Balls and Walnuts
more than you ever wanted to know
Is it safe?
I like my dentist. No, I really do.
I like her because she and I have the same attitude towards procedures: we both prefer to err on the conservative side. I know she wouldn’t recommend something if it wasn’t strictly necessary.
I like her because she’s smart and cheerful and cute. I like her because she and her husband are cool people, and I wish we could hang out together, my family and her family. We at Chez Walnut don’t get out much.
I like her because she doesn’t resemble Laurence Olivier . . . not often, anyway.
But as much as I might like her, it’s hard to keep a smile on my face when she comes at me with the drill. Wait. That deserves caps: The Drill. The DRILL.
It isn’t so much the pain as the anticipation of pain; and it isn’t so much the anesthetic injection as that horrible fat-faced feeling which seems to last for hours afterwards (because it does). Not to mention that awful unscratchable itch which presages the return of feeling . . . oh sweet Lord, it’s a good thing I bite my fingernails to the quick, or I would have scratched myself so raw I’d only be presentable for a George Romero flick.
But I’m all better now; I even ate a hamburger for dinner. Thank God for Motrin.
***
As doctors, we get to inflict pain. Lots of pain. It’s not the kind of thing that comes easy, by the way. When we’re pups in med school, we’re taught how to perform venipuncture, set IVs, and draw arterial blood, not because we’ll actually need those skills*, but because we need to get used to the idea of hurting people to help them.
All through internship and residency, I injected people with local anesthetic prior to sewing up their lacerations or resetting their broken noses or . . . you get my drift. Often, I wondered if the local was worse than the procedure. It sure seemed that way. (In the case of setting broken noses, it is that way. Nowadays, I don’t use any local whatsoever to set a broken nose. It takes five shots to numb up a person’s nose, and each of those injections is a killer. Far kinder to tell the patient to hold their breath and — CRACK! We’re done!)
In my second year of residency, operating post-call, I stabbed myself in the hand with a scalpel. It wasn’t intentional but it sure looked that way. At that instant, whoever was controlling my right hand had a score to settle with my left hand. Either that, or like the green soldier shooting himself in the foot, I was merely looking for a brief respite from combat.
I retired to our triage area, determined to wash out the wound with Betadyne. But Holy Effing *&$*&! did that hurt! Well, that wasn’t going to work, so I had this bright idea: I would inject the skin with Lidocaine and then I could irrigate the wound like crazy.
That self-inflicted shot of local humbled me. I had been doing that all this time — to people’s faces, which are far more sensitive than the back of my hand? Damn. I was Josef Fucking Mengele.
You may not believe this, but it’s at least as stressful to administer pain as it is to receive it. With adult patients, it helps (a little) that they’re consenting, understanding participants who won’t (usually) hold it against you. With children, it’s another story. And, yes, I put kids under anesthesia for anything really involved, but it’s ridiculous to incur the risk and expense of anesthesia for something relatively trivial, like a wax cleaning.
This is part of the day-to-day grind, the crappy stuff I have to do which reminds me I do earn my money, it’s not all highway robbery. For the most part, this kind of stress doesn’t stick to my ribs. Far more troublesome are the decisions, fortunately rare in private practice ENT, that last a lifetime. Do you encourage your patient to opt for the maiming surgery which will give her maybe a 10% shot at long-term survival, or do you tell her to enjoy the time she has left? Yes, it’s the patient and her family who make the decision, but more often than not she’s looking to the doctor for guidance. I duck it as often as I can, give the patient both sides of the equation, all the info she needs to make an informed decision . . .
But then she asks, What would you do?
You form calluses for inflicting pain, dull, thick areas on the brain which protect you from the worst of what you’ve done. For those bigger questions, the calluses go deeper still.
D.
*Unless, like me, you do your internship and residency at a County Hospital too poor to support such ancillary services.
I have never asked a doctor ‘what would you do?’ because they’re NOT me. They don’t live it on a day to day basis. They don’t have to deal with it in the Real World. It’s not there for them every damn second of every damn day with no way of escaping it.
Opps, sorry. Seeing the endocrinologist tomorrow with an elevated HbA1C. I’ll be told ‘you need to do better’. Yes, I know that, but sometimes it’s simply impossible. Welcome to the Real World.
I’m with you on this, nox. From my POV, these “what would you do” questions are disturbing, to say the least. I’ve given the patient the information they need to decide; what difference does it make what I would do? You’re right, I’m not them, I can’t know all the little and not so little factors which rightfully weigh into a major decision.
The problem is, there are still a lot of folks out there who want a paternal doctor. That’s not you, and it’s not my wife, and it’s not a lot of people, but some people still want to be told what to do. Worst of all are the ones who don’t even listen to my explanations. They throw up their hands, say “you’re the doctor,” and demand that I TELL them what to do. And they probably bitch to high heaven to their friends and family when I don’t do it.
This one is great.
Dr H, your Dr entries are the business.
I have a Thursday 13 up about things that give me the teary-snuffles and I forgot about your dr entries. Same with your sticking with marriage entries. Just about the most romantic stuff ever.
Thanks for the lurve, Kate 🙂
You’ll be happy to know that I tweaked my sex scene yesterday, made it even rougher and raunchier. Man, those two are nasty minxes! I can hardly wait to finish this & send it out to you.
It’s often a sign of desperation when people ask something like that, I think. As you said, they’d rather have a paternal figure do it for them: they just don’t think they can handle making the decision for themselves.
Perhaps the best answer to “what would you do,” is “I’d go home, sleep on it, think on it and research for a few days before deciding.” Not that that helps in emergency cases…
Great piece, BTW. :o)
I guess I never thought how much pressure it would put on a doctor to ask the “What would you do?” question. I am lucky that I have never had such a terrible situation and such a tough decision to make (knocking on wood now). I don’t think I have ever asked a doctor that, but it seems like have had plenty of doctors tell me what they would do if they were me. Maybe it is easier in less dire circumstances, or maybe it is just a different kind of person who can do that. When my daughter was born my doctor wanted to do a c-section. After explaining his reasons for thinking it was the course to take he looked my then husband square in the eye and said, very meaningfully, “If it were my wife and child I would want her to have the c-section.” I remember thinking, yeah, but would your wife agree to be cut open just because you wanted her to?
Great post but creepy picture that made me want to run and hide. And thanks Da Nator, yes I have asked the doc what he would do and it was desperation. Sometimes the verbiage sounds like a rehearsed spiel the doc is spewing. When you ask them “What would you do?” they wake up and suddenly realize there is human on the other end of the conversaton. “Yeah, what if you were in my shoes? WHAT WOULD YOU DO?” To them, it’s a business transaction. To me, it’s my life. I’m going to ask the question. I may or may not take their advice.
“A paternal doctor”…heh. I suspect your wife and I are coming from a similar place – the only thing that differentiates us from the MD is the fact that he (generic he) has a piece of paper. He’s not any smarter than is am. 🙂
1. I’d rather have a gyno exam than see the dentist for a filling or the double whammy visit for a crown.
2. Your “favorite” and mine, Dr. May once had to give me a shot in my lower back because I couldn’t stand, sit, lie down…nothing because of the back pain, and yes, that shot was worse than the back pain. I am having a senior moment right now and can’t recall the name of the shot. He did wheel me out to the car though.
I’m terrified of my dentist. She’s really nice and all, but still, she has a VERY different idea about what hurts like I’m getting my spine ripped out through my nostrils and what doesn’t.
I had a dental hygienist like that. Cute as a button, but she seemed to thrive on my pain.
My current dentist is very solicitous on the pain issue. She injected the hell out of me until I couldn’t even feel my toes.