A Surgeon Shaped by Service
Each year Duke Health surgeon David Powers, MD, DMD, gets a Father’s Day card and a Christmas card from Syheem Artis. “I was shot in my temple and my chin,” Artis said, “and I was in the hospital for half a year. He reconstructed everything — my chin, a plate in my jaw, a plate in my head. I’m not sure who else he’s worked on, but I would say I’m his best work.”
When Artis came into the emergency department in September 2020, he was unconscious and unresponsive. After a series of surgeries, Artis regained his ability to eat and speak and was able to return to work. For some of the surgeries, Powers teamed up with neurosurgeon Jordan Komisarow, MD, who also gets Father’s Day cards and Christmas cards from Artis. “Those two guys — their job is more than a job,” Artis said. “To me, they became family.”
Powers served in the Air Force for two decades before he came to Duke in 2013, joining the Duke University School of Medicine as a professor in the Department of Surgery with appointments in neurosurgery and head and neck surgery & communication sciences. In the Air Force, he treated head and facial injuries resulting from ballistic trauma, accidents, and blunt force trauma.
Now he uses that experience when treating patients who come to Duke with wounds to the face and head, whether from violence, hunting accident, suicide attempt, car accident, or fall. He also repairs damage caused by treatment for head and neck cancer and performs surgery to alleviate sleep apnea.
It's work he is passionate about. “If you think about the craniomaxillofacial region, that is how people interact with society,” he said. “Our patients tell us they want to have the simple joy of going out to dinner with family, to be able to eat and swallow without having to cover their face with a napkin, to be able to walk down the street and not have people stare at them.” Powers strives to restore those simple joys.
From Dental Surgeon to Medical Surgeon
As a newly minted dentist, Powers was commissioned as an officer in the Air Force in 1990 just one day before the first Gulf War. He was deployed as a medical service officer at a military hospital in the United Kingdom, where he was assigned to serve as an assistant to a maxillofacial surgeon. He was immediately captivated.
Maxillofacial surgeons were particularly in demand as improvements to body armor drove down injuries to other parts of the body, resulting in higher wound rates for the extremities including the head and neck.
So, after the war, the Air Force made him an offer: it would sponsor his medical school education if he specialized in maxillofacial surgery and committed to a full career in the Air Force. Powers earned his medical degree at the University of Texas Health Science Center San Antonio.
On September 11, 2001, he was a chief resident. Powers knew the country would be going to war soon, and he would too.
“I committed to learning everything I could to manage ballistic injuries and perform facial reconstructive procedures,” he said. In 2006, he was deployed to a military level one trauma center in Balad, Iraq, where he overlapped a short time with Gerald Grant, MD, the future chair of the Duke Department of neurosurgery.
Back in the states, after this combat deployment, Powers developed a craniomaxillofacial trauma training platform for military personnel at the R. Adams Cowley Shock Trauma Center in Baltimore. “Our job was to train people up in the management of complex craniomaxillofacial trauma and ballistic wounds,” he said, “to prepare physicians, nurses and technicians to go to Iraq or Afghanistan.”
From the Air Force to Duke
When Powers retired from the Air Force, he thought he might return home to Kentucky. However, Grant, an Air Force veteran, was part of the team that helped recruit him to Duke to establish a program in craniomaxillofacial trauma and reconstructive surgery. The chance to create a program from scratch appealed to Powers, as did the collegial and cooperative culture he found at Duke.
Powers is part of a long tradition of physicians who have served in uniform. Thousands of doctors are currently on active duty or in the reserves across the military’s branches, many entering through the Health Professions Scholarship Program, which covers medical school tuition in exchange for years of service. The Army alone counts more than 5,000 physicians.
A sense of duty and teamwork resonates across the Duke surgical community, where many surgeons share a history of military service. Surgery chair Peter J. Allen, MD, for instance, trained in the Army at Walter Reed Army Medical Center and later served as a battlefield surgeon in Iraq with the 2nd Armored Cavalry Regiment’s forward surgical team. Former chair Allan D. Kirk, MD, a transplant surgeon, spent 18 years in the Navy Medical Corps and Dawn Coleman, MD, chief of the Division of Vascular and Endovascular Surgery, continues to serve in the Army Reserve.
As someone whose work spans several disciplines, Powers values Duke’s collaborative spirit. Any given patient might need reconstruction of hard tissue (bones) and soft tissue. They might need therapy to learn to move facial muscles, swallow, or speak. “We’re very collaborative,” he said. “It’s not just a procedure of putting bones back into position. It’s holistic.”
He’s also grateful for the resources that make that collaboration possible. “We are very blessed at Duke,” he said. “We have access to the best technology, and we practice at the tip of the spear when it comes to reconstructive and regenerative surgery.”
What he values most, though, is his team — a nurse navigator, clinical nurse, physician assistant, residents, fellows, and faculty. “All of them are totally committed to the same goals as I am,” he said. “That makes it seamless and fun to come to work.”
“We are continuing to push the envelope on what is possible. I’m not practicing today the way I was five years ago and probably won’t be practicing the way I am today five years from now.”
- David Powers, MD, DDS
Powers still maintains strong ties to the military. He directs the craniomaxillofacial fellowship program, which is attended in large part by active-duty American and coalition personnel.
“Even though it’s not military-based, there is a lot of applicability to what we do here as it relates to what a deployed or combat-ready person needs to do,” he said. “In conjunction with the neurosurgical group, we do a lot of complex cranial reconstruction, traumatic brain injury research, and regenerative medicine.”
Regenerative medicine, he explained, helps people heal more completely and regain more function than was once possible using new technologies, therapies, and biomaterials.
Focus on Function
After decades of practice, Powers remains engaged and excited about the future. “We are continuing to push the envelope on what is possible,” he said. “I’m not practicing today the way I was five years ago and probably won’t be practicing the way I am today five years from now.”
For example, intra-operative imaging now allows surgeons to perform reconstruction with a higher degree of accuracy. Patient-specific implants using new materials provide much more symmetric and natural looking replacements for bones in the skull and face.
Powers is particularly excited by the possibilities of regenerative medicine. “We’ve always done a good job with the reconstructive part,” he said. “The bones will heal. But if patients cannot function and live independently, maybe we haven’t done as good a job as we thought.”
His focus on function means he wants his patients to be able to control their lips, open their jaws smoothly, swallow, speak, move, and close their eyes, and above all, feel that they are contributing to society. He wants that because he understands that all these abilities allow people to connect with others. He has seen the distress families experience when they look at the injured face of a loved one.
“We meet people and their families on one of the worst days of their lives,” he said. “To have the ability to help them through this situation and help patients regain function, form, dignity, and confidence is incredibly rewarding.”
Mary-Russell Roberson is a freelance science writer living in Durham.
Eamon Queeney is assistant director of creative and multimedia services in the Office of Strategic Communications at the Duke University School of Medicine.