Do not scream yet
I know it looks terrifying
It’s not what it seems
Do not scream yet
I know it looks terrifying
It’s not what it seems
Eight spindly legs
But oft it inspires fear and angst:
The helpful spider
Now, here is a saying from Madagascar:
“Words are like the spider’s web: a shelter for the clever ones and a trap for the not-so-clever.”
” I have always been filled with fear at the prospect of any physical intervention on my body. This may come as a surprise to anyone who knows that I am a dentist, who makes a livelihood from trying to assist people who fear my interventions, but this is the case.
For example, from an early age, I have feared going to the barber, an experience that most people enjoy. I am not certain whether this fear of having my hair cut originated from hearing the tale of the barber of Fleet Street, who used to deliver his unsuspecting customers to the basement of the butcher next door, in order for them to be turned into sausage meat. I still cling onto the armrests of the barber’s chair, just in case… Or, did my fear arise from the worry that I might be injured or infected by the scissors or the cut-throat razors, which are still used today?
There is yet another possible source of my ‘pre-barber angst’. This dates back to the 1950s, when I was less than ten years old. In those days, I used to be taken to a large hairdressing salon in Golders Green Road, where Mr Pearce attended to my coiffure. The salon was filled with a nauseous odour, that of people having the split ends of their hair singed with the flame of a lighted taper. What, I wondered, would have happened had Mr Pearce begun to singe my hair? Would my head have erupted into a fiery ball? Well, this never happened. My beloved, but neurotic, mother would never have allowed anyone to approach my hair with a flaming taper. Indeed, as a child, I was never allowed to hold a box of matches, even safety matches, because, my mother was concerned that it might have spontaneously burst into flames. She should have known better. Her grandfather manufactured matches in South Africa. “
This is a short extract from my book “Going without the Flow“, which is about the fear of surgery. It is available on Amazon, Bookdepository.com, Lulu.com, and Kindle
One of my dental colleagues, a very confident fellow and a competent operator, told me this true story many years ago.
One day, he had a nervous male patient, a well-built strong looking man. However, the patient was extremely anxious, as many dental patients often are. The patient needed to have root canal treatment and was convinced that he would experience much pain during the procedure.
As my colleague prepared his local anaesthetic syringe, he said, trying to be reassuring:
“Don’t worry, sir, after I have given you this injection, the procedure won’t hurt a bit!”
The patient turned to my colleague brandishing his tightly clenched fist, and said:
“You’d better be right because this will certainly hurt you!”
Most people are very apprehensive about making a visit to the dentist. But, how many dentists are filled with apprehension at the prospect of seeing patients? Almost every day during my 35 years of practising dentistry, I walked into my surgery with a feeling of worry, concern about what might happen during the day.
The average non-dental person might not realise that treating patients is like walking on thin ice. With many patients in the UK just itching to sue the dentists, whom they fear, even the slightest thing might lead to a legal confrontation between the patient and the dentist. Clearly when a patient suspects that the dentist has made a clinical error, pulled the wrong tooth for example or made a filling that keeps failing, recourse to compensation is sometimes reasonable. However, something far less ‘life-threatening’ like a verbal misunderstanding can lead a litigious person to attempt to obtain remedial compensation. So, to avoid trouble and also to ensure that a patient leaves satisfied, the prudent dentist must treat each patient with tact, delicately, and clinical excellence. All that seems quite reasonable.
However, there are patients, whom the dentist dreads. The very sight of their name on the day’s appointment list can ruin the dentist’s day from the moment he spots it. These people, many of whom I wish I had been courageous enough to dismiss, often exploit the dentist’s desire to provide them with excellence. They ask for the impossible, or for things they know that they cannot possibly afford, and they are never satisfied. Worse still, they keep coming back to the surgery for minor matters, which are often unresolvable because of their sad personalities. I may sound a bit harsh, but many of the persistent complainers that I saw were unemployed, receiving their treatment free of charge (because of state subsidies), and had little else to do apart from sit in dentists’ waiting rooms.
Then, there are the dental obsessives. These patients are often quite charming until they reach the subject of their teeth. Even what you and I might hardly notice becomes a major problem for them, even a life crisis. They will keep asking the dentist to redo some small repair on a tooth because they, and only they, can perceive that there is some minute imperfection. And because of fear of complaints and litigation, I used to plough on with these people and long for retirement. Sometimes, I felt like telling them that in the grand scheme of life, a minor ‘defect’ in the teeth is nothing compared with having a major illness, or starving during a famine, or being injured in a traffic accident, but I ‘bit my tongue’.
Despite my continual anxiety about keeping the patients on my side, there was the odd occasion when a patient was genuinely grateful for something I had done. Those expressions of gratitude were worth more to me than whatever fee my treatment had attracted.
So, next time you have to visit the dentist and are filled with fear, spare a thought for the dentist, who might well be feeling the same as you, but cannot show it because it would wreck your confidence in him or her.
I used to be very apprehensive about flying. It scared me to think that each time we lifted off from the runway might be the prelude to the sudden ending of my short life. I used to read the safety instruction card, and still do today. However, I had little faith that by following the safety instructions, had there have actually been a disaster, would my life have been saved. On one occasion, I became very agitated because the man in the seat beside me had not fastened his seatbelt when instructed by the voice that cracked through the loudspeakers of the ‘plane’s tannoy system. My mother mentioned my concern to him, and I felt reassured when he told us that he worked for BEA (British European Airways) and knew exactly when it was essential to fasten this safety device.
During the 1960s, there were no moving map displays in aeroplanes such as are commonplace today. However, halfway through the flight, a small piece of paper used to be passed from passenger to passenger. It contained a bulletin about the progress of the flight, and it was signed by the pilot. I used to feel privileged being allowed to handle such an important document.
It was many years later that my hitherto irrational fear of flying became rational. I was on a jet ‘plane flying into London’s busy Heathrow airport from where I cannot remember. The ‘plane was descending, the buildings below us were becoming larger and clearer, and most of the clouds were above us, when suddenly the aircraft jolted and began to ascend rapidly.
“We have had to climb,” the captain announced calmly over the loudspeaker system, “to avoid another aircrft that had come into our flight path.”
A few minutes later, we began descending
“We can now continue our landing,” the captain announced in a nervous voice, “There are no other aircraft in our way this time.”
Is fear of the needle
worse than fear of the mask?
Without them, we suffer
Many of my adult patients remembered going to the dentist when they were children and having to be put asleep under a black face-mask. This memory instilled in them a life-long fear of visiting dentists.
The day after the 17th of March 1982, when I qualified as a dentist, I was legally allowed to administer general anaesthetics for dental procedures without an anaesthetist being present. General anaesthesia is hazardous enough but without the assistance of an anaesthetist, the risks of problems multiply. I could have accidentally killed a patient on my first day in practice. For the record, I have never ever administered general anaesthetics with or without an anaesthetist.
For a brief while, a few months in the 1990s, I worked in a practice that specialised in treating dental patients while they were under general anaesthesia. The anaesthetics were administered by a visiting hospital anaesthetist, who was assisted by a fully trained anaesthetics technician. The patients, when unconscious, were intubated to maintain their breathing and all the right things were done to ensure their safety. When the patients were ‘under’, I worked on their teeth, as quickly as I could because the anaesthetist wanted to keep the patients ‘under’ for as short a time as possible.
Children were given gaseous anaesthesia through a face mask. Once, I sniffed the gas briefly. It was terrible stuff. It felt as if a knife were shooting up my nose. Most children were, quite naturally, terrified at the prospect of anything that was happening in our clinic. Getting them to accept the black mask with its attached rubber tube was often difficult. The anaesthetist was a friendly man from the Middle East. He would say to the children things like:
“This smells of peppermint.”
The child might reply:
“I don’t like peppermint.”
The doctor would then say:
“I’ve got strawberry flavour.”
“I don’t like strawberry.”
“How about some lovely banana?”
And so, it went on.
One mother impressed me. She said to her child that if he allowed the mask to be put on by the count of three, he could have a treat at McDonalds later. She counted “one”, and the child refused. And, then “two”, but the child still resisted. Then, I wondered how different it would be when she got to “three.”
I was impressed when she said:
“Two and a quarter,” and then “Two and a third”, and so on without ever reaching “three”. Eventually, her child cooperated.
I must to admit that although we got a lot of work done on fully anaesthetised patients, I did not enjoy working under these conditions. However, I enjoyed my weekly encounters with the friendly anaesthetist, ‘Dr A’. He was extremely fond of fiery chillies, which he consumed during our lunch breaks. He was always seeking hotter chillies. This was probably because his taste-buds had become partially damaged by his excessive consumption of these almost corrosive chillies.
One lunchtime, Dr A and I were sitting in the staff room with a male anaesthetic technician from an agency. Wickedly, Dr A passed him a long, thin fresh green chilli, saying:
The young man put the whole green chilli in his mouth and started chewing it. Soon, his face went bright red, and he rushed to the sink to fill a glass of water. When he recovered, he turned to Dr A, and said:
“I thought it was a bean.”
PS: Nowadays, general anaesthetics for dentistry cannot be administered anywhere in the UK except in a fully-equipped hospital.