A small sad lonely death notice

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.”

“More information.”

“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.”
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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.”