DOWN AND OUT
By Patrick J. Foy, DDS
“People are like stained-glass windows.
They sparkle and shine when the sun is out,
but when the darkness sets in their
true beauty is revealed only
if there is light from within.”
~Elisabeth Kübler-Ross
A bush of kinky dishwater-blonde hair masked the woman’s face with total disarray as she trembled like a newly-trapped animal. She dropped her head, trying to hide a face scaled with white patches and randomly sliced with reddened, shallow incisions. She glared at her feet with empty sullen eyes. Cat-scratched hands shook, clasping open and closed. In contrast, the drab-green, oversized hospital gown she wore carried a freshly-laundered, light fragrance.
Jane’s medical chart revealed that she was a middle-aged woman who had been found homeless in a back alley of downtown Minneapolis. She was dirty and cold, incapable of responding to simple questions, mumbling in a state of catatonic depression. After being taken to the E. R. for psychological evaluation, she was admitted to Station #22 where they attended to her basic needs.
Medication and electro-shock therapy soon re-fired her conscious state and brought on the agonizing dental pain caused from long neglect and an abusive boyfriend.
Before dealing with it, we had to work on stranger-anxiety as with a small child or any frightened creature.
Upon entering the room, to respect her personal space, I moved to the foot of the dental chair until she reached a state of acceptance.
“Jane, I appreciate that you’re a little nervous. I was deathly afraid of the dentist as a teenager. Your chart indicates that you have been having some tooth pain?” She nodded and cupped her jaw.
“Does the lower-left side hurt today?” She nodded again. “Can you point at which tooth is hurting you?” Her body shuddered as she opened her mouth and pointed to the back. From a distance, I could see her hollow, brown molars on red, swollen gums.
Sensing humiliation, I said, “My mother lost her teeth when she was twenty-seven and my father lost his at fifty. Both were good people.” She stopped writhing and for the first time relaxed with a calm that appeared to be trust.
We took a Panorex, a full x-ray of her upper and lower jaw, which showed that only two teeth were salvageable. Over the long term, they, too, would be of little value.
.
I gently explained that most of her teeth were beyond repair, but today we would attempt to relieve her pain. We discussed options for short and long-term future care, and she asked excellent questions. Later, she told us that she’d worked as a dental-lab technician.
In preparation for complete upper and lower immediate dentures, Jane returned for several visits and became comfortable in our office. During each encounter we were building a relationship while alleviating her suffering, along with the hospital mental health treatments and medications.
The day of reckoning arrived when I extracted all her remaining teeth and inserted the new dentures. The results were beyond her wildest dreams. The dentures not only fit well but gave her a beautiful smile.
The next time Jane came into our office, she walked with radiant grace. Her hair was styled, her eyes bright, chin lifted with pride and her face revealed a natural inner light.
A few months later, the psychiatrist sought me out at a staff meeting. He reported that Jane’s dentures had drastically reduced her hospital stay by several weeks, and lifted her self-esteem to a new height that no mental science could measure.
Our work was done.
© 2009 Patrick J Foy, DDS
Monday, January 25, 2010
Friday, January 15, 2010
HAITIAN DENTIST
“Good judgment comes from experience, and experience comes from bad judgment.” Rita Mae Brown
Destiny serendipitously pushed me onto an empty stool for lunch, as I sat down the lady next to me began to chuckle at my expense. It was a hurried sports bar and grill on an unusually steamy hot fall day in San Francisco. She appeared to be a petite Hispanic in her mid-thirties with gold-rimmed glasses with an ADA “Dentist” name tag from The American Dental Association’s annual meeting. “You don’t know what you just did” she giggled. “What” I asked.” “You see that line of people. All those people have been waiting in line to order food and after they get their food they wait and look for a seat. You just walked in, sat down and ordered with out waiting in line.” “I came from the hotel.” I was pointing at the back door. “I didn’t mean to cut in line, but I thought if there was an empty stool available, then there would be nothing wrong with me sitting down. So, I guess I am with you today.” I chuckle.
She had already received her food order and was eating as we curiously continued our conversation. She was from Haiti and I was from Minnesota. She was here for the convention to improve her dental education, see what’s new in dentistry and escape. We mutually shared our ignorance’s of each other geography. We both had misconceptions of each others worlds, cultures, and life styles. I must admit I was a bit arrogant about my United States’ training and my perceived prosperous quality of life. I attempted to get a flavor of her world by asking a ton of questions and she likewise was curios about life in a colder climate. Like most things in life we shared more commonalities than differences. We talked on and on describing and comparing our strange worlds.
She shared that she was afraid to go back home after the convention. There was an epidemic of murders that were occurring in her country. The servants of the wealthy were killing their bosses and absconding with their processions. The current government was unstable and the police were infiltrated with corruption. She said that she has several domestic servants, for example, she does not own a wash machine and clothes dryer at home. If she did have automated appliances at home she would be putting several people out of work. The poverty was so great that they employ people to do all kinds of menial domestic work.
Her family wealth was from a family owned rum distillery. It had recently lost its profitability, but with increase in popularity of rum in the Caribbean region the family was trying to re-invest in the distillery. Her family was able to afford her advanced education. She had lived a privileged life in an uncertain part of the world. Her practice was not that much different than mine. She was in a solo practice in a metropolitan area and she worked 34 hours a week.
I was aware of the extreme poverty, aids epidemic and rampant poor healthcare services so I asked her “What type dental care do you do for the poor?” She abruptly answered “I do not do any dentistry unless I get paid.” As she said this I was stunned; “How callused she seemed to her own people”. The fact that she didn’t seem to care about the poor was not how I was raised. I didn’t have a very good poker face. I must have been looking down my nose at her, she sensed my judgment.
She immediately replied” You do not understand, as a professional woman, I advocate for women rights in Haiti. Women are second class citizens in Haiti. I feel it is a better use of my time and talents in this area. I hope to make a bigger impact in my country as an advocate for women than trying to solve every little dental problem.” I was handed my smugness with her revelation. I had no right to judge her. My values, in my world did not make sense in her world.
Altruism is personal. PATRICK J FOY, DDS
Destiny serendipitously pushed me onto an empty stool for lunch, as I sat down the lady next to me began to chuckle at my expense. It was a hurried sports bar and grill on an unusually steamy hot fall day in San Francisco. She appeared to be a petite Hispanic in her mid-thirties with gold-rimmed glasses with an ADA “Dentist” name tag from The American Dental Association’s annual meeting. “You don’t know what you just did” she giggled. “What” I asked.” “You see that line of people. All those people have been waiting in line to order food and after they get their food they wait and look for a seat. You just walked in, sat down and ordered with out waiting in line.” “I came from the hotel.” I was pointing at the back door. “I didn’t mean to cut in line, but I thought if there was an empty stool available, then there would be nothing wrong with me sitting down. So, I guess I am with you today.” I chuckle.
She had already received her food order and was eating as we curiously continued our conversation. She was from Haiti and I was from Minnesota. She was here for the convention to improve her dental education, see what’s new in dentistry and escape. We mutually shared our ignorance’s of each other geography. We both had misconceptions of each others worlds, cultures, and life styles. I must admit I was a bit arrogant about my United States’ training and my perceived prosperous quality of life. I attempted to get a flavor of her world by asking a ton of questions and she likewise was curios about life in a colder climate. Like most things in life we shared more commonalities than differences. We talked on and on describing and comparing our strange worlds.
She shared that she was afraid to go back home after the convention. There was an epidemic of murders that were occurring in her country. The servants of the wealthy were killing their bosses and absconding with their processions. The current government was unstable and the police were infiltrated with corruption. She said that she has several domestic servants, for example, she does not own a wash machine and clothes dryer at home. If she did have automated appliances at home she would be putting several people out of work. The poverty was so great that they employ people to do all kinds of menial domestic work.
Her family wealth was from a family owned rum distillery. It had recently lost its profitability, but with increase in popularity of rum in the Caribbean region the family was trying to re-invest in the distillery. Her family was able to afford her advanced education. She had lived a privileged life in an uncertain part of the world. Her practice was not that much different than mine. She was in a solo practice in a metropolitan area and she worked 34 hours a week.
I was aware of the extreme poverty, aids epidemic and rampant poor healthcare services so I asked her “What type dental care do you do for the poor?” She abruptly answered “I do not do any dentistry unless I get paid.” As she said this I was stunned; “How callused she seemed to her own people”. The fact that she didn’t seem to care about the poor was not how I was raised. I didn’t have a very good poker face. I must have been looking down my nose at her, she sensed my judgment.
She immediately replied” You do not understand, as a professional woman, I advocate for women rights in Haiti. Women are second class citizens in Haiti. I feel it is a better use of my time and talents in this area. I hope to make a bigger impact in my country as an advocate for women than trying to solve every little dental problem.” I was handed my smugness with her revelation. I had no right to judge her. My values, in my world did not make sense in her world.
Altruism is personal. PATRICK J FOY, DDS
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