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Encounter #2 ~ Dentist Day June 13, 2011

Posted by Patricia Ann McNair in Blog posts, Things and Stuff, Travel.
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There was already a line when we pulled up the foothill to the clinic. Hot, muddy. The sun was high even though Honduras was in its rainy season, and steam lifted from the earth. Still, there were dozens of locals there in the brightness, snaking single-file down and away from the steps of the small, square, concrete building. Word was out. Dentist Day. The day a volunteer dentist from the U.S. would spend hours in the rural clinic shared among neighboring towns, pulling teeth and handing out toothbrushes and dental hygiene advice.

I was 17 and far from home for the summer, an Amigos de las Americas volunteer installed in the Honduran small town of San Miguel. I lived with a partner volunteer in one tiny room of the brand new town hall, our army cots covered in sweaty sheets; the things we’d brought from home (cotton skirts, books, journals, family and boyfriend photos, cans of tuna fish and jars of peanut butter, extra large bottles of shampoo and bars of soap) scattered over the tile floor and stacked on the two folding chairs. Most weekdays we spent going from school to school around the region, delivering toothbrushes and instructions on how to use them, pouring fluoridated water into paper cups, showing the children how to dunk their brushes, polish their teeth, swish and spit. (It wasn’t until I was older that I thought more critically about precisely what we were doing there, but this post isn’t about the politics of American charity.) Some days we gave out vaccinations, pushing needles into the arms of weepy children, smiling at the boys and girls with muddy feet and unwashed hair, rewarding them for their bravery with a piece of hard, sugary candy.

But this day was Dentist Day, and the dentist, a wiry man from New York who talked fast and worked fast, was in charge of things. He didn’t speak much Spanish; I spoke enough to be understood (usually,) so I was recruited to be his assistant and translator. Amy, my Amigos partner, was out front with Humberto—a local boy with a crush on her—taking names and doing a type of triage, sorting through the people and their tooth ailments, moving the most serious cases up to the front of the line.

Did I say it was hot? I’ve lived in Chicago most of my life; I know what sweltering, humid summers feel like. But I was unprepared for the oppression of a Honduran rainy season, unprepared for a sunshine so heavy it pushed against your head, pressed your shoulders down. But we’d been there for weeks by this time, June 1976, (our U.S. neighbors making ready for the bicentennial celebration that we would watch in the company of some 30 locals on the one television in town in the parlor of the doctor’s home,) and I had grown somewhat used to the wet heat and thick, still air.

Dentist David (“Dah-veed,” he asked us to call him) was helping an old woman into a chair. With just half-a-dozen people in it, the room was tightly packed. We’d been at it for more than two hours by this time, settling people in one of three chairs, me holding heads in my hands while Dentist David made a preliminary check of things, determined what tooth (or teeth, in most cases) needed extracting, shot the patient with Novocain, moved to the next person while that took effect, repeated the process another time, then circled back to the first person to do the pulling. It was usually quick work, the worst part for the patients the shot.

This old lady, though, slowed things down a bit. She was small and brown, her black hair streaked with white, and her face softly lined everywhere except where her jaw bulged and smoothed the skin out. I understand now that she might not have been any older than I am today—in her 50s probably—but to my 17-year-old self, she looked ancient. I instructed her to abra la boca, open her mouth, and she did as she was told. I put my hand gently on her forehead to tip her head back and Dentist David and I looked into the cavity before us.

The inside of her mouth was almost black but for an area around a clearly broken and rotted molar. There, her gums were red and shiny. She smelled of powder and soap, and the clinic reeked of antiseptic and sweat, but even through that complicated stew of odors, the stench of the woman’s breath was gross, fetid, swampy. Dentist David stepped back and poured himself a cup of cool water from a thermos. He poured me one and he poured the woman one as well. We all drank.

Me duele,” the woman said and she cupped her inflamed cheek with her hand. Her fingers were very long, like an artist’s fingers, or a musician’s, and her fingernails were polished in a snowy pink. “It hurts,” I translated for Dentist David, and he nodded and put his hand gently on the crown of the woman’s head. “No shit,” he said quietly to me. And to the woman, “Sí,” he said, “yo se.”

 We got to work then, shooting her with the local, moving away to an easier case, pulled a tooth here, a tooth there, then came back to the woman. We were just about to start when Amy came into the room with another woman who carried a small boy in her arms. The boy, her son certainly, was doe-eyed and crying, scared, no doubt, by all of the unfamiliar pale-skinned people and the needles and tools on the tables, by the stories we knew folks were telling outside the building, stories of pain and of punishment, of toothaches and bleeding gums. The mother held one of her hands over the little boy’s mouth.

“She wouldn’t take no for an answer,” Amy said, clearly irritated. Amy was not cut out for this work. She was 16, just a year younger than I was, yet she seemed childish in many ways. She was lazy and homesick, impatient and easily made angry. She spoke hardly any Spanish, having only taken basic conversation lessons during training, and when we were swarmed by the children of the village, as we were most days when we came home from tooth-brushing, from vaccinating, she pushed through the crowd roughly, and slammed and locked the front door of the city hall behind herself.

Está bien,” I said to the mother and child. “¿Qué necesita?”

The woman uncovered her son’s mouth. He was a beautiful boy with silky, expressive eyebrows and caramel skin. His hair was cut in a perfect bowl. He had a small, round nose that turned up at its tip, and just below that, he had a severely cleft palette. His top lip and gum and teeth formed an arrow upward, and his sweet, pink tongue poked out from the space left open.

“Can you help?” The mother said in clear English, a line she’d either practiced before she’d come to us, or was used to saying to whatever English-speaking visitor or interloper she came face-to-face with.

There was nothing we could do; I knew that, Dentist David knew that. Probably the mother knew that as well, but she had to try, didn’t she? The older woman with the rotten mouth watched the small drama unfold and stood up from her chair, motioned the mother and son to take her seat. Everyone looked at Dentist David and he swiped his forearm over his brow, pulled a bandana from his jeans’ pocket, rubbed his neck and nodded to the woman and child. They sat down. Dentist David hovered over them for a bit while the mother helped keep her son’s mouth open as Dentist David shined a flashlight at the teeth, the tongue, toward the back of the boy’s throat. He pushed a bit on one tooth and then another, followed the line of the arrow with his fingertip. He patted the little boy on his cheek, and rested a hand on the mother’s shoulder. He crooked a finger at me and I stepped closer to the group.

“I can’t do anything,” he said to me, but he kept his eyes on the mother and child, smiled reassuringly at them while he spoke. “I don’t even know what I should tell you to say.”

“And I don’t think I would know the right words to say it anyhow,” I said, also smiling at the pair.

“Tell her his teeth are strong and healthy. That he looks to be in good health. That he is a handsome boy. That from my professional perspective, he is fine. But tell her, too, that I am not an expert in these matters.”

Dentist David started and stopped, adding another sentence as soon as I translated the last one.

“Tell her I wish I could do more. Tell her I wish them both well. I am happy to have met them.”

I told them.

“Fuck,” he said. “I guess that’s it.”

I nodded and smiled again at mother and child, and offered her a hand to help her out of the chair. She stood up, her eyes shining, and nodded at us each before she followed Amy out of the room and down the front steps of the clinic.

“All right then,” Dentist David said and turned back to the old woman who had been standing close by, quietly observing, patting lightly on her inflamed cheek. “Proximo.” He said. “Next.”

The old woman sat down again and rested her head back in my hands. She opened her mouth and Dentist David went about his work, determining that the anesthetic had done its job, gathering his tools on the nearby table. He put the first of these tools in the woman’s mouth and pulled.

Nothing.

The woman was so slight Dentist David nearly lifted her from her seat. He motioned for me to hold her down by the shoulders and he pulled again.

Still nothing. The tooth would not budge.

There was a flurry of activity then, a wrestling with a tool I remember as something like a small jack, a gadget meant to get under the tooth in some way, to help lift it from the gum. He pulled and dug and manipulated and the poor woman’s mouth filled with blood even as the tooth, the obviously diseased and broken tooth, held fast to the gum. We stopped for her to spit and rinse, rinse and spit. The woman said nothing through all of this, but her knuckles were the color of bone under her brown skin as she gripped the arms of the chair, and tears streamed from the corners of her eyes and filled her ears. She kept her gaze fixed on my face.

If this were a comedy sketch, Dentist David would climb onto the woman’s lap in order to get a better purchase. In real life, it was as though he did everything just short of that. He paced around her head, trying to find the best angle from which to pull. He held his breath and grunted with exertion. He tugged and tugged. The other people in the chairs nearby leaned toward us as we worked, fascinated and frightened by the tooth’s stubborn resistance and the dentist’s unwavering effort.

And then the tooth shattered. Tiny bits of browned enamel splintered into the blood and saliva collecting in the woman’s mouth. She gagged a bit and I let her head loose so she could spit the junk out.

“Fuck me,” Dentist David said. We waited while the woman swirled water and spat at the bucket at her side. Pieces of tooth glinted in the murky pool of fluids. My head swam. I felt woozy. She settled back in the seat again and put her head back in my hands. I held her face as much to keep from losing my own balance as to comfort her. My back was wet with cold sweat. And before she opened her mouth again to Dentist David, the woman smiled up at me.

Somehow things went smoothly then. What was left of the tooth gave up the fight, and with a few quick yanks, Dentist David extracted the remnants. The woman’s mouth filled again with blood, and after one more swish and spit, I helped Dentist David pack the tooth with cotton pieces and pulled a cold, wet washrag from a Styrofoam cooler. I put it against the woman’s face and told her to keep it there for a while before she got up. And then I stumbled to a bench along the wall and plopped down hard.

In my pocket I held a letter from my mother. She had sent it just a couple of days after I’d left Chicago, but it had taken two weeks to arrive in San Miguel. The letter was full of everyday news, of weather in the suburbs, of my brothers and their jobs and studies, of driving trips planned with friends and family, of new summer clothes, of decorating projects on the townhouse she’d bought just a year before, the year after my father died. It all seemed so far away.

With my head back against the cool of the concrete wall and my eyes closed, I didn’t notice when the old woman whose tooth we had just pulled sat next to me. It was when she put her hand on mine that I opened my eyes.

“¿Está bien?” She asked. Her eyes were brown and warm, still glimmering from the crying. Am I all right? Me? This woman had just spit more blood than I had seen during the entirety of our operations that morning, and she wanted to know if I was all right?

Sí,” I told her, “Estoy bien.

And Dentist David was across the room near the chairs with two more patients, and Amy was at the door with the next in line. The old woman kept her hand on mine and it steadied me some, helped the shakiness pass. She put her other hand on her heart then, and lifted it to my face.

“Thank you,” she said in English, and when she smiled, there was still blood in the corners of her mouth, at the lines of her gums. She said it again: “Thank you. Mucho. Thank you very mucho.

Dentist David glanced at us and cleared his throat. He tapped lightly on the face of his watch. It was time to get going, I knew. I pushed myself up from the bench and the woman let her hands fall into her lap. Her face looked smoother than it had when she’d sat in our chair. I returned her smile.

“You are welcome,” I said.

And then I went back to work.

Image from Una Gringa en Honduras – http://honduraspc.blogspot.com/2008/03/brush-your-teeth.html. -PMc←

 

 

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