Abomination (3 page)

Without missing a beat, h
e walked into the operatory next door and picked the chart up from the bin on the wall, slipping Bunny’s chart into the now-vacant bin. 
Paul Rogers. 
Another emergency patient.

“How are you doing today
, Mr. Rogers?”

“Not good,” the man in the chair replied.  He was wearing a three-piece suit, charcoal, with a white shirt and blue tie.  His salt-and-pepper hair and his moustache were groomed precisely.  His black wing-tips were spit-shined.

“I’m Dr. Whitman.  How can I help you today?”

“I need all of my silver fillings taken out, doc.”

It was a request that Jamie heard often these days as the media perpetuated a mercury scare that had no basis in actual science.  Just like the imaginary vaccine-autism link.  He would do it, remove silver fillings, had done it several times before, but only if the fillings to be replaced were small.   And only after he had educated the patient on the true nature of silver fillings.  “That’s doable, Mr. Rogers,” Jamie said, “but I would hardly consider that an emergency.  You really need an exam and some x-rays so we can develop a treatment plan first.”

“It really can’t wait, doc.  You see, there are aliens who are contacting me through the metal fillings.  They want me to do things. 
Bad things.  I need to get them out now before I do something I regret.”

Jamie sighed
as he sat down the chair.  He thought he had heard everything but this was a new one.  He wondered if he would get to lunch.

Chapter 3

Jamie did eventually get to lunch, though he only enjoyed a forty-five minute break instead of the usual hour.  He had spent way too much time dealing with Mr. Rogers, and the conversation had run into his lunch break.  But that was okay.  He had taken some x-rays, conducted an exam, and successfully (he hoped) convinced the man that no one was talking to him through his fillings.  He hadn’t done any actual work, just told him that he needed to return for a cleaning and only then would he consider replacing some fillings if he really wanted to.  Mr. Rogers had left content, and Jamie wondered if he would actually return. 

He wondered if the man would possibly go on a shooting spree or kill his wife.  He doubted it, but there was always that small chance…  He would have to watch the news tonight.

Jamie’s afternoon schedule proved to be very similar to the morning: a brutal exercise of patience and self-control.  His first patient after lunch was Gary Surhoff.  He was there for an initial exam and a cleaning.  X-rays and a clinical exam revealed nothing of interest except for a lower molar with an old root canal which had become re-infected.

“You really need that tooth looked at by a specialist, Mr. Surhoff,” Jamie suggested.

“Fuck it.  It’s already dead so it can’t die again.  Do I have any real cavities, doc?”

“No.  And your gums are fine.  But I’m concerned about the infection.  You really need to have it treated before it completely destroys the bone and root.”

“When it begins to hurt, I’ll have it looked at, okay?  I’m not having another root canal done if the tooth ain’t bothering me.  They hurt like a motherfucker.”

“By then, sir, the infection can spread.  It has been shown that infections of the gums can spread to the heart.  And…” Jamie quickly scanned the man’s medical history. “… and it says here you’ve had a heart attack before.  So you are at increased risk.”

“But it’s not an infection of the gums, right?  You said it’s in tooth, right.” 

Jamie nodded. 
“And the bone.”

“I’ll be back when it hurts. 
It’s not bothering me now.  Can we get on to the cleaning now?”

Jamie sighed and began reclining the chair.

Another initial exam after Mr. Surhoff, except this wasn’t a new patient, but one who had disappeared from the system three years ago.  Jamie had read Bridgette Chelsey’s chart carefully after seeing the size of the document, scrutinizing each and every illegible entry.  Large charts usually meant a complex history.  And oftentimes a crazy patient.  Jamie wasn’t disappointed.  A bridge on her lower right had come out and she wanted to know what he could do for her.

“You were told three years ago, Ms. Chels
ey, that another bridge couldn’t be made because the back tooth isn’t strong enough to support it,” Jamie told her after examining her and taking some new x-rays.  “And I can’t get the old bridge back on because half of the back tooth is inside of it and what’s left of the tooth inside your mouth is soft.”

“But I had a bridge on it before, Doctor Whitman.”

“I know.  And you didn’t take care of it, and the back tooth rotted below the bone and has split into two pieces.  Not only can we not make you a new bridge, but that back tooth should be removed as soon as possible.  The gums are swollen and the tooth is infected.”

Bridgette Chels
ey began to cry, her heavy blue eyeliner running down her cheeks in messy smears.  “But I need teeth, doctor.  How can I go on a job interview without teeth?”

“You really only have one choice if you want to replace those teeth, and that’s a partial denture.”

“I don’t want a denture.  They’re for old people.  I’m not old.  I’m only fifty-five.  What about implants, doctor?  My friend said she had some implants placed and they were able to put caps on them.”

“Implants are a possibility, but you’re on Medicaid, and Medicaid won’t pay for implants.”

“Then I’ll pay for them.  I have some money saved up.”

Of course you do.  Everyone on Medicaid has money saved up.  And Rolexes.  And Beamers and Benzes.  You buy what you want with your own money and let the government pay for everything you need.

“We can’t accept money from people on Medicaid. 
It’s part of the contract we sign with the state.  So you can’t get implants.  Only a partial denture.”

“Can’t you just redo the bridge, then, Doctor Whitman?  Please?  I know you can.”

Jamie slumped back in his chair and sighed.

“I still can’t eat right, Jamie,” Merril Johnson whined as she popped her newly fabricated dentures from her mouth.  Older patients tended to refer to him by his first name, as if he were their grandchild instead of their doctor.  He didn’t mind.  He accepted the slimy prostheses
with gloved hands and dropped them on his tray.  “I don’t think you made them right.  And they still hurt.”

But off course they were made right.  Not only right, but perfect, as he had completed the case with Dr. Portis, the clinic’s prosthodontist. 

“Of course they still hurt, Merril.  I extracted six teeth the day I gave you the dentures.  The bone and gums are healing.  It’s going to be sore.  It’s only been a week and a half.”  To placate the elderly woman, Jamie leaned her back and made a cursory exam of the gums.  He saw healing sockets, but no ulcers or infections.  Growing pains.

“Fine,” Mrs. Johnson said after Jamie returned her to a sitting position.  “But they’re too loose.  They don’t stay in when I eat.  And I get food caught underneath all the time.”

“There’s two reasons for that, Mrs. Johnson, and I explained them both to you before we started the case.  First, we extracted the teeth the day we inserted the denture instead of taking the teeth out beforehand and letting the sockets heal.  So the lab had to do a lot of guessing when they made the dentures.  Plus, as the sockets heal, the bone changes, so the denture isn’t sitting a hundred percent correctly on the gums.  And it won’t for another two months when we reline the inside.”

Merril
snorted.  Jamie chose to ignore it.

“And…”  Jamie eyed the cane by the door.  “You’ve had a hip replaced, haven’t you?”

“You know I did.  It’s in the chart.  One year ago.  That’s why I premedicate.”

“How long did it take you to walk normally again?”

She eyed him nastily, as if he were mocking her.  “You know I use a cane, doctor.  I’m not a hundred percent yet, but I’m getting there.”

“Well, Mrs. Johnson, a denture is like your artificial hip.  It’s a prosthesis.  You’ll probably never eat again like you did when you had natural teeth.  Just like you’ll never walk a hundred percent like you did with your god-given hip.  It will get better but it will take time.  Keep the food soft for now and chop up anything big into smaller pieces.”

“Maybe I should just throw
everything
in a blender.”

“You know that’s not necessary, Mrs. Johnson.”  Jamie sighed
and reviewed his post-insertion instructions with the patient
again
.

He did a lot of sighing these days.

Jamie’s last scheduled patient of the afternoon was Danielle Morgan.  Her mouth was filled with rot, and it stank worse than a fresh corpse just pulled from the river.  She had brought her four kids with her, ages four to nine, and they huddled in the corner with looks of horror on their faces as Jamie examined their mother’s dentition.

“So, I got to get ‘em all out, don’t I?”

“Yes, I’d say it’s time for full dentures, Mrs. Morgan.”

She simply nodded, as if she had accepted this fact long ago.  “My momma got her plates when she was twenty-five.”

This would have stunned Jamie three years ago, when he had just started treating patients in school.  Very little surprised him anymore when it came to people’s varied perceptions about their teeth.  Some people simply accepted dentures as a part of getting older, though he would never classify Danielle Morgan, at twenty seven years old, as older.

“You know why my teeth is so bad, doctor?”

Because you’ve never picked up a toothbrush or piece of floss in your life?

“No
, Mrs. Morgan, why?”

“Because my babies stole the calcium from my teeth when I was pregnant.  Four kids just sucked the calcium
right out, so they was weak and they gone bad.”

Jamie sighed.  “Of course they did, Ms. Morgan.
  That’s exactly what happened.”

Jamie
sat in the faculty lounge at four-thirty, catching up on football news on the computer in the corner, waiting for five to roll around so he could head out.  At this late hour, even if a patient did arrive at the clinic with an emergency, he was not required to see them.  In fact, the front desk was supposed to turn away anyone who came.  His continued presence was a formality; he was paid to work from eight to five so he stayed until five.  He was quite surprised when, at four-forty, he was paged to the front desk.

“What’s up, Cheryl?” Jamie asked the receptionist
as he walked up.

The heavyset black woman looked up from her computer screen.  She wore a lavender bow in her hair, as she did every Friday.  A different color for every day of the week.  “We had a walk-up,” she said
with a hint of a Southern accent mostly, but not completely, lost to time.  The older woman was New Orleans born and bred, and while she hadn’t lived there in decades, some of the accent lingered.  “One of Dr. Marlowe’s patients has a horrible toothache.  Being its Friday afternoon, I figured you could at least look at her, maybe give her some medicine to get her through the weekend if nothing else.”

Jamie nodded. 
“Of course.  Who’s the lucky patient?”

Cheryl looked to her left and right to make sure that no one else was near and leaned over the desk slightly so that only Jamie would hear her.  In a low, conspiratorial
whisper she said, “It’s the gypsy.  Elena Ionesco.  I didn’t tell her you’re the only one here.”

Jamie groaned and sagged just a bit
, his whole body appearing to deflate.  Definitely not a good way to end the week. “She won’t let me treat her,” he said.  “You know that.”

Cheryl nodded.  “I know.
I know she doesn’t care for you for some reason, but she is a fellow human, even if she’s a little bizarre, and she deserves to be looked at and treated before the weekend so she’s not in pain if she wants it. Just write her a couple of scripts and send her home.”

“I don’t know if she’ll even let me touch her, Cheryl. And I won’t write her scripts unless I take a look.”

The matronly woman smiled.  “It’s your call, Dr. Whitman.”

What the hell did he have to lose?  No one would ever be able to accuse him of not trying.  “Page Ellen and have her set Elena up in room five.  I’ll take a look.”

Five minutes later, at a quarter of five, Jamie entered his operatory and found Elena Ionesco sitting in his chair. 

The clinic serviced hundreds of people and Jamie would have been lying if he said he recognized the majority of them.  He knew his own patients, of course, but he rarely interacted with the other residents’ patients unless it was an emergency situation.  But he knew Elena.  Every time she spied him in the h
allway, which was often considering how often she visited the clinic, she would cross herself, whisper into the crucifix that hung around her neck, then hurry away from him as if he were the devil.  The entire clinic was aware of the woman’s aversion to Jamie, and his colleagues would often joke about his ability to scare women away.  Though he was curious about her strange behavior, he had never attempted to talk to her.  She wasn’t his patient and he didn’t have the time to bother.

Elena wore the clothes and shared the features of the stereotypical older gypsy woman from the movies.  Her gray, shapeless frock
adorned with dozens of shiny and iridescent strips of cloth began at her head with a hood that covered her graying hair and ended at her ankles.  A dozen necklaces of different lengths and fabricated from different materials and covered with different precious stones hung about her neck, some hidden underneath the gown, others hanging in front.  Large gaudy rings adorned most of her long, withered, arthritic fingers.  Her face was a maze of wrinkles, and she had a long, slightly hooked nose which was home to a large wart that sprouted a dozen tiny hairs.  Her eyes were brown and limp, her lips thin and bloodless.  She reminded Jamie of the old gypsy woman from Stephen King’s
Thinner
, and sometimes he wondered if she would curse him if he dared to get too close to her.

Jamie walked around the chair so Elena could see him.  When those
lazy, watery eyes fell on him, the old gypsy woman seemed to shrink back into the chair as she crossed herself.  She let out a low hiss, fear and anger in equal parts blossoming in her those awful, ancient eyes.

“How can I help you, Ms. Ionesco?” Jamie asked, striving to be professional and ignoring the woman’s behavior.

“I will be seeing another doctor,” Elena Ionesco said in a thick Eastern European accent.