There, lying next to the Visa/Master Card sign was what looked like a 2-carat diamond. Or a nice piece of glass.
I put down my usual turkey sandwich, mid chew, and examined the sparkly object with the dental magnification glasses that looped around my neck. Other than a couple scratches, I had no idea what I was looking at.
The women in my family love jewelry. My mother-in-law left Communist China with her treasures sewn into the linings of her coats. She continued to purchase baubles well into her 80’s. My mother looked at the white women with their miniature July 4th hot dog earrings or chunky silver plated dog collars and whispered, “So low class.” She never sported fake jewelry until she bought a crystal Swarovski bracelet, possibly in her early dementia mistaking it for the real thing, compounding the delusion by concluding she had gotten such a terrific bargain.
“I want you to have this when I die,” she said.
So naturally I had a jeweler, like other people had handymen or hairdressers. I took the stone there after work. “It’s a real diamond all right,” he said, noting the scratches.
The following day we combed through the patients from the day before and arrived at a short list of names. Call “Mrs. Johnson” first, I said, remembering the ring on her knotty finger.
Mrs. Johnson had been frantic.
I had lost my favorite antique earrings once. I searched everywhere, scoured websites and jewelry stores for a replacement, never finding a pair that measured up. I even spoke to my jeweler about a custom reproduction.
We’ll make them look old, he assured.
As I handed her the stone, I told Mrs. Johnson, “I know how you feel.”
Her husband had presented her with this wedding ring, to replace the starter ring. “He’s been gone for so long,” she said. “But in a way, he’s still with me every day, holding my hand.”
Don’t mention the scratches, I warned the jeweler.
There was a time in dental school when I needed help with jewelry of a different sort, my first gold crown. I had worked so hard on this project, beginning with cleaning out and shaping the decayed tooth. The next step – getting an accurate replica and impression – was essential because the crown would be fabricated from this model. If the model differed from the actual tooth, then like Cinderella’s glass slipper, my crown was doomed to be ill fitting. Battling the triton spears of tongue, cheek and saliva, I finally managed to capture a good impression on the fifth try.
The patients who came to UCLA Dental School, or any school, for care usually had more time than money. Some considered it their contribution to science, to help educate a future dentist. They all understood that their treatment would take much longer than out in the real world, that
two or three students might “graduate on their mouth.”
My patient, “Mr. Carter,” was a retired mail carrier. He and his wife would make a day’s activity out of his three hour dental appointment. Mrs. Carter usually chatted with me or read romance paperbacks while I worked. Sometimes they brought me homemade cookies. I was lucky to have them.
The arduous process of fabricating Mr. Carter’s crown began with carefully producing a replica of his tooth from the impression, then making a wax representation of the crown. This fragile shell of forest green wax had to pass a professor’s inspection under the microscope. I had heard horror stories of inferior wax patterns being accidentally crushed, or stepped on, or thrown into the trash with an admonition to “do over.”
To us students, this seemed at best arbitrary. But perfection in dentistry is measured in tenths of millimeters, at microscopic levels. Depending on the professor, sometimes a smile or a giggle helped. I tried to check the inspection schedule and be strategic as to when I brought my wax crown to be approved. We all did.
Employing the same ancient lost wax method a goldsmith would use to make a golden crucifix, I melted the wax pattern in an oven, a process called “investing.” Indeed. Then I placed the pattern on the casting machine and released a speeding stream of gold into the hollowed out space to form Mr. Carter’s new tooth. It was great fun, like driving for the first time on the freeway. The crown was then drenched in water and, now black and oxidized, it had to be polished and restored to its original shine. One last microscopic hurdle loomed. The crown had to fit perfectly on the model and receive the professorial seal of approval.
Finally, on the Wednesday before Thanksgiving, Mr. Carter’s crown was ready for delivery. Everything about Mr. Carter was slow and methodical with the exception of his quick, darting
In the split second it took me to peek at the chocolate chip cookies his wife had baked for the occasion, the gold crown was gone.
I was in shock.
I sent Mr. Carter to the adjacent medical center for a chest x-ray to determine if the offending crown had lodged in his lungs, a potentially serious condition that would’ve meant further medical intervention. I absentmindedly ate cookie after cookie as I waited.
Had I done something wrong? Could I have prevented this?
He returned some time later with good news – his lungs were clear. The professor overseeing this drama explained the options. Either I could redo the entire procedure, beginning with impression taking, or the patient could consider retrieval.
“Retrieval?” I repeated, not connecting the dots of the sacrifice I would soon be asking of Mr. Carter. Yes, responded the professor as he handed me a box of large gloves. I realized he was suggesting Mr. Carter shit like a dog and sniff his poop afterwards.
I could hardly respond before Mr. Carter said as he took the box of gloves, “Don’t worry, honey. It’ll all work out.”
Three days later Mr. Carter called with one word, “Eureka!” I could not have been more thankful.
“Tell her I put it through the dishwasher,” Mrs. Carter added.
I sterilized the crown and cemented into Mr. Carter’s mouth the following week
There were other lost things over the years, but none as painful as a patient’s loss of confidence.
When a patient leaves your practice, it can be for a myriad of reasons: He’s switching jobs and moving. Her insurance changed and you’re no longer in her network. They think you’re too expensive. They’re upset over some insurance or billing issue, to which my colleagues would say, “Ha! Can’t please everyone.”
But sometimes you just don’t know why.
I have been guilty of the same behavior, slinking quietly away, even when I had no complaint against the doctor. He had delivered my second child. In my epiduraled trance, I recalled he and my husband discussing baseball. We were waiting for my next contraction. Did I want my husband to massage my scalp and something supportive like, “So grateful you’re taking one for the team”? Did I want the doctor to stare at the wall clock instead of the game on the television, timing the minutes until he would be “up at bat”? I only knew that I didn’t like watching baseball.
So when I got a call from Dr. Smith’s office down the street requesting “Renee’s” x-rays and records, it was like being dumped by a man. I wanted to ask: What did I do? Was I not pretty enough? Did I say the wrong things to your friends? Did you catch me wrinkle my nose when you presented me with the opal butterfly necklace, but only because I was expecting a ring instead?
But there’s really nothing to say. The patient has already decided to leave you.
Loss of confidence doesn’t happen overnight. Unless something horrible occurs, it’s usually small steps down a spiral staircase. It’s like a marriage. When the wife first sees a fleeting text notification on her husband’s phone, she won’t think anything of it. When he excuses himself to take a phone call outside, commenting on the cell reception, she may conclude it’s an important work call. As these transgressions mount, one day she’ll start wondering why he has so many nighttime meetings all of a sudden. And once those doubts enter her mind, everything will be tainted through the lens of suspicion. There may be a way back for a husband and wife. But for a patient and doctor, by the time the crown doesn’t fit for the third consecutive time, the dentist
can no longer blame the laboratory. Even in silence, the patient’s accusatory finger will be pointing right at me.
I had a friend in middle school. She lived on the same street and we would walk to school together, hang out at each other’s houses and listen to Freda Payne sing Band of Gold. Our paths diverged in high school. I ended up with the popular crowd, where I had longed to be and my friend stuck to the girls who were a little too tall, too shy, or too round. I acknowledged her at school, but we never socialized there. Occasionally, we would still hang out at home. She was like the quietly suffering wife to my philanderer, complicit in my unforgiveable behavior even as it must’ve pained her because she loved me.
Our lopsided friendship continued into adulthood, well beyond almost all the popular-crowd bonds I had built. We were bridesmaids at each other’s wedding. Our young families and children met each other. Then one day, she dropped me. She stopped sending holiday cards. She didn’t answer my emails or voicemails. She saw me for the fair weather friend that I was.
And I recalled the lyrics to Band of Gold:
I wait in the darkness of my lonely room/
Filled with sadness, filled with gloom/
Hoping soon that you’ll walk back through that door/
And love me like you tried before.
It’s too late though.
I try to take those “Renee” moments in stride. I tell myself not to take it personally. Sometimes you didn’t do anything wrong; you just didn’t do enough things right. Sometimes, as with my obstetrician, there was simply no connection. When you’re in such close proximity that you can see each other’s pores, that connection is critical. My colleagues are right. “You can’t please everyone.”
After all, it’s nothing like the loss of my one, true childhood friend.
My own mother lost two teeth in the span of six months, broken off at the gumline, probably swallowed and irretrievable. The food at her memory care facility was always soft and I
wondered if my mother enjoyed the rare crunch of the brittle teeth she must have eaten. I tried to shine my phone light into her mouth, but she pressed her lips tight.
To the caregiver I talked at length about the importance of brushing her teeth and controlling the bacterial population in her mouth. I mentioned its link to overall health. I compared oral hygiene to nail hygiene and complimented her clean trimmed nails. I said how nice my mother’s hair smelled.
Yet the caregiver – and my father – gave me a “What for?” look, as if to say: She’s already lost her mind and you’re worried about a couple teeth?
Teresa Yang is a dentist living in Los Angeles. Besides dental publications, her work has appeared or is forthcoming in HerStry, Mutha Magazine, The Writing Disorder and Little Old Lady Comedy. She is currently working on a work memoir about the secret life of a lady dentist.