My car didn’t want to start this morning—Dan says it’s the distributor cap—so I was late getting to work, and the first patient was already in the chair. Dr. Ross will be mad at me when he has time, and his assistant Marnie will say, “The receptionist is supposed to greet people,” using her slow voice. This patient must have been a walk-in, probably waiting at the door when Dr. Ross arrived. Meaning a mess in the mouth. Meaning no insurance. Meaning four or five wadded bills pulled from a pocket. Later today my job will be to start the quiet conversation about payment plans. “You know what to say to these patients. They listen to you,” Marnie says, pretending she isn’t looking at the hole in my mouth where a tooth should be. This is steady work, with air conditioning, and I make out the vacation schedules and give myself twelve days a year.
Marnie put the patient in the far examining room and turned up the music, but there’s no missing the moans, and I wonder how long this woman has been living with the pain beating like a hammer in her head. We get one or two a month like this, people who’ve put off and put off the visit and who hope oil of clove can combat an infection that’s already blown a hole right up through the sinus cavity. I lost my best aunt that way. The undertaker had to puff up the side of her face with cotton balls.
“I don’t mean to lecture,” Marnie likes to say to Dr. Ross, “but damn.”
I’m listening to Dr. Ross’s steady voice, and I can make out the speech about saving the viable teeth and about bridges, how teeth are a structure meant to last a lifetime, but they require maintenance. Does he know that everybody in town calls him Doctor Dollar? Probably.
Then there’s another voice, a man’s. Usually Marnie’s good at keeping family from going back with the patient. Nobody wants to see their loved one’s rotten, stinking tooth ripped from whatever is left of the bone, but this man must have bulled past her. I’m curious enough to stroll back and glance in at him—big, handsome, expressionless, maybe forty. He and his wife aren’t tweakers. They’re probably carrying cavities that started when they were eight years old. “Take them all out,” he’s saying to Dr. Ross, who winces. Marnie frowns at me to get back to the desk, but I can still listen from there.
“Mr. Poole, she still has several viable teeth. I can’t remove them. That would be malpractice.”
“I live with her and see her cry from the hurt. You don’t. Get ’em out of there.”
“We can make things better. Once we remove the teeth that are destroyed, just one bridge—”
“Listen.” He could have sounded threatening, but the man just sounds tired. He must have known what to expect, coming to Doctor Dollar. “Last night our boy was sick and she couldn’t even hold him because when he moved her head swam. I had to pull him away.”
“That’s the one tooth where the infection is worst.”
“And then it will be the next one. Everybody in my family has took them out. She can get dentures.”
“Dentures are not an inexpensive . . . ”
“You think I don’t know that?”
Not one sound from the woman. From thirty feet away and around two corners I can tell that she’s used to having her husband talk for her. I can also imagine Dr. Ross staring at the light fixture and Marnie pushing back her expensive hair, red this month, and pulling on a pair of gloves over her first pair of gloves; the woman’s mouth is probably a riot of bacteria.
I run my tongue along my gumline, checking for breaches. Sometimes at night I don’t stop flossing until blood comes, going around and around the space where 4, my second bicuspid, used to be. That one went before I started working for Doctor Dollar and, Dan says, decided to play with the team—he means the fluoride rinses, which he thinks are silly. I nag him to floss, but he shrugs and goes to bed. At least he brushes now.
I wanted to get a false tooth once I’d been working ninety days and my insurance kicked in, but Marnie and Dr. Ross said no. “The deductible’s costly on your salary, and really, you don’t need it. Your other teeth are good,” Dr. Ross said. “We could whiten them, if you want.”
“But you don’t need to,” Marnie said fast, before I could agree. “You’re good just as you are. People see you and they know this is a place they can come, where there’ll be people like them.”
“And not like you,” I snapped, and she had the grace to blush. Single woman making $2,500 a month, she thinks she has a hard time because she has auto payments. Let’s discuss Dan’s mother, moved into our living room after her house was robbed down to the studs. Or Dan himself, hands so stiff from arthritis that he can barely open a jar. Nobody’s brought up whitening again, though Marnie gets hers done every two months like church.
Now the man says, “You ain’t the only dentist. We can get somewhere else.”
After a pause, Dr. Ross says, “I’ll take out the worst ones. After that, we can take impressions for temporary dentures that she can wear until the permanent ones are made.”
“We’re not doing none of that.”
“I’m sorry, but this is the best we can do. We’ll need at least a month. We’ll try to get the order expedited.”
I’ll bet it was “expedited” that set the man off. I can hear him lean forward, closing the space between him and Dr. Ross. “Listen. I took off work today. I’ll get cut eighty-five bucks for that. She took off work, and may not have a job tomorrow. We are here today.”
A long minute passes before Marnie comes up front. I’m already pulling out the form. When no patient is in earshot, we call it the Don’t Sue Us, a joke that’s funny if you’re not the one who will have to explain to Mr. Poole how he can’t blame us for pain, or bleeding, or infection, or a bad outcome, a phrase that covers anything from soreness to death. Marnie reminds me every month or so that it’s the most important part of my job. Of course it is. It keeps her from having to have an actual conversation with the portion of our clientele who don’t arrive in cars with good paint jobs and who really watch the TV in the waiting room.
“Also,” Marnie says, “could you reschedule Mrs. Toland’s appointment for this afternoon? Any time next week would be fine.” Eighty-five if she’s a day, Mrs. Toland has to move heaven and earth to get her daughter to bring her in, when she talks to us about the old dentist, the one before Dr. Ross, the one she liked.
Before I call her I enter Mr. Poole’s information into the computer, transposing digits in both his phone number and his address. This way his credit might not get dinged when the bills for $500 worth of extractions go unpaid. It’s worked before. Then I bring him a bottle of water. He looks at the bottle and looks at me and I smile, automatically covering my gap. He’s tan and muscled. Anywhere but here he would turn heads. I say, “It’s all we have on offer. Dentist’s office.”
“I’ve been getting the message.”
“There are machines downstairs. Can I get you anything else?”
He snorts softly. “Got a miracle handy?” Closing his eyes, he leans back, his features scrubbed of everything but fatigue. He will be sitting back there for better than an hour, feet planted, making sure that the worst of his wife’s pain is taken away. Dr. Ross will get maybe sixty bucks. Out front, I wipe Marnie’s upcoming whitening appointments off the schedule, assign myself a sick day tomorrow, and practice smiling so my missing tooth shows, so Mr. Poole knows who he’s talking to.