Bees Rupai (INR 20/-)

A dentist-patient story

As a norm, I usually end up spending maximum time with Denture patients. It’s a multiple visit treatment and there is plenty of time to talk when you are adjusting the acrylic custom tray or working on that wax rim.

I have been told many times (Positive & negative comments) that I keep looking for stories in my patients but I truly feel that it’s the other way round. That their stories find me.

Monday morning 9:00 AM, my first patient at the trust was Mrs Nirmala, referred for Conventional complete dentures. Extractions were done 2 months back. As I went about the regular history of any illnesses, heart problems etc she smiled and said diabetes. There was laughter in her eyes when she said that. “I am a very sweet person” she said. I still remember that 1st day I met her, I did find her odd and her remarks very cheesy. It was Monday morning after all and who says that! But then I went about with the usual stuff and discussed the money she would have to shell out for the treatment. She nodded her head to everything I said and had only two requests. First, that it should last her a life time. So I went about informing her that Acrylic dentures are not permanent and as the bone resorbs, they have to be changed every few years. Also that the money charged at the trust is quite low so she should be able to manage it. (when I reflect on it now I realize, What a crass statement I had made). Again she just smiled and said couple of years will be enough for her.

Second request, I fabricate the dentures as soon as possible. I explained, as I explain to all the patients that my visits to the trust are limited therefore the dentures will take approximately 1month to be delivered. She thought for a while, confirmed the Denture delivery date and nodded her agreement.

Days passed and we went from initial visit to primary to secondary impressions. She always smiled when she entered the operatory, she spoke to me with an awe in her voice as If I was not just giving her fake teeth but something much more valuable. It’s a peculiar feeling. So after the final impression I saw that she had developed an ulcer on the lower anterior ridge. I told her to apply a basic inexpensive ointment. She asked what would happen if she didn’t apply, will it affect the final outcome. “Well, just delayed healing“ I answered “but it will hurt when you eat or I work on you” So I recommend that you buy it. She smiled and nodded. Next time she didn’t complain when I touched that area. She never spoke about it and I never saw the ointment.

On the day of her JR she came 1 hour late. As she entered I was a bit annoyed. Ok I was tired and more than a bit annoyed. I made my displeasure known but she still smiled. As she sat on the dental chair I could see that she was out of breath. I didn’t ask about her breathing problem or even why she was late. But by now she was used to talking to me even when she knew that though I was always hearing her out, I was never really listening. My excuse? There are just so many patients in the trust. There is always an excuse. She said “I am sorry, today I had to walk as there was a bus strike” My response was less than empathetic “Ok, but why didn’t you take a rikshaw”. She explained that she had money for only one way rikshaw fare, Bees Rupai (INR 20/-). As she is Asthmatic she preferred to take return ride home. This was the first time she had shared her financial troubles with me. I realized that her guilt at making me wait had forced her to share this fact which she had been trying to hide. That was the first time I actually listened.

To cheer her up, I did small talk like- how many people are there in your family. What do you do etc. Its like speaking of the weather, it always works when there is nothing much to speak of. Usually when they start talking about their children or grand children, it’s a definite mood elevator for them. In our case, It had the opposite effect. She said: “My son was an epileptic, he had an episode, fell and died. My husband could not bear the trauma of his only son’s death and died of heart attack soon after. I stay alone” She narrated her tragic life without any emotion. So I shut up and worked.

The night before the delivery day, the technician called and informed that there was a death in his family and he would not be able to deliver any dental work this week. I called the assistant in trust and asked her to inform the patients. I had completely forgotten her 2nd request and my promise of delivering the denture by the said date. In my eyes, she had waited a month and a week more should not have made any difference. Also what can one say when the reason given is death in the family.

At 9:00 PM I saw 3 missed calls. My daughter had just fallen asleep. When I called back, it was Nirmala. She apologized for calling me so late and confessed to begging the assistant for my number. As I re-told her about the technician’s call, she started crying and said she needed my help. She was down to her last few rupees. She had promised someone that she will join as an Ayaa/helper to an old lady. The employer had only one condition that she get her teeth fixed as without them she looked older than the patient. She was supposed to join tomorrow after her denture delivery. If she didn’t join tomorrow she would lose the job as they had already waited for more than a month. As she cried I didn’t know what to do. I didn’t have the dentures.

They say when a person is actually in need, everyone around rises above their normal self. I had no hopes of getting the dentures and I felt like a heartless person when I called the technician. I narrated the whole story and told him that in the end it was his choice and if he could manage to do something about it. After a pause he said “Don’t worry I will get it done by tomorrow” and hung up. Next day when I reached the trust, the dentures were already there with a note “We can only help the living”.

Its been a month since we delivered the dentures and as I entered the trust I was surprised to see her waiting for me. She was carrying “Kaju-Katli” an expensive Indian sweet. 3 boxes: one for the assistant, one for the technician and one for me. She had received her salary today. I told her that she should not have spent money on sweets and tried to give them back to her. She reminded me about her being too sweet and eating more sugar would get her in trouble. And that’s where this story ends.

The moral: In an age of plenty it happens sometimes, those who have less have much more to give.