DENTIST-ASSISTED SUICIDE - part one
The man at the garden party could belong to any profession but the quality he definitely has is a professional look: it's partly the preppie "casuals" he's wearing that give this impression. However, there's also something about his body language, his haircut, and complexion -- even the trim of his fingernails (or maybe the well-bread neatness of his hands) -- that express small codes about his class. In any case, Torvald thinks he knows what to expect when the two of them end up in a conversation which is half analytical and half time-killing and the kind of discussion which constitutes so much social intercourse at sedate parties everywhere.
It turns out the man is a dentist. This piques Torvald's interest. "How do you feel about amalgam
fillings?" he says.
The dentist is in his mid-thirties, only a year or two older than Torvald, and because of this Torvald presumes that the dentist will be open to skepticism about the filling status quo.
"Well, in what sense?" the dentist says, charming enough to make even his caginess seem frank.
"Uh, in terms of a possible link to nerve damage."
The dentist says like a perfectly humanoid robot, "Mercury amalgam filings are utterly safe.
There's no proven link between them and any health problem."
"Proven?!" Torvald says. "Does that mean that therefore something doesn't exist?" But just as quickly the dentist is saying "What other standard would you use?" and Torvald realizes he's taken
the wrong tack.
Torvald says phlegmatically, "The toxicity of mercury has been well-established."
People are milling around on the lawn. The August sun is setting. Sunlight shines through the dark green leaves of the grape vines like natural laser beams. Torvald quickly glances at the other people in the garden. Some of them are friends of his father's and his father's wife (whose backyard the party is being held in), but most are acquaintances of one of his step-sisters.
"What is it exactly you're concerned about?" the dentist says after a pause. Torvald can virtually hear the syllables of the sentence being turned into little chess pieces -- objects being quietly moved with a tactical goal in mind.
"Well, MS above all. But other nerve disorders also."
Then dentist says, "if amalgam fillings are such a problem, then how come so many people are walking around with them and are fine?"
"Well that's not exactly scientific, is it? How do you know they're in such great shape? Have you studied the epidemiology of the -- these diseases?"
The dentist looks stung. He eyes the table the food is kept on, and begins to change his posture as he readies himself for extrication from this particular conversation.
Torvald is tempted to become more aggressive -- to launch into his It-shouldn't-be-called-the-Canadian-Dental-Association,-it-should-be-called-the-Criminal-Dental-Association tirade -- when the dentist looks at him with a new expression. "It's true that it's been proven that fillings emit
vapours. But the amount of mercury that's absorbed from these is very small. Do you eat fish?"
"Yeah. I love fish."
"How about tuna?"
Torvald hesitates, tabulating his recent seafood consumption. "I don't eat so much of it."
"Well, tuna's loaded with mercury. If you're concerned about mercury consumption then ... ah ... keep in mind that you're probably getting more of it from your environment than from your fillings."
Torvald says tiredly, "I've heard that argument before. Doctors use it with x-rays. 'The sun gives you more radiation,' blah, blah, blah. I don't buy it. A lot of these toxins and environmental stresses, they're cumulative. The less you consume of them the better."
"There's some truth to that. But what else are you going to do? Amalgam is a beautifully durable material."
"I never said it wasn't."
"So, what've you got in your mouth?"
"Mercury."
"So you've got amalgams. Do you know what the other options are?"
"Sure, there're resins, gold."
The dentist adopts a tone of chummy cynicism. "Resins are crap. They're the rust-bucket of filling material. You know that, don't you?."
"Yeah. Not only that but they've been implicated as a cause of Parkinson's, I think."
"That's right. Any material you put in your mouth is constantly being absorbed into your system."
Torvald looks at the dentist with repressed aghastness. "Great."
The dentist realizes what he's said. "Look, there was one material that they were thinking of bringing on the market a few years ago. It was very tough and it was cheap. But it was shown there was a linkage with cancer in just a few cases and so they suspended use of it. They really do care about the toxicity of materials. And if they've allowed amalgam for all this time, that must mean it's basically okay."
The conversation has moved from chess to badminton. "Then why not, say the exact opposite? Why not argue that the CDA is so terrified of all the amalgam they've shovelled into people's mouths for all these years that they're petrified of the law suits they'd be faced with if there was even a peep of an admission of a link to nerve disease?"
"What is it you're worried about exactly? Are you having fillings put in?"
"I had them put in -- a long time ago. Then I had them replaced. Then I had them replaced again by those maniacs down at the U of T faculty of dentistry."
"Why do you call them maniacs?"
"Fu --. They're like the Red Guard of Cavities. They've got all these cadres of young dental,
students who are super-nice and want nothing more than to use your mouth for target practice."
"I'm sure they're not that bad."
"They are. They --" Torvald feels himself getting emotional.
*
It was a number of years before. Torvald had felt very proud of himself because he'd read a story in the Toronto Star about the inexpensiveness of the clinic. So he got himself put on their waiting list and then went down for a frugal visit. They x-rayed him and cleaned his teeth.
When it was time for his third visit he was running a few minutes late. He rushed up University Avenue towards Elm, the street the faculty was located on. He was surrounded by glassy high rises. There was a big blue new building on the corner of Elm and University that looked like an elongated motorcyclist's helmet.
When he got to the faculty of dentistry he was already out of breath. He was directed by a curt secretary to the second floor where he was greeted by a punctilious nurse. He was led (almost jogging) into an immense room where all the dental chair were set up in rows. The room was the size of an aircraft hanger. Torvald was shown to a chair in one of these rows and then left there, waiting and perspiring after all his rushing.
A young, chubby male with short dark hair approached him. "Mr. Leesing?" he said.
"Hi." Torvald twisted his head and smiled.
"You're here for a check-up?"
"Yeah."
"My name is Neal." Neal placed some x-rays on a small light board next to the dental instruments.
"According to your chart, your fillings are very old. They're cracked."
Torvald was still lulled by the big, clean ambience of the room. "Uhh," he muttered.
"They should be replaced."
Torvald started to become more alert. "I don't think they're that old. I just had them put in in the early nineties-."
"Well, it's 1999 now. That's seven, eight years. That's a long time."
The thought that if his fillings needed replacing at this rate he'd need an entirely new set of teeth by the time he was forty flitted through Torvald's mind like an anaesthetized thought. He felt that something was wrong with what was being proposed but couldn't quite feel his way towards a protestation.
After a moment he said, "Listen, I've been thinking of getting something besides mercury amalgam fillings put in."
"What?" Neal said. "You want a resin?"
"I guess. Is that the only other choice?"
Neal pointed his large arm towards a direction a few dental chairs away. "See that woman there? She had resins in her mouth. Now they're all rotten. They say, resins are a dentist's best friend because after a year you need a root canal."
"Yeah, but I'm not that crazy about having more mercury pumped into my system."
"Mercury amalgam is completely safe. Look at me." Neal opened his mouth. It seemed to be plastered with a dark, tin-coloured silver. He had so many fillings that his teeth looked like pewter deposits. Neal smiled at Torvald triumphantly, Neal's unhealthy complexion looking stir-fried.
What Torvald really wanted was to have gold put into his mouth, but he didn't think of mentioning this as a possibility; he knew it'd be a scandalous suggestion -- the whole point of coming to the clinic was to get dental care that a person on a fixed income otherwise wouldn't be able to afford.
A benign looking supervisor passed by Torvald and Neal with his hands clasped behind his back. He was an old man in his early sixties with a very lined face and a white beard.
"How's everything?" he said.
"We are just talking about advantages of amalgam fillings." Neal said.
The supervisor, who already appeared so bemused that it was as if his state of mind triggered a very pleasant heat in his body, looked even more warmed up. He paused.
"I'm concerned about mercury." Torvald said.
"Why?" The supervisor said. His voice was craggy, charismatic, bullying.
"Well, because of the toxicity risk and the link to nerve problems."
"There are millions of people in this city alone with amalgam fillings. Do you see them with nerve problems?"
It was the first time Torvald had heard this argument and he didn't know how to respond to it. He lay back in the chair. Its slippery vinyl seemed to be emitting hypnotic rays.
Neal hovered over Torvald, smiling generously, eager to get started.
"There's been no established link between amalgam fillings and health problems of any sort," the supervisor said, quoting scripture, and he walked away.
Torvald did some quick mental calculations. If he could get new fillings put in cheaply and then wait another eight years, by that point he would possibly be able to afford gold or whatever else the
durable, non-amalgam alternatives were. It seemed an acceptable level of risk.
"Can we start?" Neal said.
Torvald nodded.
*
Torvald was in the habit of keeping a full glass of water by his bed and drinking from it with parched thirst when he woke up in the mornings. The day after his dental appointment, he woke up and tasted a metallic awfulness in his mouth. Instinctively he reached for his glass and took a swig of water. He could taste the whatever-it-is in his mouth mixing with the water and he held it in his cheeks like a vile wine. He was groggy. He swallowed his morning water, and then, as he got up, realized he's made a mistake; he should've spat the water out (even back into the glass). But there was no point in crying over metal fil't milk, he decided, and he forgot about it.
Eight months later he was phoned up by the clinic and informed that according to his x-rays he had to come in for some work. He went down and was installed in a chair and had a device placed in his mouth that was an adjustable silver band. This was fitted around his tooth and then tightened. The student assigned to him (not Neal -- this time it was a girl named Ginny) began struggling with the band. "It's not quite on right," she said. Somewhere in the numb region of his gums Torvald could feel Ginny wrenching her band back and forth. "Your teeth are too tight together," she chastised.
Finally she started drilling. But when she finished, the band was hard to extract. More wrestling. By the time Torvald was released from his chair he was sweating and so much time had passed that he was almost dizzy with hunger. He left the faculty of dentistry and made a bee-line towards a food-court on Yonge Street. There he sat down and started eating a large meal of oil- and soy sauce-laden chop suey. He tried to eat on the other side of his mouth -- the non-drilled one -- but the slippery food kept washing through his entire mouth, hotly picking traces of the still unset amalgam. Torvald had a vague memory of a dentist telling him when he was a kid that a person shouldn't eat for four hours after a drilling, but because he'd never herd this admonishment form any of the students or staff at the faculty he figured that somehow this rule didn't apply now. The amalgam was like an agricultural pesticide; only harmful after you've been told it is. Torvald finished his food greedily.
A couple of years later he started to notice small tremors. They began in his face -- or maybe it was his arms. He couldn't remember exactly. But then one day he was getting home and putting his key in the front door when he realized he couldn't do it: like a victim of some sort of palsy, he twisted his torso to one side, he moved his lower jaw until it was in retarded juxtaposition to his face, he cramped his hand until it looked like a crippled ballerina's. He panicked. The ... key ... just ... wouldn't ... go ... in ... the ... slot.
This attack of failed eye-hand motor co-ordination passed and he gained entry to his house. But now fear started to creep up on him; it started to harden.
He talked to his mom about it. His mother had a series of chronic health ailments. She was very non-judgemental about other people's complaints and also had a large supply of health food and holistic medicine books.
"I think it's some MSey thing," Torvald said.
"Look at what Adele Davis says."
He picked up the book. It was an age-fattened paperback. It looked too old to be alternative medicine up-to-date.
"It says I should take lecithin."
"That's got a lot of phosphorous in it. You should take calcium with it."
"I drink milk."
"No, you shouldn't drink milk. It's bad for you."
"Doh! Well, what am I supposed to do?"
"Take tablets. But without vitamin D. You shouldn't overload on vitamin D."
[Wheedle:] "And where am I going to get these vitamin D-free calcium pills from? A health food store?"
"Yes."
"But I don't wanna spend money at one of those fuckin places. They cost enough as it is."
"Honey, if you want to take care of this you're going to have to try something new."
Torvald went to see a doctor.
"What's the problem?" the doctor said.
"It's something with my nerves. I have this perpetual twitch just under my eye and my hands feel funny Sometimes my legs feel weird."
"What do you think it is?"
"Um, I'm, uh, worried about MS."
The doctor looked at Torvald with an I-think-you're-insane poker face. "We'll do some blood tests. What's your diet like? Are you eating well?"
Torvald laughed self-consciously. "I guess. I cook for myself. I tend to eat a lot of the same stuff over and over again."
"Mmm." The doctor frowned skeptically. "It's sufficient to get sufficient protein. Are you drinking milk?"
*
The nerve problems don't increase but they don't disappear either. Sometimes when Torvald is walking he'll feel as if his legs might collapse under him. This never happens but he experiences himself as now a kind of hovercraft; floating on a buffer of air.
One day he's in a bookstore. He's looking at the table of contents in a science magazine. A finger
bonily pokes him in the shoulder. "Hey," a voice says. "Remember me?"
Torvald turns around. A man with soft brown hair, tortoise-shell glasses, and the look of a junior archaeologist is smiling at him.
"Hi," Torvald says uncertainly.
"We met at a party once. You were concerned about your fillings."
Torvald looks at the dentist. As the dentist smiles Torvald can see a flash of gold in his mouth.
Torvald opens his mouth to speak. He knows that what he is going to do is complain, and, more to the point, he is going to complain in a manner that is light-hearted, ineffectual. Torvald thinks of getting angry at the dentist -- causing a scene by screaming a recrimination at the dentist's whole profession. Since the dentist knows Torvald is an artist Torvald is already formulating some wit-attempting, apoplectic put-down like, "You know what medical professionals and artists have in common? They both think what they do is socially necessary."
Instead, though, as Torvald prepares to be polite and sell himself out slightly, small molecules of self-pity redden the tragedy centres of his brain while other molecules the colour of dun silver float through his bloodstream and make his highly strung nerves even stringier, weaker.
Finn Harvor
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