The Premolar Attack in 3 Parts

Part 1: Triage

Two nights before I met Dr. Fuller and Dr. Zhao, the pain had come knocking softly, like a shy relative in the village sent to greet the visiting city cousins. Just a soft harmless pulsation. I waved it off. In a few minutes, the knock grew relentless, rising in intensity until I could no longer ignore it. I popped some ibuprofen and waited for the pain to subside.

I hate pain (I welcome your so-do-we-all eye roll), but more than that, I refuse to make big pharma rich and will not swallow a single pill unless I’m convinced my life depends on it. This time, it seemed quite clear a toothache was here to torture me to death. A tooth! Never underestimate the power of a pesky little enemy in the shadows who slowly drills into your inner circle.

It was well past midnight, and I had swallowed a whole mess of ibuprofens. I couldn’t take the pain anymore. I’m not a whiner I’ll tell you that, at least not when I’m in real pain. I whine, grumble, kvetch when annoyed at invisible things like “the system”. Say system one more time! But this was pain straight from Dante’s ninth circle of Hell, worse than the system, and the devil had a red-hot prong plucked from his pitchfork boring mercilessly right through my premolar, causing a fiery throbbing that sent my head in and out of waves of torment. I would never ever wish this intensity of pain on the devil himself.

My husband was lost and tortured by my groaning. It was a terrible mourning. Like a cow dying of East Coast fever in the dead of night with no relief in sight. One day I’ll tell you that story. Stay with me on this one for now. Preston propped himself up and tried to help.

“Kill me! Kill me!” I mourned. “I can’t take it anymore!”

“Let me hold your head, the pain will go away.”

 “It’s too much! Take me to the hospital!”

“It’s going to be better by morning, I promise.”

“It’s taken too long and nothing is working. Just end my misery!” The stupid things we say over a toothache.

“That’s it. Let’s go.” He got out of bed. “We’re going to the emergency room now.”

Suddenly I wasn’t too sure any more about an emergency room run at 2 o’clock in the night.

“What do you think they will do?” I asked, trying to tone down my groaning. I felt like an annoying student about to be punished with time-out at the emergency room corner.

“They will stick a light up your tooth and give you some painkillers, refer you to a dentist to get the tooth removed and send you back home. You won’t be able to see that dentist until later in the day,” he said.

“Ok, then, let’s not go. I’ll be quiet.” I was determined to be a good girl.

“You already threatened me with your death, talking all that kill-me kill-me. We’re going!”

My tooth and me got up, threw on a coat and followed the husband out the door.

We drove through the quiet streets to a near-empty emergency room at the Good Samaritan hospital. They did my paperwork and we settled in to a long wait. Looked like only the night nurse was in and she was only pushing papers between gulps of yawns. Nobody gets sick at night? Where are all those nighttime knife stabs and bullet wounds I hear about? So much for emergency. Above my head was the sign “triage” hanging from the ceiling. I was under a code red premolar terror attack and there was no triage doctor running towards me with the soundtrack rising to a crescendo like I see on TV medical dramas. I settled my throbbing head on Preston’s shoulder and tried to sleep. This was in the vows we took – the part about keeping a spouse up all night over a toothache. We get tortured together.

As the morning broke, the doctor saw me, stuck a light up my premolar, prescribed some oxycodone, and gave me a referral to the University of Baltimore School of Dentistry. The husband had told me this is exactly what would happen, hadn’t he?

We went back home, Preston freshened up his tired self and went off to work, and I got ready to drive to the school of dentistry I was referred to. One had to be there very early as the students will only take the first ten in line. I had exhausted my annual dental insurance benefits, and this was the place to come for people who needed subsidized rates. Usually, patients travel from all over the State to make a beeline as early as 4:30am. On this day, I was right at the cut-off point. The lady behind me and her daughter had driven three hours from Ocean City, they said, and the nurse would not let them in. Rules are rules.

Dental procedures in the US could cost you 3 months of mortgage out of pocket, even with insurance. No wonder George Washington settled for wooden teeth. Don’t tell me about proof. Historian agree he had awful teeth. You ever seen an image of him smiling? No, he dared not. That’s the real triage situation.

Part 2: The Mystery

The University of Baltimore School of Dentistry has its prestige secure as the oldest in the world. Yes, in the world, I didn’t write that wrong. If the first modern-medicine dentist in the entire world graduated from this place right here in the 1840s, I was confident I was going to receive top-notch treatment.

My turn came and I met my assigned dentist students, Dr. Fuller and Dr. Zhao. They were thorough, went far beyond the normal practicing dentist that I’ve been to. Perhaps it’s what you get from being treated by students whose work counted towards their grades and graduation. No room for mistakes. I started enjoying their company. The teacher in me jumped out of the bushes of receding pain.

“What brought you two to such a smelly pursuit?” I asked them. They laughed, and both said they enjoyed being dentists. I asked them how long it took to graduate.

“Four years for general dentistry. Ten years for oral surgery,” said the lady, Dr. Zhao.

“Nooo!” I protested.



“Oral surgery is an extensive field,” she said.

“I don’t know what’s so extensive about cutting into gums and drilling into jaw bones,” I said. I’m terrible at small talk. I was well aware that nothing about the human body is simple, not a single thing. One could very well take ten years to study an eyelash and write volumes of books on it and still not know half the miracle of its existence. Still, ten years in school over teeth? Nope.

As I await my scheduled oral surgery, we launch into a lengthy conversation about teeth and cultures. I enjoy this. Death to small talk. They volunteered stories about their families. Dr. Zhao talked about how Asian and Western cultures handled teeth issues. I told them Africans would use twigs from certain trees for a toothbrush and I think they worked better than colgate. There I was wakandaring up Africans. Dr. Zhao agreed with me about herbs that preserved dental hygiene. I’m happy.

As we talked, I started getting the feeling there was something that fascinated them about me but I wasn’t sure what. The questions kept coming, I kept “teaching”.

“So, do you have family?” one of them asked me.

“Yes. Plenty of it.”


“Married?” Asked young Dr. Fuller.

They were getting daring. Was this part of the dentist’s bedside manners practice?

“Yes. And my husband has had enough of this tooth drama,” I said

“Oh!” Said, Dr. Fuller. I wasn’t sure what that reaction meant. It seemed as if he had just heard something quite unexpected.

“He rushed me to the emergency room over the pain and he got no sleep all night, poor guy!”

They look at each other, amused at something. There’s a private knowing, one I’m not a part of, and I’m now getting the feeling I’m the unknowing subject of their knowing. Like people gossiping about you in your presence, with you participating. I play along. It’s an interesting game.

“Kids?” Dr. Fuller went on.


“Do you miss not having any?”

“No. That possibility passed. We don’t miss what we don’t have,” I said.

Then I noticed that he was holding my paperwork with the bio details on me and he seemed to keep peering at it. The receptionist had completed it at check-in on her computer. She had asked me a few questions, checked the answers, printed it out and handed the form to the dentist. Nothing about that form was of any concern to me at this point. Soon enough, I was led in for the procedure. It wasn’t until I was done with my oral surgery that the entire mystery became clear. 

On my way out at the lobby, Dr. Fuller handed over my paperwork to the receptionist and said to her, “Please correct Ms. Hall’s gender right away.”

The dentist was upset with the receptionist for the careless mistake of ignoring the gender box and leaving it at the default “male”. Don’t you just hate those programmers with their default-setting buttons?

“Ok. I’ll print you a corrected form,” The receptionist said it curtly. Perhaps she felt what she did with paperwork held no connection to medical decisions. Did she not know paperwork mistakes are a major cause of medical malpractice? Not that they would remove an ovary instead of a premolar. But this dentist was still a student, and he wanted no mistakes on his watch.

“Ms. Hall, I apologize for that mistake,” the dentist said. It was my turn to be amused. All along they thought I was male because the paperwork said so, but I showed up as female, and they got curious.

Part 3: Exactly What Happened?

Let’s back up to the part just before I went in for the oral surgery to get my rogue premolar removed.

“What’s the prognosis?” I ask the dentists.

“Your tooth needs to go,” Dentist says.

“Can we not save it?”

“No. Sorry. The abscess is too deep.”

“But is there anything wrong with the tooth itself?”

“The tooth itself has no cavity but…”

“Then we must save it,” I insist.

I really wanted to save my tooth. That’s because my husband always says to me that his mother always said to him that whatever you do don’t ever let the dentist take a good tooth out of your mouth. So this is a battle that runs deep.

“Let me show you why we cannot save it.” The dentist is patient with me, and he proceeds to show me my x-rays and what they mean. “In fact,” he continues, “the lower premolar has to go too really soon.

I’m being robbed! Two premolars? What next? All my teeth? Are they fixing to set me up with dentures at my young and tender age of 13 going on 50? Am I their next guinea pig? After all this is a school. I proceed to put up a valiant fight. I’m keeping my tooth! I’m keeping my tooth!

“Ok then. I’ll go call the professor. She might give you a different opinion.”

There’s hope. I wait. Professor Schmidt was a grayed up senior dentist who wore a halo of experience around her elderly frame. She looked like she just popped out of an ancient dentistry journal. She proceeded to study my x-rays. I talked to her. I told her I’m keeping my tooth.

“I’m sorry, Ms. Hall, but here’s the reason it has to go…” I shut out her lengthy explanation, most of which I’ve already heard from the students. By this time I’m well-schooled in the human dental structure and all that it connects to. Well, Dr. Schmidt wasn’t having it. Tooth had to go. My premolar had fought a good fight and it was time to part with it.
At the oral surgery room, a dentist plants gadgets in my mouth and three students surrounding her peer into my mouth. The surgeon begins to dig into my mandible. I’m the lab rat, fully awake and all numbed up where they are excavating my tooth. It’s all quite fascinating listening to her teach while I’m lying there. I close my eyes and let the conversation wash over me – the Premolar Cantata

“Take this and hold it down… ah… uh-oh… that’s ok… scrape deeper so it doesn’t cause her trouble later… Ok let’s start sewing it up…”

They are done in half an hour. Not the slightest sensation of pain. I almost want to start a round of applause for them. Until one of the students comes in with a piece of paper and a worried look all over her face. She was one of the students. What now? 

“Ms. Hall… I’m sorry but something happened during the surgery.”

What in dentist’s hell could have happened? I was wide awake. I heard it all, and I feel quite alright. I forgot that at some point I did shut my eyes.

“I was working on your tooth and the scalpel slipped and cut through my glove and into my skin. Unfortunately it also had your blood on it. I’m requesting that you please sign off for an HIV test.” By this time the student is in sheer panic.

Pause. They all blink rapidly and wait on me to speak.

I laugh out loud through the sponge in my mouth. The look on her face! Was the terror in the room caused by the possibility of HIV infection from an African woman? C’mon now, I’ve lived in the US long enough to have been baptized in the blood of race and racism. Everything American, every damn thing, is coated in skin tones and their attendant baggage. I was the only black person in that room, an African at that. Ok fine, let’s pretend we don’t see color and drop the race issue. That means the terror on their faces could have been from the thought that I could choose to sue for careless medical procedure; that I could argue I was put in danger by said carelessness and that could affect the students’ graduation prospects. I laughed because in this moment of dread, I held the scalpel. Their lives could be determined by the decision I made. I took my time to respond. This was rich.

“It’s ok if you don’t want to sign it but that will mean I have to take the HIV test and wait for three months and be tested again…”

“That’s fine, I’ll get a test,” I said. That broke the tension right away. The nurse drew my blood and told me I could wait a few minutes at the lobby for the result. I had no intentions of doing such a thing. I was starving and I had places to go, things to do and the sunshine outside waiting on me. I had no time to wait around on results I already knew.

“Please mail me the results,” I said to the nurse. “But may I see what you took out of my mouth before I leave?”

“Sure, it’s right here.” The dentist lifted it between her thumb and index finger and brought it up to my eye level.

“There she is!” I said. “She’s a work of beauty that premolar, isn’t she? Lived in my mouth close to half a century. You served me well, you brave girl!”

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