I wrote this story, partly to help myself get through the traumatic incident from earlier in my life, and partly to help dentists be informed about what could be going on for the patient, and why they might not be able to speak about it at the time.
I offer this story with my deepest thanks and respect for your professional and caring treatment of me on 9th December 2019.
Trauma lasts Forever
I am ten years old. I am not at home with my Mummy and Daddy. They have gone away somewhere. I am staying with Auntie. She’s old. She’s Granny’s sister. She has no children of her own. Now she’s looking after me for a while. I have to stay here until Mummy and Daddy come to get me.
My tooth hurts. It really hurts. But I’m not saying anything. I don’t know what Auntie will do. I will wait until Mummy comes back.
It’s late. I am supposed to go to bed. And my tooth still hurts. My gum is sore and swollen all down the left side. Auntie says I must brush my teeth, so I pretend. I brush where my other teeth don’t hurt. Auntie sees and tells me to brush properly. I try. It hurts but I try. I don’t know what Auntie will do if I don’t. I could tell my Mum, but she’s not here. I brush my teeth. I cry. I go to bed.
It’s night-time. I am supposed to sleep, but I can’t. The left side of my face hurts and I’m hot all over. I want to get out of bed and go to my Mummy, but she’s not here. Auntie is in the next room, but I don’t call for her. I just cry. I don’t sleep. Too scared, too alone and in too much pain. Never felt this way before. I want it to go away.
It’s morning. “Time to get up,” Auntie says. So I get up and go to the kitchen. “Time for breakfast,” Auntie says and points at the bowl of milk and cereal. I drink the milk from the bowl. “You don’t eat like that,” Auntie tells me.
I know, but my face hurts and I can’t eat cereal. Not today. Auntie shouts at me that I must eat properly. And I cry out, “I can’t!” There, I have told her.
Auntie comes close to me and holds my face in her hands, looks into my eyes and sees my pain, looks in my mouth and sees the swollen gum. “We must get you to a dentist,” she tells me. I have never been to one before. I have no idea what it is. I have no idea what will happen, but now I trust Auntie. She looks at me, sees me, knows what to do.
All the way to the car, I sob tears onto my t-shirt. Auntie tells me that everything is going to be OK, and we drive into town. We get to the dentist. It’s a room filled with strangers, all looking sad and scared. There are strange sounds from the room next door. Squealing sounds. Is this what a dentist is? Auntie sits me on her lap and holds me tight. My face is burning up and I feel dizzy. But I am not scared anymore, Auntie is here. I am not alone.
We go into the dentist’s room. It has a big chair and a small table with knives and forks, and a thing with strings. Why does it have strings?
The dentist tells me to open my mouth, but I don’t want to. I turn my face away. I don’t know who he is. I don’t trust him. And he looks angry. Auntie asks me to show the man where it hurts. I can do that, I can show him. So I do. That’s when he put his finger in my mouth. And starts poking on my teeth. Right where it hurts. I scream out. It hurts so much, my face is on fire.
I want to get away, but he’s leaning on me. His right arm is across my chest, his left hand is on my forehead, and he’s looking in my mouth. He’s saying something to Auntie.
I cannot get away. I cannot move. Auntie is standing beside me, her hand on my right shoulder. It’s OK, Auntie is here. I can stay. I can look at the strings.
The man has something in his right hand and wants to put it in my mouth. I turn my face away and keep my mouth shut. He says something, but I don’t understand. This is all new to me and it’s not nice.
Auntie says, “It’s OK. It will help you. It will stop it hurting.” So I open my mouth a bit, just to please Auntie. And then he sticks me in the mouth with a knife. It hurts. He holds me down with his arm across my chest, and his left hand on my forehead, so I cannot turn my face away. He’s not a nice man. He hurt me.
And then it stopped hurting. I don’t know how, but the pain went away. Was that it? Are we done? Can we go now? I try to move. He stops me. Auntie tells me that the tooth must come out. I don’t know what that means. I want to go home. I want my Mummy. But I don’t cry. I don’t know what the man will do if I cry.
And there’s that string thing. It’s making a noise and I am fascinated by the small wheels that are going round and the string that runs around them. The man is trying to get into my mouth again. I won’t let him. He says something to Auntie. Auntie tells me to open my mouth a little bit. So I do. That’s when they put it in my mouth. The man and the lady in the white coats. They put in something in my mouth so I can’t close it.
I cannot close my mouth I cannot get away. I am terrified. The sweat from my back soaks my t-shirt.
Then they bring the end of the string thing and put that in my mouth. It starts screaming and I want to scream too. But I don’t. I hold it all inside and scream in silence as I watch the string go round the wheels. Round and round.
I am sixty years old. I am at the dentist. They are going to take care of a tooth. A tooth that has been repaired so many times that there’s nothing left to repair. It must come out. Today. We have talked through the process and I understand what will happen and why.
The dental surgical room is white and clean. The chair is comfortably padded and the dentist’s tools are laid out on a small table. There’s a computer screen, but nothing with wheels and strings.
I also know that my ten-year-old self is still here, still terrified. I know he wants to be free of this terror. He’s been silently screaming for fifty years, especially in places like this.
A young dentist in a white coat gives me some painkillers to take now. Now? Yes now. Just as well. You are going to need them. She checks my dental records, looks inside my mouth and identifies the tooth to be removed. Double checks. Checks with me too. Yes, I know which one. It’s been a long-time candidate for removal.
With a small swab, she gently applies some cream to my gum, inside and outside. Powerful stuff. The numbness spreads like a butterfly opening its wings for the first time. The tooth is surrounded by numbness. I relax into the padded chair and close my eyes. No pain here.
Another young dentist comes in to give me the anaesthetic injection. Five injections she explains, three on the outside, two on the inside. There can be more if I need it. You should feel no pain. Just let us know and we will help you. Don’t worry, I’m 60 and if there’s pain, I will let you know. I laugh at the prospect. The injections sting. A bubble of liquid forms in my gum, numbing the nerves.
A bubble of white-hot fear swells up in my belly. It tries to talk with my brain. Get out of here, it shouts. Get out of here, it clamours, I want to get out of here, I want my Mummy, it hurts, he’s hurting me.
There is no pain, I calm my ten-year-old self. There will be no pain, They are here to help me remove a broken tooth, that is all. There will be no pain, I tell him. He turns and hides his face from me.
The lead dentist, a man in his sixties greets me, “Good morning patient,” his voice booms and fills the room, radiating experience and confidence. “We will get you sorted out in no time, just let us know if you feel any pain.”
So little he knows, I thought, of the fear in my belly. But that’s my fight. I nearly tell him that I’m scared, but I don’t know what he will think of me.
They all leave the room, for a short conference about my case, I suppose. This is a place of teaching as well as dentistry. The younger ones are still studying to become dentists. They have little experience. But that’s OK, I tell myself, there will be no pain and I knew they would be treating me when I signed up. All is well. And what better place to face up to fear than here?
They are gone for some time.
The white-hot ball of fear wells up in my stomach again, stretching past my heart and reaching for my brain. I have to get out of here. Now! it screams, trying to take control of my body. My legs shake at the conflicting commands. Run. Lay still. Run. Lay still. The muscles try to obey first one command, then the other. My legs shudder. Yet I prevail. Lay still! And my legs stop shaking, for the moment.
In the middle of this clean white room, sitting in the dentist’s chair, I sit up and bring my knees up towards my chin. I hug myself. I hug the ten-year-old as Auntie did. It’s going to be OK, I tell him. I breathe deep and slow, filling my belly with fresh air as I had learned in yoga classes. Breathe in. Breathe out. Slow. Go slow. Let go of fear, let go of the pain. Focus on this moment. Be with this moment and do not judge it.
The fear subsides. I become calm. I stretch out again on the comfy dentist’s chair and begin to drift towards sleep. Wow, this yoga stuff really works.
The lead dentist comes in again, followed by the others in their white coats, “How’s the patient doing?” he asks me (or the student dentists). He invites one of the students (the one who had given me the injections) to check for numbness. She checks, and checks and checks, “Feel this, feel this, feel this? She asks over and again. “No,” I burble past her fingers in my mouth.
They begin the procedure.
It starts with identifying where to cut the gum.
Cut? My mind begins to form images of cutting, images of blood and of pain. My ten-year-old self rages at the thought of being cut. See!. He shares the picture of gore in my mind, this is what they are doing to you. I rush back to my breathing. Breathe in, breathe out, slow, slow, SLOW. My breathing is becoming laboured. My legs begin to wriggle as the conflicting messages become louder: Run, Stay still, Run, Stay still, RUN, STAY STILL. I could almost hear myself say the words out loud through my mouth filled with fingers and a scalpel.
That does it. My legs are now twisting, this way and that, attempting to run. I don’t care what they think. I am leaving, my gut says. My brain says, NO! I am staying here to face up to the fear. The effort is becoming too much and my fingers are beginning to tingle. My legs shudder. My back is soaking wet.
“Wait”, interrupts the lead dentist, his experience noticing my distress. “Is the patient feeling dizzy?” he asks the students. I wave a feeble message of surrender with my hands.
He commands, “Lift his legs!” They tip the chair backwards, rearrange me on the chair. Legs raised, wet towel on my head. “Pump your legs,” he tells me, giving me a fresh set of commands to follow, “Get the blood moving and you will be fine.”
He informs the students, “You can see from the colour of his lips that he’s about to faint.”
I am busy trying to control my legs and make them do what I want them to do, and not follow the ten-year-old’s commands to run. Gradually the tingling in my fingers subsides. The warmth comes back to my face and I begin to feel foolish that I was trying to run. There’s no harm here, I tell my ten-year-old, just people who want to help.
“Is the patient feeling better?” he asks everyone in the room. I manage to grunt a reply and am surprised how confident I sound. That’s not a ten-year-old’s voice. I am feeling better.
“Are we ready to proceed?” he asks the students.
Someone places their hand on my shoulder as Auntie had done. I suddenly feel calm, warm and calm as though the chair is enfolding me. I melt into the chair. That hand is so beautiful. It is small, a girl’s hand. I am in love.
“Is the patient ready?” the loud voice asks me and the students at the same time. I reply in a surprisingly deep and confident voice that I am ready. I settle into the chair. I breathe deeply and slowly. I fall deeper into the chair. There is no sign of the ten-year-old.
They continue the procedure. They cut. I feel nothing but I can hear the instructions about where to cut, where to stand (not under the light) and how to hold the scalpel. Yes, a scalpel. It’s what you use to cut a bad tooth free from the gum. Before you pull it out.
The small hand presses down on my shoulder. I feel seen, heard, and held. I feel protected, I feel loved.
And then it is time to pull out the tooth. Different tools are being used. I can feel them filling up my mouth, knocking against my teeth. I am fascinated by the mechanics of this extraction.
Right now the young hands holding the instruments tremble, unsure of what to do. There’s a tentative testing of what they can do, under the clear instructions of that loud voice. And this way, and that way, and rotate, not too much, just enough to feel. And then larger hands grip the tools and they do what they are supposed to do. His confidence and experience radiate from his hands. The tooth yields under his grip. No pain, just a curious loosening of that tooth from the gum. And some blood, but that’s OK.
The fire in my gut flares up again. But this time, it seems it’s less bright than before. Sure, the conflicting commands have my body twitching this way and that, but it’s more of a tremble, like tired muscles after a long walk, a very long walk. 50 years or so. I clench my hands to make the blood circulate. I pump my legs to get the blood to my brain. My words are clear in my brain. They calm me, but my body buzzes with tension. I ask my body to relax, and it does, for the moment.
There’s no sign of the ten-year-old, and I am beginning to accept that he’s gone. Or at least at rest.
The tooth breaks. The broken part is set aside. “We are going to drill, patient,” says the lead dentist, informing the students as well as me. I’m OK with this new set of mechanics.
New tools are being put in my mouth, the student dentist’s hand trembles slightly as she applies the drill to the broken tooth. The drill squeals as it grinds into the root of the broken tooth. Deeper it goes until the work is done. Again and again, once for each root. There are three. The taste of blood fills my mouth, I gurgle on it but I am not afraid.
The muscles in my legs are burning with exhaustion. My back aches from holding all the tension. Even though I release it every few minutes it builds again, and again. And I release it again and again. I breathe deeply, I clench my fists and make the blood flow to my brain. I pump my legs to gain control of them. This is a long walk. Hours must have passed.
The small hand grips my shoulder.
“It’s out!” she exclaims. I now realise this is the student dentist who had first given me the pills. She had been holding onto my shoulder throughout the whole operation. “It’s out, Martin. Well done. You have really worked hard.”
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