Dental Gum!

For this blog, I have used the title as Dental Gum (गम in Hindi). गम in Hindi means sorrows. People usually connect dental treatment with fear, pain, and sorrows. First, let me make a disclaimer or two. 

  • My daughter Priya is a Pediatric Dentist 
  • I had my first dental treatment at the age of 65, that too because I went through cancer treatment and had 34 radiation sittings. I was treated for dental caries. 

I somehow have the feeling that a person’s dental health quality is hereditary! My grandmother could eat raw mango (Kairi) easily in her eighties. I have the same ability, but I have a way to go.  

I chose the subject because I read an article about horror stories about dentists, in the US. Well, as in any field some people do not follow the ethics and can be called black sheep. Making a general statement about any whole group of professionals is incorrect. But not that I am not going to tell any horror stories (as I have taken dental treatment only once), but I will share with you some anecdotes shared by Priya with me.  

First things first, I have been brushing my teeth only once a day, I don’t do any flossing. I have never used any special brushes or toothpaste. I have had my share of chocolates and ice-creams, colas and candies. I have a sweet tooth, but now I don’t consume these things. So my heridetary theory should be ok!

Once I asked Priya about her young patients. I asked her, “How tough is it to handle the kids on the  chair?” She said, Baba, once my patients get confidence about me, they are straightforward to handle. It is their mothers who are difficult to handle. 

I am going to share anecdotes about patients, their parents, general situations in dentistry. Sometimes it is funny, many times it is surprising, but probably human behaviour remains very similar in different situations.  

Priya was treating a fouryearboy. He was very cooperative, but sometimes he needed a kid-glove treatment, pun, of course, is intended. One day he came inside, goggles and all; a la Salman Khan. He was a big fan of Salman. He came inside, sat on the chair and Priya started the work. After about ten minutes he signalled to Priya to stop. Priya stopped and asked him the reason. Without replying he indicated her to allow him to get down from the chair. Priya complied, he got down. He put on his goggles, put both his thumbs in the trouser pockets. He danced to the tune of the Hindi song, “Hud Hud Dabangg, Dabangg; after a couple of minutes, he stopped, climbed back in the chair and signalled Priya to restart the work! 

Some patients are too busy to take their kids to the doctor. There was one such lady, the same age as that of Priya. She always claimed that only time she could get her child to the clinic was 8 pm on a Saturday. After all, she was in IT. She would always tell Priya how difficult it was in IT and so on. Once the lady came almost twenty minutes late for the appointment and Priya had her next patient in another clinic. They met on the staircase; the lady started her usual dialogues of being in IT, but her hands were full of stuff bought in the malls. Priya apologised and said that she could not treat her child as her next patient was waiting at another clinic. The lady was upset, and before she could start her diatribe, Priya told her, “Look, I am a doctor, and I don’t know anything about IT. But let me share some personal information with you. My mother is handling Nvidia operations in Pune, my father runs his software business for the last 15 years, and my elder brother is working in Microsoft at Seattle for some time. So, there is a possibility that I may know a few things about IT, by induction. One more thing, when I was a child, my parents used to take me to doctors, whenever it was needed, without bothering about time and the day. Thank you!” The lady never spoke about IT stuff with Priya again. 

One lady came with her child. The child was fitted with a crown, and the child was not supposed to eat chocolates for obvious reasons. While eating the chocolate, the crown came out and was misplaced. Priya told her, “ I had told you not to give chocolates to the kid. Why did you not follow instructions?”  The treatment was done, and the crown fitted again; when she was asked to pay the money, she simply refused to pay saying that it was Priya’s fault, chocolate was incidental. Priya let her go and instructed her team not to give an appointment to that patient again!  

The next episode could be an incorrect diagnosis or was it the socalled horror story; I am not sure! I felt that it was a case of the wrong diagnosis. An eightmonthold child was brought to the clinic; Priya was surprised, as generally such small babies rarely have any teeth. The mother told her the following story. A couple of days back while the mother was cleaning the babies mouth, she saw a gold tooth in the baby’s mouth. She took the baby to three or four doctors, and all of them said that the gold tooth needs to extracted; treatment needed to be done under general anaesthesia. Since the baby was very young parents were not too keen about the procedure. Somebody suggested to them Priya’s name, and they came to the clinic. Priya looked at the child and saw what was inside. She had a small instrument in her hand. She put the instrument in the babies mouth and plucked the golden “Tooth”; it a piece of gold that was stuck in the baby’s gum. Out came a small earring. Priya gave it to the mother. It was the mother’s earring; she had never realised that it was missing. Somehow it had fallen and went into the baby’s mouth and became the “Golden Tooth”! The tears of joy came in the parent’s eyes! The father asked Priya “Doctor what will be the charges?” Priya said, “No charges; I am happy that I could do this without any anaesthesia”!  

How trial by media can affect a professional career can be seen in the following anecdote. A child was being treated by a dentist. He checked up with parents if any medicine was being given to the child. The mother said that they were not giving any other medicines. The doctor gave the local anaesthesia and started the treatment. After some time he felt that the child was becoming listless. They rushed the child, to the next door paediatrician. From there they rushed to the hospital. But the child died. The trial by media started; the newspapers showed the doctors name and the photograph of the clinic. The baby’s parents gave statements and hid the fact that there was another treatment being given to the child! The medical council did its investigations and in the end, found out that the dentist and the paediatrician had followed the correct procedures. But all the media trial and photographs in the newspapers made life very difficult for the dentist. He left Pune and moved to another city!  

Friends, life can be exciting, rewarding and tough at the same time for professionals. But some times, one loses control over the situation, and things do get haywire. Customer is always the king or a queen; the kings and the queens also can go overboard and need to be told so. But at the end of the day, professionals have to remain true to their profession and continue to perform! Don’t forget to show the smiling face, especially when a child is being treated.

 

Ignore body signals at your own peril!

Medical Illiteracy or Ignore body signals at your own peril! I was in two minds about the title for this blog. But the second option prevailed.

Not all of us are doctors by training and not all of us could have access to basic medical information, at least, during pre-internet days! It’s a highly specialized field. But in our day to day life health conditions keep on changing, as you grow older. Some changes can be discrete and some may be obvious. In our own and families interest, we should take care of having basic information and knowledge and decodify the signals our body sends.

Since this is a current ongoing medical event, I am not sharing the names, as I usually do! Yesterday, in my office I was talking to my colleague. Suddenly she said let me make an urgent call. She called and as the call progressed she sounded quite worried and anguished. After the call I asked her what happened? Her brother was not keeping well for ¾ days and she had called to find out how he was doing! She came to know all the details only after the call. He felt weak in the office; since he is diabetic and with BP issues, he asked his colleague to fetch a chocolate for him, to overcome low sugar issue, if any! He felt slightly better but decided to go home as he was uncomfortable. When he tried to use his scooter, he could not use his left hand properly; he felt very low strength in his left hand. Next day he saw a doctor who gave him some medicines and asked him to run tests. Sunday, he saw an eye specialist as he was feeling unease in the left eye!  The doctor indicated some distortion around the left eye. All signals were obvious but our friend probably lacked knowledge about the effects. I immediately coordinated an appointment with a neurologist. In next two hours he was hospitalized in a CCU. I shudder to think if my colleague had not made that call!

I will share many more such events but this particular event has made me very uneasy. It is just by chance, that I overheard a conversation and then got the wheels moving fast! There were specific indications, the person or his family did not understand the details of what was happening but can they also not understand that there was something going wrong with the body. How to inculcate this discipline in the whole family? These things are never taught in schools but these need to be picked up from someone or somewhere. A human being generally does not have detailed knowledge of most subjects other than his own subject. But health is one area which is common to all humans whether they are kings or paupers! I feel that this learning be made mandatory in school curriculum, so that people come to know basic symptoms regarding the emergency events, like heart attack, stroke and others.

In olden days there was the system of GP or general practitioners. GP’s were family friends, advisors, mentors for the whole family. I have known of GP’s who have treated four generations from families. For anything and everything related to health and not related to health too, the families would take advise of GP’s. So, they knew  most of the things about people in the family. If required, GP’s would ask the people to go to experts. In today’s times of no GP’s, I feel that a family should be going to a fixed physician and do things as per his/her advice and suggestions. Since our friend did not have “GP”, the doctors whom he saw, could not guide him properly.

It can be a good idea to guide people into basics of health management and emergency management. Basic training about patient resuscitation is one aspect but such emergencies don’t come so frequently. More than that, knowledge about basic symptoms is most essential. This will reduce time between symptoms and start of treatment. My friend Shashi has a history of stroke. A few months back when he had very high fever and felt faint, he immediately got himself checked from experts. This gave him peace of mind.

I will share one event with you to explain what I mean by lack of basic knowledge in other areas. A professor of arts with a doctorate, drove his car for two days. You will ask me what is so special about it? One of the tappets in the engine had broken and he drove the car with a lot of noise. To understand this, he did not need to know that tappet was broken but he only needed to understand that something was broken and was making loud noise. So, he should not drive the car! Period. But no! He drove on for two days accompanied by big noise! Is it so difficult to comprehend that there was something wrong with the car and not what is wrong with the car?

Two things generally happen. One is signals are simply not understood and sometimes signals are ignored. Our friend did not understand the gravity of the signals, the body was sending. However, I will tell you of someone, a few years elder than me. He apparently had good health, outwardly. He used to go to gym regularly. One day he went out, after  he came back he said that he was a bit tired and would rest for 15 min. 10 minutes later, he was dead due to cardiac arrest. He was diabetic but values were controlled. He was going to the gym regularly. Then why did this happen? When his papers were checked, the values were never good; he was informing his son, who lives abroad,  that everything was ok. He went to the gym every day; he always drove the 500 meters distance! Did minor exercise and chatted with friends, tea, have fried stuff and smoking followed. What he did was not accepting the true body condition, which further deteriorated with wrong food and smoking.

Let me assure you that our body and brain are very sharp in understanding the signals that are generated in our eco system. In young age we start knowing who our parents are, in adulthood we catch the right love signals. As we grow older, we know how to find better opportunities in jobs and in business. All this is done by capturing the signals, the indications that are emanating in our surroundings. But why can’t we catch our body signals which tell about our health? In life we master various things without formal training. Then why we cannot do it about our own health? Is it due to thought process that Cancer, Heart Attack, Strokes happen to someone else? Sudden deaths occur mostly in accidents, most other deaths  are because of ignoring the signal system created by HIM! So please keep track of these signals, it may be twitching of an eye, shaking of hand while holding a glass, heaviness in body especially on only one side, sudden sweating and so on. But at least “create” for yourself a GP system and take his/her advise as we grow 40 plus!

Cheers! Life is too beautiful to be wasted by ignoring signals from the world’s best design, “Our Body”!