Why?

ADAMLITTLE

 

In the early 1960s, I attended a preparatory (‘prep’) school between Swiss Cottage and Belsize Park in north-west London. A prep school in the UK is a place that young children aged between 5 and 11 to 13 years study in order to pass examinations that will admit them to Public Schools, which, despite the name, are actually private schools.

At my prep school, The Hall School, we were made to sit in alphabetical order (by surname) in the classrooms. We were addressed by our surnames. I suppose arranging us alphabetically might have helped the teachers remember who was who.

My surname is Yamey, so I always sat in one corner of the classroom. There were often no other boys at my end of the alphabet, although occasionally I was in the same class as someone with the surname Yeoman or Zangwill.

Often, we had to learn poetry off by heart (by rote). We would then have to recite the poem in class. Invariably, the teachers began be asking the boy at the beginning of the alphabet to commence the recitations. Then, the other boys in the class took their turns, as the teacher worked his way down the surnames towards the end of the alphabet. Often the bell marking the end of our 45 minute lessons rang before the teacher reached my end of the alphabet and I was spared the embarrassment of having to try to recite a poem that I was never able to remember. I was hopeless at learning poetry, or anything else, by heart. I can only remember things if I can put them into some conceptual framework in my mind. Poetry did not seem to fit anywhere in my head!

What continues to surprise me is the lack of imagination of our teachers. Why did they always start asking us to recite by beginning with the pupil whose surname was at the beginning of the alphabet? Why did they not begin at Y or Z and work in the other direction?

Many years later, our 6 or 7 year old daughter attended a school in which students were asked to do things in alphabetical order of their surnames. Unlike me, she was always keen to take part in class activitues. So, one day she informed the school that she  her surname had been changed to one begining with D. That way, she was always asked to participate in class activities that were being done in accordance with the alphabetical order of the children’s surnames. 

All went well until we received the termly bill for the school fees. It was addressed not to Dr and Mrs Yamey, but to Dr and Mrs D…. I told our daughter that as the bill was not addressed to us, I would not be able to honour it. Our daughter quickly agreed to change her surname back to Yamey.

A bit too far

Drill a bit,  not too far.

In the tooth is a nerve:

do not disturb it

 

DRILL 1

 

It would not have been fair to my patients if I had written what follows before I had retired from practising dentistry. If I had been one of my patients, I might have lost confidence in my dentist after reading this.

Before dental students are allowed to drill teeth on living patients, much training is required. A great deal of this is done using plastic teeth mounted in the jaws of the heads of a mannequin, known as a ‘phantom head’. The plastic teeth are held in the artificial jaws with metal screws. The screws fit into holes on the undersides of the teeth so that the crowns of the teeth appear intact. As a dental student, I spent many hours each week practicing cutting standardised cavities. The cavities had to be cut to very precise dimensions, which were neither to be exceeded nor the opposite. I recall that certain parts of the plastic teeth had to be cut to exactly two millimetres deep and much the same width. At first, I found this extremely difficult. Not only was I not yet used to using dental drills, but also the plastic cuts in an awkward way.

Eventually, the time arrived for a practical test. Unsupervised, we were required to cut one of the several cavities that we had been learning to prepare. Disaster struck. Within a few seconds of starting my tooth, I had cut too deep. The metal of the screw retaining the plastic tooth in the phantom head was staring me in the face. I called over the examiners. They studied the tooth carefully, and then one of them said to me:

“I think you have exposed the nerve, Mr Yamey.”

“We might be looking at a root treatment, here, don’t you think?” asked the other examiner.

I could not believe what I was hearing.

“I think we’re looking at a failure here,” I replied.

They agreed.

I spent another few weeks in the phantom head room, and retook the exam, which I passed with flying colours, you will be relieved to learn. Now, I was deemed ready to treat dental cavities on real teeth in real patients – under supervision, of course.

The first tooth that I had to work on had only a little decay. Nevertheless, after the intense training, which emphasised cutting teeth should be done as conservatively as possible, cutting only as little of healthy tooth tissue as was strictly necessary to retain the restoration (‘filling’), I approached my first ‘real’ tooth with much trepidation. After boring down to the two-millimetre depth that was ingrained in my mind, I could see nothing but healthy tooth – no sign of decay. I summoned the clinical teacher (the ‘demonstrator’). He looked at the tiny hole I had created with great care and laughed.

“You have not yet cut through the enamel. Keep going,” he said.

The enamel, for those who are uncertain about dental anatomy, is the outer covering of the part of the tooth that is visible in the mouth. Beneath it, is the dentine, and below that the dental pulp chamber, which contains nerves and blood vessels. Decay spreads much more rapidly through dentine than through enamel.

I looked at the demonstrator, and said:

“But in the phantom head room we were told never to go deeper than two millimetres.”

“Those were just plastic teeth,” the demonstrator replied, “forget all that.”

 

[Picture from “Der Zahnarzt in der Karikatur” by E Henrich]