One Grandchild, One Sickness

A contemporary told me of a rule she and her friends observe at the monthly meetings of their luncheon group: “Only one grandchild, only one medical diagnosis.”

 

 

The rule struck me as wise. My grandchildren proliferate, for which I give thanks and tell stories and show pictures. This is a picture of my latest, Sadie.

 

 

Last night I visited Sadie’s house. To my good fortune she happened to be crying. My son passed Sadie to me and I placed her against my left breast. My heart beat at its steady 46 beats per minute and over the next few minutes I patted Sadie’s back in gentle diminuendo. She stopped crying. She rooted and tried to suckle. My collar proved unnourishing. After a while Sadie gave up on fluid and slept. I held her there, on my breast, for some minutes: was it twenty? Was it only five? I never felt more deeply alive.

 

 

So much for the one grandchild. Now for the one medical condition. Like grandchildren these proliferate as we age. I have lots. Every condition generates a story of compelling interest to the sufferer, and to the sufferer alone. Today’s was a visit to the periodontist. Have you ever been treated by a periodontist? If not I congratulate you.

 

 

In reality the periodontist is a dentist. The difference is one of specialisation. This practitioner doesn’t implant, doesn’t fill cavities, doesn’t do root canals, doesn’t make bridges. Nor even, in the usual sense, do extractions. Instead the periodontist extracts scale, plaque and whatever you have saved for your retirement.

 

 

Because the periodontist is truly a dentist she has lying horizontally on a jet age bed that rises and bends and straightens in response to unseen signals from the practitioner. Behind your right ear the practitioner keeps a small table upon which lurk small pointed instruments of hardened steel. These she keeps out of your line of sight lest you seize one, and in a reflex of self defense, you plunge it deep into her eye.

 

 

In short, periodontic procedures are notoriously painful. I took my seat this morning on the dental bed. The bed lay down and so did I. I opened my mouth. A bright light shone upon my face. I closed my eyes. At this point I ceased speaking. The periodontist looked inside. She said some gloomy things: ‘Gingival recession… pockets… these front teeth are loose, might lose them…’ She fondled my gums for a good time: ’I’m applying local anaesthetic jelly’, she said. I tasted something distinctive and highly unpleasant. I recognised the taste, one I remembered from the day in the bath in 1951 when my older brother pissed in my mouth.

 

 

Perio, as I will call her for brevity, now poked a hissing instrument into my mouth. I salivated. As the instrument hissed it cooled itself with a constant spray of watery mist. Fluid accumulated somewhere near the hole through which I customarily breathe. Perio probed, the gadget hissed and misted, the fluid level rose and for a time I breathed under water. This went on for a longish time, a form of dental waterboarding during which Perio asked repeatedly, ‘Are you OK, Howard?’ Each time I lied: ‘Yes, fine.’

 

 

From behind my left ear the unseen dental nurse waved a wand that hissed and sucked. Frequently this sucking instrument missed its target and sucked at my lower lip, a strangely sensuous experience. My mouth being open and full of fluid prevented me from thanking my unseen sucking kisser.

 

 

The bed became erect: ‘Rinse’, said the Perio. I rinsed. The bed collapsed and I took the hint. My mouth fell open and so, briefly, did my eyes. I beheld before me at eye level a long thin syringe of glass and steel, moving towards my gums. I’ve seen that sort of syringe before in movies in which a figure such as Mengele carries out unspeakable acts. I closed my eyes. My trapezius muscles clenched. My gums swelled hugely, all sensation fled and the balance of my hour passed. I drowned repeatedly. I rinsed, I spat. The bed erected itself, Perio said, ‘That’s it.’

 

Happily, I paid for her next BMW. I was happy because nothing hurt. I’m sure she’s not a real periodontist.

 

Dressing up to Undress

Patients who attend a doctor in emergency come dressed in their ordinary rags and tatters. Their outer clothes vary and their undies are sundry. Those who attend, foreknowing, for their piles or their pap, wear their best undies. We all do it; we prefer to dress up to undress.
 

That’s why I’m hurrying out to purchase a toothbrush. When my regular dentist enquires I assure him I my teeth regularly – and I do – every birthday as well as at Passover and Yom Kippur. Regularly. Never fail. (I suspect my dentist’s true question goes not to regularity but to frequency. But I answered truthfully.)

 

So I do already own a tooth brush. It has served me, three times a year, for twenty years. It’s an old comrade, faithful and ragged. Today, however, I’m investing in a toothbrush of twenty-first century manufacture. I’m going to brush my teeth today. I’ve googled ‘how to brush your teeth’ and I’ll imitate the you-tube that shows how it’s done.

 

I’m preparing to visit a special dental practitioner, a periodontist. I’ve never seen a periodontist before but I am reliably advised that this professional will be a torturer with higher degrees and advanced training. So I will come prepared – with a brand-new overdraft facility from the bank and my gums sparkling after the attention of the new toothbrush.

 

Why has my faithful old dentist sent me to his colleague? Apparently my long gums are going to get longer, my wobbling teeth will all fall out, my destined dentures will never chew adequately and a gummy grin will decorate my mouth in senescence. In short my days of mastication, like life on this planet, are numbered. There’s just time to enrich a professional before it all comes to pass.

 
 

Like everyone else I’m dressing up for my own funeral.

 

 
 

The Tooth

In his last decade Dad and I drove every year to the Gippsland Lakes for a few days of sailing. Those lakes are plenished by rivers that flow down from the Great Dividing Range on their way to the sea. In the course of the drive of four hours we had time enough to evoke time remembered. Passing through the township of Trafalgar we’d sight the turnoff to Bruthen, a small town nestled high in those hills. Dad and I remembered Bruthen for our separate reasons, I for the Snowy River – mighty in verse, a miserable trickle in its reduced reality when I found it in 1968. Dad remembered Bruthen for the tooth.
 
‘I did a locum in Bruthen. It would have been 1935. I was a year or so out of medical school, wandering around the country, working in little towns – like you do, Howard.
I remember the drive up into the hills. I was driving a Sunderland. I remember that car for its unusual transmission: in those days manual transmission was all we had, but the Sunderland had something unique: you pre-selected a gear manually and it would change itself. Strange at first, unfamiliar, but just the thing as I wound up those hills and around those bends.’
 
Dad smiled as he remembered: ‘Bruthen was a one-doctor town. On my first day there a man came in with a toothache. His face was swollen and he pointed to his upper jaw on the right side. This was the 1930’s; we had no antibiotics the: the man needed a dentist. “Doc,” he said, “I’ve got a tooth for you to pull.”

(I pictured my Dad as I was at that stage – green, keen, torn between the need to be a proper locum tenens, literally, ‘holding the place’ of his absent Principal, while untrained for the task. Where I was timorous and trepid, Dad was fearless as an aspiring surgeon, aware of his solitary state – no colleague to consult, no training beyond seeking and accepting responsibility – and rising to the challenge. Dad would believe he could do the job and he must do so.)

Dad continued: ‘“I’m not a dentist. I can’t do that.”
“Why not, Doc? The regular doctor always pulls teeth.”
“I don’t have any instruments…”
“Yes you do, Doc. In the cupboard, up there.”

He pointed. Hoping he was incorrect I went to the cupboard. He was quite right. I found two pairs of steel dental forceps, half-familiar instruments, a bit sinister-looking.
“See, Doc? You use this pair for lower teeth, and this one for uppers. Mine’s an upper.”
The handles felt alright in my palm. Usable, not impossible…
“Doc, you know the trick to this tooth-pulling business? You have to push downwards to pull a lower tooth and you push upwards for an upper.”’
Dad said: ‘I didn’t know the trick.
The man pointed to the tooth. I applied the forceps, closed my palm, gripping the tooth hard, then I pushed up as the man advised. Nothing happened. I squeezed harder and pushed harder. A crunching sound then all resistance fell away. I looked down at the forceps: the tooth, a molar, sat beneath its roots, which were long and stout, like antlers on a stag.
“See, Doc? Nothing to it.”
The man fingered the cavity where his molar used to sit. He withdrew his finger, bloody and slippery with spit: “Wrong tooth, Doc. It’s this one.” He pointed again.
I said I was sorry: “You really need a dentist”, I said.
“No dentist in Bruthen, Doc. You do it.”
“Are you sure?”
“Yeah. You’re good at it. Go ahead.”
It was easier the second time. I looked down at the tooth feeling satisfied with myself.
“Good work, Doc!…but… it’s the wrong tooth.”
Feeling miserable I washed the forceps and placed them in the sterilizer.
The man said: ‘What are you doing, Doc? You haven’t finished.” He pointed to the next tooth along. 
“Are you sure this is the one?”
He was sure.
I removed that tooth like its predecessors. Like its predecessors it too was the “wrong one.”

‘We continued, tooth following tooth, until I had cleared all the upper teeth on the right side. Then we agreed to call a halt.’