A friend called me last evening; he had a facial infection thanks to his sneaky wisdom tooth/ third molar. The poor chap’s face was swollen and he looked like he had been in a car crash. He could barely open his mouth and was running a fever. The darned thing hadn’t even erupted. It was causing all this mayhem whilst being cosily nestled in its bony abode.
My friend, who has been forced to have a liquid diet the past couple of days, finally mustered up some courage and decided to visit a surgeon. Ideally, such cases are to be dealt with by an Oral and Maxillofacial Surgeon (OMFS).
Ah yes! Finally, we come to why he called ME. Well… I am one, that’s why. I am an OMFS that is.
He wanted to know if I knew any highly qualified, extremely experienced, caring, skilliful, meticulous, perfectionist surgeon in Bangalore who could deal with his situation. I was dumbstruck for a moment. Now, if you’re a doctor, you would understand. Referring your family, relatives or friends to a particular doctor is always a harbinger of complaints and embarrassment. You will forever be held accountable for whatever transpires during and decades after the appointment.
Like any other surgery, wisdom tooth removal has it’s share of complications and nuisances. And I did not want to be responsible for my friends’ virgin third molar experience… (I hope he does not read this!). But he was insistent and even brought up the matter of “brotherhood of the elocution masters forever” (Don’t even bother asking what that means!) .Finally, I relented. I called an ex- colleague of mine and fixed up my football- faced friend with him.
This friend of mine called me again this morning. He is scheduled to undergo surgery this evening and he is nervous. He wants to know what to expect. Will it be very painful? How long will recovery take? Can he go to work the day after? What is the complication rate? Will loss of the tooth cause any problems? (!)
I tried to reassure him as best I could without getting into any specifics. After all, I was/ am not his doctor. I thought it would be best if the surgeon actually performing the procedure explained matters and allayed his fears. Moreover, I am sure he will call me again this evening, after the surgery.
Illnesses are always scary. Makes us feel vulnerable and helpless. They make us place our trust and lives in the hands of doctors who in most cases are absolute strangers. For the doctor, you are one among many. But for the man suffering, the doctor is THE WOMAN (or man!).
I have also undergone my fair share of surgeries, including a surgical third molar removal when I was about eighteen. So I too have been on the bed, rather than beside it. This incident made me think back to the day when I got my third molar surgically removed. How anxious I was. How petrified. I am not particularly scared of needles or doctors… and yet I barely slept the night before.
The tables have turned. I am the doctor who has to now think like a patient. An OMFS may perform fancy cosmetic procedures or visage-altering jaw surgeries, she may fix up crushed and battered trauma victims, or even resect enormous facial tumours; but her bread and butter will always be A THIRD MOLAR REMOVAL. It is one procedure that any self- respecting OMFS should be able to perform in his sleep and with one arm tied!
At the same time, it is also one of the most difficult procedures. A procedure that can sometimes go horribly wrong. Imagine manoeuvring half a dozen instruments in a 4 cm wide space, cutting the mucosa, drilling the bone, digging the tooth out, sewing up the back of the mouth….I’d rather fix up ten broken bones on the face than remove a deep seated third molar!
It might appear very easy and effortless from the outside, you might think the surgeon overcharged you, or that he was rude when you tried to relay your fears to him, or that he botched up… You are the patient here, why is he not taking you seriously?
No my friend, you have no idea, not an iota, zilch; about what the surgeon is thinking….
With this background, let us study the minds and thoughts of both the surgeon (OMFS) and the patient prior to, during and after a “routine” wisdom tooth removal. Compare and contrast.
PATIENT (Mr X)
Wonder why the back my jaw hurts so much. Maybe I have a cavity on one of my back teeth. Damn. And I always am so particular about oral hygiene. All you toothpastes and flosses and mouthwashes can burn in hell…
Visits a dentist. Dentist says he has to get his third molar removed. Refers him to a surgeon.
Sugeon! SURGEON! What? WHAT? Really..!!!! Can’t this inept, good-for-nothing nincompoop just give me some medicines for the pain. I’m sure this greedy moron is being paid a commission for needlessly referring patients to his equally greedy and moronic surgeon friend. The nerve.
Like hell I am going to this surgeon…
Three days later, Mr X develops a facial infection. Mr X asks Dr Google for help. Is spooked by pictures of all the potential complications of leaving such an infection untreated. Terrified, he books an appointment with the surgeon to get his third molar removed.
Lord, what is that fellow going to do tomorrow. Why did I look at those pictures online. Just getting the LA shots are supposed to hurt. Drilling bone… How would that be…Will my head seem like it’s going to explode…
Oh God, all this smell of surgical spirit is making me nauseous. And this rude surgeon guy is making me wait endlessly. What is the point of giving me an appointment if I have to come here and wait. Ill-mannered fool he is.
All this fancy furniture, I am sure he fleeces all his patients.
This guy is making me sign all these papers and consent forms. I’m sure it is just to save his ^&*% from being sued. Why did I come to him? Urgh…Should have gone elsewhere.
And soo many complications can occur it seems. B!@#S!@#$. Google did not say all this. I’m sure he is making some up just to scare me.
AAAAAAAAh, this LA itself is so painful.
IS he going to CUT ME with that blade???? Why cut huh? Doesn’t he know non-invasive surgery?
Ewwww…I can taste blood…
My God! IS there supposed to be sooo much blood….
Oh no, is that the bone saw….
Ouch, did an instrument just slip!
My God, what is he doing inside….what is that weird sound…
It’s out….! THANK HEAVENS IT’S OUT! Hallelujah … Aah! It’s over… I’m alive…
What? Is that curved thing a needle? Is he going to stich me up now….
I can’t take this anymore. I am going to pass out.
Where am I? Did I faint? Is it over?
Oh … it’s over… Finally.
What? So much for this procedure. Daylight robbery I say! Thief. This guy is a dacoit. What did he do in these 30 minutes to deserve this much… Criminal this is!
SURGEON (DR Y)
The guy sounds super anxious. I really hope he is not one of those “pest patients”….
Aah, Dr. Z would have sent across the X- rays by now, let me take a look.
Oh oh! This one is not going to be easy. I really hope the patient is pleasant and co-operative….
Uff! This case is taking longer than expected. I hope Mr X has not arrived early for his appointment.
Mr X must have reached by now…poor guy must be waiting. I hope Ms. S has offered some juice.
He surely seems antsy, I better explain things to him in detail. Maybe having all the information on hand will calm him down.
He seems the “sue- the-doc for fun” type; better get the consents in order…
I better give the LA meticulously, He is already so nervous….I don’t want him jumping out of the chair…
Nice, nice incision Dr Y! Pat yourself….hardly any bleeding…
Stop shaking Mr X. Let me do my job please…
Please tooth, come out, please,…..soon
AAArgh, I need to apply some force….
Oops, the chisel has hit the bone, he will think some instrument slipped or something…
I will miss movie night with family tonight it looks like….no Y, stop thinking about that…patient first.
My back hurts, my neck hurts, my arm hurts….
Assistant, buck up dude… retract more…
Need to cut some more bone…more drilling…will this guy be able to tolerate it…
It’s out….! THANK HEAVENS IT’S OUT! Hallelujah … Aah! It’s over… I’m alive…
Now, just need to close…
What! Is he sweating…? He seems dazed….
Noooooo…please don’t pass out now….please don’t faint…
Mr X, Mr X, wake up…
Assistant , get the BP apparatus fast…
Finally, it’s over. God …please don’t test me often like this…
He looks so morose while paying…I should be charging him so much more. Countless hours of hard-toil, a decade of training and patients like him… I should be earning much more…My loan payments are also due… And he has the audacity to look morose…Tsk Tsk
Later, at dinner that day….
I hope Mr X is doing well. Poor chap. I hope there are no complications. Maybe I should give him a call and check on him….
Till next time….