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The following is a true story I wrote
that just might touch your heart...
After graduating from University of Marylands dental school in 1968, I accepted a one-year dental internship at Sea View Hospital on Staten Island, New York. Sea View, once a prominent facility in the treatment of tuberculosis, had become little more than a geriatric home for senior citizens unable to care for themselves due to chronic illness or financial hardship. As a young dentist interested in all phases of dentistry, I found myself challenged with every sort of advanced adult dental treatment. Illness, neglect, old age and lack of resources had conspired to turn routine dental problems into the most difficult challenges I would face in a 30 year career as a dentist.
One day Lola, age 81, was wheeled in to the dental clinic. Many of our patients were in wheelchairs or flat on their backs on stretchers. Something about Lola was different, however... While many of our patients were sad or chronically depressed, Lola wasnt even there. Her eyes were vacant, sort of unfocussed and not seemingly even connected to a brain. Except for the gauze wrapped around her head making a horizontal bandana across her nose, her face was blankly attractive. But there seemed to be some sort of elegant humanity there...somewhere....silently behind the surface. Or so it seemed to me, based on what I dont know.
I introduced myself cautiously and promptly learned that she had no interest in being there and was only there because the nurse brought her. I asked if she had any dental problems. She said there was nothing particular. This minimal conversational exchange was accomplished on her part with a very few barely audible words and no emotion. She passively complied to allow me to look in her mouth.
She had dentures that were so loose and ill-fitting as to be almost useless. This was largely due to the fact that she had a large part of her upper jaw - the front part of the palate - missing. Cancer surgery had resulted in a grossly deformed anatomy. Suddenly I realized what the face bandage was about. Intellectually, I knew before this moment that she had had facial surgery that she was trying to keep from view, but in my minds eye, I was still seeing her with any missing parts essentially filled in. Sort of like how when we see an almost closed "C" our brain tends to fill in the missing part and see an "O" or "circle". But now I was in touch with the fact that she was living with what would be a gross deformity to most of us.
Now I sat back and just talked quietly with her and told her that I felt I could understand that it must be hard for her and that sometimes dentists made facial prostheses - artificial facial parts made out of rubber or plastic to be worn with a temporary adhesive to fill in and esthetically replace missing parts. Sometimes people would lose an ear, a nose, an eye along with part of the cheek structure or other part of their face as a result of a car accident or other trauma, or due to surgery to remove diseased tissue such as cancer. I told her that I didnt know very much about it but that it was something I was interested in and suggested that if she wanted me to I would try to make a prosthetic nose for her so she would look pretty much normal.
I was getting excited about the prospect of making a facial prosthesis, something only very few dentists ever get to do. Lola was blank. I couldnt tell if she had heard me at all. I thought she should be jumping out of her wheelchair, but no, she barely heard me at all. I kept talking, at this point more for me than for her, I think. Eventually she minimally indicated that if I wanted to do it, she would go along. Well, that seemed good enough!
Over the next month or so I spent several days at a cancer hospital in Brooklyn where it was routine practice to make facial and other prostheses for patients. The doctors and dentists there were generous in sharing information and techniques that I could take back to Sea View. During that time and after, I saw Lola several times in the clinic to get impressions - molds- of her mouth and also of her entire face. From these I made plaster models of her face and her mouth. As the visits passed, Lola began to get used to me and tolerated my probings and stretchings and drippy, sticky, sometimes slimy materials. Gradually she came to see our meetings as a social event and she began to talk more. She was ok being there with me face to face with her bandages off and part of her face missing. Eventually there was even a little spark of excitement in her.
I came to understand that she didnt want to allow herself to get her hopes up of looking normal again for fear of being let down...again. I also came to understand that when patients lose body parts like legs or arms, usually their family still comes to visit. When someone loses part of their face, I painfully learned, it was not at all uncommon that family and friends stop coming. Im sure nobody means to stop, it just seems they lose their ability to relate to the patient. Its as if so much of our identity is tied up in our faces that when the face is destroyed, so is the identity. This sad fact was reported by other professionals working with such patients
Over the next months I managed to fashion a silicone-rubber prosthetic nose for Lola that matched her skin texture and color and unless you knew what to look for, youd never guess it was not part of her! Between that and a new set of dentures she looked ...as Billy Crystal might say, ab-so-lutely ma-velous ! Lola was actually in tears of happiness. I dismissed her from treatment with the caution not to put makeup on the prosthesis as it was not skin and would possibly be damaged. She laughed...the thought of using makeup was so alien to her that she thought my caution to be ridiculous.
Prior to this Lola never left her wheelchair except for her bed and she never spoke to anybody . She just sat day after day in her ward staring vacantly. About a month after finishing treatment I went to the ward to see how she was doing. She was nowhere to be found. I learned from a nurse that Lola was now the self-appointed social director for her ward and others. She no longer used her wheelchair at all, continually flitting about here and there under her own power.
When I finally caught up to Lola, I was going to yell at her but I stopped myself in time. She was using makeup all over her face for the first time in years and had almost ruined the prosthesis. And she was alive ...she had come alive again not only physically, but emotionally, too. I cant describe how good I felt to have been a part of turning that caterpillar into this butterfly before me
I dont know how much longer Lola lived. I left to serve two years in the Army. But I always feel good knowing that as long as she did live she was probably really alive for the duration. Sometimes I remember Lola to help put my troubles in perspective and to remember her spirit that just needed a little bit of love to wake up again. Hi ! Lola, wherever you are !
Michael C. Goldman, DDS
General and Cosmetic Dentistry
3815 East-West Highway
Chevy Chase, Maryland 20815
Phone (301) 656-6171
HOME TOPICS / INFO ABOUT DR.GOLDMAN TO EMAIL ME CONTACT OFFICE
Holism in dentistry is an approach to dental treatment, primarily caring for patients' health and safety from both a conventional as well as "alternative healthcare" point of view. It is sometimes called "biological" dentistry or "biocompatible" dentistry. In it's fullest sense, I believe it acknowledges and deals with the mind, body and spirit of the patient, not just his or her "teeth". See Topics / Info.....
Cosmetic dentistry is about doing quality , esthetic dentistry in a way that looks natural to begin with, and furthermore, can even improve one's attractiveness through techniques such as bonding, bleaching, veneers, caps, implants and more. It can be like "instant orthodontics" in correcting crooked, twisted or misplaced teeth in many instances. Dark or misshapen teeth can be restored. Smiles that lack youthful vigor or beauty can be revitalized! See Topics / Info..
Bleaching, veneers, bonding, caps, bridges, and implants are cosmetic dentistry treatments that are also discussed in Cosmetic Dentistry, and more...