Читать книгу Every Last Lie - Mary Kubica - Страница 15

NICK

BEFORE

Her name was Melinda Grey, and I should have known right away, when she walked into my office some six months ago, that she was a problem patient. We’d talked about them in dental school somewhere in between local anesthesia and oral pathology. Problem patients. You wouldn’t have known it to look at her, for her small size seemed to contradict the barracuda she was. She was a pleasant-looking woman, approaching middle age, with soft brown hair and benign eyes, the kind that made great contact when she talked.

Ms. Grey presented as a phobic patient. She blamed it on an extensive dental history complete with emergency everything—root canals, abscesses, a fractured tooth—and a habit of choosing dentists with a lousy bedside manner because they tended to be cheaper, their appointment openings more readily available than someone like me, who had a calendar full of patients, until I met Ms. Grey, at least, and then suddenly I had time in my day to spare.

Her dental insurance was lousy, which she admitted to me, another red flag. I should have ended our appointment there and had Stacy look into coverage before I did any work, but Ms. Grey was the last appointment of the day, an emergency walk-in, and she was in a great deal of pain. The tooth was decayed; that I could clearly see. It would most likely need to come out. I offered a root canal as an alternative to extraction—a root canal, which would cost her three grand or more with the crown—but she shook her head and said that was more than she could afford. The tooth was a molar anyway, and she didn’t care to save it. By comparison, an extraction wouldn’t surpass a couple hundred dollars at best, and, seeing as Ms. Grey had no plans for an implant and intended to leave a hole in the back of her mouth that no one would see, the procedure would be relatively cheap.

It was a simple extraction. The tooth was completely above the gum line and required only a local anesthetic. I used nitrous oxide to help calm Ms. Grey’s rattled nerves. I lifted and pulled the tooth with my elevator and forceps; I packed the wound. I sent her home with pain relievers, though I made the decision not to prescribe antibiotics because, in my professional opinion, they were overprescribed, a problem that led to antibiotic resistance and a whole host of other bad things. I was strictly opposed to the use of blanket antibiotics. Ms. Grey was forty years old and completely healthy. She didn’t need antibiotics. Still, as always, I told her to keep an eye out for signs of infection: puss or other discharge, the formation of an abscess, fever or excessive pain. I said it out loud, maintaining eye contact so I was sure she heard. “There’s always some degree of pain following a tooth extraction,” I remember saying, perched there beside Melinda Grey on my burgundy stool, unpinning the bib clip from around her neck, wiping the last of the bloody saliva from her lip with a napkin. “What you want to keep an eye out for is excessive pain. Severe pain or swelling in two or three days from now. If you feel like something’s not quite right or if you have any questions—any at all—please, don’t hesitate to call.” And she nodded her head as if she heard.

I told the hygienist to make sure Ms. Grey had my business card before she left, one that listed the office number as well as my cell phone, which I always gave out so that I could be available to my patients twenty-four hours a day. It seemed like the ethical thing to do. I never wanted my patients to feel they were lacking for care. I also told my hygienist to schedule a follow-up appointment for Ms. Grey in one week, so I could be sure the wound was healing as it should be.

Ms. Grey never called. She never returned for her follow-up appointment.

What I failed to realize was that one of my hygienists was out for the day, home sick with a strep throat infection that had already blitzed half our staff, and the other was up to her neck in patients, taking on the workload of two. In the middle of all that chaos she had apparently forgotten to have Ms. Grey give informed consent, signing a simple form that indicated she knew the risks associated with the procedure.

I also didn’t realize it was the beginning of the end for me.