Friday, February 28, 2014

I Love CE!


Spring has always been a time to look forward. I enjoy planning out my summer, setting goals, and reviewing my expectations.

Professionally, it is the excitement of planning to attend bigger CE events. They are perfectly timed, approximately every other month. This year, I attended the Chicago Dental Society’s Midwinter Meeting. HOW HAVE I WAITED THIS LONG TO GO??? What a great meeting! I added some great participation courses to my transcript for my future MAGD, and I am kicking myself that I didn’t enroll in more. Lesson learned! Calendar blocked for next year!

Following the #CDS14 meeting will be the Michigan Dental Association’s Annual Session. I have and will always continue to support my local component and fellow colleagues.

The commencement of my annual meetings is the Grand Marshal of the series, the 2014 AGD Annual Meeting & Exhibits. If you haven’t attended, you should reconsider. It is here in Michigan this year and a great time to “Rethink. Refresh. Renew.” Before you start throwing out the jokes (Will there be power? Will it be safe? What exactly is there TO DO in Detroit?), it is going to be a great time! Admittedly, we don’t have the honky tonks of Nashville, but there will plenty to see, do, and learn at the #AGD14!

I am not a part of the committee that created it, but I LOVE the title theme this year! Think about the words! Michigan, as a community, has been working on that theme for many years. We are still treading water and sometimes making waves. Outside of the city limits, which of course has had its fair share of poor publicity, we have been making it. According to Webster’s:

Rethink: to think again about (something such as a policy or course of action), esp. in order to make changes to it. (n): a reassessment of something, esp. one that results in changes being. made

Refresh: to give new strength or energy to or to revise or update (skills or knowledge)

Renew: to give fresh life or strength to.

I particularly like “refresh.” Who wouldn’t want to refresh? This triad of words is exactly how I feel as I approach an upcoming CE weekend or event, and even more so after I leave. Something that is said causes me to rethink how I may have approached a task or situation previously. I learn a new skill that renews my interest in a technique I was fearful to take on. And I absolutely have refreshed my drive to learn more, see more, and do more.

Colleen DeLacy, DDS, FAGD

Monday, February 24, 2014

Hard to Swallow

“Doc, I think I just ruined your afternoon.” Although my patient is a joker, I knew he was not joking when he uttered those words.

This illustrates how a routine day can quickly become a memorable one. Let’s talk about those times when something completely unexpected happens during a dental visit.

I always try in my crowns before final cementation. For twenty-odd years, patients have asked if anyone has ever swallowed a crown. Fortunately, for all those years, I’ve been able to answer say no. Until now.

We were trying in the lower left second molar. The crown needed to be inserted several times as I needed to adjust the occlusion quite a bit. We were just about there with the occlusion when… Gulp! Just like that. I turned my back and it was gone!

It was not a great feeling when I realized what had just happened. How does one handle this situation? I first made sure he had indeed swallowed the crown. In other words, he was not choking or struggling to cough. Fortunately, there were no signs that. Quite simply, the crown was there one second and gone the next. Plus the patient was absolutely sure he had swallowed the crown. That made it unnecessary to subject the patient to a chest x-ray in order to confirm that he had not aspirated the crown.

The take-home lesson for my staff and I was to be prepared and remain calm. Although this was my first such encounter, my staff had been through it before with previous dentists they’d worked with. It felt good to have my staff compliment me on how I handled the situation. Remember, it is best to remain calm and reassure everyone in the room.

Understandably, the patient wanted to know what would happen next. In my usual honest way, I informed him that it would “come out the other side.” I gave him a minute to, uh, digest that thought. Then I told him he could either look for the crown or we could make him a new one. He scheduled for a new impression. Since this visit had already caused enough excitement for everyone involved, we opted to recement the temporary crown and call it a day.

I felt I needed a new impression since the original crown needed so much adjustment. At this point we might as well start over. When he came in for his next appointment, he was joking about what had happened and promised not to swallow anything. He also kept apologizing for stressing me out by swallowing that crown.

Now, when patients ask me if anyone has ever swallowed a crown, I have a different answer.

Andy Alas, DDS

Friday, February 21, 2014

Why Are We Not Thorough?

When I was in dental school, it took three hours to do a new patient exam. It involved reviewing the medical history, the extraoral soft tissue exam, the TMJ exam, the intraoral soft tissue exam, forensic charting of the teeth (fillings, recession, furcations, mobility) and the 6-point perio charting (including bleeding on probing and suppuration), as well as review of the appropriate radiographic series (full mouth and/or pan plus bitewings plus selected PAs). We were taught to be thorough.

Then we got out of dental school and entered the “real world” of general practice dentistry. Suddenly, most of our colleagues were not charting the extraoral findings, not doing a TMJ examination, or not charting the periodontal status on every tooth (they may have looked but did not record anything, or they did the lesser PSR recordings, which look at a selected subgroup of teeth). For many, a new patient exam is a 5- to 10-minute greeting by the dentist. How does the patient benefit from this?

I recently had a new patient in my office. I always book a one-hour examination with me, not including dental hygiene services. We still do complete forensic charting as taught in dental school and add an intraoral series of photographs, as well. In this particular case, there was a deep pocket on the buccal of the upper right second premolar when all the other teeth were within normal healthy periodontal parameters. This tooth had been treated endodontically and had a post and core and crown. It all looked normal and was asymptomatic, but the deep pocket in one location (of 6) on that tooth was a strong suggestion of a vertical crack on the root.

We had two choices. We could wait until the tooth was symptomatic and act, or react. Or, we could assume the vertical crack was there, extract and preserve the bone for placement of a single tooth implant. We elected to do the latter. Upon examination after extraction, the tooth really did have that vertical crack. If we had not done a thorough 6-point probing on every tooth, we would have missed this finding. My patient was grateful we were thorough, and told us that no dentist had ever examined him this comprehensively in his past. We had earned his trust.

I do a lot of consulting for insurance companies, lawyers and disability management companies for orofacial and TMJ injuries from trauma, mostly motor vehicle accidents (MVAs). In these cases, I am asked to determine which injuries are due to the MVA and which are pre-existing problems. It’s a detective process for me and I enjoy sifting through records from my colleagues to attempt to figure out the source of the pain and dysfunction. Unfortunately, so many of the dental records I review have areas on the forensic chart for the extraoral and TMJ findings to be recorded that are completely blank. These critical structures are either not examined at all, or nobody takes the time to record their findings. This leaves me, and the patients, in a difficult quandary. It is sometimes to the patient’s detriment when I cannot demonstrate definitively that a problem is directly due to trauma and not a pre-existing problem.

I presume that we are taught to be thorough in dental school for a good reason. Why do we stop doing this? How do our patients benefit from us not being thorough? This is my plea to you to get back to basics and be more comprehensive. I think you will be surprised by how grateful, surprised and delighted your patients will be when you do this. I am now beginning to redo the complete examinations on patients who have been part of our practice for 10 years or more. So much has changed in that time that it is time to revisit their goals and their health.

And now for an update on my practice sale. I had it valuated in the Fall; within three weeks of listing it, I had two firm offers from two incredible dentists. I had the difficult decision of deciding between these two. I chose the dentist with 20 years of experience who possesses a skill set in general practice dentistry in treatment areas that I routinely refer out. This will likely lead to me reaching my goals of fewer hours and less stress faster. Did I make the right choice? Time will tell. I have such admiration and respect for the other dentist, and I hope I can find a way to work with her in the future.

I am now still in the final negotiation stage and hope to have the deal completed before the end of March. Onwards and upwards. And back to the grind…

Warm regards,

Larry Stanleigh, DDS

Wednesday, February 19, 2014

Success and Giving Back

To laugh often and much; To win the respect of intelligent people and the affection of children; To earn the appreciation of honest critics and endure the betrayal of false friends; To appreciate beauty, to find the best in others; To leave the world a bit better, whether by a healthy child, a garden patch, or a redeemed social condition; To know even one life has breathed easier because you have lived. This is to have succeeded.
—Ralph Waldo Emerson

I really enjoy this quote. Nowhere does it state that success is your mansion, yacht and sports car. It’s about the connections you make with people and the community.

In my residency, I am fortunate to be able to complete complex dental procedures and treatment plans for patients at a reduced rate. Most of these patients would not be able to afford this treatment at a private practice office. Unfortunately, even with a 50% discounted rate applied to procedures, a few of these patients still cannot afford to get treatment. For a few of these, treatment would literally change their lives.

As a 2013 dental graduate, I will struggle to be able to afford to give away much free dentistry out of the gate. I need to get my six-figure dental school debt that starts with a three under control before I’m in a comfortable enough position to extend free services out of my office. Of course, I want to be involved with events like Mission of Mercy and Give Kids a Smile as much as possible.

While I may not be able to give out free dentures right away, I am able to contribute to my community in other ways. For instance, I currently volunteer at the Idaho Humane Society, taking dogs out for walks and giving cats some much-appreciated petting. Families wander around checking out the animals for one to adopt, and I can assist them in this special event. I have to admit though: this volunteering is a little selfish because it’s free pet therapy after a stressful day!

Some other opportunities for giving back may be tutoring area school kids, helping out with reading day at the library, volunteering at the food bank, coaching a kids sports team, and more. The volunteer opportunities are endless and doing something outside of dentistry is a great change of pace. I hope for the new dentists like me that we do not become close-minded to giving back just because we are in debt. Think of it as an opportunity to step outside the dental world and find something enjoyable to do for others.

This pleasantly plump lil’ lady loved rolling in the grass and belly rubs.

I wanted to adopt this Border collie, an excellent fetch partner.

Free pet therapy after a long day!

Katie Divine, DDS

Wednesday, February 12, 2014

Brush with Fame

As a college student in New York City, celebrity sightings were practically an everyday occurrence. Having your morning route blocked off by a camera crew or being forced to wait until a director got a satisfactory shot of an Olsen twin strolling across campus was a perfectly valid reason for being late to class. It was totally normal to share a subway car with late night hosts, TV stars, and popular musicians. One time, in order to drop off an assignment before my TA’s deadline, I begged a production assistant to grant me access to a building that had been closed off for filming and wound up getting to watch the entire cast of “Mona Lisa Smile” file out of the classroom where I attended lecture twice a week.

Although I was fully cognizant that celebrities are just plain human at the end of the day, I guess I never gave too much thought to the idea that they, too, have to go to the dentist. Not that there’s been any shortage of reminders. In school, our first esthetics lecture contained headshots of famous actors and actresses whose dental work we would later analyze ad nauseum, discussing all the things we would have done differently and what improvements we’d make to them if given the chance. (I’m looking at you, Tom Cruise.)

These days, when a celebrity goes for a checkup, it’s not uncommon to have the mundane minutiae of the visit documented on a camera phone and then shared with millions of people online. I even received a text message alert when one of the Kardashians left her most recent dental appointment and was reportedly—brace yourself—STILL feeling numb. Why her dentist’s ability to achieve profound local anesthesia was considered breaking news is beyond me.

Yet, for someone who loves pop culture as much as I do, the concept of having a famous person in my office, let alone my dental chair, had never crossed my mind. In my universe, dentistry and celebrity were two totally separate entities whose intersection I had not ever considered. Sure, I’ve marveled at how Kate Beckinsale manages to keep her skin so youthful and radiant, but wondering what teeth whitening products she uses and whether she’s got smooth or stippled gingiva doesn’t keep me up at night.

I suppose that I should have expected to come into contact with some celebrity patients eventually after moving to southern California, where the rich and famous come to work and play. Shortly after joining my current practice, I was slowly introduced to some of our more high-profile clientele. I had the opportunity to meet a local news anchor and some professional athletes whom I’d probably be more excited about if I followed any sports at all. And although San Diego doesn’t see nearly as much celebrity activity as New York or Los Angeles, I’ve come across plenty of Californians willing to shell out big bucks for a Hollywood smile.

A few weeks ago, I got to see and experience what having a bona fide celebrity in the office is like when Michelle Phan came in for her appointment. For those who may not be aware, Michelle is a former waitress turned YouTube sensation turned beauty products mogul who has successfully parlayed her passion for cosmetics into a burgeoning makeup empire. She now has millions of loyal fans around the globe who follow and celebrate her every move through countless social media outlets. In other words—as we say in San Diego—she’s kind of a big deal. People know her.

As someone whose formal instruction in the application of lip gloss started and ended two decades ago in the girl’s bathroom at West Brook Middle School, I was not at all familiar with her career or her celebrity status when I first joined the practice. In preparation for her arrival, I typed her name into an online search engine; within seconds, I found results that even the NSA might deem excessively intrusive.

On the day of her appointment, the sight of THE Michelle Phan standing in our reception area was equal parts startling and surreal. No matter how many times I’ve stumbled across famous people, seeing them in the flesh is something I have yet to grow fully accustomed to. When you’ve witnessed their lives play out on television and all over the Internet, it almost doesn’t seem real that they’re right there in front of you, and even more unreal that they’ve come for dental treatment. I mean, I’ve never seen a Minotaur before, but if one was waiting for me in my operatory, I’d probably be just as surprised to see it and just as disoriented by its presence.

Just to be clear, I am in no way implying that Michelle Phan bears any resemblance to a Minotaur.

But once the initial oh-my-gosh-she’s-just-as-pretty-in-person-as-she-is-on-TV shock wore off, it was back to business as usual. There really was no difference in how she was being received in our office compared to any of our other patients. The front desk greeted her just as warmly as the patient whose appointment was right before hers. Our assistants made the same efforts that they make with every patient we see to ensure that she was as comfortable as possible throughout her stay. We treated her the same way we treat all of our clients: like members of our family.

Perhaps that’s the secret to keeping everybody on our patient roster happy. Treat every person like a star, and every star like family. While it may never be the official slogan of our office, I hope that every patient in our care understands that that’s what we’re striving for.

Before she left, Michelle graciously posed for pictures with our staff and even recorded a video testimonial to share her thoughts on being seen in our office (spoiler alert: she’ll be back). I’ll admit, I’ve always thought it was kind of cheesy when I saw dentists plastering photos of famous people all over their offices and websites to market themselves as a “Celebrity Doctor,” as if evidence of treating a star is supposed to be indicative of a higher level of skill or credibility. Then again, I suppose it wouldn’t matter all that much to me if a patient came to my office and specifically requested to be put in my care just because I had a history of treating well-known public figures.

What I’ve come to realize is that the most successful doctors are the ones who can provide their patients with such remarkable service that they’re eager to come back and willing to go out and tell the world what a great experience they’ve had. The highest compliment my patients can give me is the referral of their friends and family. I know that if I never see another famous person’s name on the schedule again, it won’t be a reflection of my abilities as a clinician or businesswoman. What I really hope to see are the same familiar names and happy, smiling faces returning again and again because they trust me to provide them with the best dentistry I can.

Diana Nguyen, DDS

Monday, February 10, 2014

A Senior Moment

Your “senior moment” as a dentist can come at anytime. I stood at the podium addressing my colleagues at the House of Delegates during the Arizona Dental Association meeting on September 21, 2013, in Sedona.

It hit me, and the words just fell out of my mouth. “This is not my profession, this is not my association.” At the age of 61, I am able to start wrapping my arms around the fact that the profession and the association belong to the younger dentists now. My role, as I am in my senior years, is to try to facilitate their transition in while Debbie and I transition into another purpose.

I think the thing that hit me first is that Errol (51) and Karl (65) were not there. This was the first meeting of the HOD where Errol Kahn and Karl Zimmerman, two very involved dentists, were only with us in spirit.

And then the real irony of this meeting hit. As the clock moved closer to 11:00, everyone in the room knew that long-time AzDA supporter and past presidential candidate for ADA, Charley Siroky (76), was about to be buried just two hours way in Phoenix. Charley had been a pillar of the association. He was involved in so many ways. And yet, God made it happen that many who would attend his funeral were not going to be present. His friends and colleagues from all over the state would not be there to say their final goodbyes.

I could not help but see the lesson crystallize as it was evident that, no matter how important a dentist was, the reason for their importance was our profession. No one person is bigger than the association or the profession. Understanding that there will be no more Dental Association meetings for Errol, Karl or Charley has changed my view of the world and, more specifically, my view of my place in organized dentistry.

Realizing that Charley was only 15 years older than me has helped me understand that I have much I want to do with the remaining years of my profession and life. I'd like to remind all of my younger colleagues who sit and worry about their future and the future of the profession that we all did at your age. You should be involved and thinking about how you will spend your career in dentistry.

My great hope is that you will think and worry and become passionate about your profession and life as a dentist. More importantly, I hope the time flies by as it has for Debbie and I, and that you will have that senior moment and realize it is never was about you. The best in dentistry is yet to come!

Enjoy being a dentist,

Bob Oro, DMD, MAGD

P.S. This is my final blog for AGD; it belongs to the next generation.

Friday, February 7, 2014

Control Freak

How and when do I stop being a control freak?

I was raised in a family of control freaks. Everyone thinks they know best, and they probably do know best. On top of that, no one has the patience to teach anyone else, and therefore end up doing everything themselves. Naturally, I grew up to be exactly the same. Now, as a new business owner, I realize that the family trait I have is actually a curse.

I started my own practice a little short of a year ago, and I did everything myself at first. Although I started fully staffed, at times I was my own receptionist, treatment coordinator, biller, assistant, hygienist, marketer, manager, designer, HR, etc. I’m sure that sounds very familiar. I used to think that I had to take on these roles regardless of the staff being present. They were new and they did not have the proper training yet. It never even occurred to me that it may just be my handicap of not being able to let go.

Now that my staff is fully trained and fully capable of doing all they were hired to do, I still find myself immersing into their tasks and taking over their responsibilities. This results in my being very tired and feeling hopeless that as the practice grows, my load will keep getting heavier, for no good reason. I have realized that my inability to delegate is the source of my problems. I’ve also that heard many other practitioners go through the same phase, but eventually learn to adapt. I’m doing my best to adapt, but keep finding myself taking over pretty much everyone. I think I can do it best, though that probably isn’t true anymore.

How do I stop? Should I stop at all? Will I stop naturally as the practice keeps growing and I just don’t have the time? Should I even worry about it now? I don’t know how to handle this and I find it to be one of the most challenging issues I’ve encountered in this quest to have my prefect practice.

Mona Goodarzi, DDS

Wednesday, February 5, 2014

They Like Me. They Really Like Me!

Since the time Sally Field received her Oscar for Best Actress for her role in 1984’s “Places in the Heart,” her acceptance speech has been misquoted more times than it has been properly repeated. In keeping with the misquoters, I have taken liberties with her speech to talk about a problem I have.

“They like me. They really like me.” For the past 24 years as a business owner, this has been my modus operandi. I’ve committed to these words as a personal philosophy, of sorts. It chants in the back of my head when I deal with difficult patients and it taunts me during those challenging moments with team members. Recently, I have started to ask myself if this mantra has brought value to my business life or if, in fact, it has created additional and unnecessary stress.

I’m a people-pleaser. I’ve always been a people-pleaser. I could write a whole paper on why first-borns struggle with the need to make people happy but, I’ll save that for another time. Suffice it to say, people pleasing is kind of “ma thang.” Inherent in the need to please people, of course, is getting that warm fuzzy feeling when your mission was accomplished. That people are pleased and, maybe they really like you (an added bonus), is success!

Well, that has been MY measure of success. It turns out that maybe, after all of these years, my success barometer has been a bit corrupt. Because, while I have been working my tail off my entire career — my entire life, actually — I am exhausted. And, I have little to show for trying to make them like me.

Oh, lots of people like me. That’s what I’m good at. But have I earned their respect? Do my patients and team take me seriously? Am I a good leader and effective manager? Is getting people to like me an effective business strategy? I’m not so sure.

My practice is growing, and quickly. That’s the good news. With growth, the drama and conflict have increased. That’s the bad news. And, in my constant analysis of the situation, the common denominator turns out to be me. “Nice” does not generate effective business methodologies. What to do?

Perhaps, the wisdom that comes of age can serve me here (and make me feel better about the whole age thing). I need to remind myself about the people who bring value to my life and to my career. I don’t really have to accumulate a boatload of insincere likes anymore. Maybe the respect that I show others will allow them the freedom to make their own choices about me. And, ultimately, straightforward communication can ensue. No more pressure to make people happy when I need to make difficult decisions and then follow through with them. What a concept!

There will be no more killing them with kindness. At the end of the day, it’s really killing my effectiveness. Keeping more team members and more patients in a growing practice all happy and liking me will kill me, metaphorically. Don’t panic. I’m not going to become an “owner-zilla”. It’s not in me. But I am going to try to be more mindful of the health of both my business and my psyche as I try to hone better leadership and management skills. These are skills that I was able to elude when my practice was smaller.

Thank you, Sally Field, for allowing me to parse and ponder your famous misquote!

In case you were wondering what Sally Field really DID say in her acceptance speech on March 25, 1985, here is the actual quote:

“I haven't had an orthodox career, and I've wanted more than anything to have your respect. The first time I didn't feel it, but this time I feel it—and I can't deny the fact that you like me, right now, you like me!”

Claudia Anderson, DDS

Monday, February 3, 2014

Freshman Operative Practical

Remember the freshman practical, a strictly timed test that decided your fate?

Alphabetically seated in the operative lab in 1975, I studied beside Ms. Oleander Jacobs. She was later paired with me for clinical exercises that she couldn’t perform without seriously hurting me. She lacked the didactic skills for good—or even acceptable—dentistry. But on one particular day when the test involved waxing a crown in the lab; I felt safe.

Nervous students watched the clock slowly tick toward 9 a.m. Tension filled the air as the instructor announced, “Now.” Matches were struck and a room of Bunsen burners whooshed to life—at least, most of them did.

“Mine’s not working. Whaddo I do?”

“You should’ve checked it earlier, Mr. Brown. That’s the sign of a good clinician. See if you can share your neighbor’s.”

“I can’t find my wax instrument,” another student desperately announced. “Does anyone have an extra?” No one came to his rescue; he had to make do with a discoid-cleoid.

“I need a match. Can I borrow a match or a lighter?”

“A lighter? No one smokes, you nimrod. Use this,” he said, while tilting his burner to pass the flame.

Habitually dirty, Oleander was more grimy-gross than usual. Her pungent body odor mingled with the scent of cheap candles and the heat of several dozen miniature campfires. The mix began to weigh ponderously in the air, which didn’t help my nerves.

But wait! Something else is afire—some familiar stench. Several nearby students raised their heads to sniff the air like Basset hounds. Then it came to me: burning hair! Instinctively looking left, I stammered, “Oleander, you … you … your hair is on fire!”

She swatted the top of her head, as one might do with an annoying fly they have no hope of hitting. Irritated at the interruption, she briefly glared at me before bending back over the lab bench. She pressed her chin firmly against her chest and studied the die with her Coke-bottle glasses. Her flailing had not only failed to extinguish the blaze, but had further fanned the flames, which shot ever higher from atop her oily mop.

Floyd, seated to the left of Oleander, sprang into action. He jumped up, jostling his steel lab stool, and made a mad dash to the sink. Grabbing a stack of paper towels, he ran them under the faucet and smacked the top of Oleander’s headwith the wet wad. This merely encouraged the fire, which reached further heavenward. Maybe it was my imagination, but I thought I saw a hint of blue at the tip. Was the conflagration going critical?

Maybe that guy who couldn’t find his burner could use Oleander’s head.

Throughout it all, Ms. Jacobs continued to diligently carve her wax, which she had transformed from a block to a marble. Her detached countenance contrasted sharply with the flaming emergency, which Floyd and I had to deal with. Water wasn’t the answer, and the lard lurking in the depths might spread the fire. Baking soda wasn’t readily available, but the fire extinguisher seemed inappropriate. Then again, that might be fun...

Water seemed to be the only option. I jumped up and completely knocked over my stool, which crashed to the floor with a loud, metallic clank that caught the attention of an ever-widening circle ofstudents. Several turned to gaze wide-eyed on the pyrotechnic glory that was “Oleander the Human Torch.”

I filled a green mixing bowl with water and dumped it on her head. Miraculously, the flames were snuffed out before the grease fire could spread. Floyd whacked her head with wet paper towels one last time, just to make sure. All was well, but Oleander was drenched.

I thought she would have been grateful, thanking me and Floyd for our heroic efforts. Conversely, she could have gone ballistic. But, she simply kept on working, never again lifting her chin off her chest.

When my metal stool had reverberated against the floor, the clueless instructor glanced up briefly, but quickly went back to his cheap paperback. Students around our little bonfire seemed to enjoy the comic relief, while those seated further from the epicenter diligently carved their crowns without pausing to see where the awful stench was coming from.

With the misplaced flames duly extinguished, Oleander and the entire class were safe. However, those seated near the fiasco found it hard to concentrate and quietly chuckled through half-smiles. From time to time, the proctor put his book down and strolled around to inspect our progress. But he never suspected the close call in Section J. Everyone passed that test, including Ms. Jacobs and her two-man fire brigade.

The following day, Oleander arrived at school, as slithery-slimy as ever, her hair still unwashed. I discreetly searched for a burnt spot on her scalp but couldn’t find one. She turned, caught me staring and actually smiled. I weakly smiled back, hoping I wasn’t sending her the wrong signals. Somehow, the scorched field had blended in with her disheveled mop.

Oleander somehow made it through all four years. I found it hard to imagine her responding appropriately to a patient’s angst, and hoped she went into research. But I never knew. Afraid that she had misinterpreted my stare, I never stayed in touch.

Jim Rhea, DMD


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