A Visit to the Dentist

16 comments

1. This post real­ly hits close to home as I’ve been in and out of the den­tist office sev­er­al times since ear­ly Novem­ber! For­tu­nate­ly, I haven’t had to deal with as much hubris in the den­tists and staff as you did. Cring­ing at the thought. 

   HOWEVER…there was still the same for­mal­i­ties that tend to lack in empa­thy when it comes to all the legal forms to cov­er their behinds in case they mess up and also when it comes to the cost of the fees. I had some unset­tling moments in their finan­cial office after the ini­tial x‑rays and exams and before they start­ed treat­ment as I con­tem­plat­ed what I would have to sac­ri­fice to help cov­er costs or if I would have to put off treat­ment alto­geth­er. Some­thing that if I did, could have led to oth­er seri­ous health impli­ca­tions. For­tu­nate­ly I was able to get a loan to cov­er my costs so I could start treatment. 

   I had to pause when I read what you said here: ‘Who knows, maybe some of my courage was removed with my tooth.’ 

   I paused because the day before yes­ter­day I began a draft for a post that is still saved in WP that was about my den­tal ordeal. The quote I select­ed for the post was one by Lao Tzu:

   Being deeply loved by some­one gives you strength, while lov­ing some­one deeply gives you courage. 

   There were areas of my jaw that have 80% bone loss and it has pro­gressed rapid­ly over the course of the last 1.5 years. I was remind­ed of the quote above as it hap­pens to be a favorite of mine.

   I was remind­ed that I must have plen­ty of courage because I have and do love oth­ers deeply. Yet since my hus­band died, I have not known that love in return. Yes, in lit­tle ways here and there by trea­sured friends/family/people. Yet still…not the kind of love I had with my hus­band. The kind that helps me feel strong. I told anoth­er Twit­ter friend awhile back that when I was in the mil­i­tary, I felt that the only rea­son I did so well and made it through the tough­est of times was because I knew my hus­band (ear­ly on we were only engaged and not mar­ried yet) loved me and it was his love, devo­tion, and reg­u­lar let­ters that he wrote to me almost dai­ly that helped get me through. 

   His love was my strength. My love is some­one else’s strength. 

   Hav­ing such rapid bone loss has seemed more like a metaphor that I have lost a great amount of love and strength and it has­n’t been replaced. 

   Any­way, thanks for shar­ing your expe­ri­ence. Now nei­ther of us have to feel like the lone ranger when it comes to the den­tist today! : )

2. Dear Saman­tha~

   I love the way you find metaphors in things, as I do. And then the metaphors lead to asso­ci­a­tions, and the asso­ci­a­tions to insights and even more questions.

   A beau­ti­ful com­ment, my friend. My wish is that your work heals quick­ly — and that some­how that bone loss can be undone, which is to say that the loss of love and strength won’t last because some­thing new — or some­one new — comes into your life.

   All the best
   Dan

3. 😀
   nice post Dan, too many things said in here so not sure which appeals to you more.

   Are you dis­sat­is­fied as a cus­tomer who is to bear all the risk while your den­tist enjoys unac­count­abil­i­ty or

   Are you dis­sat­is­fied with the costs asso­ci­at­ed with such work or

   Are you unhap­py about the fact that a doctor/dentist behaves like a sales­man for his ser­vices or

   Are you upset with the fact that the so called den­tist who is tech­ni­cal­ly qual­i­fied & good, fac­tu­al about his mat­ters & high­ly effi­cient in his work fails to be effec­tive for you because he lacks the sen­si­tiv­i­ty towards the patients & lacks empa­thy in his deal­ing with peo­ple or 

   Are you angry with your­self that you lacked the courage to diplo­mat­i­cal­ly bring his per­son­al­i­ty flaw to his atten­tion & sub­se­quent­ly guide him toward prop­er behav­ior or 

   Are you upset with the so called real­iza­tion that there can be behav­ioral issue on your side to escape such respon­si­bil­i­ties by jus­ti­fy­ing your­self with
   ” you kind of know when there’s an open mind on the oth­er side of the wall”

   or

   Abut your per­son­al revenge or “Pas­sive aggression”.

   Cant real­ly com­ment much here but will say two things;

   1. Do you think you are respon­si­ble to change peo­ple (to bet­ter 🙂 )even when you are not solicit­ed or welcomed?

   2. Does that Den­tist also have a need for empa­thy for what he is & does?

   Hope these will add to your quest of reflection.

   Always a plea­sure read­ing your thoughts.

   Have a nice day ahead 🙂

4. Inter­est­ing ques­tions Gurmeet. 🙂 

   I cer­tain­ly can’t speak for Dan how­ev­er I did want to share what came up for me when I read some of your ques­tions based on my own experience. 

   In my expe­ri­ence, report­ing IMPACT is a part of assertive­ly express­ing our integri­ty. It’s a form of self-respect as well as pro­vid­ing valu­able infor­ma­tion to others. 

   Report­ing IMPACT does not mean we lack empa­thy for oth­ers. It means we include empa­thy for our­selves. If we have a poor cus­tomer ser­vice expe­ri­ence, report­ing the impact of our expe­ri­ence gives the busi­ness an oppor­tu­ni­ty to improve. They don’t HAVE to change yet if they don’t, it could even­tu­al­ly impact their busi­ness in a neg­a­tive way that results in loss of cus­tomers and business. 

   Report­ing impact does­n’t force any­one else to change. Yet with­hold­ing the infor­ma­tion does not allow for hon­esty in relations. 

   Thanks for your ques­tions and insights that caused me to won­der more on these things. 🙂

5. Dear Gurmeet~

   As always, thank you for stop­ping by. Your ques­tions are always are provoca­tive, and while I know that you intend them to help me with my own reflec­tions, I cer­tain­ly hope they help you with yours, too.

   The post is, I think, pret­ty straight­for­ward in its mes­sage about insen­si­tiv­i­ty and an appro­pri­ate response. As you know, I write more as an artist than philoso­pher, so I can under­stand that this style might cre­ate some con­fu­sions — hence all the ques­tions you generated!

   Pos­si­bly, too, you iden­ti­fy with the den­tist, Gurmeet, which is fine. In fact, I’d say it is cru­cial to find that empa­thy — and also com­pas­sion — for the den­tist as he is an emblem for the insen­si­tiv­i­ty that is poten­tial in each one of us, don’t you think? Hence, had I cho­sen to offer him feed­back in the moment, I would have done so tact­ful­ly and as a mat­ter of per­son­al integri­ty more than with any sense of respon­si­bil­i­ty for chang­ing oth­er peo­ple. In addi­tion, in a very prac­ti­cal sense, this is also a mat­ter of cus­tomer feed­back on the pro­fes­sion­al­ism of the busi­ness, so it could be very help­ful even with­out the moral ques­tions being involved.

   The point for me is that if none of us speak up in the face of insen­si­tiv­i­ty — in this case also includ­ing some poten­tial racism — then we are tac­it­ly com­plic­it in the injus­tice. What I found dis­cour­ag­ing in this sit­u­a­tion, in addi­tion to sim­ply find­ing myself in it, was a cer­tain lack of con­gru­ence, my pas­sive response until I start­ed writ­ing. Then I real­ized just how deep my feel­ings were. Hope­ful­ly I can con­scious­ly mod­el here what I think many of us go through.

   Oh, well, I am quite sure you under­stand from your own life expe­ri­ences exact­ly how much we are all learn­ers and how we can help one anoth­er with our mutu­al edu­ca­tion. So per­haps that is a deep­er pur­pose of the post.

   Thank you again for writing.

   All the best
   ~Dan

6. Hi Dan,

   A great mul­ti-lay­ered thought piece. 

   Den­tists, of course, evoke emo­tion­al trig­gers for many peo­ple, cer­tain­ly for me. I’ve spent exorbinant sums of mon­ey, way too much time and lots of dis­com­fort and frus­tra­tion deal­ing with den­tists. In fact, just recent­ly. Most approach their work like mechan­ic engi­neers. When I shared with my lat­est den­tist that the last time I had an extrac­tion, I sat in my car after­wards and cried. She looks puz­zled as if she had no sense of the feel­ings asso­ci­at­ed with the work she does.

   But this post goes much deep­er. For me it is about the tac­it con­sent we give for peo­ple to speak and behave in ways that we find unac­cept­able and even offen­sive. Even when they are “car­ing” for our bod­i­ly needs! 

   Yes, den­tistry, like most all health care deliv­ery in the US is a busi­ness — first and fore­most. They are struc­tured as such with per­func­to­ry man­ners with an eye to exe­cut­ing the tasks at hand. All of the docs and relat­ed ser­vices I deal with ask the insur­ance ques­tion before they ask any­thing. I find them most­ly cold and “pro­fes­sion­al” far from the mod­el of empa­thet­ic “care-giv­ing” I want and expect. For me this rou­tine behav­ior — these pro­to­cols — are less and less tolerable. 

   But the deep­er ques­tion is when and how we step out of our com­fort zone and share what we feel. In the case of your den­tist you were lit­er­al­ly in a “dif­fi­cult” position.
   The unconc­sious com­ments made by the den­tal staff, as you know, speak to the cul­ture of that office. It’s OK to talk about patients (and with this sort of casu­al judg­ment and big­otry) with oth­er patients. 

   These are choic­es we all make in our dai­ly life to get things done. We ratio­nal­ize and low­er our expec­ta­tions. That’s the way things are. Well he’s a jerk but he does good work. I believe we con­done the com­part­men­tal­iza­tion of expe­ri­ence when we do not per­son­al­ize these rou­tine inter­ac­tions and expect more.

   These days the chal­lenge for me is how do I com­mu­ni­cate my feel­ings and needs when I encounter these expe­ri­ences (espe­cial­ly as a “cus­tomer”) with empa­thy and clar­i­ty? Yes, of course every­one deserves empa­thy — but I being assertive does not pre­clude being empathetic

   Com­pas­sion­ate care and ser­vice is not the norm. But we do our­selves and the larg­er cul­ture a dis­ser­vice when we tol­er­ate cal­lous and thought­less behaviors. 

   Thanks for your can­dor — and as always weav­ing words togeth­er to pro­voke deep­er thought.

   Best ~ Louise

7. Hi Saman­tha,

   Thanks for shar­ing your thoughts. I am sure you do make con­struc­tive impact in lives of peo­ple around you. Assertive­ness is a new mantra nowa­days as a bal­ance between aggres­sive & pas­sive. Though I believed the mes­sage in your sto­ry was pro­vid­ing dif­fer­ent per­spec­tive to the mat­ter. 

   Dear Dan,

   Thank you for your response; it’s always a delight to have a con­ver­sa­tion with you on any matter.

   I don’t know if I can put myself into any cat­e­go­ry (artist/philosopher)  as eas­i­ly as you there­fore all I have are ques­tions and rarely the answers. This is also the rea­son why I have dif­fi­cul­ty to say some­thing with absolute­ness on things.

   I do not think I iden­ti­fy with the den­tist, and only tried to state that its bit dif­fi­cult for me to con­clude him as insen­si­tive. I have known peo­ple, fam­i­lies and cul­tures which are so diverse that where one behav­ior which is seen as brash is con­sid­ered jovial by oth­ers. I am sure for per­son of your expe­ri­ence this is some­thing com­mon­ly seen. I live in a coun­try which is so diverse that with every 100 miles there is a change of lan­guage, cul­ture, norms etc. So I always shy away from form­ing opin­ions on mat­ter or peo­ple per se. 

   I remem­ber a sto­ry which I was told quite some time back. In one cul­ture if you vis­it a fam­i­ly and are served tea, you should not emp­ty the cup & leave a bit to show that you have been nice­ly fed with no more scope to drink. On the con­trary in anoth­er cul­ture if you leave some tea in the cup it is seen as you’re not appre­cia­tive of the taste of tea.

   But even if we can some­how come to this con­clu­sion that the per­son is not sen­si­tive and lacks empa­thy, would it be right to state that even as a cus­tomer when it was not solicit­ed by him. If cus­tomer sat­is­fac­tion would have been impor­tant to him, he would have sure­ly asked. Do I as a cus­tomer am respon­si­ble for him or his busi­ness. Since it is not rel­e­vant or impor­tant to him, why is it so impor­tant for me to make him aware about it? What is the pur­pose of telling some­one that he needs to improve (as per my def­i­n­i­tion) when the oth­er per­son do not see it that way. It would have been a mat­ter of integri­ty if it was my job to make him aware of his flaws & he was keen to know about such things.

   And if it is indeed the pur­pose of my life to improve his life irre­spec­tive of the fact that he desires so or not, wouldn’t it be bet­ter to be empa­thet­ic with him so as to con­vey the mes­sage bet­ter. Wouldn’t it be nice to know him & his life first before mak­ing any judg­ment about him?
   One friend of mine used to quote his father, “If you want to under­stand some­body, live that per­son entire life exact­ly the same way he did. Till than don’t draw con­clu­sion or judg­ment and avoid advice.” Not sure how rel­e­vant his view is but it does give a perspective. 

   I can under­stand your point on peo­ple tac­it accep­tance to what is con­sid­ered immoral or ille­gal & our behav­ior turned into a habit to be pas­sive about it, but some­times such thoughts do take the form of moral polic­ing which can turn into much worse sce­nar­ios than they actu­al­ly were. Where do we draw the line? And who will decide that? In mat­ters of racism, equal­i­ty is slow­ly turned into uniformity. 

   Thank you again,and have a nice day 🙂

8. Dear Louise~

   I so appre­ci­ate the flow of your reflec­tions and feel­ings! They are clar­i­fy­ing and assertive — and beau­ti­ful. As you point out, this is not just an issue of indi­vid­ual doc­tors and offices but an issue of mech­a­nis­tic, mon­ey-based busi­ness cul­ture dri­ving health care and, in turn, the expec­ta­tions of soci­ety for how peo­ple are to be treat­ed. This is a sys­temic issue, not a per­son­al one — and that makes it so much worse. It is just remark­able to me what we’ve all learned to put up with. 

   Thank you again for shar­ing your expe­ri­ences and per­spec­tive. You make me glad I wrote this post. Appar­ent­ly, I’m not alone in fac­ing the dilem­mas of intervention.

   All the best, Louise!
   ~Dan

9. Dear Gurmeet~

   Yes, I enjoy our dia­logues very much, as well!

   I think you raise very impor­tant ques­tions about judg­ment and empa­thy, and espe­cial­ly from a cross-cul­tur­al per­spec­tive. I’m total­ly with you on the point about pro­vid­ing feed­back when it is not asked for. How­ev­er, and it’s a big “how­ev­er” for me, I don’t believe in absolute relativism. 

   I think your point is that we need to be sen­si­tive before div­ing in to crit­i­cize some­one else’s lack of it. I’m in agree­ment there, but also know when my gut tells me my needs aren’t get­ting met or my val­ues are being abridged. I will make a judg­ment. Fail­ing this, there’s a very long slip­pery slope that reduces my capac­i­ty to stand up for myself in my own life, to stand for cer­tain things I believe are impor­tant. In a per­fect world, yes, it might be bet­ter to get to know the doc­tor over time before offer­ing my obser­va­tions or advice. Dia­logue rather than sim­ply dump­ing feed­back is always bet­ter in my book. But there is also a time and place for clar­i­ty and plain spo­ken­ness, which if one could call it a duty, would be a duty to my self and the world I seek to help co-cre­ate. Such is, in part, what I believe it means to lead.

   Thank you, again, Gurmeet for embrac­ing a chal­leng­ing exchange!

   All the best
   ~Dan

10. Dan, anoth­er delight­ful per­son­al reflec­tion from you that trig­gers so many mem­o­ries and con­nec­tions. One is a mem­o­ry of some­thing that hap­pened only last week: a meet­ing up with an old con­nec­tion from New Zealand, Dr. Robin Young­son, who was in Lon­don deliv­er­ing some work­shops around com­pas­sion­ate health­care. He set up an organ­i­sa­tion, Hearts in Health­care, some years ago and has writ­ten a book, Time to Care. Here is a man with a respect­ed med­ical pedi­gree any med­ical pro­fes­sion­al would be envi­ous of who decid­ed that health­care needs more com­pas­sion and sets out to build a glob­al move­ment. A real inspi­ra­tion and some­one who had me so rapt in con­ver­sa­tion, that he had to excuse him­self to go back to his hotel room at a late hour so he could sleep. There are peo­ple who know how to do it.…. and.…another.. a dear dear friend of mine who I used to be co-ther­a­pist in a group with some years ago who was a psy­chother­a­pist AND a den­tist. …who relat­ed how many of her patients had expe­ri­enced abuse in their lives and how deeply pan­icked they would be in a den­tist’s chair, lest the ‘pow­er­ful one’ take advan­tage of their vul­ner­a­bil­i­ty. The sen­si­tiv­i­ty with which she admin­is­tered her den­tal care was core to her work as a den­tist. …there are com­pas­sion­ate ones out there. I’m so sor­ry that you had the expe­ri­ence you describe and the notion of big­otry, mon­ey-grub­bing and non­cha­lance enter­ing a health­care pro­fes­sion­al’s surgery fills me with revul­sion. I’m glad you are on the mend, my friend.
    Warm­ly, John

11. Dear John~

    It is won­der­ful to hear from you! It is emi­nent­ly clear that there are indi­vid­ual prac­ti­tion­ers who care deeply, although the over­all cul­ture of health sys­tems seems to con­tin­ue slid­ing in the direc­tion of mechan­i­cal, buy­er-beware care; not much dif­fer­ent than airlines.

    On the pos­i­tive side, how­ev­er, I do think of the very sen­si­tive physi­cians I’ve known, includ­ing a cur­rent col­league of mine who is a prin­ci­pal of Oncotalk, a pro­gram that aims to teach physi­cians bet­ter com­mu­ni­ca­tion skills with their can­cer patients. Absolute­ly fab­u­lous and fas­ci­nat­ing work.

    Clear­ly, it isn’t that we are not capa­ble. To me, it’s just anoth­er kind of entropy that proves if love is going to have a foothold, it’s going to hap­pen with inten­tion and con­scious­ness, with aware­ness and desire for even more aware­ness as time goes by. 

    I do hope you are doing well in your new loca­tion. We’ll need to talk one of these days…and thank you so much for your kind tweet about the artis­tic val­ue of some of my posts. I return the compliment!

    All the best
    ~Dan

12. After cring­ing, bit­ing my tongue and doing oth­er things in my mouth that could pre­cip­i­tate a vis­it to my own den­tist while read­ing your obser­vant, con­tem­pla­tive post, here’s my two cents:
    Nev­er mess with a den­tist when he’s got you in the chair.
    I total­ly sup­port the more pas­sive “hang­ing this guy out to dry with all my judg­ments but not talk­ing to him about it direct­ly” approach in this instance — but then again … maybe I’m sim­ply jus­ti­fy­ing my own habit­u­al instincts of self-preservation!
    Great post, Dan.

13. Dear Blair~

    Thank you for this won­der­ful (self-pre­serv­ing) support!

    All the best
    ~Dan

14. Dan I enjoyed this and found it real­ly impact­ed me emotionally -

    It’s impos­si­ble to know when to say some­thing and when to let it slide — we have to assess it at the time and with­in the context — 

    The event was about sub­tleties — these are always hard­er to call out — and also hard­er to assess — the recep­tion­ist may have made the com­ment as a mat­ter of fact — “that’s an apple — that’s a pear” — or as a mat­ter of judge­ment — “that’s a good apple- that’s a bad pear” — 

    All we can do is be as con­scious as pos­si­ble about our own val­ues and behav­iour and con­tin­u­al­ly act with high regard for the cir­cum­stances that we are in — you had a nee­dle in your mouth — some peo­ple have a mort­gage and a bul­ly boss — deci­sion are complex -

15. Dear Dionne~

    Yes, absolute­ly: “we have to assess it at the time and with­in the con­text.” And we usu­al­ly need more infor­ma­tion, which is why at best I might have offered feed­back about the way things sound­ed, not con­clu­sions about the way they were. I would have expect­ed some form of defen­sive­ness, as well as some of my own learning. 

    It’s been extreme­ly help­ful for me to hear so many reac­tions to the sit­u­a­tion. It now feels like one of those exis­ten­tial moments of choice where there is no right or wrong nec­es­sar­i­ly, only a choice as if for all of us about what to do and how to do it.

    Thank you again, Dionne!

    All the best
    ~Dan

16. I believe you are right. A busi­ness per­son should be pro­fes­sion­al. He real­ly did know you and they cer­tain­ly should not have been talk­ing about anoth­er patien­t’s sit­u­a­tion in front of you. With regards to the assis­tant, she should have removed her­self from the room when she per­ceived the call was going to be difficult.

    Key for a busi­ness is its rep­u­ta­tion. I believe this group dam­aged theirs. If that part had not occurred I bet you would have thought more pos­i­tive­ly of the office and prob­a­bly pro­vid­ed referrals.

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