What the dental hygienist told me while I was in the chair.

This is really the first time you've ever had novocaine?  No cavities at all at age 33?  You're doing pretty good.

I actually work on a lot of people that it's the first time they ever had novocaine.  Sometimes the first time they ever had dental work too.  A lot of recent immigrants.  People who don't speak much English.  Makes it hard to communicate sometimes.  I remember this one guy, he brought in his elderly father.  After his shot, while we were working on him... well, I never saw anyone in the dentist's chair with such a big smile!  The whole time we were working he had this big grin.  The son was interpreting for him.  They were from Ethiopia originally, I remember that.  The son told me that his father thought it was magic that it didn't hurt.  Can you imagine that?  Magic.

But we don't let family members be interpreters anymore.  We used to, but I brought it up in a staff meeting once and said it made me uncomfortable.  And so now we use non-related interpreters.  Ever since that staff meeting.  It was after just about the worst day I ever had.

This man and his wife came in.  The wife didn't speak English at all, and the husband was interpreting for her.  Well, the cleaning was causing her a lot of pain, and I mean a lot.  I could barely work on her, she kept jumping out of her skin, like you were before your shot, but much worse.  Tears were just running down her face.  And I suggested that we give her some anesthetic, you know, a shot.  And the husband said, "I'll talk to her."  And he spoke to her.  Really sternly.  And then he said to me, "She does not want the painkiller.  Go ahead."

Well, I went on with the cleaning, but she was still flinching and jerking a lot.  It was really hurting her.  So I stopped and I told him that I really thought she would be more comfortable if I could give her a block.  And he spoke to her again, really harshly again, and then he told me "She will be fine.  She says she does not need a pain killer."

And I started to feel really bad about it.  I couldn't ask her what she wanted.  I only had his word for it.  But she was crying so badly.  I felt like I was abusing her.  And I couldn't really do my work with her jumping and flinching and crying in pain.  I have refused to work on people who refused to take a painkiller, because you just can't if they're jumping every time you touch them.  So I told him that I would not be able to work on her anymore unless she received anesthetic.

He said, "Give me a moment."  And he spoke to her for a long time.  Very harshly.  And when it was all over he said to me, "She will be still now."  And... she was.  I finished the cleaning, and she didn't.  Move. A. Muscle.  Not one more peep out of her the whole time.  I was so glad when it was over.

And I just felt sicker and sicker about it all day.  I should have refused to treat.  I should have refused to treat her without her getting some anesthetic.  But, you know.  I could have gotten in trouble for that too, maybe.  And at the end of the day I brought it up at the staff meeting, and I said I didn't want family members to serve as sole interpreters anymore.  And so, now they don't. 

Comments

[MrsDarwin]

Wow. I even felt a little sick just reading it. Poor poor woman.

[entropy]

Oh. My. Gosh.

That is horrible.

[Christine the Soccer Mom]

That just makes my skin crawl.

Thank God (again and again) for my wonderful husband.

[Meira]

Well, my first thought (before reading) was "Damn, that's one chatty hygienist!". Which I guess is a very good thing, considering how bored I was at my last appt when the hygienist didn't talk at all.
And then I read it. And now I'm feeling a bit sick, too.

[Margaret in Minnesota]

Gee, and to think that my hygienist just comments on how many kids I have...

I'm joking. That's what I do when the subject matter makes me uncomfortable, and certainly this story does.

[Derek]

Imagine when they come to the ER with a potentially serious problem. I saw a youngish Somali woman in the ER during med school - she was there for abdominal pain. The potential diagnoses in abdominal pain are wide, especially in a female - everything from constipation to ectopic pregnancy (there are wide cultural variations in the ability to localize and describe the quality of pain). I couldn't fully examine her, and her husband had to be present the whole time. What do you do?

In addition, the cultural attitudes toward pain and pain-killers can be weird. When my mother-in-law visited us from China, she broke her dentures, so we took her to a dentist - he wanted to pull her (last remaining) 2 stubby teeth, to make a denture that would last longer. She was literally shaking in the chair before he began. It turns out that she had several teeth pulled in China without anesthetic (too expensive), and she was dreading the pain again. A shot of novacaine later, and she was happy as a clam.

I saw another woman in China having some kind of abdominal surgery (I think it was ovarian surgery of some kind - I was a baby med student in a foreign country). She was conscious, with a spinal anesthetic of some sort and was groaning and moaning during surgery. The OR nurse walked up to her, smacked the on the shoulder, and said "Why are you being so difficult?" I was stunned.

A friend of mine in China was in a motorcycle accident and broke her leg. She was in a lot of pain in the hospital and they clearly hadn't controlled her pain. Nor did they want to - as it was explained to me, painkillers can be addictive. I didn't go back to visit.

[bearing]

(I suppose I should add for the sake of accuracy that obviously I was not toting a tape recorder nor taking notes. What you're getting is my best reconstruction of the story from memory when I got home...)