is this? he frowns, suspecting. Then turns away from the patient to the steriliser in order to grimace to the eyebrows. It can be only prolonged vitamin and mineral deficiency; calcium, he thinks, over the frame of his glasses, the cloth mask. What else to explain this extreme oral pathology?
Nothing that will comfort this poor woman; a slight, elegant young lady wearing imitation pearls. She is in a worn, mint green pastel twinset and fawn pencil skirt, her slim, stockinged legs extended past his bent waist, feet enclosed, he has noticed, in classic two-tone pumps, scuffs polished out, but rather down at heel. Still, yes, most lovely; an effort to appear chic.
He pulls his mask down and in an engaging, broken English, repetition with variation allowing him pause to place the words he needs, he finds this not good, no, and for this he is sorry. Not before is he having seen such a terrible thing. Now please, he requests with an upturned palm, To rinse. Twice, he indicates, raising two fingers like a scout’s honour. And while she does, he scoots crabwise to the counter on his stool, and with his back turned, pens notes into a folder.
With each sip from the glass of pink liquid – discreetly sloosh, and spit – Nora avoids following the debris that swirls down the porcelain cavity.
Then Dr van Toren swivels around to face her, capping the pen. And for me, he continues, I must say to you. What also I am seeing here today, you (another beautiful, sophisticated gesture), this is a lovely lady. But, however, she is too thin. And I am asking why. This is my big question. What can be the reason? So if you would please to tell me: What is it, the food you are eating?
And then there is very little to say.
And so there is Nora, in her early twenties. And despite having been careful, she has a runty baby, a half-day clerical job (plus typing at home, addressing envelopes for various companies), a part-time husband, and not a tooth in her head. Single, whole or otherwise.
She is toothless. Which has to be some loss. More than any young woman might have expected, and certainly so much less than she had hoped for.
On bad days, Nora will become sarcastic, which is the closest she can get to humour. So much for the dream! A rocking chair, a cup of tea, a book and a baby. Forgot to include the husband, didn’t she. Took it for granted. And yes, the teeth. Now look at her. She gargoyles into the mirror. On worse days, as you may expect, she cries, unable to tolerate the sight of her slumped lips and flayed gums.
Nor was it possible, at that moment in the dental surgery, to appraise her face through the image of the dentist’s expression, the neat, considerate man who probed her sensitive mouth. Not only because he kept his emotions politely in check, or was man enough to deflect instances of imminent professional failure, but because she herself could not bear it. To look. See her degradation reflected.
In the chair, she focused on his name, worked in black satin stitch above the upper right-hand pocket of his white coat. Van Toren. What did his name mean? And why the need for the stitching? To identify him back in dental school? Kept, in his present practice, in case, distracted, he forgot who he was? Perhaps he was even accustomed to losing his coat, which again would make him forgetful. Perhaps it was merely a requirement of the dental profession; a rigorous, upfront code of ethics; a sign of the workmanship one might expect at his hands. Certainly, the stitches were extraordinarily precise. Machine embroidered, probably, otherwise an unusually dedicated wife.
Nora tries not to think of his hands, as they ebb and flow, away from her and back again. She studies his head, the dark, oily curls clustered above his forehead, giving his sallow skin a suggestion of youthfulness. He is maturely handsome, she sees, though scorns herself for such a conventional observation when she’s not remotely looking. The dentist leans back, pausing. Nora notices that in the left pocket is a black-and-silver Parker pen. Fountain. Capped. Still might leak. And a tiny penlight torch. Though off, unlit. Still, pen:light. They lie comfortably together.
Dr van Toren was thorough, but gentle. Thoroughly gentle. His pensive insight and compassion were offered lightly, without knowing regard for the authority he extended over the young woman in the tilted chair. He asked once, and did not probe further into Mrs Murphy’s unsatisfactory answer. His clinical enquiry was reasonable, and he hoped that she was too.
This left her both grateful and excruciatingly shamed. To be seen in such a debased condition by a person who saw her situation without her having said.
The only solution, understandably, was complete extraction. Of all the roots, and the shards of damaged crown and cusp which remained. Thirty-two. Nothing could be salvaged.
He tells her this. Against his wishes, and against her own best interests, he tells her more. He does this in the interests of expense, which he sadly appreciates is of more than passing interest to her.
For the procedure will cost substantially less if it is performed in his rooms, rather than under general anaesthetic at the day clinic in Durdoc Centre. And he means today, now, because she must know that this, what he has to do, what she must have done, it cannot wait.
The chair will also be more painful, yes, but since she has no choice, this is what she chooses. Afterwards, you see, there are still the dentures to consider, the cost of which will not be inconsiderable.
Dr van Toren spares his patient no details, refusing to pretend. He is not cruel, but neither will he deceive. For from what he can gather, studying his patient sympathetically, examining the damaged teeth, she has already been injured by complex deceits and denials, her own, even, and certainly those of others.
As always, the solution will be pain and money; both will be at her expense.
It was not unexpected, so Nora steels herself, consoles herself with nothing. What did she think a dentist could do? Save her? Save her teeth? Perform a miracle? That Dr van Toren, like some fantastical towenaar, could magic back that which had disappeared?
The questions burn like a dispassionate blowtorch as she cauterises her foolishness, making ready.
When he is done explaining, and has arranged, through the receptionist, to reschedule his appointments, have the neighbour look after the patient’s baby for the rest of the day, and for her place of employment to extend her sick leave, he proceeds.
Beginning with Novocaine injections, which are tolerable in the soft gum, but pierce her hard palate like inflexible wires, glowing red hot. When she is numbed, the man continues, tactful and courteous. However, he must lean over her and steady himself and grip fast and twist, using the resistance of the chair in order to do his work.
He cannot be clinical, for the action is not in the hands, merely, but the whole body. The torso strains in the manner of a labourer hauling a heavy machine. The feet and legs, too, although obscured from the knees down by the chair, cannot stand by indifferent to the whole business, as they are called upon to balance and counter-balance, rooting the dentist’s weight as if he were shirtless in an old-fashioned slaughterhouse among blood-stained workers, all in slippery aprons hoisting deadweight carcasses with hooks and chains that have been muscled over iron girders. So if the dentist is deft, he needs also to be strong. He is sweating. Heavily. Nora can smell him. It is far more than mere beads on the upper lip; his face is glistening, close enough for her to study the pores.
And so it proceeds, this extraordinary, deliberate violence. The specialist mechanics of the dentist. The crude instruments of medieval dentistry known as the pelican and the turnkey lying behind the gleaming modernity of stainless steel.
Because what happens, after all, is this. He makes her comfortable, after a fashion, then cuts a long, deep incision into the gums, the full curved length of her lower jaw. Using a fleam,
