The chill of the drill
On the choices we're forced to make to live a good life
It’s 8:10 in the morning. I pace outside a Midtown building, sigh, head inside. At the elevator bank, my head swivels, left, right, left again. Finding the button, having pressed it, I wait.
The elevator lifts me skyward. Fourteen floors up, I head across a short hallway, press a buzzer. The door unlocks, and I enter. As I doff my coat, scarf, and hat, a soft, cheery voice greets me.
Seconds later, I’m taking a seat. I’ve dreaded this day, but I couldn’t put off any longer; the pain simply was too great. The doctor tells me to relax; I breathe deeply in, then resign myself to what’s going to come. The chair reclines, and now my gaze takes in a clinically sterile ceiling.
As I’m writing this, my rear gums are inflamed and aching. I’ve been alternating between sipping a cocktail before bed and downing extra-strength ibuprofen, acutely aware that one should not take the two together due to the potential for internal bleeding.
Like me, the novelist Jonathan Corcoran suffers from bad dental health. Like him, I don’t really remember a time when I didn’t have trouble with my teeth. My parents weren’t exactly poor, but they struggled to make every dollar count. They lost our house during the first Bush recession — in 1990-91 — and after my step-father lost his job, he went into business for himself. Combined with my mother’s chronic illness, that meant our healthcare costs skyrocketed. And that meant that dental care sometimes fell by the wayside.
It wasn’t until I joined the Army at 22 that I was finally able to receive regular dental care. It wasn’t great, but it was better than nothing; and the best part was that I didn’t have to pay for it. By the time I left active duty nearly seven years later, my mouth was full of fillings.
That’s also the last time I had regular dental care. Which explains the condition of my teeth this morning. My dental care, like my career, jitters hither-and-yon. On the occasions I have dental insurance, I take advantage and see a dentist. But those opportunities are scarce. This is how I become an expert on what I refer to as palliative street dentistry.
I’m a recovering alcoholic, so cocktails aren’t part of my treatment regimen. But I’m extremely well-acquainted with all the Orajel varietals; the mouthwash, the glass bottles with liquid tincture and the gels you dab. I learn to choke back the throbbing, dull ache in my jaw, waiting until the last possible moment to take ibuprofen.
My mother cried back then, when the dentist told her the cost: It was a third of my family’s annual income. It was, in other words, impossible. I cried too. I was already working my way through college; there was simply no time left for me to work off a $12,000 bill and keep up with my classes. So I ignored the pain until I learned to live with it, and became that guy who never open-mouth-smiles in pictures.
That’s me, too. As I started writing this newsletter, I started taking selfies of myself. I didn’t smile in them, until a friend asked me to; and her kindness was the suasion I needed. Far more often than not, I resort to a wry half-smile that really resembles more of a pained, shamed grimace.
I tell my dentist - a sweet, gentle woman my age - that my tolerance for dental pain is fairly low. She smiles, reassures me, and for the first time, a dentist actually takes that seriously. She is generous with the anesthetic; every time I complain about pain or sensitivity, she quickly acts to ameliorate what aches me.
Nevertheless, my leg twitches spasmodically every time I feel a twinge of pain. I breathe deeply, trying to meditate away my discomfort and soreness.
She works deftly, briskly drilling and grinding away at my molar, removing the broken filing that’s my reason for being there. As she works to heal my tooth, she explains what she’s doing, and tells me that despite my telling her that my pain threshold is low, I’m really doing quite well.
People dread getting root canals; I can see why, but for me, they’re old hat. I know it’s a two-part procedure. We’re doing the first part today, removing the old filing, cleaning the tooth, making sure that there’s no infection present. But my nerve is inflamed, and when a nerve is inflamed, it bleeds. So much of my visit this morning is spent dealing with that.
We’re going to try to save the molar, but the reality is that I may not have a choice. I may lose the tooth; in which case my choice is to have extracted, and an implant put in its place, or to simply lose it altogether. I’ve already lost two teeth. I’d rather not lose a third, but this decision may not be mine to make; my body, my history, may have made it already for me.
Either way, it’s more money that I really don’t have. I’ve already exhausted my meager savings earlier this year, dealing with the sundry problems that life brings you. Despite my luck in finding a well-paying job with good-to-excellent benefits, my need for dental care is outweighing my desire and need to set money aside.
My days are spent with my body wearily coping with the accumulated pain of years of training for combat, carrying more than 100 pounds of gear on my stout frame, and playing rugby as a hooker. The checks my body willingly wrote two decades ago are now being cashed with pain, and that pain carries a compound interest that weighs on the soul and the mind. That pain, I can deal with.
My teeth are another matter. I can’t disguise them, and if they hurt, eating is made exponentially difficult. I will get this tooth fixed. The others, though, may wait.
She means well, but I dread the dental hygienist. The judgmental tone in her voice is probably just exhaustion; the only dentist I can afford to see has an office that’s a in perpetual spin of budget-seeking patients. I’m one of scores of people who’ll sit her the chair today, and whenever I leave, I hear someone standing at the dreaded reception desk trying to argue their way out of a bill in an embarrassed tone.
Sometimes I’m in that corner too, wheeling and dealing for a way to swing basic treatments with money I don’t have. To my shame, I often go months or even years between routine cleanings, opting to spend money on debt or bills or food instead.
This, too, is me. Before my dentist could work on fixing my broken molar, I needed to get a cleaning. Not having had one in over a year, the hygienist lectured me, her tone severe. But given a choice between a cleaning and paying bills, what choice am I going to make?
Still, the shame stings. Shame is a force multiplier — whatever situation you’re in, shame only serves to make it worse. A cage, shackles, chains: that’s what shame is. It cloaks my spirit, wraps it in a bear hug so tight I can barely squeeze out breaths.
I’m embarrassed to smile in pictures because I don’t want people to see the grave condition of my teeth. Once, I’m standing outside the Speaker’s office in a state house, lobbying for veteran’s benefits; one of my colleagues cracks wise, involuntarily I smile widely. The person standing across from me — also involuntarily — looks at my face and winces ever so slightly. I freeze, cast my eyes downward. I doubt I crack another smile the entire time I’m there.
I’m ashamed every time I see a dentist, because I’m so tired of justifying why my teeth are so bad.
Like Sisyphus and his rock, Jonathan, myself, and so many are seemingly condemned to choose between a good life and good teeth. It need not be so; dental care shouldn’t be a luxury, but a necessity, critical to our well-being. Dental insurance isn’t meant for the sick. It’s meant for those with healthy, glowing smiles, who need only visit my dentist once or twice a year, to get those smiles polished up.
I spent a solid hour this week looking at the new dental insurance plans my company picked. I selected the one with the highest maximum. But when I looked for my dentist’s name, she was nowhere to be found. I called her office; they accept my new insurance plan, which will take effect in the new year. But since they’re not ‘in network’, I will have to pay in full for any major dental work she performs.
I will need a new dentist come the new year. I wonder if maybe I should visit Mexico and embrace life as a dental tourist.
Ask me again if I like my insurance. I like the fact that I have it, however useless it might really be. It’s better than nothing, which is what I’ve had for most of the past decade. But how useful is insurance if it doesn’t cover the work that needs to be done? Dental insurance is useless for people like Jonathan and I, the people who need it the most.
When Pete Buttigieg and Joe Biden caw about people who like their insurance, I chuckle mirthlessly. Of course they like their insurance, I say to myself. Their teeth are in excellent shape; they’re the insurance industry’s favorite kinds of patients. But what about me? Don’t I matter, too? And, sure, this will be when the good mayor will say, This is why you’d choose Medicare for All! You’re whom I think about when I say Medicare for All Who Want It.
But that’s the thing, you see: insurance only really works when the healthy and the sick are in the same pool. Otherwise, you have what we have now: insurance that only works for the healthy, because the sick are left to fend for ourselves, nursing cocktails, choking down over-the-counter medication, and swirling anesthetic mouthwash around our decaying teeth.
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We’re heading into the weekend. I hope yours is restful; we sure could fucking use it, right? Anyway: I love all of you. I’m here for you. I want you to know that you’re awesome because of who you are, and that your flaws and foibles and genius make you a brilliant person. Be well, and if you need anything, holler at me.