Continued from last week

This X ray picture showed the entire ramus of the mandible having a large radiolucent lesion.The picture was consistent with a huge dentigerous cyst!  “I have been saying it for years”, is all that he said.

Considering his mental condition I wrote a note to his hospital doctor about the cyst and the emergency that it had become by now.

Time had passed. It was two years and he hadn’t showed up with his tattered self deprecatory essay. And then one day he turned up with his wife. He had got his Dentigerous cyst operated. It had been a major surgery with reconstruction and scars on his cheek. He had put on weight and his facial tics were gone. He wasn’t the psycho that I was accustomed to seeing. But rather a self respecting man with a compartment and demeanor to match.

His wife was thanking me for all the help I had extended to him. Help? Well I had just written a note to his doctor, that wasn’t much work. And about the diagnosis, it was just a cake walk. It was all over the X ray. What was there to thank me all about.

“Thanks for believing him”. And then she spoke continuously for ten minutes. He was normal before his wisdom molar problems. When his dentist asked him to get it, out obediently he got it removed but the pus would not stop oozing. Every day he went to the dentist and every day he was told he was imagining things. His dentist’s deprecation of him increased with every visit. The whole hospital ended up labeling him a “psycho case’. Being too cultured he turned the contempt he received inwards and ended up becoming a psycho. But now everyone believes him after his surgery. He had indeed been speaking the truth all the time but no one believed him. That broke him.

And what was his reaction? I asked him, did he hold a grouse about his previous dentist? ‘No’, he said. ‘In Tamil we have a saying ‘a tree laden with fruit bends with the weight of the fruit’. I have received so many benedictions in the last two years I would rather be thankful for all the good things I received and choose to forgive and forget all the bad past.

That was like a slap to the entire profession for labeling the patient’s undiagnosed complaints as “psychological”.

Take some time to diagnose your patient’s complaints not everyone will take you to court for misdiagnosing, and not everyone goes bitching about falling standards in medicine, worse still some might mutely tolerate our professional incompetency. And That’s tragic, isn’t it?

CONCLUDED.

Dr Sanjay Jamdade is a speaker on dental implants and is a visiting consultant with few prominent dental clinics in and around Mumbai for implants and oral rehabilitation. He is also the CEO of Dr Jamdade’s Dental clinic and Implant center since 23 years which is a practice devoted to aesthetic dentistry, microscope assisted endodontics, implants and oral rehabilitation situated near Tarapur Atomic Power Station at Boisar Tal Palghar Dist Thane near Mumbai, India, email: –sanjayjamdade@gmail.com

Disclaimer : The views expressed in this blog are solely the views of the author and need not reflect the views of DentistryUnited.com . For any clarification you can get in touch with the author directly at the address mentioned above.

He politely asked to see me in my free time. I was new in my practice and I had all the time he would want. As I looked up to assess him, I saw a simple, slim, slightly balding but smiling middle aged man, who seemed to be too eager to please me. He had a “shubnum” bag slung over his shoulder. Seemed like a very respectable gentleman to me.  Salesman! I guessed.

Shoot, I told him. He reached into his pocket and fished out a tattered piece of paper, opened it, straightened it up and then with a smile on his face he said “Sir I will read you few sentences and at the end of it I shall ask you for your opinion. After that I shall pay your fees”. ” Hey what is this all about?”  I exclaimed. When he repeated his words  I said.  “OK, go on”

My jaw dropped, when I heard him. He had composed an essay completely denigrating himself calling himself foolish, stupid and idiot, ignorant and any and every debasing word. “I am a fool” “I am the most ignorant person on earth” “I should be locked up in an asylum” and on and on till the end of the page.

“Any corrections Sir?” he said with some facial tics. ” No”. “But I am not sure I understand……” “Any Corrections Sir?” “No”. “Phew” I wasn’t understanding what the game was. “Sir what are your fees?” I realized here was a very disturbed person, probably even a psychotic. My mouth dried up. “Sir what are your fees?” I was tempted to say “it’s on the house mad fella” but I ended uttering a figure. He paid and left. This guy was a masochistic psycho! Yearning for hate and contempt, begging for punishment and paying for it!

I found out from other practices in the vicinity that he showed up on all of them! The other doctors saw him as a easy  source of income, making money without raising a finger! They winked at me and congratulated me for my new source of extra income.

He kept on coming for years. I would sometimes suggest more derogatory words for him to add to his resume’! And I also expected to be paid higher for my suggestions! You see, I have a mastery over language and I could add more color to his self-deprecation and make money on it! Occasionally he even made me put my initials on the literary alterations I had suggested and he profusely thanked me.

Then one day he turned up as usual and while I was expecting him to fish for his, by now notorious tattered note, when he said ”I came with a different problem today, ”Can you check my teeth?”

“You see I had got my wisdom molar removed many years ago, the wound didn’t heal and there was pus coming out for a long time. Whenever I saw my dentist he said there was no pus, ‘you may be imagining things. It’s all psychological’. But I can still feel the pus coming out”

On examining him closely just behind the lower second molar was an almost puckered up wisdom molar socket, I could put the entire beaks of my tweezers which would disappear inside it. Though there was no pus there might have been some bad tasting liquid discharge. Something was the matter. Taking an intra oral radiograph showed ‘nothing’ behind the second molar. A larger extra oral X-ray was ordered.

Contd in part 2 next week

Dr Sanjay Jamdade is a speaker on dental implants and is a visiting consultant with few prominent dental clinics in and around Mumbai for implants and oral rehabilitation. He is also the CEO of Dr Jamdade’s Dental clinic and Implant center since 23 years which is a practice devoted to aesthetic dentistry, microscope assisted endodontics, implants and oral rehabilitation situated near Tarapur Atomic Power Station at Boisar Tal Palghar Dist Thane near Mumbai, India, email: –sanjayjamdade@gmail.com

Disclaimer : The views expressed in this blog are solely the views of the author and need not reflect the views of DentistryUnited.com . For any clarification you can get in touch with the author directly at the address mentioned above.

She wanted to change her orthodontist. She wanted us to take over her case. She had suddenly discovered that her orthodontist’s practice was very inconveniently located. She was suggesting us to either continue with her orthodontic treatment at our facility or next best take off her orthodontic braces for good.That was pretty unusual, how come it took her 4-5 months to realize a geographical fact? For a young smart student like her that would have been easy to figure out right at the start. We were now put on our back foot! Now it was me and my orthodontist who were pleading her to continue her treatment with her current orthodontist. After all the treatment was on it’s way and it is unprofessional to interrupt a co-professionals efforts. She refused to budge.We decided to cross check with her orthodontist. He wouldn’t mind us taking over if that was in the best interests of the patient.

Resigned to our fate we agreed to take over. However on opening her mouth we were taken aback. A mouth full of calculus, deep caries in nearly every posterior tooth, swollen bleeding gums. An orthodontic problem which was an obvious extraction case yet all premolars intact. And seen were a mouth full of brackets and arch wires. And any X-ray pictures? Study models? None whatsoever! What on earth was the treatment plan?Tongue in cheek we politely inquired for an explanation for the undone dentistry. She wasn’t even aware or told about the calculus, swollen gums, caries and pre-orthodontic extractions at all.What had happened? The patient sub conscious had somewhere along the way sensed that her case was being handled, politely put, in a manner leaving a lot to be  desired.

But her mind wanted to avoid conflict and it now invented a “geographical inconvenience”!Young dentists often ask how patients can tell whether they received good quality dental care. Well there is an inbuilt mechanism in this world. Sixth sense. Call it protective instinct, if you will. Don’t believe me? Well, try it, just keep staring rudely at a person standing ahead of you in a bus or train but facing away from you, for some time, and more often than not he turns around to look at you. In a way we all have eyes behind us. Nature saw to it that a protective instinct developed for our protection. We have premonitions, we can just tell something is wrong somewhere, but can’t say what.People usually know, that they got a raw deal. Once their protective instinct has awakened them they cross check with their friends and other patients receiving similar treatment. Call up their distant cousins, who are dentists and have a discreet word with their family physician and finally “google” their queries. And that nearly frames the dentist’s lies!Be so honest, thorough and sincere that your patient’s sixth sense bell never rings! It’s these little bits that add up to creating a reputation, And without reputation where would you be?

Dr Sanjay Jamdade is a speaker on dental implants and is a visiting consultant with few prominent dental clinics in and around Mumbai for implants and oral rehabilitation. He is also the CEO of Dr Jamdade’s Dental clinic and Implant center since 23 years which is a practice devoted to aesthetic dentistry, microscope assisted endodontics, implants and oral rehabilitation situated near Tarapur Atomic Power Station at Boisar Tal Palghar Dist Thane near Mumbai, India, email: – sanjayjamdade@gmail.com

Disclaimer : The views expressed in this blog are solely the views of the author and need not reflect the views of DentistryUnited.com . For any clarification you can get in touch with the author directly at the address mentioned above.