I recently had a patient who was the living embodiment of two of the seven deadly sins (sloth and gluttony). Things were going well until I tried to raise the chair. The chair failed to budge. The obese patient was left stranded like a beached whale with arms flailing searching for something to grab onto. He could still be there but my assistant managed to push him onto the floor whereby he grabbed hold of the chair and pulled himself up. My question is. Do they make bigger chairs for today’s bigger patients?”
The chair I have can lift 175kgs. There are people who weigh more than this but it is more likely the motor in the chair was failing. Don’t blame some poor victim of the marketing arm of multinational food conglomerates when all he is doing is telling you the motor in your chair is starting to fail.
I have recently moved to Sydney. How do I decide which orthodontist to refer my patients to?
Orthodontists are different. I mean they are all different from each other. I don’t mean they are different from normal people. They differ in personality; the way they run their practices and in their area of interest. To find out you need to start referring to the local orthodontists and looking at their patient management. The other way is to go and visit then in their surgeries. Spend time talking to them and watching them work.
As you have a variety of patients with a variety of needs you should refer to several different orthodontists. There are multiple benefits in doing this. Different patients should be referred to different orthodontists based on the idea that each patient should go to the best orthodontists for that particular patient.
The other way to do it is to refer to the guy you went to Uni with. Not as stupid as it sounds. You need someone you can communicate with. It is easier to ring and discuss a patient if you share memories of a noisy, smoky room full of drunken testosterone charged students; late night souvlaki in Carlton and a hatred of certain Cons demonstrators. It is called bonding and has nothing to with phosphoric acid.
I have a cute patient, with a relaxed smile, who always thanks me and brightens the surgery. I’d love to do a few more fissure sealants, but my wife working in reception refuses to make her an appointment saying she takes months to pay her bill. How do I get to see her?
Answer: Ring her up and tell her you need to meet to discuss her oral hygiene. Suggest somewhere a little less clinical. Maybe a local coffee shop or pub. Sounds like you might have to pay the bill.
A patient rings up and says, “The filling you have just placed has just fallen out?”
What do I say?
Answer: There are three possibilities.
An unrelated filling on the other side of the mouth has fallen out. Not directly your fault. But it is possible you indirectly precipitated the loss. When you filled the aforementioned tooth you ground the occlusion and put the force elsewhere and bingo.
A scrap piece of amalgam or composite has hidden itself and resurfaced later.
The tooth is sensitive and will settle down. A reasonable assumption that sensitivity is caused by something falling out.
There is the fourth possibility that the filling you just placed has fallen out. I know what you’re thinking. Nup never happens but it is possible and in fact it did happen to me once. I had to fess up and redo the filling. Before redoing the filling stop, think and work out why the filling came out. No point putting back exactly the same filling.
When I greet my patients and ask them, ‘How are you?’ they reply with, “Alright until I saw you.”
Why do people say this? Do they think it is funny and that I am going to laugh?
Answer: I have a few suggestions for you.
You could respond in kind with, “Funny you should say that but, I was feeling alright until I saw you.”
You could be self-righteous and say, “Well I’m really happy to see you.”
You could act like a prima donna master chef and say, “That’s it I’m just not going to work unless I’m in the mood” and walk out leaving the aforementioned patient mute and begging for you to return.
My personal favourite is to ignore the comment, change the subject and add 10% to the bill.
Every time I go into reception I move an aspidistra to its correct position. When I return the plant has always gravitated back to where it was? Is this a case of walking plants?
Answer: I suspect your receptionist is moving the plant. There isn’t much point owning a dental practice unless you can randomly and erratically exercise some authority. Wait until the waiting room is full of patients then while pacing up and down loudly rant and scream sarcastically. Finish by picking up the plant and throwing it at her. This will make you feel a whole lot better and hopefully the plant will break and you can get rid of it.
I have a young female patient who needs veneers. How do I convince her that this is what she needs?
Regards Cosmetic Dentist.
Answer: Tell her that after she has the veneers done she will land a job as a model; become a reality TV star; attract hoards of followers on twitter; secure the lead role in a Hollywood blockbuster and marry Geoffrey Edelston.
My practice is not busy. How should I go about marketing it?
Regards ‘Not Very Busy’.
Answer: What you need is a marketing strategy that can be incorporated into your business plan. A plan applied to your practice so that feasible opportunities to produce positive outcomes can be realised and then levered. An integrated marketing plan that has an internal component for your existing patients and an external component to attract new patients. A plan that helps you differentiate your practice to create a sustainable competitive advantage.
Then again come to think of it all the good dentists I know don’t need a marketing plan. Their work markets their practice. You may be quiet because your work is rubbish. Any marketing based on poor quality goods will give your practice an artificial boost in the short term but ultimately do nothing.
You could be one of those dentists doing the general public a service by not being busy. You could be a physically dyslexic, immoral, lazy, slothful alcoholic who does more harm than good. If you are then accept your fate in life. You are a loser and will never be busy. But you can still be a loser who has not wasted thousands of dollars on marketing. Save your money. There are some things you cannot polish.
Unfortunately a salesperson will sometimes arrive when I’m not busy. I then have to manipulate the truth by telling Beryl I am too busy to see them. This lying makes me feel guilty. How can I absolve my guilt?
Answer: This salesperson has just driven for hours with a headache through horrendous traffic; lugged their samples up stairs while checking their voice mail messages and stuffed their half eaten lunch into your pot plants. The least you can do is speak to them. They are just doing their job. One day you will need them. Go and listen to them. Treat them with respect. Be polite. Accept their brochures and wait until they leave before throwing them in the bin.
I have just placed an on-line ad; watched my in-box overflow; glanced at multiple identical applications; interviewed six applicants; found my procedure manual; filled out mega forms and employed a new dental assistant. After two weeks she left in a hurry, mumbling something about weird control freaks; you should be locked up and on her way out accidently knocked over the delicious monster scattering soil everywhere. How do I avoid the same thing happening again?
“Here we go again.”
Answer: Move the delicious monster away from the door.
I have a member of staff who cannot sit still. While eating my lunch she will start sweeping up all of my crumbs. The slightest pause in the day and she is away arranging magazines into neat piles. She will then move onto the kitchen. She cleans and arranges the cups into a neat little row with their handles all at the same 45 degrees. I have done my best to foil her. I will scatter the magazines. I will follow her and sneakily move a cup askance. Point it the opposite direction. When she notices this she blissfully straightens the cups again and then rapidly moves on. I am at my wits end. I dream of her disappearing into a cloud of steam from the autoclave leaving behind only her immaculately clean shoes and a used chux. What can I do? I don’t think I can fire her.
Answer: You have Irritating Nurse Syndrome. A dentist working full time with the one assistant will spend more time with her than their partner. Prevention is better than cure. Don’t employ someone who will irritate you. Next time you interview job applicants go for the one you feel comfortable with. The one you would like to prefer to sit and watch TV with. Never be influenced by amount of experience, résumés, the quality of the application, or their interview. Experience often has to be unlearned. Everybody has a good resume—which they didn’t write. Good answers in the interview often means they have applied for lots of jobs.
Go for personality or gut instinct everytime. This assessment starts when they walk in the door and will take less time than it takes to set 3 mm of A3 composite resin.
As you say it is difficult to fire her. If you can’t fire her then you can either begin to enjoy her eccentricities—see her as strange and interesting like an animal in a David Attenborough documentary—or hope she finds your crumbs so annoying she resigns.
A mouse ran across the surgery floor and my assistant screamed making the patient anxious? How do I stop my assistant from screaming whenever she sees a mouse?
Answer: Buy a mouse trap. Next time she screams load the trap and place her fingers in it. A few bruised fingers and she will learn her lesson.
A new dentist has just opened up across the road. He has done a letter drop, has big signs and ads on the radio. How do I compete?
Choose your own answer:
Answer No 1: Good dentistry.
Answer No 2: You have or should have lots of advantages. Reliable, dependable, well know, secure. The other dentist has to overcome these disadvantages. His advantage is he is new fresh and up-to-date. He somehow has to prove he is secure, reliable and dependable. You have to prove you are up-to-date. If you are doing modern state of the art dentistry then you really shouldn’t have to tell anybody. It will be obvious. If you aren’t then you deserve to be worried.
Answer No 3: You are asking the wrong question. Don’t compete. Go and help your colleague. Become his friend. Create a symbiotic relationship where you both benefit. Refer patients to him. Help with emergencies. You will both attract different types of patients. Grow dentistry. Grow dental health.
Answer No 4: Do what I do. I ignore everybody else. I’m not going to spend my time worrying about other dentists. They can worry about me if they want.
Cementing a single veneer. I check everything. And re-check. Hesitant to start. And then I begin. I remember the time cement hardened between the teeth and I spent hours trying to remove it. Can’t let that happen. So before the cement is fully set I floss between the teeth. And I remember the time I flossed out the cement and the veneer came off. Can’t let that happen. I check the bite, and the margins—everything looks good. I can exhale. I adjust the chair so that the patient can have a look. Jessica gives the young lady a mirror and the lady doesn’t say anything. Just stares and stares and then says,”The colour. It’s too dark.”
I avoid her eyes and sigh, “Okay can I have another look at it.”
I say,” We have funny lights in here. You have to see how it looks under different lighting situations. You need to get used to it. I think it looks good. It’s better of being slightly darker rather than slightly lighter.”
This last bit doesn’t go down that well. Eventually she agrees to see how it goes. To take it home with her-which as it is cemented in place was a touch inevitable. She goes.
My mood has changed the way a cool change sweeps across the city. The colours dissipate leaving behind dull, drab sepia. I cannot move. I sit motionless surrounded and enveloped by the surgery. The walls seem everywhere. I can sense muffled people moving but they seem a lone way away. The energy has been sucked from me the way water disappears down the plug hole. I must force myself to move. I stand and sigh. I move very slowly. Every step resembles a climber on Mt Everest. Laboured. I get the next patient and I can’t believe I was so stupid. Why did I make such a basic mistake. Dentistry 101. Jessica is irritating me. The way she leans over and holds the suction tube. And this patient’s tongue. If it does that just once more I will drill a bloody hole in it. Then it will learn what to do. Why do I put up with it? My back is aching. I want to curl up and make myself smaller and smaller. To lie still and let things happen as I lie observing the world go by through dull eyes.
I ring the lab. They took the shade. They ask me which brand cement I used. What colour did I use? Did I try it with different cement? Why did I cement the veneer if it was the wrong colour? This needles me. I know I made a mistake. They don’t have to rub it in. If I can get the models back to them and they can remake it’s not really there problem if I have to cut the veneer off.
I tell them that we should be alright. The lab says,” We are very happy to remake it.”
I don’t think she will ring back. She’s too passive— eager to please—too nice. Unlike me doesn’t know what’s possible. I think she accustom herself to the veneer. And I tell the lab,” I don’t think it will be necessary she won’t complain.”
They like the sound of that so they immediately repeat their offer. I tell them that it won’t be needed.
Next patient is a blur. He says,” I hope I don’t see you a while.”
Very funny. He goes and I sit motionless.
And then I reluctantly get the models out of the bin. I know what I have to do and I pick up the phone and ring the patient.
“We will have to redo the veneer. The colour is not right. We will make an appointment for you.”
She passively agrees with me. Sounding slightly stunned and confused.
And I immediately think about the next patient. Let’s get this show on the road. The colour has returned. And next time I cement a veneer I will have one more thing to remember.
Mary automatically smiles. Irrespective and everybody smiles back. Even Jessica likes her. Two days ago she came in for a routine exam. We talked about a few things and I told her everything looked good, she was doing a fantastic job and there was no need for any treatment. She smiled, thanked me and rang up the next day to say that a tooth had broken. To me this is embarrassing. Not to her. Perhaps this is why I like her.
Years ago I asked her, "How's your husband?"
She burst into tears, sobbing hysterically and managed to squirt out, "He left me."
I sat there squirming, fidgeting and looking at the clock. Half an hour wasted. I could see the goldfish laughing at me.
Today she wants to talk about her daughter.
She asks me, "Could you please talk to my daughter? She says she wants to be a dentist. She's obsessed about her teeth. Can you talk to her?"
"Sure no problem."
And then she continued," and tell her that being a dentist is a terrible job, and that she should do something else."
"No I can't do that."
She looks puzzled and confused and hurt. After a couple of moments thought, she surfaces, forgives me and says," Oh I suppose not."
Beryl is peripatetic; endlessly moving between reception and the surgery. Wherever the action is. As soon as Mary leaves the surgery, Beryl sees an opening and approaches me. She always has something to tell me. This time she says, "Mrs Parker rang up and she says, 'what a good job you did yesterday and she didn't even feel the injection.'"
"That's not enough information. Give me a clue."
Beryl doesn't. She is on the move. Walking away from me and shrugging her shoulders in disgust.
The next man lies in the chair. His phone awakes with the sound of a horse neighing. The man squirms and says, "My children did that." The second time we hear from the horse he is not as embarrassed. By the third and forth time we ignore it. When he leaves Jessica snorts, "We need a sign about these phones. We have to train these people." The goldfish laugh. They know nothing is going to change.
A lady rings Beryl, "The filling is still painful when I bite. It's already been fixed once. Still sore. Can't get time off. These people I work for are bastards. Shit. Shit. I'm only a single mum. Now I've got an aching tooth as well. I work for complete morons. The teacher says my son needs extra work in maths. What are you going to do about it?" She is talking faster, louder and shriller. Beryl makes her an appointment for the Friday after next and then comes and tells me about it.
An old friend comes in to have her teeth cleaned. I have been seeing her irregularly for years. She has sent her son and other friends to see me. The routine is for us to talk about her work and once again I do this. She says that she is no longer working. She has just had a heart attack. While she is saying this she gets out a sheet of paper with her medications listed. She looks reasonable well. Not like some people who when they begin chronic medications age decades within years.
When cleaning her teeth I see that she still smokes.
"Are you still smoking?"
"I'm cutting down."
I've had enough of this nonsense. Her gums are a disaster. The teeth should have been taken out years ago. This routine cleaning of teeth is a complete waste of time. And she still smokes.
After cleaning her teeth she prepares to hurry out. I prevent this by placing my chair in front of her. I sit facing her and say, ''I'm a bit worried about your gums."
She looks stunned. Where did this come from? I don't want this aggro. She looks irritated. Desperate to leave.
"These medications you are on…some of them can have a very bad effect on the gums…I don't think some of these teeth are going to make it…if we are talking five to ten years then I doubt…"
She gazes into the distance, "I'll be dead by then".
"Don't say that, look at it this way, at the moment we have two options. Take out all the teeth and have dentures or keep going the way we are going.
"I'll be dead in ten years."
She walks out, leaving me staring at an empty chair.
Jessica says, "Ah well, that went well."
I can hear the goldfish. They are saying, "You don't have to be that sarcastic."
A newspaper lies sprawled across the front desk. On top of the newspaper lies a patient’s card with the word “DECEASED’ in big black letters across the front. I peer at the open newspaper and see that a small sad lonely death notice has been circled.
Beryl articulates my thoughts, “She must have killed herself.”
I nod, look at the card and then pick it up.
I open the envelope and review her history. What went wrong? I first saw her seven years ago. She initially presented complaining about the position of the 12. It was prominent. She wanted it capped.
I referred her to an orthodontist. I look at the letter from the orthodontist. It talks of Class11 Div11, completing diagnostic records and fixed appliances for both upper and lower arches. It talks about payment options. A screaming silence about her mental state and it wasn’t because we didn’t know. It was bloody obvious that something was wrong and straightening up a few teeth wasn’t going to help. Orthodontists don’t fix emotional problems. This is not just hind sight because I remember her well. Not because she was lovable or nice and friendly because she wasn’t. Not because she collected broken appointments and was on our bad debtors list, even though she was.
I look at her medical history and there is no mention of medications or mental illness. She must have been treated for something. Perhaps she hasn’t told us the truth. Perhaps she wasn’t actually being treated by a medico. I can’t believe that. Her doctor must have been onto her.
I see that in 2004 (after no activity at the orthodontist) I made bleaching trays for her. She collected them and took them with the intention of bleaching her teeth. A futile and pathetic hope that whiter teeth would change her life.
Meanwhile Beryl has answered the phone and is impatiently listening while waiting for an opportunity to put the caller on hold. She finally gets her chance and turns towards me.
“It’s one of your turkeys. You know the ones you told us we had to get rid of. To tell to go elsewhere.”
“She’s always late. You know. This is her third serious major, can’t sleep at night toothache in six months. She never cleans her teeth...”
I know. I know what the experts say. Job satisfaction comes from enjoying what you do. Treating people you like. Treating nice people who believe in dentistry. They universally say get rid of the turkeys. Fly with the eagles. And the clincher. You will make more money.
Beryl starts tapping the phone on the bench. I hate that.
“Well what do I do? How do I tell her to go elsewhere? Do I tell her we are busy or offer her an appointment in three months time?
I start rambling on about born victims. Some people are always the victim. Do you remember at school every class had one kid who was always being picked on? Even by the teachers. A kid who could never do any right. I remember one kid who was bashed up mercilessly and a few years ago I found out that when he arrived home in the evening, from a day of torment at school, his father bashed him up all over again. I feel guilty.
Beryl is still waving the phone in front of me, “What do I do?”
“We will see her after the last patient. It’s her lucky day. We’ll squeeze her in. Someone she doesn’t know has just killed themselves and I feel guilty.”
Beryl turns away from me and as Beryl prepares to speak on the phone I can hear her mumble, “I don’t know why you bother going on these courses if you are just going to ignore everything they say.”
She is sitting in front of me wishing she was elsewhere: like on the front page of a magazine. The photo of her would be of her head and everybody would comment and say how good she looked. How her skin was pure and faultless like Nicole; how her hair was thick, wavy and fulsome like Golden Stephanie; how her smile was perfect like Julia. Her height and weight suggest she chose them. That means they look perfect. Her make-up shouldn’t look this good: it enhances their looks. Her clothes will be replaced when she wants to rebrand herself, not when they wear out.
And she is sitting in front of me looking harassed, worn out and frazzled. A gap between her upper incisors is ruining her life, and I know this because I have already spoken to her mother, but I start off ignorantly and ask her, “What can we do for you today?”
She puts her hand up and covers her mouth and then says, “The gap between my teeth.”
I go with genuine concern and inquire,” Yes?”
“I don’t like it.”
And then I slowly ask her,” Why?” and she searches the room for inspiration hoping someone will answer for her and eventually she mumbles, “I don’t like it.”
“I just don’t like it” and she assumes that that will be the end of it. That her explanation is replete.
I could just do it. Then again I could tell her to see the gap as a positive, an asset and something to be proud of. I could talk about the need for maintenance, talk about a waste of the world’s limited dental resources, talk about a billion people in this world who spend all day hungry while she worries about a variation of normal which when it is changed and when she looks like what she imagines every other sixteen year old looks like, won’t change her life a smidgen or make her one iota happier or improve her school marks or get her a better boyfriend or improve the health of her dentition or fill her full of joie de vivre. I could talk about how she should take charge and control of her own body and sometimes this means accepting yourself as you are and being proud of and celebrating differences. I could say that if you go down this route where your happiness depends on what you think other people are thinking of you, then you’ll never ever be happy and you’ll never ever, ever be satisfied.
I remember an old saying that ‘you deserve the patients you end up with.’ Well if this is true then I’m doing something wrong.
At high school when they came around and asked me, “What do you want to do when you leave school?” I’m sure I didn’t say, “Close midline diastemas that nobody notices and nobody else cares about.”
And at Uni I’m sure such things were not on the curriculum. I’m sure I never sat in a lecture theatre thinking, “One day I will pander to emotionally volatile teenagers. I will pretend to help them. I will be a cross between a nail technician and a hairdresser but I will think myself better than both.”
I know that wasn’t what I was thinking. Deep down past dreams of money, status and libidinous females was the feeling that I might be able to help somebody, to actually do a smidgen of good. It never occurred to me that this would be dentistry. And nobody agrees with me, nobody cares. Nobody. Everybody reassures me, ‘Big deal, if that is what she wants then it’s up to her. It’s her decision. Who cares?’
Then alternatively I could sympathise with her as she battles against the media and its personalities and the marketing of the major brands which is way more sophisticated than she will ever be. She doesn’t stand a chance. Every photo in every magazine she buys will have digitally enhanced teeth with all gaps eliminated and every female news reader will have a wall of perfect porcelain veneers.
And then Jessica kicks me. I realise I am mumbling aloud. Jessica nods towards the patient, indicating that I have finished closing the gap. I raise the seat and go and greet mum who is an old feminist foe of mine. Not the ‘can’t stand you breathing’ type. More the type that corrects you for saying ‘fisherman’, but I like her and we get on well, even so, I don’t think we will be discussing what happened to the revolution and I don’t think I will be asking her if a person enslaved to the media and marketing of large multi-nationals is really liberated?
Some mornings unfold better than expected. Your patients are interesting people you’d prefer to chat with. They think that they have difficult problems but I know (I’m not telling them) that they have simple routine problems. They think I am a great dentist: I feel like a great dentist. We are running a few minutes late but the next patient can wait. Jessica has a new joke:
An old lady goes to the dentist. She walks into the surgery and greets the dentist. He greets her and then puts on a pair of rubber gloves. She stares at his hands. He says, “These gloves come from overseas. I’ll tell you how they make them. They boil up a huge vat of latex. The workers come along and stick their hands into the molten latex. They then take their hands out of the vat and wave them around until the latex dries. They then peel the gloves off and pack them in boxes.”
The old lady says nothing. No response apart from a blank look. The dentist sighs and commences drilling. Half way through filling the tooth, the lady suddenly bursts out laughing.
The dentist stops drilling and asks, “What’s so funny?”
She says,” I’ve just realised how they make condoms.”
We laugh out loud and are abruptly interrupted by Beryl ushering in a new patient. We both suddenly stop laughing, and guiltily glance towards each other and then simultaneously greet the patient. The patient speaks first with a firm admonishing “Good morning”
She is forty four years old, five foot two, weighs 75 kgs, wears stockings, her hair is big, an unnatural ochre colour, soft, fluffy and contains product that helps retain it’s shape, eyebrows darkened, the usual lipstick (it won’t come off ), wears prescription glasses with no frame, works for the Department of Health as a manager dealing with clients who have rights and responsibilities and can at times be fractious, deals with staff ‘you just have to treat them right’, carries some of her work in a brief case which rests upon her abdomen, has just applied for a new position in a different part of the same department, not on more money but the experience would look good on her CV, legs crossed at the ankles with knees slightly apart, wearing a skirt and top with matching jacket embellished with a silver brooch of an animal (could be a tiger).
She seats herself without looking at the chair or wiggling backwards, then looks around the room, glances over her left shoulder at the bench tops and stares at Beryl who is placing some clean instruments in the drawers, continues her visual tour of the room, stares through me to the bench (and the pile of cards hereon), looks at the computer screen attached to the dental chair.
And then she says (more talking to herself than anybody else),” I think I’m in the wrong place. I’d better go.”
And then she pauses (now that she has our attention) and waits very deliberately and says, “Sorry.”
By the time she has said this, she has levered herself from the chair and is moving irreversibly. She has tightened her grip on her briefcase and is looking past the door, not looking at anybody or anything and not waiting for us to say anything. Just going. And now she has gone and the room is empty.
Jessica and I look at the cavernous space in the middle of the room.
Jessica shrugs her eyebrows and sarcastically says,” Do I clean the chair?”
I don’t care. I’m going to have a cup of tea and I reply by using that word, that word that signals the end of the conversation, that word that pretends I don’t care, that word that is taking over the world, the word affecting insouciance, the word that means don’t stress me out, that word that irritates me whenever I hear it, the word I use subconsciously fifty times a day, “Whatever.”
How did things come to this? I wake and shower. I worry about where to put my clothes. I remember that I can't throw them on the floor. I worry about everything. Everything will be wrong. Put in the wrong place or. Everything is out of my control. I can't find the bloody newspaper. It should be up the top of the drive or under the car or in the shrubs. Bugger it. As I search the dog from next door startles me by suddenly barking. Why don't they do something about that dog?
No vegemite. Anywhere. I am sure I mentioned that we were out. I look in the fridge, cupboard and on the bench. I'm not going to mention it again in case I've already done so. That would be provocative. I'll have to wait until somebody else notices. If I had an empty jar I could place it in a prominent position on the bench.
My son is looking for his shoes. I ask him, "Where do you normally keep them?"
He looks at me with a “that's a funny thing to say look”. He then does nothing. Well if he wants to school in barefeet, he can. Who cares? I think he'll only do it once.
I walk to work. I cross a small side street and flinch as a four-wheel drive car turns the corner ands sits on the horn, waiting for me to scurry out of the way. I don't. I slow down and dawdle across the road.
I arrive at the safety and security of my surgery. My surgery. My rules. My staff; when they arrive. At the moment no staff. All's quiet. The phone rings. A new patient. I explain that we are not seeing new patients.
"What about family members?"
"Yes we are seeing family members."
"Well my spiritual family sees you. My pastor comes to your practice."
I tell her that unfortunately we do not have any appointments and advise her to go elsewhere. I make a few suggestions. It feels good. For the first time today I have control of something.
A man enters the front door. He wears a bushwalking jacket, carries a camera and has a wife who trails behind. I can see what is coming. He tells me he is just visiting Hobart and has been up all night with an aching tooth. I ask him to show me the tooth that's troubling him. I tell him we will see him as soon as the staff arrives. He sighs and thanks me.
The phone rings. It is a sales rep from some company.
"I'm just ringing up to see how you found that free sample that we sent you."
I think she means the one I threw in the bin.
She politely grovels for my time. I refuse her and politely end the conversation.
Another man walks in. I know him. From the four-wheel drive earlier in the morning. He doesn't recognise me. He has no hope. I let him tell me his story. And then I write down a few names and phone numbers, which I give to him. He doesn't argue. He tacitly accepts the phone numbers. As he slowly walks out he peers intently down at the numbers, looking for the trick. Perhaps his earlier rage was due to his toothache.
I feel like superman who is gradually having his powers returned. Slowly and steadily they are coming back to me. I am starting to feel in control. And when Beryl goes to get the post I'll tell her to buy some vegemite.
And next week what happens. Before crossing the same small street I turn and look. The same four-wheel drive is poised ready to turn into the same street. This time the driver recognises me and waves to me for me to go first. I stand and wave for him to go. We both wait and I break the impasse by walking. Bugger this; he can wait for me.
First patient of the week. A new patient. A retired male in his sixties. Thin, dressed in jeans and a tight t-shirt. Cynical and self-pitying. He aggressively informs me, "I want my teeth cleaned, nothing else." He dares me to disagree.
This is going to end in tears. I could slow down, stop, and carefully tell him what I believe and why. I could slowly explain why we need to get a proper history and do a thorough exam before we begin treatment but sometimes it’s easier to instantly dislike someone. It saves time.
I say, “We are having a look at your teeth”, recline the chair and begin probing his teeth. I slowly chart his mouth as he gradually becomes more irritated. He tries to talk above my fingers in his mouth, “the filling is okay. There’s nothing wrong with it.” I continue probing, looking to the goldfish for assistance. I slowly peer at the teeth.
He’s still wants to say something and I carefully grab a perio probe and begin probing.
“My teeth are fine. I just want my teeth cleaned. That’s all.”
I reach over and sit the chair up. As the chair rises he looks around baffled and confused. I tell him, “I think you should see someone else.”
The chair spits him out and as he rushes out the door he yells,” I think I should. “
I start to say, “Have a good day. “ But Jessica is the only one listening. He’s gone. I can hear him racing down the corridor, the front door slamming and then silence.
Jessica says, “That’s a bummer first thing of the week.”
I disagree. By Friday we would have forgotten him. Better now.
I tell Jessica, “I should do that more often.” but I’m shaking and the pressure has built and she is not convinced. Give me something to hit. I should have yelled at him.
Beryl approaches and asks, “What was that all about?”
“I’m right. I know I am. You can’t clean teeth without looking at them. The idea is ridiculous. You have to know what to look before you can do anything. I know I’m right.” I desperately plead my case.
The next patient is waiting. A lady who wants to know how her gums are, how her cleaning is going. ”Because I’ve been working very hard at it and I’m expecting some good news.”
Her cleaning is constantly improving and is now close to perfect but I’m distracted by the previous patient.
I can cope with anxious patients or patients that disagreement with me (I actually enjoy them) or honest ignorance but I hate the ones who don’t believe my motives, don’t trust me, think I’m only trying to rip them off. I can cope with someone who says, “I want a second opinion”, “let me think about it” or “I don’t believe you” but this guy didn’t trust me. He didn’t believe me. But this lady does. In fact I’m continually surprised by the trust people have.
I really should do it more often. Stand by something. I normally end up compromising. Because I like the person and they might change and improve or because it‘s stressful laying down the law. To be fair to this guy I should have told him why I didn’t want to continue our relationship but to be fair to me he ran out of the surgery before I could. The next patient is another true believer and the first patient is beginning to recede and I‘m reminded of Jesus Christ and how he spent more time worrying about the stray sheep then the good sheep.
I imagine him ringing back to apologise: “I’m sorry I walked out on you. I’m sorry I didn’t trust you. Can I please return? I‘ll pay for the last visit.”
But it’s not going to happen. What will happen is him complaining to his friends.
And at the end of the day I have spent time stressing and worrying about one black sheep, distracted and anxious and taking the good patients for granted. Assuming that they’ll be satisfied and that they will return. I think JC was wrong on this one. Tomorrow I’ll worry about the good sheep, the ones that trust and respect me. It’s a lot easier and there’s a lot more of them.
This blog is the fictional story of a dentist. The dentist works with Jessica and Beryl in a town a lot like Hobart. The blog tells the story of what these people get up to and the work that they do. If you feel that you recognize yourself in one of the stories please remember it is fictional and the characters and stories are all fictional. Though all the stories are based on my time as a dentist in Hobart and are based on things which actually did happen.