Life and death. These are the last thing that a dentist deals with in his everyday practice. But we do encounter some every once in a while.
About half a year ago, a patient came in complaining about gum swelling and swollen lymph node. Although the clinical presentation did not conform with routine dental problems, we were taught to apply the routine management first because common diseases are far more prevalent than rarer ones. I reviewed the patient twice in two consecutive weeks, but the lymph node swelling did not resolve, so I decided to refer the patient to a hospital for further check up.
The patient came back today for dental check up. He wore a mask, which isn’t common for dental patients unless they’ve a fractured incisor, so I asked what happened. It turned out he was diagnosed to have acute lymphoma (a type of cancer) in June, and is on chemotherapy now. The mask is to prevent infection since he has compromised immunity during chemotherapy. He said he didn’t go to the hospital right after my referral, but two months later he had lymph node swelling in other areas, so he went to have a check up, and the diagnosis was made.
What’s the implication of this story? For one, I feel limited as a dentist. There’re many things that we’ve learnt to do in dental school, but diagnosing cancer is not one of them. Seeing this patient’s misery I can’t help but wonder, could I have done better? What if I insisted that he must seek hospital care sooner? The whole story may become different had we done things differently.
But I think the more important implication of this story is one that is easier said than done: we’ve got to get the job done. When others call you “Doctor”, it represents a trust and delegation of responsibility. We may not know everything, but we’ve got to do the best within the reach of our abilities, yet at the same time be fully aware about what we don’t know and try to improve on those areas. This doesn’t only confine to life and death issues; it also applies on our every day work, like simple fillings, tooth extraction, and the like. Yes, dentistry is not about money. It’s about enriching people’s lives. Let’s do it.