Friday 14 October 2011

Hard to Impress

“Can you guarantee to fix my tooth in one appointment?” the woman on the telephone asked.

“I never guarantee anything without seeing the tooth first, but I do help most people get out of trouble in one appointment,” I said.

“I don’t ever want to have to come back again,” the woman said.

“Okay,” I said.

“Which type of x-rays do you use?” the woman asked.

“We get the big ones that go right around your head and show all your teeth and jaws, the orthopantomographs,” I said.

“What about bitewings?” the woman asked.

“We like to have the big OPT’s first because we get much more information with less radiation exposure that way. But if we need small x-rays for detail, we can always get them too,” I said.

“How will you tell if the tooth would be better off with a filling or an extraction?” the woman asked.

I spent another five minutes discussing the criteria for restorative versus extraction treatment planning. Every answer seemed to lead to another question.

“You know a lot about dentistry, and you ask intelligent questions,” I commented.

“I am a dentist myself,” the woman said.

“Wow. That’s great. Where do you work?” I asked.

“I don’t work as a dentist. I’m a medical secretary, I work in the London teaching hospitals,” the woman replied.

“Oh,” I said.

“I gave up dentistry five years ago, soon after I graduated. I didn’t like working on patients unless they were unconscious,” the woman said.

“Oh,” I said.

The woman, Anna, had heard about me from another of my clients, who recommended me. She booked an appointment for the following Monday.

“Welcome,” I said, when Anna arrived for her visit with her husband, Keith.

She shook my hand. My nurse offered various forms for Anna to complete. I checked her health history and other details.

“Would you like Keith to come with you into the treatment room?” I suggested.

“Oh, no. He can stay out here,” Anna said, indicating the lounge room.

“Okay,” I said, glancing at Keith. He seemed used to being referred to in the third person by Anna.

Anna settled into the dental chair, and we examined her mouth and teeth together as she looked in the hand mirror.

“It’s the lower right wisdom tooth; it probably needs to come out. I realized after I spoke with you last week,” she said.

I checked my charting and her large OPT x-ray, obtained that morning.

“I think you’re right,” I said. “Would you like to have it done today, after we’ve cleaned your teeth?”

“Yes, please. I don’t ever want to come back again.”

I numbed Anna’s lower jaw and gave her teeth a spring clean. I sat her up in the dental chair for a rinse.

I felt my nurse’s hand gently on my shoulder. I looked up. Ada pointed to a large brown spider in the corner of the treatment room.

I decided not to draw attention to the minibeast, and to deal with it after Anna had left the room.

Anna’s attention had been caught by Ada’s hand signals, and she turned her head.

“Oh, my God, you have a huge spider in your surgery!” she exclaimed.

The moment for silent monitoring had passed. I got up, calmly apprehended the spider in my gloved hands, crushed it, and wrapped it in the gloves and a plastic bag. I disposed of it in the outside bin. I asked God for karmic forgiveness.

I scrubbed up, gloved back up, and took Anna’s wisdom tooth out. It was painless, and took seconds.

Anna joined Keith in the lounge.

“It was amazing,” she said.

At last, I thought. She’s ready to acknowledge my superior skill, extensive training, and comforting chair side manner.

“She chased and caught the biggest spider I’ve ever seen. She was so brave. I could never have done that!” Anna said.

Keith smiled. I smiled. Anna apologized for any earlier abruptness. I suggested a routine annual recall to keep her smile in top condition.

Anna got out her diary and we confirmed a time.