Marrow

Yesterday afternoon I spent almost three hours in a dentist's chair having an emergency root canal performed on a dying molar. The diagnosis startled me -- the nerve inside my tooth was dying -- because I had never thought of teeth as living things and especially not as separate from me, so that while I was still alive they could be dead. And the treatment -- to scrape the infected nerve out of the roots with long sharp implements -- sounded and felt downright barbaric. This isn't so much because of the pain; rather, it's the poking and prodding deep into tissue -- nerve and bone and blood vessels -- that ought to remain private, inviolate, hidden in the dark of the body. I'm waxing faintly religious here. So let me correct myself: I don't consider the body sacred, only private. And the consent to have it invaded, no matter that it's for the purpose of good health, never feels voluntary, even when, as wasn't the case yesterday, I have time to consider the implications of that consent.

Once I gave it, I entered a different world. A dentist's office has its own rules about the passage of time, about what a human body is when it's lying, head lower than the heart, mouth agape, on disturbingly comfortable soft leather chairs in pastel colors, hands and feet crossed, every muscle in the body tensed as if to remind you that you, as a whole self, still exist, that you are more than a tooth about to expire, more than a mouth that produces inconvenient saliva that interferes with the surgery you're undergoing. It's a position of utter defeat, of profound discomfort that stuck with me through the evening and the night, through dreams and terrified moments of wakefulness in the small hours of the morning. But the most traumatic aspect of this vulnerability for me was the fact that I couldn't speak, that my mouth was full of sterile rubber, my tooth isolated from the others but a metal brace in such a way that I couldn't articulate most consonants, so when the dentist asked me questions my answers were slurred as if I'd been drunk. And of course I was too discomfited and troubled to ask any.

In the end I did ask some. Lips still numb, tongue sluggish, I asked about nerve fibers and antibiotics and success rates and why the anesthetic didn't work as well as it was supposed to. The dentist gave me a small, condescending smile after every question, but also a complete answer. He is a rather young man with thick, longish, black hair, and a feeble, fingers-only handshake that alarms me. Perhaps he shook my hand that way because I am a woman, and that troubles me even more. But he's supposed to be a very competent dentist, and wouldn't I take competence over a firm handshake any day?

I watch House, MD, the television show, in part because this question of competence versus kindness is at the core of the story. It's not simply a question of convenience, at least not to me; true, it's easier to be mean than to be kind, but that's not the point. The much deeper problem is whether being a brilliant doctor requires stripping a person of dignity, reducing him or her to a puzzle to be coolheadedly solved. And if this kind of cruelty is necessarily the price for exceptional competence, is it worth paying it? This dilemma seems to me to be specific to Western medicine, whose fundamental assumption is that the body and that other part of the self that isn't the body are two different things irrelevantly connected to each other. When you get sick, you cease to exist as a whole being and become the sickness. The part stands for the whole. This transformation is even more humiliating than the inability to speak.

I have to go back to the dentist for another appointment, and I don't want to. Every fiber of my being tells me not to go. Well, there's one exception: my logical mind says: Don't be ridiculous. Infections have to be treated, and doctors are the only ones qualified to treat them; so you have to go to the doctor. I feel compelled to submit to this reasoning. And as a protective measure I become didactic, force myself to learn something from this experience, console myself that, if nothing else, it's material to write about. When I was young, nine or ten, my father said to me, after I had my feelings hurt by someone, to write about it. I set out, vengefully, to do it, determined to have my pound of flesh. Maturity hasn't entirely exorcised that impulse out of me. But I have a more powerful motivation now that trumps revenge: I want to learn not to fear death, and that means learning first not to fear smaller things, like the death of a tooth, like the dentist who kills it.