By Brittany V. Tian

Editing: Clair Gist Bradberry

Dr. Joel Dickens is an Associate Professor in the Department of Obstetrics and Gynecology. After working as a pediatrician for four years, Dr. Dickens decided to pursue a new specialty and completed a residency in OB/GYN. One of his most unique experiences has been his work as a missionary physician in Nalerigu, Ghana.

What brought you to medicine?

When I was growing up, I loved animals and always thought I would become a veterinarian. I ended up going to Baylor for undergraduate and most of the other students were pre-medicine. I felt it was close enough to veterinary medicine and decided to join the track as well. It seemed like it would be a good fit for me.

Were you immediately drawn to any specialty during medical school?

I liked surgery during medical school but felt a bit intimidated during my rotations. I really enjoyed working with kids and decided it would be a fun experience and patient population to work with.

What was your path in medicine? You are a practicing OB/GYN now, but I understand that you also worked as a pediatrician before.

Yes, I worked as a pediatrician for a few years after residency and decided to go back because I always liked surgery. I appreciated maternal health, and my family knew that we were interested in helping in a developing area at some point in the future. I felt some surgical skills would be beneficial in that setting. It just so happened that the residency program director in Galveston had a second year OB/GYN resident leave in the middle of the year, so I ended up filling that spot and joining as a second year. The program counted my experience being an attending in Pediatrics as my intern year, so I finished the OB/GYN program in three years. I worked for about eight years as a practicing OB/GYN and then decided to spend four years volunteering in West Africa.

Four years in West Africa is incredible. What got you interested in missionary work?

Reader’s Digest had a scholarship during my fourth year of medical school to help at hospitals in developing countries. While I did not get the scholarship originally, I ended up spending some time in the Congo during my fourth year anyways, around two months. After that experience, I knew I would likely go back and help later in my career.

What were some of the biggest differences that you noticed working in West Africa in comparison to your time in the States?

The area that we were working in was very underserved, especially in the field of surgery. The ratio of surgeons to the patient population in the United States is around 1:5,000-10,000 in some areas. In West Africa, the surgeon-patient ratio would be around 1:1,000,000. We were specifically located in northern Ghana, serving a population of about 300,000. It would depend on who was present at the time, but there were sometimes only two doctors at the hospital at once. They would be staffing everything. And while I did a lot of OB/GYN, we had a general surgeon there when I got there initially that left about six months later. It left me doing a lot of general surgery to fill that gap – hernias, bowel resections, etc. It was a lot of fun, and I learned a lot in that environment. We would have visiting U.S. doctors come through as well who would teach me new techniques. I kid that one of the craziest days here at UAMS is one of the normal days there in Ghana.

What were your work hours like when you were in northern Ghana?

On average, they were longer there than at UAMS, but my family lived in a house on the hospital compound about a 0.25 mile walk from the hospital. Since we were there from 2008-2012, cellphones were just coming to the area, so it wasn’t so easy to call someone. Sometimes the nurses would walk down to the house if they really needed you. Even though I was working a lot, I would always come home for lunch and dinner. It wasn’t unusual to eat dinner with my family and help get the kids to bed, then I would go back to the hospital and operate until 1 or 2 in the morning. They were busy days, but when we were home, we were home. It was good family time because we didn’t have as many distractions around. It was also a nice experience for our family and for my kids to experience another culture. It was a good opportunity to see how another part of the world lives.

Are there any moments from your career that remain with you today?

There are plenty of stories, but one that I remember now is a young female that came in with a ruptured uterus and heavy bleeding. We ended up doing a Caesarian hysterectomy. However, unlike in the States where there are large available blood banks, it would be up to the individual patient to find blood from family, friends, etc. Since she was in such an emergent situation, she did not readily have blood available. One of the nurses and a visiting medical student, a girl from Baylor, luckily ended up being matches. Those two units were enough to take the patient into surgery. The medical student, who was in the surgery with me, had obviously just given blood. The student began to faint during the surgery, but luckily, I was able to catch her across the bed. The patient wound up pulling through and doing well. Those big emergencies train you to be more efficient because you don’t really have the time to wait.

Has that necessary efficiency informed your training? Or influenced it in some way?

I kind of learned to do things quickly there. Since I practiced more general surgery there as well, I feel more comfortable working with similar surgical conditions now– adhesions, more emergent conditions, etc. I also worked on really minimalizing blood loss in the OR.

Do you have any plans for going back?

After coming back home, we helped some of the local people go to medical school and residency. The plan would be to go back and support them more. My goal would be to take some medical students and residents with me next time.