Wednesday, December 31, 2008

variety in my practice

After thousands and thousands of extractions, fillings, root canals, dentures, cleanings etc etc, work in the clinic gets monotonous. The queries, fears, expectations and reactions are almost identical in all patients. It is the variety in personalities and idiosyncrasies of individuals that makes my work interesting.

The short, slender and frail looking lady with her palm covering a mildly swollen jaw reluctantly entered the clinic. I am sure that she must have been suffering at least for the past three or four days and that it had taken her that long to make up her mind and build up the courage to visit my clinic. I showed her the chair. She went near the chair and stood there hesitating. I assured her that sitting in the chair is not painful and asked her to sit. She sat down gingerly on the edge. I took the mirror in my hand.
“No, no doctor. please don’t touch the tooth. It hurts”.
It took time to convince her that I just intended to look into her mouth. She did not believe me. I kept the mirror aside and held my hands back. I asked my assistant to focus the light. She opened her mouth half. That was enough. I knew what the trouble was and what was to be done. I told her the bad news. She had to have her tooth or whatever remained of it, out. There was no other way. She almost fainted. She took a few minutes to recover and digest the news. Now it was time for queries.

“Can’t it be cured with medicines?”
“Can the tooth be removed when there is pain and swelling?”
“Will it affect the eyes?”
“Will the swelling increase?”
“How many days does it pain afterwards?”
“My sister is getting married next month. Will I be alright by then?”
“Will it bleed a lot?”
“How long will it bleed?”
“I get scared if I see blood”
“As it is she is weak doctor, will bleeding cause anemia?” (Husband)
“Will it hurt too much?”
Here I had to mention that I will be giving an injection to make the jaws numb.
“Will you be giving an injection?”
“ I am more scared of injection than removing my tooth”
“Can’t it be done with out injection?”
“Where will you give injection?”
“Inside the mouth? Oh, god, can’t you give it on the Hand?”
“Last time when she took an injection she fainted doctor. It took half an hour for the doctor to make her OK” her husband gave her the cue to faint.
Now, I answer all the queries according to the mental condition of the party, mixing elements of sincerity, honesty, compassion, indifference, and humour where possible. I answered the lady with patience and tried to calm her down. But the statement regarding the tendency to faint made me apprehensive. Even after witnessing hundreds of faintings in the chair, and uneventful recoveries, my hands start shaking when a patient faints. Apart from my own nervousness, I need to deal with the patient who has fainted, my assistant who gets agitated, patient’s attendants who are anxiously hovering around, and the people in the waiting room who are trying to peep in and are fearing about their fate. It is something which I can do without.

When I heard the husband mentioning that she fainted on taking an injection, my thoughts were on finding a way of postponing the case, and hoping that they find some other dentist. But I was sure that the removing the tooth at the earliest was the best thing for her and braced myself for the work, with a prayer on my lips. I made sure that the emergency drugs were ready, assured the lady repeatedly that I will manage with minimum of pain and prepared the syringe. She closed her eyes tight, asked her husband to hold her hand, requested my assistant to hold the other hand and hesitatingly opened her mouth. The lips were quivering. I touched the gum with a cotton swab to apply some numbing paste before the injection. She gave out a shout. Two or three heads from the waiting room peeped in. I injected a few drops in the gums. Her body was shaking. I adjusted the chair to a reclining position expecting her to faint any moment. She did not. Slowly I injected the local. Once the tooth was numb, there was no more trouble.
I finished the extraction in minutes and the lady was unable to believe that the tooth had been removed. She thanked me and asked me to give her another appointment for the removal of one more tooth which was troubling her now and then!

The captain (he had retired from the army after his short service) was a contrast to this lady. Boisterous, fearless and confident. He was a regular in my clinic for the past five years. I had done a few simple fillings for him and he insisted on getting his teeth cleaned every year.
He entered the clinic as jauntily as ever. Well built, fit, confident and smart as always in his jeans and shirt. (I wonder how some people get the clothes to fit them perfectly. If the trouser waist fits me, the length is too much. If the sleeves of the shirt are OK, the chest is tight. I try to get the cloths tailored, but results are worse. All in all I end up looking like -to borrow the expression from Wodehouse- like something that the cat has brought in.) I look at the captain with awe.

He sank in the chair with his usual remark.
“ I like this chair doc. It is so comfortable. I think I should buy one.”
He adjusted the head rest to suit him and stretched his legs. I wished all my cases were as easy going as the captain. He said that he had a little pain near the last tooth while chewing. I was surprised to find a wisdom tooth erupting. It is rare to see a wisdom tooth erupting at the age of forty. But sometimes it does. A part of the gum that was covering the erupting tooth was coming between the upper and lower teeth and causing him pain. I told him that all I need to do was to snip off that part of the gum.
“ Why can’t you pull out that bloody tooth and be done with it? I can do with one tooth less.”
I said that there is no need. Just snipping the gum would do. I asked him when does he wants me to do it.
“When? Right now. Finish it. Take your scissors and cut it out”
I told him that I will inject a few drops of local.
“Why bother with all that doctor. I can easily bear a bit of pain”
His words were music to my ears. Still, I said that though he may be able to bear a bit of pain, it is difficult for me and I would be more comfortable with a few drops of local if he had no objection.
“Objection for the injection! Doctor saab we are used to bullets. Do as you please”

He opened the mouth wide. I loaded the syringe and was about to inject when he closed the mouth shut. I told him that I was yet to inject and asked him to open the mouth. No response from the captain. His hands fell off the handle and his head rolled. The captain had fainted.

It took me twenty minutes to revive him. Since he did not recover in the reclining position of the chair, I had to lift him with the help of my assistant- who was not of much use, and put him flat on the ground. He opened his eyes only after slapping him hard and splashing water on his face. His pulse and pressure remained low for more than ten minutes. I was about to call for my physician friend when he opened his eyes and wondered where he was.

He said that it never happened earlier and felt that it was probably because he had skipped dinner the previous night. He told me to go ahead and try again. But I had had enough. I knew he was frightened. I was sweating and had sprained my back while lifting him. I told him that we will do it after a day or two and prescribed him a tranquiliser to take before the procedure. We scheduled it a week later.
It is now two years. The thin bit of gum covering the last tooth is still there and troubles him now and then. He says that it does not bother him much and manages with pain killers, antibiotics and mouth washes. I accept his words with relief.

Thursday, December 25, 2008

merry christmas

Went for a walk as usual this morning. I had got up earlier than usual and it was still dark. Passed the Ponda church on my way. Church was looking good with Christmas lighting. The parish boys had taken pains to create the scene of birth of Jesus in the compound, which was also very good. A little away from the church, I could hear loud music, laughter and shouts. Obviously a party, celebrating the festival after the mid night mass. When I went near, I found a group of men in a joyous mood. Music was blaring from their cars. Some of them were in their senses and were still capable of holding their bottles in their hands. There were a few who were known to me. I went near to wish them and shook their shaking hands further. By then one stout fellow who had more of Christmas spirit in his stomach than in his mind, came from the back, put his hands around my waist, lifted me up and started dancing. I took it in good humour for the first few seconds. When he did not put me down, I got worried. My back was strained and I was afraid that he may fall holding me. I had no intentions of spending the Christmas and new year time with my body in plaster. Luckily others noticed my distress and got me released me from the Christmas mood.

Since the church was looking good, I could not resist the urge to go back and take a picture. Went back with my camera from a different route and clicked the pictures.
Merry Christmas!

Sunday, December 21, 2008

popular waiting room!

My clinic can boast of a waiting room which can be labeled as ‘comfortable’. It is well ventilated and cool, has comfortable cane chairs, a clean toilet, and latest English and marathi magazines. Not year old issues. If I remember to switch on the CD player, there is some music too. Some of my patients have expressed their appreciation about the toilet and the availability of fresh magazines. Occasionally I find some one sitting in the waiting room AFTER the treatment to finish reading whatever they had left when called in. But till recently I did not know how popular it was.

The waiting room and the treatment area are separated only by a half door. The legs seen below the half door tell me that there is a person attached and he/she is waiting. I rarely find more than two legs waiting.

It was nearing closing time and I was treating the last case. A casual glance towards the waiting room showed four legs. I was half way through the last case and had some urgent work outside, to attend to, after that. Even if I had to just check the two people waiting out and fix appointments, it would take ten to fifteen minutes. But two patients waiting was quite good and I did not want to miss them. With reluctance I decided to stop at whatever stage I was and continue the treatment at the next appointment. I explained the situation to the person in the chair and requested him to bear with the inconvenience. He was good enough to accept. I sent him off and called the next person in.

“Oh, no, doctor. There is nothing wrong with my teeth. I had given my scooter for servicing in the Honda showroom next door and have to wait for it. One of my friends Mr.Varma is your patient. He told me that your waiting room is a nice place if I need to wait and so I am sitting here. This is my friend who has come with me. I hope it is not inconvenient to you”

I learnt that the waiting room had become more popular than the dentist.

Friday, December 19, 2008

old is gold

There is lot of bonhomie between the brothers when it comes to watching their favourite videos on the computer. I did not take the picture to record that. I wanted to appreciate the chair which has endured many such bonhomie during it’s life of more than forty five years. If I remember right, we paid about twenty rupees per chair and bought four chairs which we transported to our house on a horse cart. The picture shows the usual way the chairs have been used. Old is gold.

Friday, December 12, 2008

Ratnana PadagaLu contd.

It was not possible to write about Ratnana padagaLu the way I intended. I can not give it up too. I will restrict myself to few PadagaLu in English script and a bit of my blabber.
Two verses from the poem Kudukar maatva (mahatva) meaning the greatness of a drunkard.

Arth illaant negabEDaaNNa
Naa kuDadaaDO maTTu (song)
kuDakar padagoL okk (hokku) nODidre
mastaag (plenty) ave guTTu.

Ravvi (sun) kaaNad kavvi (poet) kanDa
andre kavigoL tatva
kavvi kaaNad kuDuka kanda
annOd kuDukar maatva

any explanation from me would spoil the beauty.

Thursday, December 11, 2008


One of my patients went to sleep while I was working today. No. He had not fainted. He was asleep and snoring peacefully. I consider someone going to sleep on the chair, a compliment. It is nice to witness someone who is comfortable in the chair and relaxing. The usual stock in the chair have apprehension writ on their faces, their body taut and toes curling. Even though the sleep was causing difficulties for my work- his mouth would get closed involuntarily- I managed to finish my work and woke him up. Fortunately the cavity was in the front tooth and visible. If it were at the back in some invisible area, and had I done a filling using a tooth coloured filling material, he might have refused to believe that I actually did some work while he was asleep.

Sleeping customers is not new to my profession. I believe one of my predecessors, the barber to the king Krishnadevaraya, arrived at the palace one morning and found the king fast asleep. It seems he performed his job with such great skill that the king was astonished to find himself already shaved on waking up. The story says that the barber was richly rewarded with gold, lands and what not! I wish the monarchy remained and I had a chance to do a filling for a king.

Monday, December 1, 2008

G P Rajaratnam - my ramblings on ratnana padagaLu

It was some months back that Shruti had mentioned in one of her postings that this is the centenary year of one of the legends of kannada literature Sri G P Rajaratnam. Being one of the confirmed fans of Sri Rajaratnam, I thought that I would write about the great man to the extent possible from me but I was at a loss as to what I would write?
My only contact with Sri Rajaratnam was when he visited our college as a speaker in one of the functions. I have read and enjoyed his poems but have no knowledge or authority to write about them in an informative way. Since there is no other way that I can commemorate his centenary, I decided to write what ever I have felt about his very popular collection. Ratnana PadagaLu is a collection of poems in a style which was new to the kannada literature at the time of it’s publication. I believe that it came under a lot of flak from the traditionalists. It was not just new, it was unacceptable. The language is raw, rural kannada with no polish whatsoever, written just as an illiterate would speak And the poet claims himself to be one! The poems have a liberal sprinkling of slangs in kannada and urdu which are commonly found in the language of a very very common man. When the collection was ready, I believe there were no publishers to take up the task of publishing it. Rajaratnam decided to publish it himself but lacked the finances. He was so sure and firm about his style, that he pawned the gold medal that was awarded to him for academic excellency and published the book. It became an instant hit.

I tried to write down the poem verse by verse and add my explanations. The transliteration tool in the composing menu does not co operate. I type something and see something else. Where as, whatever I type comes out perfectly in Baraha. On top of it, as I started writing more and more I started getting more and more doubtful about my ability to write about Ratnana PadagaLu. Hence I have just photographed the poem and added it as an image to whatever I had managed to put together. the language used in the collection is raw but very appealing. the meaning is fully cooked and full of wisdom. i will put out the parts that have appealed to me most, along with my ramblings.

In the very first verse, the poet ( a teetotaller) notifies his fondness for the spirits, and informs that he talks a lot when he is under it’s influence. He calls himself “Ratna” and declares that whatever he spurts out is the effort of his drink. The first stanza is a simple statement.
(The important point here is the disclaimer. The words are not mine, they are the efforts of the drink. I did not say them.)

“Vyasa, the author of Mahabharata found Vinayaka to write down his epic and I met this vagabond who joined my words and made a poem out of it. Who knows what was his compulsion to do so?”

Writing it? Go ahead, you half wit. And I will render whatever help I can. “thinking thus, I have got it printed. Don’t blame me.”

“I do not know any letters. One needs to learn if one wants a big job!. If the verses are appealing, credit goes to my drink. If they are bad blame the vagabond!”

The real poet turns himself in to a mere spectator. He creates the ‘drunkard’ Ratna and the vagabond. The drunkard in turn attributes all his words to the drink absolving himself from the ownership of the words. And as far as writing it down is concerned, the culprit is the vagabond. And Ratnana PadagaLu gets along splendidly.