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Unfiled February 11, 2005
 
Expensive Pain
By John Dolan Browse author Email
 
 

When I hear people boast that they've never had a cavity I realize I'm from an older world, where every mouth was a coral garden of caries. That awkward age, after the invention of refined sugar but before universal flouride. I spent hundreds of hours, and a horrifyingly great chunk of our scant income, having the holes in my teeth drilled out and filled with metallic putty.

You encounter a whole torturers' row of dentists with teeth like mine. The first and most fearsome was Dr. Georgian, a sour old Armenian who considered novocaine a sissyish fad. My mother had to drag me screaming up the dark, cigar-smelling stairs to his dingy office in Oakland. I still get a reflux of terror every time I smell cigar smoke.

At least he didn't lecture me like Dr. Cabrera, who was always chatty and nice to my mother but assumed a stern expression after looking in my fetid mouth. He'd probe around in there, hissing in disgust, then sit on his stool, pausing for dramatic effect before telling me I'd lose my teeth by the time I was thirty. I got the main point, that I was a pig, but the prediction and the age given meant nothing.

I understood the problem -- in my own, insane way. It was simple: my mouth couldn't lie. I could try to grin and nod at people and maybe fool them some of the time. But my mouth couldn't lie. It was the Mouth of Dorian Gray. The dentists looked in there and could see what a pig I was.

Then came Dr. Satre, a tall, gawky Christian type who was absurdly nice, ridiculously nice. Better yet, he used nitrous oxide. After a minute or two inhaling the gas, the social awkwardness of having a middle-aged man sticking his hands in your mouth while a young blonde woman looks on impassively vanished. You were in a quick, private mental world, in which the same succession of insights came every time. They always vanished when Satre turned off the gas, but they were glorious while they lasted, and Satre never shamed me.

Since then I've always tried to find dentists who offered nitrous oxide. True, sometimes you end up in the hands of a gas-dealer whose dental skills are not exactly of the first order. But then there are plenty of incompetent sadists, too -- dentists who can't handle a drill and don't believe in pain relief of any kind.

These pro-pain dentists flock to New Zealand, where I'm living now. New Zealand is the epicenter of pointless stoicism. As a friend said, "when it comes to medical care, the human/livestock distinction hasn't really penetrated NZ." In Dunedin, it was common knowledge that "if you ask for painkillers they won't give them to you, because that would mean you want them." A friend of mine went into the A&E with acute endometriosis, begging for relief from the pain -- and, of course, didn't get it, precisely because she wanted it. Another experienced a horrific natural, drug-free childbirth against her will -- because she made the mistake of asking for pain relief.

I once spent five hours on the operating table, fully conscious with my eyelids sliced open, having an intense panic attack and begging for sedation, and not getting anything. Instead, the anesthetist held my hand. She picked the right career -- holding somebody's hand for $600/hr is much more lucrative, less messy work than honest prostitution.

I should say NZ medical care has many admirable features. Accident care is absolutely free. Consider that, my gullible fellow Americans, and compare it to our own corrupt, callous system -- and reflect on the fact that half of all American personal bankruptcies are caused by medical charges. A visit to a New Zealand doctor costs about $35. It's a decent system, in its stiff Victorian way.

Alas, most of its practitioners share the Victorian notion that pain is salubrious. Ideally, then, you'd want to avoid looking for an emergency dentist in NZ at midnight on New Year's Eve. But that's when my premolar started throbbing in that steady way that notifies you it's going to get worse and worse.

I started flicking through the Auckland yellow pages seeking dentists who stay open over the long Christmas/New Year's break, when NZ, like Moscow, shuts down completely. Only one clinic would even consider seeing me on New Years Day.

Naturally I chose to walk rather than take a taxi; naturally I panicked, got lost and finally stumbled into the clinic pouring sweat. And naturally the receptionist was a terrifying caricature of a German woman from the old days, before they were somewhat humbled by defeat. She was about six foot two, gray-blond hair, long arms and legs, an even longer face, and gray-blond skin over it. She bounced in running shoes and clearly despised me on sight. I agreed with her, and responded by sweating even more.

She looked me over, sniffed, shook her head and ordered me inside. The dentist was a tiny Chinese guy who looked horribly familiar. I used to teach 1,000 medical students per year at Otago. Several hundred of them were from the Dental School. I looked over at the wall and sure enough, there was the dreaded University of Otago diploma.

See, those people hated me. My "Communications" course was one of the hurdles they had to jump over to make it into med (or dental) school. Naturally the ones who hated it most, and were most paranoid that it was being used to weed them out, were the Asians. As the Bard would have said if he'd taught at Otago, "O what a tangled web we weave/when first we can't get a tenure-track job in the US/and become mercenaries running a despised antipodean compulsory first-year Comms course!"

Once I realized how much the med students hated me, I dreaded needing medical care in NZ. I was sure they'd find some way to retaliate. And now, oh God, the Prussian receptionist was motioning me into the torture chair of an Asian graduate of that program. In the immortal words of Carlito, "Heah come da pain!"

Figuring I'd better find out, I asked him if he'd taken the course. He was evasive, claimed he couldn't remember. The room chilled, and the Prussian Grenadier lady made a show of getting a towel, lifting my head with her gloved hand, and wiping my pouring sweat from the headrest. She sniffed, too. It was the sniffs that hurt.

Well, those and the drill. The dentist told me I needed a root canal. Root canal -- it stands for serious pain, right? They'd give me nitrous, and something strong to use at home, right? Wrong. He just went to work with the drill, and made it sing on my old filling, boring down to the sump where the pus was swelling against the taproot.

It went on and on...and then he was mumbling to the Prussian-ess in a tone I knew too well: the something's-gone-wrong tone. Finally he stopped dead, with my tooth laid wide open. I thought he was about to demand an explanation of the B- I'd given him in 1995 or something, but he said that my nerve was "calcified" and he couldn't find it. It would have to be left to "Jim," the senior partner, who'd be in tomorrow.

He stuffed the hole again and I asked if there'd be any prescription pain relief till tomorrow. Naturally not. After all, I'd asked for it; I obviously wanted it; therefore I wouldn't get it.

When cultural historians look back at our era, the whole drug thing will puzzle them more than anything else. Why is pleasure the only intolerable side effect? Why are people getting gang-raped in prison for liking pleasure?

It's very strange, especially when your tooth is asking the hard questions, by throbbing at every pulse.

It throbbed all night, keeping me company, and awake, until it was time to return to see Jim. This time I took no chances, arriving an hour early, having swallowed two of my precious hoard of Xanax. I was calm, sweat-free.

The Prussian lady was prepared anyway: as I walked in, she followed, carrying two huge towels, and ostentatiously put one on the seat of the chair, the other on the headrest. All that was missing was a bucket and a mop.

Jim was also an Asian Otago graduate, but cheerful and confident: he'd tested out of my course, it seemed. And the "calcified" nerve that had hidden from the junior partner was no problem for him. He scraped and scraped, gouging every gobbet of tender pulp out of the tooth, while I flinched and blinked and occasionally, for variety, groaned. When I got up two hours later, having aged a year or so, he told me that Advil would be all I needed. But this no longer surprised me, and at least the worst was over. I paid the bill, breaking us for the month, and wobbled to the bus station.

With its usual droll sense of timing, the molar behind the tooth they'd just fixed started throbbing. A good, steady throb, the kind you know will only get worse and worse by the day. And it would be far more expensive, with its three roots full of pus.

It turned out they'd fixed the wrong tooth. Next week I had to go through it all over again, times three. And once again I heard, "Advil should be all you need."

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