Hank comes back and he sits down next to me.
Theyíre ready for you.
You ready for them?
I hold up the tennis balls.
Itíll be interesting to see what you look like with teeth.
Itíll be interesting to have them again.
Iíll see you in a while, Hank. Thanks for everything.
Donít mention it.
I walk toward a door where a Nurse stands waiting for me. As I walk past her she is careful not to touch me and I am brought back from the happy afterglow of pachyderm memories and I am reminded of what I am. I am an Alcoholic and I am a drug Addict and I am a Criminal. I am missing my front four teeth. I have a hole in my cheek that has been closed with forty-one stitches. I have a broken nose and I have black swollen eyes. I have an Escort because I am a Patient at a Drug and Alcohol Treatment Center. I am wearing a borrowed jacket because I donít have one of my own. I am carrying two old yellow tennis balls because Iím not allowed to have any painkillers or anesthesia. I am an Alcoholic. I am a drug Addict. I am a Criminal. Thatís what I am and I donít blame the Nurse for not wanting to touch me. If I werenít me, I wouldnít want to touch me.
She leads me into a small Room. The Room is like many other Rooms I have been in lately, except that it seems cleaner and whiter. There are stainless steel cabinets along the walls, trays of sharp sparkling instruments on top of the cabinets, a large halogen lamp hanging from the ceiling. There is a surgical chair sitting in the middle of the floor. It is metal and it has green cushions and long menacing arms and all sorts of straps and buttons and levers and gears. It looks like a medieval torture device. I know it is for me. I walk past the Nurse and I sit down in the chair and I try to make myself comfortable but itís not possible. Torture devices are not made to be comfortable.
Doctor Stevens will be here in a minute.
Can I get you anything while you wait?
A Babar book.
I would like a Babar the Elephant book. You have them in the Waiting Room.
Iíll be right back.
She leaves and Iím alone and as I settle into the chair and look around the Room, I start to panic. The last of the Librium is nearly gone and the food in my stomach has been broken down to the point that it no longer holds and everything speeds up. My heart, my blood pressure, the thoughts in my head. My hands are shaking, but it is not the heavy shaking of withdrawal. It is a quick and fragile form of shaking, a form of shaking that comes from fear. Fear of this Room, fear of the chair, fear of what the cabinets hold, fear of what the instruments do, fear of whatís going to happen to me here, fear of a pain so great that I need to squeeze tennis balls to make it go away.
The Nurse returns with the Babar book and she gives it to me and she leaves. I set the tennis balls in my lap and I open the book and I try to read it. As I turn the pages, I can see the words and I can see the pictures but I canít read the words and I canít understand the pictures. Everything is speeding up. My heart, my blood pressure, the thoughts in my head. I canít concentrate on anything. Not even Babar.
I close the book and I clutch it against my chest and wait. Everything is shaking. My hands, my feet, the muscles in my legs, my chest, my jaw, my remaining teeth. I pick up the balls and I squeeze them and I try to force the strength of the shaking into the balls and the balls start shaking. Everything is shaking.
The door opens and the Lumberjack Dentist Doctor Stevens walks in and he is followed by another Dentist and two female Nurses. Doctor Stevens pulls up a stainless steel stool and he sits down on the stool near the bottom of the chair. The other Dentist and the Nurses begin collecting bins and instruments and opening cabinet doors and closing cabinet doors. The noises they are making are sharp and I donít know what exactly they are doing but I know the sum of it will be going into my mouth.
Sorry for the wait. We were reviewing the procedures weíre going to do today.
The other Dentist leans down and whispers something in Doctor Stevensís ear. Doctor Stevens nods. The sum of it will be going into my mouth.
The first thing we want to do is cap the outside two teeth. We looked at the X rays again and the roots seem to be intact, the bases stable. Once theyíre capped, they should be fine.
After we do that, we need to do root-canal surgery on the middle two. The roots are unstable and if we donít do the surgery, your teeth will turn black and die. After they die, they will fall out. Iím assuming you donít want that to happen.
No, I donít.
Iím sorry to be so blunt.
I appreciate your bluntness.
I want you to know exactly what weíre doing and why.
I donít want to know any more.
There is one thing.
This is going to be incredibly painful. Because youíre currently a Patient at a Drug Treatment Center, we canít use any anesthesia, local or general, and when weíre done, we canít give you any painkillers.
I hold up the balls, give them a light squeeze.
And you think you can deal with that?
Iíve been through worse.
Iíve been through worse.
Doctor Stevens stares at me as if what I have said is incomprehensible to him. I know what Iím about to experience is going to be horrible and I donít know if Iíve been through anything worse, but in order to do this, I have to believe that I have. I stare back.
Letís go, Doc. Bring it.
He stands and begins talking in hushed tones to the other Dentist and to the Nurses and he helps them prepare the bins and instruments for their use in my mouth. I sit and wait and my body slows down and my mind slows down and I stop shaking and I stop squeezing the balls and I am calm. I have accepted that this is going to happen and that I need it to happen and that itís going to hurt. A calm descends, a calm the Condemned must experience just before Execution.
Doctor Stevens steps forward and stands over me.
Iím going to lean you back a bit.
He reaches down and he pulls a lever and he slowly and gently leans me back. The halogen light is directly over me and it is blinding in its brightness and I close my eyes. I am holding the balls and the Babar book is resting on my chest, just above my heart.
Do you mind if I move this book?
Iíd rather you didnít.
Thatís fine. Weíll work around it.
I hear the shuffling of feet and the placement of bins and someone lifts my head and places the strings of a bib around the back of my neck and clips them and places the bib on top of the book. The chair moves farther down and farther back and a small firm pillow is placed beneath the base of my skull.
A female voice. A clinical manner.
I need you to open your mouth.
I open my mouth.
If it hurts, say so.
Now stay still.
I stay still as someoneís hand pulls my bottom lip out and stuffs the space between my lip and gum with cotton. I can feel the stitches stretch and blood start to seep. The same procedure is done with my upper lip and my cheeks and it feels as if my mouth is full of soft fibrous dirt and almost instantly, everything is dry. A spray of water moistens it, but not enough. It is dry and it will stay dry no matter how many sprays I get.
I lean back into the chair and I close my eyes and I open my mouth wide and someone hands me the tennis balls and I take a spray and I hear low quiet words and the sound of a drill being tested. The drill goes on and off, on and off.
Check the sander.
A sander goes on and off, on and off.
Check the secondary drill.
The secondary drill goes on and off, on and off.
I feel the presence of People standing over me. A hand grabs my upper lip and gently pulls it so that my gum is exposed. A spray covers the remains of my teeth.
Here we come, James.
The spray continues and sander is turned on and as it comes in toward my mouth it gets louder and the noise is high and piercing and it hurts my ears and I start squeezing the balls and I try to prepare for the sander and the sander hits the fragment of my left outside tooth. The sander bounces slightly and white electric pain hits my mouth and the sander comes back and holds and pain spreads through my body from the top down and every muscle in my body flexes and I squeeze the balls and my eyes start to tear and the hair on the back of my neck stands straight and my tooth fucking hurts like the point of a bayonet is being driven through it. The point of a fucking bayonet.
The sander moves its way around the contour of the fragment and I stay tense and in pain and I can taste the grit of the bone on my tongue and the spray is spraying and it collects the grit and sends some of it down my throat and some of it into the space beneath my tongue. It continues, the sanding and the spraying and the grit and the pain, and the constant electricity of it keeps me tense and hard. I sit and I squeeze the tennis balls and my heart beats even and strong as if it needs the test of this ordeal to prove that it works correctly. The sander stops and I relax and I take a deep breath. There are soft voices and there are instruments being picked up.
I think thereís a cavity here, James. I need to check.
The cotton in my mouth has shifted enough to allow me to speak comprehensibly.
Itís gonna hurt.
Get it over with.
I prepare for more but Iím not prepared for what hits me. As a sharp pointed instrument pokes around one of the sanded edges of my tooth it finds a small hole and it penetrates the hole. The electric pain shoots and it shoots at a trillion volts and it is white and burning. The bayonet is twenty feet long and red hot and razor sharp. The pain is greater than anything Iíve ever felt and it is greater than anything I could have imagined. It overwhelms every muscle and every fiber and every cell in my body and everything goes limp. I moan and the instrument goes away, but the pain stays.
Itís definitely a cavity. We need to fill it to cap the tooth correctly.
Every fiber and every cell is limp.
Every fiber and every cell is white hot and burning.
The pain is greater than I could have imagined.
I take a deep breath.
Do what you need to do. Just get it over with.
Low muffled voices, the opening and closing of cabinets, the changing of instruments. The drill is turned on. I sit and I wait.
The drill comes and the drill hits and I squeeze the balls so hard that I think my fingers are fucking breaking and I moan. I moan in a steady tone that fills my ears so that I donít have to hear the drill but I still hear it and I concentrate on the sound of the moan so that it will distract me from the pain but it doesnít. Bayonet bayonet bayonet bayonet bayonet. The drill makes a hole and moves around the circumference of the hole and makes it wider and the grit mixes with the spray and moves down my throat and collects beneath my tongue. Bayonet, bayonet, bayonet. The hole gets larger and larger. Bayonet bayonet bayonet. Thereís a fucking drill in my mouth. Bayonet.
The drill stops, the pain continues, the squeezing continues, my moan continues. Doctor Stevens tells the Nurses and the other Dentist to move quickly and they do. They stuff the hole with some sort of putty and they wipe it away and they stuff it and they wipe it away. The stuffing buffers the open pain of the hole and the piercing pain fades and a dull throbbing agony remains and my heart beats strong and steady and the agony beats along with it and it doesnít bother me. I have lived with agony for so long that as it beats along with my strong and steady heart, it doesnít bother me.
I stop moaning and I open my eyes and through the deep well of tears resting atop them I can see some sort of blue light being held above me and being focused on the putty. The putty gets hard and closes and melts around the hole and I hear the sander and see it moving in and I close my eyes and the sander hits and the chemical grit of the putty fills my mouth. The process repeats itself. Putty, blue light, sander. Putty, blue light, sander. I become immune to it and immune to its pain and I squeeze the tennis balls and I wait for it to end and it ends. One down, three to go.
Now we want to cap the outside right tooth.
I nod yes.
Do you want a break before we do it?
I shake my head no.
A moment of preparation and then the sander comes back and I endure it easily. There is no cavity and no drill so the putty and the light come back and theyíre nothing. Iím holding the balls but not squeezing, the steady moan is gone, my heart rests. An easy and seamless rebuilding on the outside right. Two down, two to go.
I hear the shuffling of feet and the shuffling of instruments and the opening and closing of cabinet drawers and I open my eyes. Doctor Stevens is speaking with the other Dentist and the Nurses are putting the used instruments in a small sink for sterilization. Doctor Stevens finishes talking and the other Dentist leaves the room.
Is there a problem?
No, thereís no problem.
I sit up.
Whereís he going?
Doctor Stevens pulls up the stool.
I didnít want to tell you this until we were ready to start, but I want to strap you down while weíre doing the root canals.
Aside from the factor of pain, one of the reasons we anesthetize Patients during root-canal procedures is so they donít move. We need you to be still to work, and Iím not sure youíll be able to be still if youíre not strapped down.
Youíre sure youíre okay with it.
Yeah, Iím fine.
The Dentist returns carrying two long thick blue nylon straps with large pressure-secure buckles. They are the kind of straps used to hold large objects onto the roofs of cars, to hook boats up to trailers, to keep the doors of animal cages shut. They have seen some use and they are the only thing in the Room besides me and the tennis balls that is not sparklingly clean.
I lean back in the chair and the Dentist steps forward. The Nurses have stopped cleaning the instruments and they are staring at me.
Could you hold your arms at your sides?
I put my arms along the sides of my body.
The Dentist lays the straps across my body so that the buckles fall beneath the chair. He crouches down and he hooks the loose end and he pulls it and the straps start to tighten around my body.
Let me know when itís secure.
He continues to pull, the straps get tighter and tighter. When I canít lift or move my arms in any way and when the straps start digging into my skin and pressing the Babar book into my chest, I let the Doctor know the straps are secure. He locks the buckles and he stands and he walks to the sink to wash his hands. Doctor Stevens and the Nurses step forward.
Weíre going to try and do this as fast as we can.
Make sure you do a good enough job so that I donít have to come back here.
Iíll definitely do that.
I close my eyes and I try to settle in and make myself comfortable. There are wads of cotton in my mouth and there is a throbbing agony from the earlier drilling and there are thick, blue nylon straps digging into my skin and pressing a book into my chest. There are fingers grabbing my upper lip and pulling it back and there is a cold spray dousing the exposed remains of my front two teeth. There is a tennis ball in each of my hands and there is the knowledge that Iím about to undergo a dual root-canal procedure without any anesthesia. There is the sound of my heart beating ever more quickly. There is anticipation. There is fear. There is no comfort.
The drill is back on and it is working through the fragment of my left front tooth. It is moving through a thinner, more fragile section of bone, so it works quickly. It shoots the grit, makes the hole, penetrates. At the point of penetration, a current shoots through my body that is not pain, or even close to pain, but something infinitely greater.
Everything goes white and I cannot breathe. I clench my eyes and I bite down on my existing teeth and I think my jaw might be breaking and I squeeze my hands and I dig my fingers through the hard rubber surface of the tennis balls and my fingernails crack and my fingernails break and my fingernails start to bleed and I curl my toes and they fucking hurt and I flex the muscles in my legs and they fucking hurt and my torso tightens and my stomach muscles feel as if theyíre going to collapse and my ribs feel as if theyíre caving in on themselves and it fucking hurts and my balls are shrinking and the shrinking fucking hurts and my dick is hard because my blood hurts and my blood wants to escape and is seeking exit through my dick and my dick fucking hurts and my arms are straining against the thick blue nylon straps and the thick blue nylon straps are cutting my flesh and it fucking hurts and my face is on fire and the veins in my neck want to explode and my brain is white and it is melting and it fucking hurts. There is a drill in my mouth. My brain is white and it feels as if itís fucking melting. I cannot breathe. Agony.
The drill comes out and a vacuum starts sucking the dying flesh surrounding my root from the canal that holds it. The agony does not subside. The vacuum stops and the remaining flesh is scraped from the interior of the canal with some sort of sharp pointed instrument. The agony does not subside. The vacuum goes back and comes out, the scraping continues. The agony does not subside. The root has to be clean to heal correctly. Please clean the Motherfucker fast. Please please please clean the Motherfucker fast. The agony does not subside.
I start to fade into a state of white consciousness where I am no longer directly connected to what is being done to me. My arms are no longer my arms, my legs are not my legs, my chest is not my chest, my face is not my face, my teeth do not belong to me. My body is no longer my body. There is white. Everywhere there is white. There is agony. It is agony that is unfathomable. I try to will myself back to reality and back to the drills and the vacuums and the instruments and the cotton stuffing and the spray and the grit and the Doctors and the Nurses and the rebuilding of my teeth, but I canít come back. My body wonít let me come back. It is as if it is sparing my mind what it can and pushing into a realm that is horrible, but somehow less horrible. I give up and I give in and I am consumed by the whiteness and the agony and I am there for what seems to be eternity. The whiteness and the agony. The whiteness and the agony. The whiteness and the agony.
I am brought back by the screaming pitch of the drill. I can feel a tooth on the left front side of my upper gum and I know the drill is coming in to fix the right. It hits and penetrates and I am conscious during the penetration and the process of endurance repeats itself. I lose the air and the ability to breathe it. I clench my eyes and I bite down and I squeeze the tennis balls and every single cell of my body feels as if it is going to explode from the force of the pain. If there was a God, I would spit in his face for subjecting me to this. If there was a Devil, I would sell him my soul to make it end. If there was something Higher that controlled our individual fates, I would tell it to take my fate and shove it up its fucking ass. Shove it hard and far, you Motherfucker. Please end. Please end. Please end.
The vacuum sucks and the instrument scrapes and I endure. The interior of the canal is cleaned and drained and I endure. The canal is filled with new flesh and the root is protected and I endure. There is putty and blue light and a sander, putty and blue light and a sander, putty and blue light and a sander. I endure. Iím somewhere in Minnesota and Iím a Patient at a Drug and Alcohol Treatment Center and Iím having my front four teeth rebuilt and Iím strapped into a chair because I canít have any anesthesia. All I can do is endure.
I feel water flowing off what must be teeth and the last of the grit washes down my throat. The cotton is removed from my cheeks and my gums and I hear muffled voices and the sink is running and cabinet doors are opening and closing. I open my eyes. I see flashes of white and I have trouble focusing. The halogen is still on. There is movement and the halogen is off and something moves away from me and other things move toward me. I hear the buckles on the straps release and the straps are pulled off and the Babar book is removed and my body is now free to move and function as it wishes and I am immediately cold and I am immediately shaking. I try to sit up and I am unable to sit up. I try to lift my head and I am unable to lift my head. I try to focus my eyes and my eyes wonít focus. Iím cold and getting colder. Iím starting to shake harder. I am still clutching the tennis balls. The agony has yet to subside.
Someone lifts me and wraps a blanket around me. The blanket is warm and the warmth brings on an intense nausea and I can feel it coming and thereís nothing I can do to stop it and it comes. It comes easily, and somehow its coming loosens my stomach and my lungs and my torso and although I still canít focus my eyes, I can see that itís red. It comes and comes and comes. Red red red. All over the blanket, all over the chair, all over the floor, all over myself. I let go of the tennis balls and I try to lift my hand to wipe my face but my hand is shaking and my face is shaking and I canít make them meet. My hand falls to my side.
Get some more blankets and get some water. Hurry.
I lie back on the chair.
Are you okay, James?
Can you understand me?
I moan again, nod yes.
You need to go to the Hospital. Iím going to call an Ambulance.
I donít want to go to a Hospital, so I gather whatever strength I have and I push myself up and I open my eyes. Doctor Stevens is standing in front of me.
You need Medical Attention. Attention we canít give you.
Lower the chair.
Doctor Stevens lowers the chair. I put my feet on the floor. I am cold and I am shaking and everything hurts. Iím sick of Doctors and Dentists and Nurses and chairs and tests and halogen lights and instruments and clean Rooms and sterile sinks and bloody procedures and Iím sick of the attention the weak and the injured and the needy receive and I donít want to go a Hospital. I have always dealt with pain alone. I will deal with it alone now.
Get Hank and get me back to the Clinic.
You need Medical Attention.
Iíll be fine.
If you leave here, it will be against my direct advice.
I push myself from the chair. The muscles in my legs are twitching and my legs are unsteady. I take a small, slow step and I stop. I take the blanket off and I drop it on the chair and I take another small, slow step and I stop.
Can you make it?
Do you need help?
My eyes are focusing and my stomach is settled. Iím still shaking and Iím still cold and Iím still hurting, but being away from the chair makes me feel better. I look at the door. If I can get to the door, Iím closer to being out of here. I want to be out of here.
I take another step. My legs are jelly. Another step. They weigh a million pounds apiece. Another step. They hurt. Another step. They throb. Another step. Each movement is a titanic effort. Another step. After each I donít know if I can do it again. Doctor Stevens is watching me and the Nurses have returned and they are watching me and I know if I falter I go to the Hospital. Another step. Another step.
I get to the door and I stop. To my right is a mirror. I glance toward it and catch a glimpse of myself. I am white as chalk. My face is hideously swollen. The area around my mouth is splattered with flakes of dried blood. There are stitches protruding from my lower lip and my eyes are black. There is a bandage across the bridge of my nose. I am too thin for my frame and what flesh I have is loose and limp. The white T-shirt Iím wearing is caked with brown and red vomit stains. The tan pants Iím wearing are caked with brown and red vomit stains. I look like a fucking monster.
I turn to Doctor Stevens and the Nurses. The Nurses look away, Doctor Stevens does not. I speak slowly.
Thank you for helping me.
No problem. Itís what I do.
Iím not what you do. You went beyond what you do today. Thank you.
Doctor Stevens smiles.
I smile back. It is my first smile with my new teeth. Iím amused by this and I smile wider and I point toward my mouth. Doctor Stevens laughs and he walks toward me and he puts his arms around me and he hugs me. We are two men who have just been through a terrible ordeal together. Although it was worse for me, I know it wasnít easy for him. This hug is our bond, our bond to learn from what we have just been through and become better and stronger because of it. I know he will keep the bond, I donít know if I can. I pull away.
Take care of yourself, James.
I turn and I slowly walk away and I donít look back. It has always been a fault of mine, but it is the way I am. I never look back. Never.