Friday, October 28, 2011

"The Right Answer" *

* Maybe hardest in the area of fear and trepidation. (Though, in fact, not easy to ascertain anywhere. And there’s always the possibility of, in some areas at least, that no “right” answer exists. Whoo. Scary. Especially to someone who finds comfort in certainty. Not the fake kind, the kind that’s verifiably real.)

When my daughter Anna was young, she had a lot of colds and nasal related discomfitures, and she and her mother sought out the wisdom a number of doctors and specialists. The first three agreed that Anna needed to have her tonsils out. The last doctor they consulted – and you will see momentarily why it was the last doctor – opined that with diligent maintenance, Anna would not need to have her tonsils out. Anna concluded that that last doctor was correct. And she never had her tonsils out.

A lifelong tussle with colds, a raw throat and sinus infections points to the questionability of that last doctor’s determination, but Anna, wishing to retain her tonsils, and avoid the unpleasantness (read: pain) that their removal entails, anointed that last doctor, despite being medically outnumbered – by a multiple of three to one –


Where were her parents in this process? Entirely on Anna’s side. Dr. M had never had her tonsils out. And the following anecdote will illuminate the position of the parent chronicling this account.

I was recently having my teeth cleaned, when Jane, who tries not to hurt me but only partially succeeds, reports noticing that a piece of a filling on one of my bottom back teeth has broken off. Jane encourages me to schedule a follow-up visit with the dentist to check the situation out, suggesting I may need a replacement filling. Or possibly a crown.

The moment I was apprised of this unwelcome discovery, I could feel the muscles in my chronically spasmy upper back tightening into pretzel-resembling knots. The three herbal tranquilizer capsules of Valerian which I precautionarily take in anticipation of the torture of teeth cleaning worked to minimal advantage. They simply made me spasmodically goofy.

My dental office currently includes two dentists, a woman who recently bought the practice, and my semi-retired original dentist who sold it to her but still works there half a day a week. I decided to consult the dentist with whom I had an extended relationship. I had met the new dentist, but only in passing, usually with me racing out the door after the cleaning, an avoidance response to any further possible unhappiness.

My retiring dentist has become a psychologist. But, in truth, he was always a psychologist. He has the (unfortunately rare) talent for relaxing his patients. Especially patients like me, who, despite serious, pre self-medication, enter the dentist’s office, terminally clenched.

The new dentist had a reputation for being capable but “no-nonsense” in her chair-side manner. She had once what’s the opposite of “endeared” herself to Anna by announcing, “You have so many cavities. I won’t tell you how many, because I don’t want to scare you.” You’re objective. There’s something not the best about that approach, isn’t there?

When Anna subsequently visited the retiring dentist, he assured her that an application of (painless) sealant would easily solve the problem. And that was that.

You can see, then, why I selected the retiring dentist to check out my filling.

And, once again, the man came through. He examined my now less than whole filling, and informed me that, though the surface was not longer smooth, the seal was fully intact, and that

Nothing at all needed to be done!

I love that retiring dentist!

And yet…

Anna didn’t get her tonsils out, and she probably needed to.

So what does that say about my filling?

Some doctors are softies. (On a later occasion, when the retiring dentist informed Anna that she needed to have two wisdom teeth out, Anna related that, while he was telling her this, he stepped out of the examining room, because he was about to cry.)

The question is – and it escalates in importance as we advance to more serious decisions – do we accept laissez faire pronouncements, because they coincide with exactly what we want to hear? Or do we reject, or at least question them, because they sound too much like exactly what we want to hear?

On the other hand,

Are we better off swallowing the bitter pill and submitting to the designated treatment no matter how unpleasant it is in the name of maturity and a (hopefully) more reliable outcome?

And then there’s the money issue. One would truly hope and pray that no doctor would deliberately over-treat you – or in the case of more serious concerns, carve you up – simply to run up the bill. But they might. Sure, doctors are human beings, but stockbrokers are human too, and look what they did. Who knows what financial pressures these medical practitioners are under. If you asked them about that, they would probably – perhaps justifiably – take offense, or offer an equally unhelpful wisecrack. So you’d never find out.

I suppose some doctors choose medical careers to get rich. I just hope I’m lucky enough never to run into one. The more pervasive problem arises in the gray areas, where more aggressive treatment is not, perhaps, an imminent necessity, but it’s not unjustifiable, objectively, and to the doctor or dentist making the decision, that it's the superior way to go.

“A new filling? You could get away without one, I suppose, but ‘Better safe than sorry’, don’t you think? A new crown? Eliminates any future concerns. And it’s whiter than the tooth you’ve got now.”

I don’t know what the “right” answer is, or how you even begin to determine it.

I just know that Anna is drippy again.

And that my broken filling is starting to itch.


JED said...

And maybe if Steve Jobs doctor had been more insistent that he have the operation on his then-treatable cancer...

Or if Mr. Jobs had been a little less adamant about not having it treated...

Mac said...

And then there's Dr. Conrad Murray. Always best to get a second opinion when your doctor suggests Propofol. Unless you're having an operation.

Joe & Tim said...

Unless she's lactose intolerant, have the tonsils removed!

Jenna Schrock said...

Hmmm, maybe it's better to wear a dental crown on your tooth. Well, it's a good thing you have a dentist who understands you concerns regarding that matter. And as for Anna, she can opt not to have her tonsils removed if she feels like it's not necessary as of yet.