Wednesday, December 19, 2012

the joy : it's the way you look at things (medical and dental jargons ahead)

Nayli and I (pictures and story were published with her mother's consent)

I remember meeting this girl about a year ago for the first time ever. She was the youngest patient I've ever had so far - she was only four. She was scared of dental treatment. I studied hard on how to give painless local anaesthesia (LA). Actually this is bullshit. The current advances we have at the student polyclinic doesn't allow us to give an ultimate painLESS LA, but provided correct techniques being applied, the score pain patients give us may go down to 1 out of 10. That's even better than the bite of a red ant. I studied hard on nerve supplies to make sure I don't mess up during such procedure. Handbook of Local Anaesthesia by Stanley F Malamed was and will always be my best friend. Truth to be told, I was so afraid of inflicting pain on my patients that I began performing root canal treatment only during my fifth year while most of my colleagues had done at least one RCT during their fourth year. 


When I met her, she was having a large abscess around her upper labial sulcus and her upper lip was actually lifted upwards due to this. Had to prescribe her antibiotics a couple of times before I was sure abscess wouldn't be in my way in anaesthesizing her teeth (failure in treating the main cause after fifth day being on antibiotic and the abscess might start to grow rapidly again). Did so many extractions, pulpotomy, crown strips, stainless steel crown (SSC), and a Nance appliance and finally, she learned to smile widely. I love how she calls SSCs as 'gigi robot' (robotic tooth). After completing her treatment plan, yesterday, I met her again, just for a follow up. She had been practising whatever I taught her. "Nayli, gigi bersih ni", bagusnya. "Dia taknak tidur selagi tak gosok gigi sebab dia kata takut hantu datang kejar orang gigi buruk (and so I made up stories)", her mother, Kak Na, said. A year ago, I loved bringing Nayli and her elder sister, Ariesya, to the medical school cafe, because I know that that's the only time Nayli would be eating her veggies (and so Kak Na said). "Kita nak jadi tinggi macam Kak Z", she would smile while wincing from eating bitter veggie. She'd try to take whatever food I took. Her favourite dish was a plate of white rice with a fried chicken and nothing else. When she finished eating, she would sit on my lap and turn to me, asking me to wipe her mouth. I'm not the type of lady who carries a handkerchief or tissue papers around, but whenever I knew I would meet her, I would carry one along. The day I thought I would be finishing my DDS, I received a text from Kak Na saying, "Z, budak-budak ni taknak ke sekolah sebab Kak Z tak nak jumpa diorang". I actually cried. One of the things that pumped me up to resume my studies was meeting them once again.

Yesterday, as usual, while doing medical asepsis (proper hand wash), Nayli ran to me and jumped while clapping "Yay, yay, Kak Z, kita dah sampai, kita dah sampai!", she exclaimed and quickly grabbed my wet hand and led me to her mother. As soon as I brought her to my dental chair, she said, "Kak Z, Nayli seghonok jumpa Kak Z hari ni. Lama tak jumpa Kak Z". As usual, she prefers to be covered with a blanket. When I went away to get her blanket I was surprised to see her standing beside me. "Bakpo Nayli ikut Kak Z?", I asked her. "Nayli takut Kak Z pergi", she answered. She missed me, and so she said. She followed me wherever I went. The thing about my body is I get hot flushes randomly. Not sure why. Nevertheless, she was always grasping my hand so tightly, as if she was afraid I would disappear anytime. When I completed her recall visit and pushed her blanket aside, she looked at me as if she wanted to say something. She's a very quiet girl. She wouldn't talk to you unless she's comfortable with you.

"Kenapa, sayang?".

"Kak Z, nanti kita pergi makan dulu sebelum papa sampai boleh? Lepas tu kita pergi tengok buku okay?", she recalled.

"Alamak, Nayli, papa kata dah nak sampai. Nanti papa marah".

"Kak Z, call la papa. Cakap kat dia. Nanti mesti dia wi", I would call her father if Nayli and her sister insisted on tagging along with me during my lunch break, but unfortunately, it was 4.45pm already and all shops and cafe were closed already. While filling up certain documents, again, she looked at me while twisting her fingers.

"Nayli nak duduk atas peha Kak Z?", I asked. She didn't answer but climbed onto me instead. She was wearing rubber gloves I gave her. "Kak Z, Nayli nak jadi doktor kiki macam Kak Z", and she imitated the way I usually flex my fingers whenever I put my gloves on. I laughed. When her father arrived, I brought her to his car and carried her onto that Triton. "Bye, bye, Nayli. Kalau datang KL oyak la ke Kak Z okay?". "Bye bye, Kak Z! Nayli sayaaaaang Kak Z", she waved, kissed me on the cheek, and started to cry. "Papa, bawalah Kak Z naik kereta". I could only smile and waved back. No words can describe the love I have for this little girl. I always admire the way Kak Na and her husband brought these kids up to be such loving people. 

Yet another meaningful moment in my life.

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