This blog contains material I wrote and posted on between the years 2005 and 2011 only. It does not contain any new material. For newer writing, please check my main blog (Bill the Butcher).

Tuesday, 27 November 2012

Specimen Of The Day

The man (apparently an educated urban type, though not English speaking) asks me why he has tooth decay. I spend a few minutes explaining the triad of bacteria, high carbohydrate diets and  improper brushing; then I discover he is shaking his head slowly side to side with a metronomic rhythm. Then he says, "No, there are insects eating my teeth."
I go: "Huh?"

"In the village the man who knows about these things" - which means witch doctor - "showed me. He took out the insects from my teeth and showed me."

I: "There are no insects in teeth."

He: "No, the man took them out and showed me. Dentists know nothing."

I: "Uh...and how did the insects get into your teeth? What did they breathe? How come you can't see them when you look at the teeth?" 

He: "I don't know about all that - but he took them out and showed me, still alive."

I: "Don't tell me you fell for some crude sleight of hand trick. He must have hidden them in his hand. I told you how tooth decay starts..."

He: "Yes, I understood all that, but I saw him take insects out of my teeth, and out of my ears as well."

I stopped arguing at that point. I'm sure he has insects in the brain, at least, though probably nowhere else..

I wish, though, that I'd asked about the type of insects he'd  had in his teeth. Termites? Cockroaches? Boll weevils? Witchetty grubs? Lice?

No, lice are actually something he might have, so I'm sure the insects would be something else.


There is a man for whom I'd done a porcelain bridge. He came back with a complaint. Apparently, his teeth make musical noises at him when he "waters" them (whatever that is). Obviously, his words weren't music to my ears. Maybe he has no music in his soul, but what wouldn't a lot of people I know do for a bridge like that!

Yesterday one of my patients - a young female - fainted. She was sitting at my desk after a session of root canal treatment. I was rinsing my hands at the sink and talking to her while my assistant was working in the laboratory. She wasn't answering and I turned to see her put her hands over her face. I turned back to dry my hands and when I looked back at her she was leaning over her chair with her head hanging down at an angle. I walked over quickly, caught her and began trying to get her to the dental chair to make her lie down so the blood would flow to her brain (the proper procedure for treating syncopic faints). Well, her sweater rode right over her belly and over her bare breasts to gather itself under her neck. I'm sure I couldn't tell you why she wasn't wearing a bra. I got the sweater down again as far as her rib cage and called my assistant for help. We got her into the chair and after being placed with her head lower than her feet she recovered quickly enough. I asked her why she fainted - hadn't she eaten? 

Her response: "Oh, I always faint whenever I get any pain."

Wow! A built-in anaesthetic! Another thing some people would kill for...

Lesson to be learned: If you are in the habit of fainting - wear a bra, damn it.    


Even by Specimen of the Day standards, this one was exceptional.
First thing, he was a doorbanger.  I put up a notice on my clinic door to stop people just banging on the door trying to walk in while I’m working on someone. Mostly this notice works. In this case it did not.
Anyway, so when I was through with the people who were waiting I called this man in. He – even before getting into the dental chair – began telling me of the swelling on the left side of his face that he wanted me to treat. I looked at his face, didn’t see any swelling. I got him into the chair and looked inside his mouth, and found a lot of teeth broken down to stumps on the left lower jaw – but no swelling. I examined his face, inside and out, on the submandibular side (below the jaw). No swelling, nothing at all. I told him this.
He went “But can’t you see the swelling? It’s there!”
I told him that I couldn’t see any swelling. I pressed below the jaw, on the gum, everywhere – no trace of a swelling, no pain, nothing. I told him that all I could do was remove the broken stumps. He wasn’t willing for this. He wanted me to treat his swelling.
I told him for the nth time that there was no swelling.
He said, “Wait, I’ll show you.” He took out his mobile phone, accessed the gallery, and after a lot of fiddling around found a photo of his. “Look,” he said, “I took this photo, it clearly shows my swelling.” I looked at the photo. There was no swelling.
“But see,” and he touched the right side of the photo, “there’s the swelling, right there.” I looked, just to humour him. No swelling, of course, and I informed him that there was no swelling on the photo and none on the face and in any case it was the wrong side. He began fingering the right side of his face. “Isn’t there a swelling here?”
“No, I’m sorry, there is no visible swelling.”
He brightened instantly. “But there is an invisible swelling!”
I intend changing the name of the clinic to Butcher’s Institute For The Demented before I turn into a raving lunatic myself...  

Never a dull moment at the clinic…infuriating, yeah, but not dull.
Among my specimens over the past couple of weeks, the first who deserves mention was a woman who turned up exactly two weeks ago. She had, let’s see – and I had time and opportunity to study them all –
Four piercings in each ear(OK, this is not her ear);
Three rings on each hand;
A braided anklet with little silver bells; and
Hair streaked brown and purple.
Well, this female – she was thirty years old, and her name is Ivy - came to the clinic for an extraction. She knew she was coming for an extraction; she made an appointment on the phone specifically mentioning that I’d earlier advised her to go for an extraction. All right so far?
Well, she came and sat in the chair, and as soon as she saw the instruments she began blubbering – and after I injected her she began bawling like a baby. I have five year old child patients who cry less. I had to stop every thirty seconds to allow her to catch her breath and gather courage to open her mouth again (and that’s why I got to know exactly how many piercings etc she had.)
Every thirty seconds she would ask “Is it over yet?” And the fact that she had a badly broken tooth that required suturing after extraction didn’t help my case any…
I just wonder – when she had all those piercings, did she moan and groan so much? What did she do the time she lost her virginity? I can just imagine the screams at the first sight of her husband’s penis…
Last Sunday she came for removal of the suture. I moved fast – she was still preparing to turn on the waterworks when I took out the stitch and got her off the chair. I did call her for a review appointment today but she never turned up. Big surprise.
And then there was yesterday. The first lot I want to talk about was a set of armed police of the Central Reserve Police Force (CRPF).

These characters, who always go around in packs, are all armed, mostly with 5.56mm INSAS rifles. The first guy sat in the chair still carrying his INSAS, holding it like a staff with the barrel pointing straight up. When I stood beside him that fucking barrel was pointing to the underside of my chin. Now I don’t know about you, but I don’t do my best work with a loaded assault rifle pointing at my jaw and all set to blow my head off at a reflex pull on the trigger, so I made him go out and give it to his pals in the waiting room. The second character left his gun outside, but wanted to be treated still wearing his bulletproof vest. He wouldn’t fit in the chair with it on. And afterwards he demanded a “discount for the military”. Dog.
OK, so my waiting room was full of these characters when the next specimen turned up, a highly nervous woman I’ve been treating on and off for a year and more. She saw the waiting room full of police with guns and decided, on the spot, that I had
  1. Been arrested; and/or
  2. Been shot/shot at by terrorists.
You can all stop laughing now. 


What do you do when a specimen ("patient", for the uninitiated) accuses you of trying to drive her insane?

This creature turned up the day before yesterday. She was fairly young (24) and well-dressed. Also, and this is significant, she is an ethnic Khasi (while I'm Bengali).

She needed a filling in an upper wisdom tooth. I told her she needed a filling in an upper wisdom tooth. She said filling or otherwise treating an upper tooth, "everyone" had told her, makes people go insane or blind or both because it damages the brain. Great.

Beyond the standard explanations, I didn't attempt to persuade her, knowing it was useless. She left saying she'd return "another day". Well, I don't think, I told my assistant.

Sure enough, an hour later I got a phone call from a dentist I know. This man, an ethnic Khasi as well, said that the female I've been telling you about had just visited him - and accused me of trying to make her blind or mad because she is, you guessed it, a Khasi and I'm Bengali.

If that's what she thought, I don't think she needs my help to damage her brain - if she has one. 

Yesterday, at about 8.45am, I was working on a patient when there came another of those for whom the notice doesn't work, apparently. This guy came and stood hammering at the door while I was trying to work on the specimen in the chair. Finally, my assistant went to open the door and asked the guy to wait, whereupon he immediately began screaming at him.

I abandoned the sterile instruments and went to the waiting room, and asked the character (English-speaking; he had no excuse there)  to pipe down. I showed him the notice on the door, right in front of his face, and asked him to wait. Then he got stuck into me, shouting. I told him that he was at liberty to seek treatment at any other dentists', but he had no right to shout at my assistant. He then began waving a finger in my face and screaming abuse. Then he stalked off, shouting that he was going to kill me.

I'm still alive!

I might not have been, however, if guns could have been bought as easily in India as in some parts of the world I could name...since maniacs are everywhere.

Just in case I get shot, stabbed or bludgeoned to death in the not too distant future, though, you know how it came about.


There's a specimen - a pretty much OK guy - I've been treating for years. Also, I've been trying to get him to quit smoking for years. He's got all sorts of smoking related dental problems, worn and stained teeth, degeneration of the oral mucous membrane, etc.

Yesterday, when I was cleaning his teeth, he quite out of the blue volunteered, unsolicited, the information that he'd quit smoking. Fine, I said, thinking maybe I'd made some impression.

Then he leaned over towards the spittoon and a cigarette packet fell out of his pocket. 


One of my specimens, who came to me for the first time today, said she needed all her (very extensive) dental treatment done and over with quickly; she is leaving for Calcutta at the end of the month. I asked why she hadn't come before. This is what she said:

"Oh, I couldn't come earlier because I had a toothache, you see."

No, this is not something I made up. I swear by the Flying Spaghetti Monster I didn't.


Totally exhausted tonight…I mean, it’s one of those nights when I feel as though I don’t even have the energy to raise my arms, but I had to share this with you people, so although there will be no story tonight, here goes –

All right, what follows – however contrived it seems, however incredible – is not a joke.

A few months ago, I had a specimen called – let’s say – Khidor Das (which is not quite his real name).  This Khidor had four extensively carious teeth (all four were upper premolars – “bicuspids” to Americans) – and none of them was really very bad. All were amenable to root canal treatment and crowning.

Although offered root canal and crowning, Khidor insisted on having these teeth extracted – all four of them. In the case of the two teeth on the right side, he agreed to root canal and crowning – only to insist, when the root canal treatment part was almost over – that the teeth be removed, even though extraction on both sides required bone removal and suturing. I should have been warned then.

Anyway, Khidor decided, back in May, to have a removable partial denture constructed (even though offered fixed prosthesis therapy) to replace the missing teeth. This construction was somewhat difficult, since he had extensive wearing of all his natural teeth and little space between his jaws. Anyway, I did construct one and delivered it to him about a month ago.

At that time he said he’d like a second denture constructed as a “spare” in case he lost or broke the first (which, naturally, I’d only just delivered). I don’t know how many other dentists get specimens asking to have alternates to the new dentures they’ve just been provided, but it was a first for me. In any case, because I was swamped with work, I asked him to turn up at the end of the month. And he did, not wearing the dentures I’d given him, claiming they were “loose”.

Well, OK. I began the process of making him a new one and asked him to bring the other (“old”) one for refitting.

Today, in a marathon one hour session, I fitted the fresh dentures I’d made for him, correcting all the problems until he admitted there was nothing wrong with them. He then took out the other set I’d given him, from his pocket. He’d cut it just about in half – all that was left were the teeth and a thin isthmus of denture base material connecting them. Why had he cut them? Because, he said, they were loose. Wow.

So after he was informed that the denture was irreparable, he left (after paying for today’s set, of course). My assistant and I had a goggle and laugh over that. We moved on.

It wasn’t over. We should have known it would not be.

Three hours later Khidor was back. He had brought the denture I’d given him today back to us. He’d already cut it in half, and had knocked out one of the teeth for good measure.

No, this is not a joke.

(As to what we did – we fitted a tooth and sent him on his way, informing him that the “right to refuse to serve” clause now applies. I don’t know if it penetrated his thick skull though.)

These people are driving me insane.


Today's Specimen of the Day was a woman who had a toothache.

What's so special about that, you ask?

Just this: She claimed, repeatedly, that she had toothache in bouts that recurred every ten minutes and lasted an hour and a half each time.

I'm still trying to work that one out.


One recent afternoon, I saw a face in an electronics store in the same building as the one in which I have my clinic; a face that brought back a sudden flood of memories…

In 1998, I was working for the dental clinic of the polyclinic in this town run by the Ramakrishna Mission. I was running the clinic singlehanded; there wasn’t even an assistant. Among my specimens at the time was a woman I’ll call Binnie. It wasn’t her real name, but it was close enough to it that it will do. She was the wife of a pastor of one of the fringe churches, as it happens, and her husband was always out of town saving enough souls to justify his grants from the parent church somewhere in the US’ Bible Belt.

At this distance in time I no longer remember what treatment Binnie had needed – but she did have to visit the clinic several times. After the first couple of occasions she took to standing very close to me while I was talking to her, close enough so that the tips of her breasts almost touched me, looking intently up into my face. It was, frankly, both interesting and uncomfortable, because I didn’t know when someone might walk in suddenly and see her apparently rubbing her nipples on me and breathing into my face.

Then one day she said, quite suddenly, “Why did you take this line of work?”

I: “Uh, well, it’s just a job, you know?”

She: “Ohhh…you like filling holes, do you?”

I (gulping a little): “Well, it’s part of what I do, yes.”

She (raising her face until her lips were almost touching mine): “I’ll bet it feels good to fill in holes, huh? And you must get all those pretty girls with problems, like, um…it must be a good job.” (Problems likewhat, holes to be filled in?)

I (backing away slightly): “Well, some of them have awful teeth.”

She: “Why don’t you come to my place sometime? Just call me and let me know when and I’ll tell you if it’s convenient.” (Pauses) “We could, ummmmmm…”

I was younger then, and my hole-filler was in a state of some agitation, but fortunately I wasn’t quite stupid enough to let it take over my decision-making abilities. So I didn’t go over to her house to help her fill in holes…if that’s what she wanted. She was certainly very holey, anyway, and not surprising considering that she was a pastor’s wife.

Years passed and the entire episode slipped from my memory, not just because I didn’t see her again but because as I grew older my interests in hole-filling waned considerably. Over time. I completely forgot the thing had ever happened.

So, that afternoon when I saw Binnie in the electronics shop, and it was she, looking much the same as when I’d last seen her, the memories came flooding back. I stood there in the corridor looking in at her. I don’t know if she saw me or if she would’ve recognised me if she had; in the last decade I’ve removed my hair, grown a beard, and switched from spectacles to contact lenses. She kept industriously examining microwave ovens and refrigerators, anyway, and after a minute I went about my business.

I wonder whom she got to fill in her holes for her these last years. I certainly didn’t…


A couple of days ago a drunkard decided to sleep it off in my waiting room.

He was an oldish man with several days' stubble, wrapped in a shawl and so inebriated he could scarcely see. He came in sometime in the late afternoon, when I was busy on a specimen, and after some futile shoving at the door of my treatment room curled himself up on one of the seats in the waiting room and dropped off.

After my assistant discovered him, she called me and I tried to shake him awake. He mumbled and turned and snuggled further in and wouldn't even look at us until we shook him hard enough to just about knock him off the seat. And even then he wouldn't leave until we shut off all the lights and informed him we'd be locking him in for the night.

Oh, and that wasn't the last of it. He was so drunk he couldn't orient himself - we had to physically point him at the door and - er - give him some impetus towards it.

I suppose we're lucky he didn't pee or throw up all over the waiting room, though.


Four days ago I had a specimen who arrived with an impacted wisdom tooth, with gum swelling and pain (pericoronitis). I'd prescribed an antibiotic and painkiller for three days, one tablet of each together three times daily, and asked him to come along when the medicines were finished.

Just now he turned up, complaining that he still had pain, I took the X Ray, checked him and couldn't figure out why he should still have pain. I was thinking in terms of antibiotic resistance and chalking out a different treatment plan. Then he said that I shouldn't give him any medicines because he hadn't finished those I gave him the last time. Reason: he didn't feel like taking so many tablets.

Against stupidity of this level even the gods of dentistry endeavour in vain.

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