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More than Medicine

Unveiling Smiles, Inspiring Hope

Article by Stephanie Hower

Photography by Provided by Dr. Muskett and Dr. Grosso

Originally published in Billings Lifestyle

A smile is a window to the soul, yet congenital defects can make this ability difficult, if not impossible for some children. Dr. Alan Muskett and his partner at Billings Plastic Surgery, Dr. Grosso, are among a concerned group of doctors and health professionals who work to repair cleft lips and palates in patients from other countries who would otherwise be unable to receive treatment. Restoring the smiles of affected children is more than just an act of altruism, it’s an artform.

Encouraged by their predecessor at Billings Plastic Surgery, Dr. Walter Peet, Dr. Muskett and Dr. Grosso began traveling to Central America and Mexico with Smile Network, an organization primarily based in Minnesota. 

“Surgeons, anesthesiologists, surgical techs, nurses, record keepers, volunteers, and team leaders compose the teams,” explains Dr. Muskett. “In many of these countries the surgeons and the hospitals are available, but will not provide care to those without resources. I traveled with Dr. Peet to Cuernavaca Mexico for my first trip, working with him and getting the feel for the heavy schedule and the rustic conditions. Often we work in older or abandoned hospitals, as the local hospitals and surgeons, although unwilling to care for the indigent, don't really want us there.”

The first few days of these trips are devoted to screening patients, sometimes as many as 100 children and their families. 

“We will run two or three operating rooms, each doing 5-6 children a day, the next Monday through Friday,” continues Dr. Muskett. “We will operate on 50-75 children during that time.  Needless to say, that puts quite a load on the anesthesiologist, nurses, surgical technicians, post-op care providers, and the team leaders. These are small, often undernourished, fragile little humans, so the focus has to be supreme and the physical stamina unyielding. It is common to become ill, either from a GI ailment or a weird cold/flu bug, so one had better learn to operate between episodes of vomiting or worse. Air conditioning is rare, and the toilets are no more predictable than a slot machine.”

Not only do Dr. Muskett and Dr. Grosso offer their expertise and services, their children have participated as well. Dr. Grosso's wife, Dr. Lorinda Grosso, has also served as a pediatrician.

“I was privileged to share several trips with my daughter Sally, now a Doctor of Neonatal Nurse Practice at Cincinnati Children's hospital," says Dr. Muskett. "Luke, my son, was my assistant on two trips, and did a great job. That is a tremendous thing to share with your children--they get to see Dad in battle, they see families with nothing, they work with some of the finest minds in medicine.” 

Dr. Grosso's son Matthew assisted on a Peru trip, and his daughter Megan has participated on 2 trips to Peru and one to Guatemala. Overall, the Billings’ Community has been a strong contributor to serving under-privileged areas. 

"Dr. Chuck Aragon, an anesthesiologist, has been a team leader several times," Dr. Muskett adds.  "Mandy Charpentier RN and Corrina Main, Surgical Tech, from Billings Plastic Surgery, went to India with Dr. Grosso, and have lent their talents on other trips as well. Debbie Hammond, RN, also from BPS, traveled to the Philippines." 

After visiting an area multiple times, members of the surgical teams may be able to connect with past patients, an experience Dr. Muskett treasures. 

“One girl, who I noticed on my first trip, always covered her mouth with a scarf or her hand,” he recalls.  “When I saw her the next time, she proudly smiled and displayed her nearly seamless repaired lip. I would have to say that has been one of the highlights of my career--the chance to unlock a smile hitherto concealed. There are cultural stigmas associated with cleft lip and palate (the cursed is a translation), so these repairs are highly significant, apart from the functional aspects.” 

Surgeons and medical professionals such as Dr. Muskett and Dr. Grosso reap more than just emotional benefits by participating in organizations such as Smile Network. 

“It is a very intense, highly technical, surgical experience…35 cases a week of extremely precise, delicate surgery on small, sickly kids," describes Dr. Muskett. "I pride myself as a very efficient, decisive surgeon, and I feel I can do a lot of kids well with a minimum of trauma…Being a part of a team with a goal to help those they don't know and never will is a peak experience. Talented, giving people working under duress, keeping their composure, not complaining--it is a band of brothers and sisters.  At the start of the surgical week, I feel like I am standing in the tunnel before the Super Bowl. I reinforce my own feelings of gratitude, for being born into a good middle class family in the United States.”

Dr. Muskett, Dr. Grosso, and their families want to continue this work in the future, but perhaps with more extensive follow up and longer stays, where they can better assess results and provide follow-up care. Their hope is that someday, providing basic health care will not just be a compassionate gesture by altruistic surgical teams, but a priority of the governments where the indigent are in dire need. 

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