Yesterday was what many dentists, colloquially, would refer to (behind closed doors) as a cluster-#$%&. The team was down a sterilization tech, and though we didn’t have a terribly heavy flow of patients, the pieces didn’t really seem to fall into place. I carried my usual load of patients but felt like I needed to be on roller skates. Each patient seemed to need additional time; time I just could not seem to invent. I went past my allotted time with a new patient emergency who started the appointment by saying: “I have mental issues.”
I needed extra time to build trust and make her feel comfortable; my goal was to make her feel more safe than she ever had been with another provider, one who might have dismissed or eye-rolled at her beginning remark. I also needed extra time with a patient who presented with symptomatic irreversible pulpits on tooth #13 with decay extending right into the pulp chamber. Her chief complaint was pain on the lower left and it simply didn’t make sense to her that it was coming from an upper tooth. She also was persistent about not wanting any more root canals, or teeth drilled into, and was trying to convince me to treat the tooth “in some other way.”
Stacking on top of those two, I chose to take more time with a patient who presented for a second opinion having just found out, in disbelief, that he had periodontal disease; not just any the kind of periodontal disease, the kind that necessitates the extraction of at least 8 teeth. This patient was in a wheelchair, following a stroke, traveled with his frail wife and had difficulty moving into the operatory and dental chair. I chose to extend this appointment and perform the initial periodontal treatment in order to save him and his wife an extra trip to the office.
Somewhere in that morning, I’d also accommodated a patient who was scheduled for a filling, but broke a different tooth; not just a tooth that now needed a crown, but a tooth that now needed me to initiate endodontic therapy as lead by caries. Each one of the above patients got the best version of me, the accommodating, gentle, compassionate, and thorough version of me. Without a minute to spare, lunch was spent in a coaching meeting, a meeting that may not have gotten the best version of me. My body budget, my emotional allowance, was shot and it was only 2 pm.
As I was completing my charts, waiting to be called for my next patient, I overheard a conversation in operatory 1, the one closest to my private office. An operatory that, according to the schedule, was to be unoccupied.
“Who was in there,” I wondered.
I walked the hallway and instructed one of the assistants to scope out the rest of the treatment rooms to confirm who was where and why. As I was walking away, I overheard her voice carry into the operatory and back to me, in volume most certainly heard by the patient: “hey, who is the guy you have in the chair?”
This wasn’t just any patient, this was the new patient. My heart sank. Not only was that conversation unlike what I thought was acceptable in front of patient, the message made us look like we didn’t know what we were doing. This of course, furthered my disappointment of not knowing who it was and why a patient was seated in an unmarked treatment.
MISTAKE TO MACABRE
I got irritated. In fact, I am being quite gentle in my description. We, as a team, have spent the last 2 years in coaching creating a practice which respects and takes great care of patients, a practice devoted to compassion and service. In meetings, in huddle, and one on one, I’d taught, asked, and trained our clinical team on the importance of entering the patients name into the schedule prior to welcoming them into the treatment room, primarily for safety’s sake, but also for the sake of cooperation and organization. I slowly noticed myself lessening in irritation and falling into resignation.
As I began to notice the extent of my emotionality, I went from thinking “how many times do I need to say the same thing over and over?” to “what is the point of any of if? it’ll never change,” and “I will never run a successful practice, I am a complete failure.”
That was the feeling with which I left work.
I got home, exhausted, and ate my dinner quietly. My husband asked what happened at work to make me so distant and I told him I didn’t want to dwell on it. Yet, moments after I said that, I went up to my bedroom, changed into my pajamas and did just that: I dwelled on it. I fell prey to the circular thinking and catastrophizing. I questioned my decision to be coached, my own methods, my ability to execute plans. I questioned my leadership style, my ability to encourage, to inspire. I questioned it all. I even questioned my career choice. Sadly and solemnly, I went to bed early, hoping to wake up with a different perspective, a rebirth of optimism.
This wasn’t the first time I’d gone from a mis-scheduled patient to my feeling like I had no business owning or running a practice. It wasn’t going to be my last. More importantly, the steep progression of my emotionality, the disfigured reality that I witnessed, is neither novel, nor is it solely present in the field of dentistry. That type of bend in the truth doesn’t discriminate, it’s present in us all, at varying times, and definitely at varying magnitudes.
A sideways comment from a teenage daughter can send a mother thinking she’d been a terrible parent. A break up with a partner can make someone feel like they’ll never be loved again. The loss of employment can lead to an unfairly perceived representation of what the future may hold. Accelerating at 3.6 seconds from mistake to macabre may not just be innately human, it may also be necessary to lay the groundwork for building resilience.
THERE IS A LIGHT IN DARKNESS
Each morning I wake up to a dark, quiet house. I get ready for work, and arrive at the empty office 2 hours before the first patient. Still in that darkness, I sit on the floor of my private office meditating. Sometimes I choose white noise as the background, sometimes music or chanting, but often I open an app for guided meditation. Today, within my 10 minute space of reflection, I performed a sushumna nadi meditation. In simple terms, I was to visualize my spinal column. In its process, I began to imagine my backbone as a quintessential source of support and strength; strength, constant strength. A strength I believed I had.
It was a palpable tenacity, an undeniable and forever lasting concentration, attached to me, one within me. The realization dawned upon me, I need the burden of yesterday, and many days like that before, to build me up, to build resilience. I had developed that stamina, one symbolized by my spinal column, from the mistakes and obstacles I’d fought along the way. The day before was a challenge; but nonetheless, a challenge that made me get up today, the day after my cluster-#$*k, amped up to try harder, to be better, to lead with more compassion and understanding.
Resilience was the reward for a hard day. Building residence doesn’t necessarily erase the annoyance of repeated training and coaching with little change. After all, I am human. I think that what I am saying is this: not following a previously taught protocol made me feel entrapped in my own personal failure; but since, I have come to recognize, with time and with meditation, that maybe I wasn’t a failure after all. The negative occurrences build resilience and the resilience built hope. The hope to get up, to keep coaching, teaching, learning, healing, and serving.
I have no doubt that a day will come again, in a not so distant future, where a patient will be seated and not entered in the schedule. I have do doubt, that again, I will move thru the cycle of frustration, emotionality, and ultimately move into understanding. I also have no doubt that when it happens again, the cycle mentioned above will be shorter and will involve less irritation and resentment than before, simply because i will have come to understand that there will be a reward in it; a continually developing resilience.
ABOUT THE AUTHOR
Dr. Maggie Augustyn is a general dentist (Elmhurst, Illinois), an author, and columnist (Dentistry Today). She completed her formal dental education, earning a doctorate of Dental Surgery from the University of Illinois at Chicago (UIC). Augustyn reads, researches, writes, and speaks on the things that make us human first and dentists second. She has also been featured on various podcasts bringing attention to mental wellbeing, the things that make us hurt, and those that make us come alive. She is an inspirational speaker around the country and can be reached at maggie.augustyn@gmail.com.
FEATURED IMAGE CREDIT: MinskDesign/Shutterstock.com.
