Full Circle

Just weeks after immigrating to Boston from Vietnam in the summer of 1991, Thanh-Trang Nguyen, D01, settled into Mark Doherty’s dental chair at the Dorchester House community health center.

A shy 18-year-old, Nguyen had an engaging smile but spoke only a few words of English. A social service agency had referred her there for a dental checkup, a standard part of the refugee resettlement process. It was the kind of preventative care Nguyen had not known in her native country.

Early efforts to communicate with Doherty, the director of dental services at Dorchester House, were challenging, Nguyen recalls. After examining her teeth, Doherty said, “Not good, not good. You’ve got to clean your teeth better. Do you floss?” Embarrassed to admit she didn’t understand, Nguyen replied, “Yes, yes, yes.” A skeptical Doherty followed up: “Do you know what floss is?” A repentant Nguyen admitted she did not.

As Doherty worked over that summer to fill her cavities and perform extra cleanings to restore her oral health, Nguyen’s English improved, and their relationship blossomed. “I was a tremendous teaser, and she was a great target,” Doherty says. “Tough as nails, but a great sense of humor.”

Doherty found a patient as eager to learn about how to take care of her teeth as she was to understand his profession. In her dentist, Nguyen found a mentor. By that fall, Nguyen had summoned the courage to ask if she could learn to be a dental assistant under Doherty’s guidance.

Their professional journey together began with Nguyen volunteering after school a few days a week. Although she had graduated from high school the year before her family left Vietnam, Nguyen repeated her junior and senior years at Cathedral High School in Boston to learn English. Doherty offered friendship and fatherly advice, wrote letters of recommendation and encouraged her each step of the way, from high school to Regis College to Tufts School of Dental Medicine.

He encouraged Nguyen to apply for a postgraduate fellowship, remembering how much that experience had helped him improve his skills and confidence after he graduated from dental school. It provided “continuity and comfort,” he says.

She received an Advanced Education in General Dentistry fellowship from Lutheran Medical Center in New York, which places dental residents in community health centers. And so she returned to familiar ground, to Dorchester House, where, she says, “seeing Dr. Doherty and the staff helping the community inspired me.” She was hired for the dental staff at the end of 2002.

Then in 2011, two decades after the shy teenager had come to Dorchester House for the first time, she took over her mentor’s old job, director of dental services.

“Even though I always wanted to be a dentist,” says Nguyen, “I always doubted that I could make it.” She says unwavering encouragement from Doherty kept her strong. “I wanted to make him proud.”

Dental Dreams

“She was tiny, extremely shy,” Doherty says of their first meetings in the clinic. “Getting her to utter more than a couple of words was tough. But she was smart as a whip. There was no doubt in my mind she could do anything she wanted to do” once she cleared the language barrier.

Nguyen already had an idea about what she wanted to do, and that was dentistry. It was a childhood ambition she had carried into adulthood. As an 8-year-old living in the town of DaLat in the Central Highlands of Vietnam, Nguyen had a painful toothache. “In Vietnam we only had access to emergency dental care,” she says. “There was no such thing as preventive care. You’d only go to the dentist if you can no longer bear the pain.

“My mother gave me some money and told me to walk down the street to the dentist’s office. I found a young woman [dentist] all by herself. I don’t remember exactly what she did, but I remember walking out of the office painless. That was the first time I wanted to become a dentist.”

Her youthful aspirations strengthened as she watched Doherty at work. She repeated high school hoping to improve not only her English but also her chances of going to college.

“In Vietnam, education was very much based around rote memorization,” Nguyen says. In the United States, “it was all about collaboration and independent thinking, something I had to get used to.”

What a challenge that must have been, taking high school classes in a language that was foreign, says Doherty, who notes that Nguyen was quickly earning top grades. She was accepted to Regis College in Weston, Mass., where she earned her undergraduate degree in biochemistry. Then she headed to Tufts School of Dental Medicine, a choice that allowed her to remain near her parents—who by then had moved from Dorchester to Roslindale—and still be close to her second home at Dorchester House.

The Breath of Freedom

When her family came to the United States, Nguyen says, Dorchester House, which provides health care and other services to residents of the low-income neighborhood, was one of the lifelines that sustained them. They had only $20, but received help from the New York-based International Rescue Committee, other immigrants and public assistance.

“Life was unbearable [in Vietnam] after the war,” Nguyen says. Her father, an officer in the South Vietnamese army, had been imprisoned for seven years in the brutal “reeducation camps” where the new communist regime banished many who had supported the old government.

After his release, her family faced systematic discrimination, she says. “My father, once a captain, took odd jobs … from cutting grass to feeding horses to illegally holding night classes in physics and math at our home. My mother went from being a French teacher to a peddler. We craved the breath of freedom.”

In 1989 the U.S. government established the Humanitarian Operation Program to assist former political prisoners still trying to flee Vietnam more than a decade after the war had ended. Those who had been imprisoned for more than three years were offered asylum. Nguyen’s family was able to leave in 1991.

“We were the lucky ones,” Nguyen says, avoiding the fate of thousands of Vietnamese refugees who died at sea and in the jungles while trying to escape.

Her parents were determined to succeed in America. They worked full time during the day—her father in a floor-sanding business and in manufacturing jobs, her mother as an office clerk; they took community college classes at night. Her father now runs his own dry cleaning business in Dorchester, and her mother is an assistant vice president at a financial company.

Doherty says Nguyen’s life experiences add dimension to her skills as caregiver. “When you grow up in a culture that is a minority, you learn things” about challenges that others may not fully appreciate, he says.

Today nearly one-third of the patients at Dorchester House are Vietnamese. “It feels good when I can speak their language,” Nguyen says, “and they are grateful they can address their concerns in a language they know.”

No matter what language her patients speak, Nguyen’s “best quality is that she listens,” says Doherty, who now advises community dental health programs in his role as the executive director of DentaQuest Institute’s Safety Net Solutions program. “She distills information and uses it in the best way for her program, her family, her patients, her staff. She’s learning all the time. She’s not afraid of risks, but they are well-measured.”

After Doherty’s successor as director of dental services at Dorchester House left in 2011, Nguyen was promoted. Joel Abrams, the center’s president and CEO at the time, said he chose Nguyen based on recommendations from Doherty and others about her clinical skills as well as his own observations about her potential for leadership—evidenced, he says, “in the way she relates to others, the respect she garners.”

The history of Dorchester House, founded in 1887, contains numerous examples of those who once benefited from services there moving on to build new programs, Abrams says. Nguyen’s promotion resonates with that tradition of “consumers becoming overseers,” he says.

The Dorchester House Multi-Service Center, as it is now called, has gone through its own transformation over more than a century. Founded as a settlement house in Boston’s Fields Corner neighborhood to provide cultural, recreational and educational activities, primarily to immigrants, the center has relocated, evolved and expanded multiple times. Now the center cares for more than 26,000 people each year, providing services that range from primary and specialty care to educational programs and social services to recreation (there is a pool and a gym).

Doherty and Nguyen still talk by telephone nearly every week, and they continue as colleagues. Since 2004 Nguyen has been a dentist for Commonwealth Mobile Oral Health Services, a program Doherty founded in 1979 to provide dental care at 250 sites throughout Massachusetts, including schools with low-income students. Nguyen treats elementary school children at the Boston Renaissance School in Hyde Park on her day off.  Students are taken out of class for examinations and cleanings, and, if a cavity is found, a filling is done immediately. “We grab them while we can,” she says.

With a busy life—Nguyen has three children, ages 8, 3 and 1—she says it is difficult to imagine what’s next. But her goal at Dorchester House is to increase the number of dentists so that more patients who rely on subsidized care can be served. The center’s oral health department has a staff of 23, including 12 dentists who provide adult and pediatric care in general dentistry, periodontics, endodontics and oral surgery. Nguyen sees patients as well.

When Nguyen talks about her life, she often interjects: “I’m a very lucky girl.” She says she is grateful for all the help she was given, from those who assisted her family’s resettlement to the support services she received during her education to the opportunities that have come her way. Above all, she treasures Mark Doherty’s guidance.

“I can’t express enough my gratefulness to Dr. Doherty for having faith in a teenager who barely spoke any English and for persistently encouraging her to follow her dreams,” Nguyen says. “I can only hope for the opportunity to pay this forward someday.”

This story first appeared in the Spring 2013 issue of Tufts Dental Medicine magazine.