I sit patiently in the waiting room, tapping my pen, sifting through the potential questions he may ask and the potential lies I may conjure up in response. They call my name; I see eyes shifting in my direction as I solemnly walk through those menacing doors. I am placed in a cold plastic chair, required to put on a bib, seat reclined, and asked to relax. Yes, you have done quite a splendid job in making me feel comfortable enough to relax in this daunting and isolating environment. “He’ll be with you in a moment,” the assistant proclaims. I shift in my chair again, hoping that this change of position will speed up his arrival. I have places to be, errands to run, facebook statuses to check, time to waste…waste anywhere else but here.
Finally, the man of the hour arrives, stretching his hand out in a grand gesture of superiority as I remain awkwardly fixated in my chair and bib. So, the games begin. He opens my mouth wide, pokes and investigates around like a child picking at his food attempting to avoid his vegetables. He sits back up after making his evaluation. He stares at my judgmentally.
“How many times do you floss?”
“3 to 5 times a week I respond.” We both know I am lying. Well, I am half-lying; there was that one week I remember being particularly good about it. Yes, 3 to 5 times seems appropriate. It is enough of an exaggeration to get only a slight reprimand rather than the full-blown frown of disappointment.
“You’re gums are bleeding at the touch. You must not be doing it right. Are you brushing properly?”
“I have been brushing morning and evening everyday for two minutes; I even time myself. I think it’s my genetics. My dad has the same problem too; we just have more bacteria in our mouth than the average person,” I respond in a single breath. It is true; I am particularly good at brushing, though two minutes may be a slight exaggeration. It seems extremely unfair that some people can have such little regard for their teeth and never have the problems I encounter. I am unbelievably frustrated with dealing with these darn teeth. First the retainers, than the braces, than the retainers again, than the cavities, than the fillings, than the root canals. When will it ever end? Can they not just yank them all out and give me Veneers?
“Let me show you how to properly brush and floss. Here, hold the mirror while I demonstrate on your teeth.”
Great, for the umpteen time you are going to teach me once again to perform a task I have been doing since the age of three. By all means, continue humiliating me and directly demonstrating how incompetent you perceive me to be. Do you know how much you waste when it comes to flossing? That is money down the drain. On the other hand, if you fail to floss, you need more frequent dental appointments to fix the damage you have caused. Who does not love a good Catch 22?
“Get it? See how easy it is? If you don’t take care of them, some of those smaller problems will turn into cavities, and you’ll need fillings. All right, it was a pleasure (firm handshake), see you in six months.”
Does he not know I know it is easy? It only takes an extra 2 minutes to floss, but sometimes I am in a rush, and it is such a hassle, and I rarely see the immediate effects of not performing it…well, unless there is spinach stuck in my teeth. How embarrassing! I am so educated; I should know better. I will be better at it. When I return home, I will floss immediately…we all know that will only last for a week until I fall back to old habits again. What right do I have to expect my patients to listen to my orders, when I am the noncompliant medical student?
The above encounter is a familiar scene for most. It is for that same reason I will attempt to use it as a means to providing a new perspective on living with diabetes. In no way is this to delegitimize the seriousness of the disease and the struggles that patients face on a perpetual basis. Rather, it is my sincere hope that by relating a personal experience like a dental cleaning, society may better understand a pandemic that is quickly sweeping the nation. We often wonder why those with chronic illnesses do not do a better job in managing their own health. Why are they so noncompliant when they know that what is at stake is their very life. It is not that they are plagued with suicidal tendencies or are ill educated about the subject matter, although this may hold true for some, but rather there is a buildup of frustrations. This ongoing battle with a foe that your peers and even society at large cannot truly understand can be overwhelming and expensive. It is no surprise that many patients lie about taking their insulin shots or checking their blood glucose because the tremendous amount of guilt and judgment that is passed upon them. We expect that something that takes only minutes to do and can sustain a healthy life would be innate and clear cut, but when we fail to take the two minutes to floss our teeth, how can we expect them to take countless injections and needle pricks?
Is it unfair? Absolutely. Can their situation be changed? Not currently. Can we change our attitude towards the diabetic population and the chronically ill at large? You bet your normal blood glucose we can.
