, becoming our best man. From that new beginning, we saw that Lynne and the boys all gave their lives to Jesus and now we returned to the Ukiah area to re-open our practice, but that wouldn’t last long as God had shown me that we would be starting a Christian marriage ministry and a medical device company, side by side. Wow! What a change of direction. We had failed in marriage, but now God was going to use us in the very area of our lives where we had failed. Isn’t that just like God?
Some of My Flying Days
In recalling some rather interesting moments in my flying days, I must state that back in the 1960s I got interested in flying airplanes so over the years I passed my Private and Instrument flight tests and later my Multiengine on up through my jet flying experiences. That was all quite an experience which I started after I was very involved in my surgical practice, so that much of my flying during those training years started often during the evening; especially my Instrument flight training which went on for much of a year at night, over the mountains of Mendocino County in California. That was a bit of a drag. It was most interesting that although at age 17 years I entered the Navy Air Corps in 1943, but when I found I could continue in my pre-med college training as a Navy man, I got back out of the Naval Air Corps to continue toward my medical training. Otherwise I might well have ended up over one of those Pacific Islands during the heated battles of WWII. God had a plan for my life and was certainly taking me down the path He wanted.
Most of my flying was done from the El Monte Airport just east of the Pasadena city. As Captain Dale Black has mentioned in an earlier chapter, the El Monte Airport has a short runway and when I was first training at that airport it didn’t even have a tower. It was an uncontrolled airfield just about 25 miles east of Los Angeles. Often my flying would take me over downtown Los Angeles at night and the sight and lights were spectacular from about 10,000 feet ASL or less.
Over the years I bought several planes, but the earliest was the Cessna `185, then later I bought the Cessna 206 which was a workhorse. Both had fixed landing gear, single wing and single engine. It was an exciting life for this still somewhat young or middle aged surgeon. Later I purchased the spectacular Cessna P-210 which was the earliest single engine, pressurized aircraft in America. I bought it in Albuquerque and flew it back to northern California. It was a quiet, fun airplane to fly and could cruise easily in the low 21,000 feet level ASL. It would cruise at about 200 MPH and was just a beautiful aircraft with retractable landing gear. Years later I purchased a Hawker –Siddly twin engine, jet airplane which could travel with reasonable tail winds up to 550 MPH. WOW! In that airplane we literally could leave LAX and arrive at DEN in about 2.25 hours.
Anyway, back to the story. One very interesting moment in my flying experience occurred back in the late 1960s when I purchased the Cessna 206. I purchased it used from an aircraft sales person there on the El Monte field. On our maiden flight, with me piloting the aircraft we headed east toward San Bernardino and when at about 7 or 8,000 feet altitude, all of a sudden the engine just stopped. Went caput, and now what do we do? Well we were fortunately able to get the engine re-started and finally flew back to the field. We found there was an airworthiness directive regarding that problem on that aircraft and it had to do with the fuel line which came across just in front of the firewall which would get overheated by the engine and literally cause the fuel to boil, thus causing the engine to fail. The solution was to wrap the fuel line with asbestos in hopes that would correct the problem. I had many good hours flying that particular plane. There is a story about that plane that came to mind so I wanted to add it to this book.
Back at the time of the TMJ Symposium which I co-hosted at Hollywood Presbyterian Hospital in 1964, and where I performed a live surgery which was in February 1964, featured as TV program titled Surgery 64, some interesting things were happening. Many newspapers across the country were featuring the medical innovation of being able to replace all or a portion of the TMJ. So I was receiving calls from patients across the country that needed help. One such call was from a physician in some smaller town in Montana who had a 30-40 year old patient who had been blown up by dynamite in a mining accident a few years earlier and his lower jaw was fused to the skull base so that he had no ability to open his lower jaw to eat or speak or whatever. He was in a real predicament and no one had the correct answer…until now.
So, he was referred to me in Pasadena California and after getting all of the necessary radiographs of his skull and mandible, plus his health history and a clinical exam and workup, we scheduled his surgery at Hollywood Presbyterian where his fused jaw was released surgically and replaced with my rather new partial TMJ implants to both right and left TMJs. We kept him in town for about a week and then sent him back to Montana. As I recall he was a rather quiet man who may have had other issues in his life which I learned nothing about.
A number of years later I was flying my C-206 up to that same area of Montana to visit my son, Robert Jr. who we called “Chris.” I had taken another pilot buddy of mine along named Jim Fry. We frequently flew together as we were able to mentor each other and we always that way had a back-up pilot in case one was necessary. I was taking about 5 of my younger children up with me for a few days visit with Chris, who by the way was an excellent commercial pilot. We had been visiting with Chris for about one day when a rather rugged storm came into the area and Jim Fry and I decided to drive back the 5 or 10 miles to the small airport where I had left my plane, thinking perhaps we needed to check on it and to tie it down more securely.
After visiting the airport it was now pitch dark and we were driving along this small two lane country road, when all of a sudden we see a car lying upside down in the ditch on our side of the road. The lights are on in the car and we can’t tell if the driver is still in the car. As we are gathering information by inspecting the car, a few farmers began to gather. One had said the driver had gotten out of the car and was over at that farm house across a rather large field or pasture.
As about ten to fifteen minutes elapsed, a man approached and said hello to his farmer buddies when they addressed him as Doc. That of course raised my level of curiosity and when I explained I too was a DOC it turns out when he hears my name that he remembers that it was to me that he had referred that injured patient some5 or 6 years earlier. When I inquired about the patient the answer I received stunned me. He said the patient had done very well jaw wise but had other emotional or family problems and he had taken his own life just about 8 months earlier. I was shocked and so saddened by the report, but can you imagine how God had allowed me to be on that road at that moment to meet that doctor and learn that sad news. So many things in my life could only have occurred because my heavenly Father wanted me at a certain place at a certain time. Over the years I had heard of a number of patients who had committed suicide because they were unable to get help for their TMJ problems, for which I have always been so moved and saddened. But this is and was the only patient that I have ever been made aware that has taken his/her life after the time of receiving our TMJ implants either partial or total.
One other time that I might mention where we were bringing surgical help to someone, somewhere was on one of my flying medical missions into Central America or Mexico. I had flown into Guatemala a couple of times in single engine planes to help surgically correct someone’s problem, but the trip I wanted to mention was one that was originally organized by my friend and flying mentor, Captain Dale Black. On this trip we would be flying about 1000 miles south of the San Diego/Tijuana border to a small island called Isla de Cedros. It would be a joint trip of evangelizing the natives on this small island, as well as my bringing some need surgical relief, and then later over to the mainland to do some of the same. We would be flying two different planes using three pilots. I would co-pilot the Citation II jet airplane with Dale and another pilot and friend would be flying the twin reciprocating aircraft with passengers. My wife, Lynne, would be with us to help with both areas of our scheduled endeavors as well as Paula, Dale’s wife. This would be a fun time for all of us.
The island was about 75 miles off the shore of Mexico below the level of the Mexican peninsula known as Baja California. As we approached the island it was amazing how small it appeared from some 28,000 feet. The runway was not only a small runway but without any tower or runway lights etc. It was just a tarred runway that seldom seemed to have much traffic and there were some small rocks on the field which concerned me greatly.
We got safely landed thanks to Captain Dale’s expertise. It had been a great flight down to the island and Dale had generously let me pilot most of the way up to the more difficult part of the landing which I could well, have handled, but never as expertly as my dear friend and brother in Christ, Dale Black. No one was aware we were even coming to the island and it never seems to make much difference in either evangelism nor in my doing some rather routine surgery such as teeth removal or some simpler other surgical procedures.
I don’t exactly remember where we went at first but there was someplace where I extracted a few teeth from the mouths of some of the natives. Then some lady arrived to tell us about some older lady up in a house that had some tumor in her upper jaw region which apparently was putting pressure up toward her eye and beginning to affect her ability to see. In these back country and at times very primitive situations there is no ability to have x-rays taken or other lab tests. You might as well be in the jungles of Guatemala where I have had to do many of the same surgical procedures. I always bring along all of the surgical forceps, scissors, hemostats, bandages and anesthetics which may be needed for such an excursion. As the Boy Scouts say, Be Prepared.
We had plenty of opportunity to evangelize and to see that quite a large number of people on the streets were saved by confessing Jesus as their Lord and Savior. It always was a grand experience. But now, what about the lady in the house?
Someone transported Dale, Paula, Lynne and me to a simple in the town house where this older lady lived. We were escorted into the kitchen area which was a 10 X 10 foot room with a couple of chairs and a kitchen table. It was in that setting where I examined this little 75 year old woman who probably didn’t have a clue where these Gringos came from; after all her world was probably less than 1 mile square. She may have been born on this Pacific island, Lord knows, but like so many natives in the various countries where I have been privileged to help by doing some simple surgery, my 6 foot frame and different, but foreign accent seems to give me a perceived position of authority and if I say obre la boca, they do. Just kidding, in case you thought I might be fluent in Spanish, I’m not. Poquito!
After a cursory exam of this lady’s face, neck and oral structures I came to the conclusion that she had likely a large maxillary cyst, or possibly fibrous tumor, which if I was very fortunate, I might be able to totally excise with her sitting in a chair or at worst, lying on the coffee table. Nothing about this reminds anyone of surgery 1000 miles north within the boundaries of the United States, but oh well. Here we go.
I injected xylocaine into the nerve area just below that eye and then around the anterior portion of her maxilla, that is upper jaw. Everyone’s eyes enlarged slightly as I began to incise and strip back the tissues of the upper jaw up to an area just below her affected eye. The bulge of the bone over her left maxilla was evident and with a sharp bone chisel and hand pressure I removed a large section of thinned out bone over the anterior maxilla over the antrum or maxillary sinus. When this had been accomplished I was able to use a periosteal elevator to separate the soft tissue mass from the antral wall and when I finally grasped the mass with a hemostat, I was able to withdraw a cystic mass probably 1x2.0 inches in diameter, to everyone relief and surprise. Lynne helped me with the procedure as she had done many times before. After closing the tissues with sutures and leaving the woman with a few pain pills, our trip was over and we departed the island, praising God for the opportunities He had afforded us on that day and that trip. I believe the woman was very relieved, but I suspect she was still asking herself how these foreign appearing people made their way out to her island?
Dale had checked the fuel levels of the two aircraft and we would need to proceed straight east to the mainland which was possibly 125 miles to find some fuel for our return home. We made it over to Guaymas and then we were dismayed to find they did not have jet fuel which was required for the Citation jet, but they had avgas, which is aviation fuel for the non-jet aircraft. That would be fine for the second plane but was not recommended for the jet. Dale and I knew that you could use avgas, in an emergency, to fuel a jet but it could only be used as an emergency fuel and for not too long of a flight, so that’s what we did. I must say I was a bit concerned as we flew toward Mexicali, Mexico for our inspection and border crossing. We also accomplished some surgery and some evangelism on the streets of Mexicali. At one moment we had some 40 or more people lined up for me to exam and do extractions on, right there on the streets of Mexicali. What a sight and what a day.
There probably were a number of other interesting moments during the years which I was piloting airplanes which I may have forgotten about. But that’s OK as I gave you just a sampling. My trips into Guatemala and the Ukraine or Spain all had their interesting moments, but that will have to wait for another book.
A Twelve Year Old Is Healed Of Cancer
The following story is absolutely true and occurred now some 30 years ago. I had written about what happened in my book, Miracles Along the Way, back some 20 years ago. I was now a born again Christian and the Lord made a certain command to me so very clear, but I was learning I was to wait for His timing. The story which will start in the next paragraph is exactly what was published as a chapter in the book in which I was describing many miracles which happened early in our Christian walk. I this particular case the Lord made it very clear to me I was to pray over a 12 year old son of a lady I had led to the Lord about 18 months earlier. I had never seen her after that but we heard her son was dying of brain cancer.
Now, the rest of the story…Let me say, that I have never seen Matthew after that moment, but I did see the mother about 18 months later when she waited for us at the Ukiah airport as we flew our plane back into town. She let us know they had just confirmed by CT scan of Matthew that there was no evidence of a tumor at all in his cranial cavity. These are the times when one steps out to do what the Lord, by His Holy Spirit, is making known to you.
There is a story which blessed us so much. A few years ago a married woman came to visit us to ask if we could help her restore her marriage. We felt that first of all she needed Jesus as her Lord and Savior, and he allowed us to lead her in prayer to make Him her Lord. Then we gave her knowledge of how to stand in faith on God’s promises for the healing of her marriage. A year and a half went by and we never saw her again nor spoke with her, but we later heard that her twelve year old son was dying of brain cancer.
God put on Bob’s heart that he was to lay hands on the boy and pray for God to totally heal him. Some weeks went by. Then one evening as we came out of church another couple, Glenn and Charla Edwards, wished to join us at a restaurant for coffee. As we entered our booth I recognized the entire family of the young cancer victim, sitting in another booth. The mother kept looking over and seemed eager to talk with us. As they were leaving they came over to say hello and that gave Bob the opportunity to address the illness of the young son. Bob asked if they would sit a moment and he began telling them how God had impressed upon him that we were to lay hands on and pray for the boy’s total healing. They agreed. Bob began telling the boy, his mother, father and brothers and sisters how Jesus healed all who came to Him and believed.
Bob knew much of what he was speaking about was directed to raise their knowledge of God’s healing power and to raise their faith in a personal, loving God. Bob felt many of his words were being directed toward the father’s unbelief. He could see the expectation of the healing arise in the son and in the mother. The son was beginning to almost glow with anticipation.
We laid hands on the young boy and began to speak words of God’s healing over him. The four of us knew the young cancer victim was totally healed that evening. The mother’s comment to Bob as we parted was most interesting. Remembering we had not talked to her in eighteen months, she now said to Bob “We knew we were to see you. “ God had made it perfectly clear to Bob and to her that Bob was to pray over her son. The atmosphere in that particular restaurant that evening was charged with the Holy Spirit. We felt we could have led all to Jesus, but His direction to us was to bring healing to a twelve year old cancer victim. We knew much seed of the knowledge of God had been spoken into the father’s life that evening as well.
Over a year went by before we came back t that city. We had spoken of the boy’s healing that year across America wherever we were ministering. We came back to the city and inquired about the boy and learned from family friends the boy just that week had a CT scan and MRI performed and was told there was no evidence of brain cancer! He was totally healed! We praise Almighty God for the wonderful miracle He performed!
This story is an interesting one and certainly one with many turns. It was during that time when we had left cattle ranching in Oregon and come back to practice oral surgery in the small Menodocino County town of Willits. It was in this town that we had purchased a small medical building and were enjoying the practice and again living in a small community. Across the two-lane Highway 101 was a small hospital known as the Frank Howard Hospital, named after the son of the owner of the world famous race horse Sea Biscuit. The son, Frank, had suffered critical injuries in a tragic road accident and had been operated in this small hospital, but later died. The senior Howard really wanted to help this small hospital that he donated a large amount of funds to help it become an even better surgical hospital.
I had operated a number of trauma cases and other TMJ surgery patients in this small hospital, but there is one such patient that I want to tell you about. His name was John. But let me start at the beginning of the story. Some 6 months before I had met John, our small medical building had been burglarized by a man and some of the narcotic injectable, and a few other items had been stolen. We had an alarm system which had alerted the police and me personally, that a robbery was in progress. It was about 10:00 PM on a Saturday night and Lynne and I were just getting into bed when the phone rang. After getting dressed we travelled the mile to the office address to find the Willits police were on the premises.
With the police in attendance, we inspected the inside of the building and basically found a couple of vials of Demerol missing from the refrigerator and a small television set I had borrowed from my son Andy’s bedroom and placed on my desk, missing. There was some small residue of what appeared as particles from the roof tiles lying on my office desk, so the police took a look up in the attic, with guns drawn, but no one was spotted.
The building was again secured with the alarm reset and we went home to rest for the night. Over the next few months one of our rather unsavory patient acquaintances had let out that he knew who had broken into my medical building. This fellow was definitely very familiar with the Mendocino drug “cartel” known for raising marijuana in the mountains of Mendocino County, the “marijuana capital” of the U.S. He had told me it was a John Gonzales who was living with his girlfriend “Rosie”. It seems the police were also aware of the goings on of John, but had little to go on. I was particularly upset with the fact that John, the burglar, had stolen my son. Andy’s, very small TV from off of my desk. There seemed nothing I could do, or better yet, should do to attempt to be in touch with this fellow, John. I did, however, do a short stake out of John’s known house, but saw nothing that I should do. That, I’m sure was wisdom.
At least 6 months went by and there was no resolve to the burglary problem so, basically, I had put that behind me. It was another late evening when I received a phone call from one of the emergency room doctors at the Frank Howard Memorial Hospital telling me of a shooting and the facial injury of a man who was now in the E.R. and bleeding. Would I come down? Yes, was my answer and again I got out of bed to see what needed to be done at the hospital.
After visiting with the E.R. doctor, meeting the patient and reviewing the radiographs of the skull, I determined he needed to go to the operating room immediately so that I might debride and close the wounds after reviewing and correcting any bony palatal and maxillary bone injuries. The police were stationed around this patient, William Johnson. As I was scrubbing up before the surgery, the nursing staff had prepared the patient, who was lying on the operating table and had him full draped by the time I entered the actual surgery.
Everything went as planned with me removing a 38 caliber bullet from the palatal-tonsillar region and then closing all soft tissue wounds to face, oral and soft palate regions. The police had been stationed outside of the surgery. As I finished the surgery, I stayed at the table side as the nurses removed the drapes and began to get the patient ready to move on to the gurney to be transported back to his room on the surgical floor. As they did this, they turned Mr. Johnson slightly on to his right side exposing his left scapular region, which displayed a large, colorful tattoo with the name “Rosie” prominently displayed. Rosie? That rang a bell in my head. Was this really John Gonzales? It was confirmed as the police now took the man into their custody. This really was John Gonzales, the very man that had burglarized my office, stolen drugs and Andy’s small television set, and now I had spent 80 minutes performing surgery, for which I would never receive a cent. Why was I the last to learn who he really was?
Over the next few weeks as I benevolently cared for my new found friend. John Gonzales, we had may laughs over the situation. He really was rather delightful, but still a crook, and we always just joked about when he might bring Andy’s television back, but he never did. By the police waiting until after the emergency surgery before they arrested the man, it would keep the City and County from having to pay any medical bills. Pretty smart, but I must say I felt like I had been robbed by the city and by “Rosie’s” friend.
It so reminded me of the other “John” that I had operated on and who helped me develop the Endosseous dental implant. He, too, was a big drug dealer and the possible murderer of his own physician father. But thanks to my friend, Chief Justice Don Wright, of the California Supreme Court, he had been incarcerated.
So, all in all, it makes for an interesting life. Just enjoy the path Lord lets you take, and do all the good along the way that you can.
My Drag Racing Experience
There was an interesting moment in my life when I was given the opportunity to race some cars on the Bandimere Speedway in Morrison, Colorado. Let me give you a little history as to what happened. When Lynne and I knew we were to close down my surgery practice in Northern California and move to the Denver area to start a medical device company alongside of a marriage ministry, then that is what we did in January, 1989. Both Lynne and I had been ordained and called by God to start both the ministry, Covenant Marriages ministry and the medical device company, TMJ Implants, Inc. We were both ordained in the ministry of Jesus Christ and we took that calling very seriously. We wrote books, produced television programs and ministered in churches across America and even into parts of Europe.
It was during those most active years of ministering, in 1998, that I was called to be part of a pastor’s racing competition at Bandimere Speedway. I had met the son of the owner and founder of the speedway sometime earlier. His name was “Sporty” and he was always helpful and friendly. There turned out to be about 35 pastors from the Denver area churches who were invited to the competition. In this case the cars would be Chevy Luminas and the distance would be the quarter mile standard racing course. Two racers would be lined up at the starting light and then the lights would change from Red to Yellow to Green.
I am at this moment in time 72 years old but in pretty good shape physically. The average age of my 34 other competing pastors was about 34 years of age. So, I am twice as old. Well it took about 5 or 6 runs to get us down to the last two competitors. I turned out, by somewhat of a fluke, to be one of the last two competing pastors for the large, perpetual trophy which was standing over to the side on a card table. It was beautiful. Whoever wins get his name engraved on the base and can retain it for one year and then the next year all is repeated.
Well, the two of us are lined up at the starting point and darned if I don’t beat the other racer and win the trophy. I had invited my 21 year old son, Matthew, to be with me during that race. Well, wouldn’t you know it, Matt sees a sign regarding a drag racing course to be put on about a month later at Bandimere by the Frank Hawley Drag racing School and he asks me if we might take that 3 day course together. Being the sport that I am, I said sure.
So when that day arrives we again go out to Bandimere for the three day course. There are probably about 6 or 8 signed up; then I see the drag racing cars. WOW! I thought we would be in street cars. WRONG! These cars were something and me after some 5 lumbar discs have been removed in part am now signed up to race these fast, confining vehicles down a quarter mile track going up to 150 MPH in 9 seconds. Matt was excited and then I too got excited.
We both succeeded in becoming drag racers at that moment three days hence and it was very exciting. Our pictures were put in the Drag Racing Nascar magazine and they mentioned that at 72, I was the oldest they had taught and that my reflexes were remarkably good. I do suspect my flying jet aircraft and my years as a surgeon helped to make that all possible. It takes coordination and discipline. Anyway, thank you Matt for the experience.
Bob at 72 years of age, drag racing
Matthew at Bandimere Speedway
The Call to Start TMJ Implants, Inc.
It was in 1987 that the Lord made it very clear we were to start a medical device company alongside of a marriage ministry. The vision of that had been given to me back in 1983 but it took this long before I knew we were to do as He had commanded 4 years earlier. Had we ever known how complicated and expensive this venture would have been, we never would have started.
I have learned the lesson here is to devote your life to doing what God would have you do, and then even if it appears you have made some mistake, the Lord is not only more than enough to forgive you for your mistakes but then lead you by His Holy Spirit in the very path you are to take.
The path we were being led on was an absolutely impossible task, but fortunately that fact was kept hidden from our eyes. When I knew God wanted us to pick up the earlier vision He had given to us, I just said to Lynne, it seems we are to close this practice and move to Colorado to start the medical device company alongside the ministry. The medical device company would be to manufacture and distribute the TMJ implant invention the Lord had given me some 27 years earlier.
I had no idea how difficult that venture might be, especially since we had no finances to start the journey, other than $10,000 we had gotten for the sale of our home in Calpella. I had sought a Regulatory attorney in Santa Rosa before we left California to see what we might need to think about in the way of regulatory obstacles as we were to start. She informed me that since our implants had been around some 16 years before the Medical device Act of 1976 had even come into being, that we had nothing we needed to do. Wrong advice, as we later found out.
I have really learned that if God is calling you to do something; just step out and do it. Much like Moses at the Red Sea, He had to put his foot in the water and the Lord did the rest. Since I have written several books which tell of this venture, I’ll leave it alone other than to say, we did bring forth those excellent implants for the world to enjoy. One of the books which I talk about this journey was, Run To Win and another very recent book was called, FDA, you were WRONG! Both of those books will tell you the battles which laid ahead, much like for Moses and Joshua, the road ahead was actually a battlefield and a mine field. But now let me just give you an inkling of some of the good which occurred from taking our step of faith.
As we started TMJ Implants, Inc. and a sister company which I founded called, Medical Modeling, Inc. we were now able to use the CT scan data to reproduce the actual bone anatomy of a given patient’s skull, spine hip, knee foot or any other bone anatomy, thus making the stock devices less important. Now we have the actual shape of the patient’s own bone thus allowing an accurate design and manufacture of a particular and precise implant. This was an early use of this technology in the reconstruction of a patient’s bone anatomy. This development of ongoing technology allowed us to accomplish many things which had not been possible in earlier years. Let’s look at a couple of examples. In these examples I was given the opportunity to help plan what might be accomplished and then to design, along with the actual surgeon, the implants which would be needed. Although I was in many of these surgeries and frequently acting as an unpaid consultant, the surgeries were being accomplished by other very capable surgeons.
A young patient was born with a developmental deformity of bilateral Golden-har Syndrome. In this instance both ears were missing as well as both TMJs and much of the mandible. An earlier surgery had attempted to replace much of the missing mandible with rib grafts but this had only been slightly helpful.
I was given the opportunity of designing the surgery and the implants which would reconstruct the two TMJs and the missing mandible. This patient and her surgical reconstruction with our implants were featured on Ripley’s Believe It Or Not, television program. I have incorporated a few pictures regarding this surgery.
In the following case: views of a lady with a massive tumor replacing half of her mandible. By resecting half of her mandible and reconstructing it with Co-Cr implants, the patient is able to continue to function esthetically and to function by the chewing of foods.
This next young patient’s mother had gone through a moderately difficult delivery of her son some 8 years earlier. The obstetrician used forceps for her delivery and after her son was born, there was a tear in the tissues over his left ear and a bruise over his left pre-auricular region. In time all healed well, but the ear was repaired with sutures following his delivery.
Over the next 12 months it was determined that her baby had a limited function of his lower jaw, apparently caused by injury at the time of his delivery. As the next year went by the baby’s mandible would only open about ½ inch. They waited for another year before her physician advised an x-ray be taken of his temporomandibular joint. It was found from the radiograph that his left condyle of his mandible showed a flattening of its contour and seemed to be somewhat fused to the skull base.
No one ever came up with a solution as to what could be done and over the next 6-8 years little, Matthew, had very limited mobility of his mandible, ate only small amounts of soft foods and was developing a more decided unilateral under-development of his jaw and face. He was examined by a very capable orthodontist in an Eastern state where this young man lived who knew that we might be able to gather some surgeons together and improve the condition of this young patient. The orthodontist and I had spoken on several national meetings when he decided to get me involved with a couple of our very talented surgeons in the Denver area. Drs. Randy Robinson and James Curry were the surgeons who would plan and execute this surgery after some consultation with me as to how to best handle the ankylosis in this age patient. We all agreed that a hemi-arthroplasty surgery would be the avenue of choice along with a technique for elongated the left side of Matthew’s mandible by distraction osteogenesis, a technique which Dr. Robinson had helped pioneer.
A CT scan of his skull allowed us to construct an SLA model of his entire skull so we might see exactly what the condition of his left condyle was. Also how deficient his left half of his face was so that in our treating his ankylosed TMJ, we might also elongate his mandible and reposition his lopsided maxilla. These are complicated surgeries, for any age patient to endure, but mother and son were very much in favor of what was being planned.
The SLA models show the ankylosis (the attachment of mandibular condyle to skull base caused by forcep delivery injury.
These two views show the distraction of the ramus of the mandible to allow for proper growth and symmetry of mandible and face.
Here we see the flattened condylar articulating surface and lack of proper height to ramus. I the bottom photograph we see the placement of the custom Christensen Fossa-Eminence Prosthesis to relieve ankylosis and allow motion.
Here we see the patient 21 days after reconstructive surgery eating a hamburger,
Here we see Matthew at age 16 with full motion of his lower jaw and a reasonable correction of his facial asymmetry. Some future minor corrective surgery may be recommended depending on his future growth.
The FDA Issues
From the beginning it was apparent that the FDA was going to be a problem. This discussion has been complete in the book titled, FDA, you were WRONG! Let me just say at this time that from the original approval process of our, then, 40 year old and successfully used devices, we saw persecution and corruption in the whole process. One or two of the FDA hierarchy in the division we had to go before were extremely biased and corrupt. We did all we could to draw attention to the way our company and its implants was being treated, even going to Congressional leaders to help, but all to no avail.
Many stories had been written about the battles we were going through, but little seemed to help. Finally, one of the FDA’s top administrative people went to bat for us knowing we were being treated so poorly and I believe that broke the camel’s back and we got our approval for our devices in 2001. But that did not stop subsequent attacks which finally allowed the FDA to levy a $630,000 penalty against me personally, and our company on the most ridiculous of claims. To make this a short chapter, since so much else has been written about the attacks, let me just say they caused our little company to go out of business. That was a sad day for Bob and Lynne Christensen.
Since that time, Bob has busied himself in the writing of another 10-15 Christian books.
The Colorado Society of Oral and Maxillofacial Surgeons
Special Recognition Award
At the 41st Annual Meeting of the Colorado Society of Oral and Maxillofacial Surgeons meeting in the Broadmoor Hotel, Colorado Springs, On July 28th the first ever Special Recognition Award was presented to Dr. Robert W. Christensen for his 64 years of service to humanity, innovation and contributions to the field of oral and maxillofacial surgery.
The presentation was awarded by Doctors Randolph Robinson, James Curry, Crayton Walker and Ricardo Alexander (in absentia). The three day meeting had as the only presenter, Dr. Eugene Keller, Director of the Oral and Maxillofacial Surgery department at Mayo Clinic; who had spoken that very morning on the 25 year history of using the Christensen TMJ implants as their mainstay in surgery of the temporomandibular joint. Dr. Keller had made the statement that the Christensen Partial TMJ implant was useful in correcting the problem in 95% of the arthritic TMJs seen at the Mayo Clinic. No other treatment had the long, 52 year, history of success that the Christensen Partial Joint implant had shown for this joint.
Dr. Robinson led off the presentation by saying,
Many men elect to go through life never asking the hard questions of “why” and “why not” because they are afraid of offending or learning what might be demanded of them in response to the answers, but not Dr. Bob Christensen
His innovation, creativity, and tenacity have contributed immensely to our specialty of oral and maxillofacial surgery. I met Dr. Christensen at Truman Medical Center in about 1986 or 1987 when I was a third year resident in oral and maxillofacial surgery when he was giving a talk before our residency program.
What I learned was that a man with an idea could build a company and help many more patients than he could by operating on them one at a time. After all, so I thought, this is America, entrepreneurs welcome. His work was an example to me that a person could take his ideas to market to help others.
I don’t remember a lot about the lecture other than a few slides but I remember the enthusiasm of the speaker and his little side jokes which seemed to entertain him sometimes more than the audience. He did not display any tone of arrogance and was approachable with questions, rare qualities among us surgeons.
As an inventor and one who has dealt with the vicissitudes of the Food and Drug Administration, I always looked up to Dr. Christensen for trying to keep his work moving forward for the sake of those patients in need. I know the hurt and burden this struggle has been for him and have the highest respect for him as a result. He did everything he could for as long as he could.
Over the years he has helped me with many of my joint patients along with Dr. James Curry. At one point we even seriously tried to merge our two companies together. I enjoyed reading the early proof of his latest book, Just Remembering-- A Surgeon Recalling the Past because it gave me a greater understanding of the adventures of a man who has made a difference for others. The surgical stories are entertaining from his first patient as a dentist in Chester, California to performing a tracheostomy on a calf. The amazing stories of his various endeavors include operating a Cat-9 bulldozer in a river to flying a Citation jet make one think, on one hand, this guy is crazy but, on the other hand, gee I’d like to do that, too.
His story shows that even through adversity can mean opportunity and that no one escapes adversity. The adversity comes unfairly sometimes from friends, colleagues and government regulators causing frustration and anger. But the key is how that adversity is used for advancement in deepening a relationship to God. I hope you will find his story fun to read and inspiring as I did to ask the hard questions ”why” and “why not”.
Then a word from Dr. Crayton Walker who had just that day flown in from Salt Lake City to assist in the presentation. His words follow:
Tribute Dr. Robert Christensen
Colorado Society of OMS
July 28, 2012
I feel honored and privileged to be here tonight and offer my tribute to Dr. Robert Christensen. To me he is a mentor, colleague and friend – I call Bob.
Bob has worn many hats in his long and distingued life. In no particular order – husband, father, Christeian, author, patirot and soldier, cowboy and horseman, pilot, Dortor and Oral Maxillofacial Surgeon, inventor, CEO of a Medical Products Company and Phlanthropist. Few people have the energy to keep up with him.
In the Bible, Matthew 5: verse 15 and 16:
15: Neither do men light a candle and put it under a bushel, but on a candlestick; and it giveth light unto all that are in the house
16: Let your light so shine before men that they may see your good and works and glorify your Father which is in heaven.
Bob – your light so shines!
Over the last 25tyears I have had the privilege to know and work with D. Christensen. I believe that the Christensen fossa implnat is the best prosthesis available on the market for alloplastic reconstruction of the temporomandibular joint. This prosthesis was invented by Dr. Christensen in the 1960’s and has proven track record of successful patient use in the world over a 50 year time span. Today Dr. Keller has given a wonderful presentation on his use of the Christensen fossa implant used at the May Clinic.
In Oral and Maxillofacial Surgery both at the Scientific Podium and written literature it has been stated that alloplastic TMJ reconstruction should be the last resort for patients who need TMJ’s surgical treatment. In my professional practice over the last 30 years time, I have seen patients undergo conventional meniscus repair with failure, dermal grafts, temporalis muscle flaps, meniscectomy, and costrochondral bone grafts with resorption and ultimate failure. It is well known that with the increased number of surgical procedures for the patient, the chance for surgical success goes down. In my professional practice, the Christensen fossa implant has stopped this escalating cascade of surgical treatment with the patient undergoing usually one surgical procedure with resolution of the patients pain and TMJ dysfunction problems. With now increasing emphasis on quality of care and cost savings for the patient and insurance companies, these issues are only going to be brought into sharper focus going forward in the future.
Bob and TMJ implants was way ahead of the general scientific community with the SLA anatomic models from CT maxillofacial scans with custom fabricated prosthetic TMJ components. Bob has never been satisfied with “good enough” and instead has always tried to improve his product for the patients we both serve.
I operated on a patient with Treachers Collins Syndrome with his jaw fused open for the previous 15 years time. An SLA anatomic model was obtained and custom prosthetic total joints fabricated. Because of financial considerations, all these services were donated by Dr. Christensen for this patient. In addition to this, he got on the plane, came to Salt Lake City and helped me perform this surgery. This small story has been repeated many times over by Dr. Christensen with many surgeons and patients worldwide.
I personally want to thank Bob Christensen for all that he has done for me as a mentor, colleague and friend. The patients with TMJ pain and dysfunction that require surgical treatment have been well served by the skill and surgical expertise of Dr. Robert Christensen.
The profession of OMS thanks you for your selfless service, dedication and sacrifice to our specialty and the patients that we serve.
Crayton R. Walker, D.D.S., M.D.
Oral and Maxillofacial Surgeon
Dr. Walker’s words were followed by Dr. James Curry, who read a letter sent to him by Dr. Ric Alexander, of Long Island, New York. It follows:
Honoring Dr. Bob Christensen
I would like to take this opportunity to applaud the Colorado State Society of OMS for honoring Dr. Robert W. Christensen. Bob has served has served our profession honorably for some 50 years as a surgeon, inventor, author and most importantly as the President and CEO of TMJ Implants, Inc.. TMJI devices have improved the quality of life of thousands upon thousands of patients. I was reminded of that the last 2 days when I had the opportunity to see and follow up on a couple of my patients who have had his TTMJ-R devices in place for 13 years. Both function normally and are pain free. I first met Bob in 1991 and he and Dr. Don Chase convinced me that the same things happen to the TMJ as happen to the hip and knee, i.e., arthropadies, disc dysfunction, trauma, tumors, etc.. They believed that if you treated joint disease like orthopedic surgeons treat joint disease the patient’s would get well. They were right and it changed the way I thought about temporomandibular joint dysfunction and has allowed me to help hundreds of patients over the years. Bob Christensen is to TMJ devices what Steve Jobs was to Apple computers. Both are examples of how small businesses grow and turn into something big. Bob started hammering out his devices on a work bench in his garage as did Steve Jobs and both turned their products into successful businesses. I will be forever grateful for what I have learned from Bob. I am also grateful for having had the opportunity to teach other surgeons how use these devices during a period in my life when I dabbled in academics. Congratulations from the North Shore of Long Island Bob, this is American and you deserve to be honored. Dr. Ric Alexander
When Dr. Curry finished, he presented Dr. Christensen with the following very beautiful plaque before the 120 present at the evening banquet. Dr. Christensen thanked the Society and the individual presenters and then said though the Lord had graciously bring forth this new surgical technique, for restoring pain reduced and improved function to tens of thousands of patients around the world. It was people like the presenters and many of the surgeons in the room that had allowed this technique to be brought forth to a nation and a world. He also mentioned his gratitude to Dr. Keller and the Mayo Clinic oral and maxillofacial surgeons who had fully accepted this implant reconstructive surgery and had helped to bring it forth to the nation.
Drs. Walker, Curry, Robinson and Christensen
Robinson, Walker, Jenson, Christensen, Curry and Matt Christensen
Joan Johnson, Lynne Christensen and Sherilyn Curry
Bob and Lynne Christensen
A Surgeon Recalling the Past
As a person looks back on his or her own life, what will that person see? Will it be a life lived to the fullest and hopefully as a blessing to others? Or will it be a life lived only worrying about what I might get out of it and to heck with anyone else?
All of us have choices to make as to how we are to live our own lives and too frequently we are not too concerned about what that life looks like to the world, our family and most importantly, our God.
We certainly all make mistakes as we live our lives and then too frequently, near the end of our lives we determine we have made all sorts of mistakes or we should have lived differently.
The author admits he made plenty of mistakes and at times they were not only hurtful to him, but also those around him or those whose lives were touched by his.
It wasn’t until he was learning to fly jet aircrafts that a young ex-TWA captain named Dale Black brought to his attention that he was not a born again Christian, that then his life began to really change.
He realized then, that God truly loves him, but more importantly he could now live his life even to a fuller extent, and be a blessing to many others. Oh, yes he had been led silently by God to be the best surgeon he could be, but God even had a bigger plan where he might take the knowledge he had in the surgical field to a world which needed that enlightenment.
He, Lynne and others travelled the world teaching other capable surgeons how and what to do in some of these common and sometimes rare maladies which affect the human race. Sometimes in Ukraine, where he led the two operating surgeons to the Lord during a surgery, but other times in Spain, England, Ireland, Honduras, Columbia or Mexico. God always had a purpose for Dr. Christensen bringing knowledge of the Lord Jesus to a hurting world. It almost always was mixed with the knowledge of a great surgical technique for restoring proper pain free function to a patient with some serious TMJ problem or the patient might be missing much of the jaw, the TMJ or the cheekbone, orbit and part of the skull.
Whatever the mission, he recognized the call and was most anxious to go forth to teach his techniques to the younger surgeons. Sometimes the call was to our military bases such as Brooke Amy Medical Center (BAMC) or Eisenhower Medical Center or Walter Reed or the National Naval Medical Center. He and Dr. Curry and Alexander all enjoyed the opportunities afforded and always returned home feeling a degree of accomplishment. We all realized the hand of God had been in the opportunities which we all had been granted.
The author hopes by making this short book available it will give the reader a small glimpse into the life of a surgeon who had lived and practiced in the last Century. Now, folks, go finish your mission, and enjoy the ride. Bob Christensen
Other Books by the Author
The Seagull and the Pigeon
Satan, You’re Not Stealing My Marriage
Standing in Love
Unleashing the Power of Covenant
When You Say I Do, God Says I Will
Why I Chose To Believe In My Marriage Healing
Turning Earthly Profits into Eternal Rewards
The Face of God
Run to Win
On My Heart
Miracles Along the Way
Lord, Increase Our Faith
The Greatest of These Is Love
Hope In the Midst of Changing Circumstances
Faith, Hope & Love
The Breaking Point
The Calling, of God On Your Life
A Heart For God
FDA, You Were WRONG!
David vs. Goliath, Round 2
Innovation, the Missing Link
Just Remembering-A Surgeon Recalling the Past
Isaiah 60: 1-4
Arise, shine; for thy light has come,
And the glory of the Lord is risen upon thee.
For, behold, the darkness shall cover the earth,
And gross darkness the people;
But the Lord shall arise upon thee.
And the Gentiles shall come to thy light,
And kings to the brightness of thy rising.
Lift up thine eyes round about, and see:
All they gather themselves together,
They come to thee; thy sons shall come from far
And thy daughters shall be nursed at thy side.
Then thou shall see, and flow together,
And thine heart shall fear, and be enlarged;
Because the abundance of the sea
Shall be converted unto thee,
The forces of the Gentiles shall come unto thee.
Page 101 the name of the county Menodocino or Mendocino