Another number.

The moon still hung pale over the Lake. It sneered a little then seemed to glow stronger as the snow came down in sheets. The car was slow to start: it gasped and coughed until the engine finally spluttered into life. The driver was tired and very late. He´d never wanted to leave the house but he felt obliged, obliged to be another number in a queue doomed to finish back here in the end.

New snow upon old ice! It cloaked and choked the country road, blurring the ditches and leveling the dips. The bends straightened and where they´d found old Pat dead in his overturned wreck the year before, he braked too hard and lost control.  Clutching desperately, the engine dampened and the tyres took off, they whizzed for a second then floated across the whiteness.  Time slowed; he let go.  And silently the car slid sideways down the road in the stillness of a winter morning.

He didn´t panic, moon – hedge – T-junction – hedge, he simply closed his eyes until the music then thoughts came in steady succession. “Who will buy my sweet red roses? Two blooms for a penny, a wonderful morning. You love Oliver but what was that actor´s name, the one who played Fagin? He reminds you of your Dad, dancing, singing and always smiling. How you miss those long walks on the farm, wellies disappearing in his huge footprints. Will your son think of you in the same way when you´re gone…”

His head was a hive of arcane activity, he whispered to himself as the car spun on. “Shit, you forgot the telephone bill; herself won´t be happy. Nor will she be happy when she hears about this tumour under your tongue. It doesn´t hurt but you should have told her, she´s already suspicious of these early starts and sure anyway, you´ll have to come clean in the end. Or with any luck, this will be the end.” He stopped.

The car had too, the motor cut, it now pointed back in the direction of home.  He gathered himself, removed the wool cap and mopped the sweat from his brow. Relentlessly, the snow fell still in the immense silence of space. And after a moment´s consideration, he started up again, turned the car around and continued into town.

The waiting room was busy with numbers. Knowing looks and long names isolated the professionals from the non-infectious, gloves and masks from their ulcers and lumps.  There was no explanation when he opened wide his mouth, nor when the surgeon pulled his tongue first this way, then that. Few courtesies as the painless ulcer was measured and catalogued and little poetry as the expert felt excitedly for that hard swelling beneath his chin.

Old ice and new snow, he mused, “you´ll tell her this evening so”.

Dr D. Mac Auley.

Published Meath Chronicle 27/03/2013.

Five Years of HSE Neglect

Published Meath Chronicle 24th June 2015. 

In 2010, the Fianna Fail/GP government removed the treatment of gum disease from Medical Card holders. Gum disease can cause bad breath, swollen, bleeding gums, loosening teeth, pain and ultimately extractions. Despite a 2014 survey on oral health showing it now affects 80% of adults, the current government is more than happy to leave nearly one-third of the Irish population with an untreated disease. 

And don´t think they don´t know! 
The government paid for the above study. Leo Varadkar while Minister of Health wrote, “Oral disease impacts on the majority of the population...the prevalence of dental decay and gum disease remains high. These conditions are preventable…” However, he´s not willing to do anything about it, his mates in the HSE are also happy to neglect Irish health. Although their website admits one of the best methods of prevention is a regular “scale and polish that involves having the plaque and tartar scraped away from your teeth with a special instrument, before your teeth are polished to remove any marks or stains”, the HSE fails to point out this treatment is not available to the vast majority of GMS patients. 

It´s not just about teeth! 
Inflammation in your gums affects other parts of your body; its presence increases your risk of heart disease and it´s also linked to strokes. Researchers have found that men with gum disease were 49% more likely to develop kidney cancer, 54% more likely to develop pancreatic cancer, and 30% more likely to develop blood cancers. Failure to treat oral inflammation is having wider health impacts on people abandoned by the state. 

So, why aren´t people up in arms? 
Unfortunately, gum disease has few notable symptoms until it is too far gone – loose, painful teeth that need extraction. There is also a lethargy within the dental profession to deal adequately with a disease that is so prevalent; the government isn´t exactly leading by example. In addition, successful treatment of gum disease requires a commitment from both parties – dentist and patient. Although I´ve threatened it often enough, a dentist can´t be stood looking over you every night when it comes to floss those lower molars. 

Early gum disease

I´m a Medical Card holder and think I have gum disease. What next? 
Firstly, get a diagnosis. The next time you go to the dentist, ask him/her if you have gum disease – request it in writing as is your right. Once you have the confirmation inform the HSE – best to also do this in writing. Now you are in a stronger position, the government is aware you have a disease that they are refusing to treat. If your condition worsens, which is very likely, then they have a substantial liability should you wish to seek compensation in the future.
In a recent compensation case, a 51-year old man from the North of England successfully sued his dentist when he failed to diagnose and treat his gum disease – he received £20,000 in settlement. 

Maybe the current government will understand measuring people's health and well-being in terms of monetary value can be a double-edged sword.

Dr Don Mac Auley.

Toothache.

Published Meath Chronicle 21st October 2014.

He switched on the bedside lamp, the clock beamed 5.22am. It was now seven minutes since the man had become acquainted with his pain, yet he still didn´t know it. His thoughts flustered over damp floorboards, the warm air forcing him outside. A streetlamp puddled rainy light upon the stairs, the bannister led down, down until he landed in the kitchen. With the first mouthful of whisky the discomfort eased and suddenly he became aware of its absence.

As the storm abated he now felt alive and tingling like an electric fence. In the toaster´s reflection he drew back his lips to see canines project from a cloud of tartar, rattling each molar without joy, the gum looked red but that could be the light and anyway his tongue had already failed to find any cavities. He finished the glass and took off again.

At the door, the queasiness returned. Square miles of waves began to roll and pitch their heaped suffering upon his lower jaw; the pain swept him back to the table. Gently cradling his head, he popped pill after bitter pill, drowning each one in alcohol. He waited for the miraculous transition but it never came. Chaos and treachery reigned. The gates of misery opened and so started a slow, monotonous descent to hell; the man dug his nails in. Then he made himself small to resist the pain however it multiplied quickly, extending its territory until throbbing radiated from above the temple all the way down his neck.

With his head flat on the table between two bags of frozen peas, he tried to stop the advance. Contorted and gasping, he struggled again for clarity. At 6.38am, the analgesic Cavalry arrived. He welcomed them, whooping and chuckling as the pain receded but he could soon tell by their poor equipment and lack of numbers that the relief wouldn´t last long; the man grabbed the phone and dialled her number.

He heard himself imploring repeatedly “Hello? Hello? Hello?” even before she´d answered. “What do YOU want” she finally responded recognising his voice “Do you know what time it is?” “You´ve got to help me, I´m in agony…please…” She cut him off, “We´ve been through this a million times”. “But, you don´t understand, my tooth is killing me, I can´t stand it any…” Before he could finish the sentence she´d hung up. When he rang back he got a high-pitched melancholic drone that penetrated his ear, down his jaw and the ache stirred again.

Back in the bedroom, it grew worse. The dentist would be open in two hours but the man knew how he´d react from painful experience, “Don´t be a coward, man, it´s only an abscess. If you can stand a small injection we´ll take it out for God´s sake”. He could see it all clearly now, he had entered a new state, the agony had revealed his reality – he was weak and completely alone.

After that, the pills didn´t taste so bitter.

Dr Don Mac Auley.

Spinning a jig.

Published Meath Chronicle 23th April 2014.

If, in public, you´re used to flipping your nipper bottom-up to sniff his latest offering or your “wheels on the bus go round and round" all the aisles of the local supermarket then you could be accused of baby bliss; that complete lack of self-awareness parents wear with such ease, as if your little one had infected you at birth. And often to reach out to him you too regress to being an infant, squeaking, gurgling, thrumming and fee-fi-fo-fumming. You develop your act, first in private, on the bed or sofa until you take it on the road. Before you know it you´re just another street act, with a captivated audience of one. One that will smile and laugh while others whisper and stare.

But don´t take your unique fan for granted as research now shows that even newborns, despite their unfocused eyes and lack of coordination, have built in body awareness and can even learn in their sleep.

At the University of London researchers showed that when healthy newborns were shown a video of another baby´s face being stroked by a soft brush, at the same time as their own face was stroked by a similar brush they showed interest. When the video was played upside-down or the stroking was time delayed, the newborns were less interested. They concluded young babies have the ability to differentiate themselves from others - when what babies see in relation to their own bodies matches what they feel they can empathise just as adults do. Another study looked at sleeping infants just 1-2 days old. Scientists played a musical tone followed by a puff of air to their eyes 200 times over the course of a half-hour. Rapidly, the newborns learned to anticipate the puff of air upon hearing the tone by tightening up their eyelids.

So what does this mean for your distracting performances? Well, you´ll have to find new material, better routines and like every entertainer gauge the audience´s reaction, as unpredictable as it may be. For example, the other day I thought I´d brighten up the baby´s mood by showing him his reflection in the mirror; it had always worked with the dog who barked and threw mid-air tilts. At first, the baby really stared as if he didn´t recognise himself, then he put his hand up to his chin like an auld boy rubbing stubble between chubby fingers. Still looking in the mirror he wasn´t rubbing, I realised he was cleaning. The rediscovered carrot was off his chin and in his mouth before I could scrape my own chin off the floor. He gave me one of his big, thoroughly entertained smiles.

“Hey diddle diddle” seemed hollow after such a humbling experience. Like half of Ireland I had the DVD somewhere so I´d have to dig it out. Twenty years was a long time ago, worn legs and tired shoes, but it would really blow him away. It may also explain why you see your dentist jigging his Riverdance between the aisles in Tescos!

Dr Don Mac Auley.

Total recall.

Published in Meath Chronicle Tuesday 27th August 2013.

There was no respite all morning. Only a child remained before lunch, a loose milk tooth that must be numb by now.  The kid hopped in the chair and with his father sat opposite, the dentist searched for the offender.  They usually fall out on their own, he thought, but this one had stubbornly hung on – disrupting sleep and breaking habits. The dentist stroked his glove over tiny teeth, the child´s bruised tongue leading the way until he felt the culprit fidget between his fingers. Hesitating, he looked up at the child´s father, his familiar expression and the sharp edge of the baby tooth sent a shudder through him.

The dentist´s stress and hunger left him, an exquisite warmth rose in his stomach. Suddenly joyful, he saw himself reflected in the child´s eyes. Time became invisible; he felt the wobbly tooth with his own tongue, the ease of its movement back and forward as he rubbed its rough under-surface, a metallic taste filled his mouth and he looked up into his own father´s soft, hazel eyes, knowing this man would always love him and never do him harm.

He was calm watching his father deftly make a loop in the black thread, stout fingers working their magic, explaining as he went, “a loose tooth is like having a stone in your shoe, son, you can shift your weight or wiggle your toes but at some point you´ll have to take off your shoe and remove it” and with that he handed over the noose which the son placed around the tooth. The father gave him the end of the thread and watched intently. The boy never flinched under those caring eyes, the tooth was out and the father threw him proudly upon his shoulders so he was taller than himself.

The dentist recovered. Smiling at the little boy in the dental chair, he popped the milk tooth in an envelope. The father gave his son a big thumbs-up as he jumped off in delight.  “Didn´t I tell you wouldn´t feel a thing”, he beamed, “I´ve been coming here for years, he´s the best dentist”. “Look, look Daddy, for the tooth fairy”, he held up the packet and then tugging at his father´s coat, “Daddy, Daddy, I want to be a dentist when I grow up”. “Well son, not everyone can be a dentist, you´ll have to study hard at school”, he patted his son on the back and they headed for reception. 

But the dentist had broken his contract with habit. Now, he would have to rebuild it all, recall a difficult youth, suffer his father´s death, escape the North, treat an infinite number of patients and learn his trade. Until then, he would return to the surgery riding upon those strong shoulders, sob some and think to himself - you need a lot more than hard study to be a dentist.

Dr. Don Mac Auley.

Raising fears.

Published in Meath Chronicle Tuesday 23rd july 2013.


They´d been shouting in whispers all morning, her younger brother hadn´t noticed. Yesterday´s clothes gave off a musty odour adding to her tiredness while downstairs the parents batted looks of scorn over cereal bowls as she umpired their silence.  Still unaware of the game she hoped things would improve when Dad finished his coffee and left for work.

They didn´t; the car was tense. Finally, switched on to the situation, her brother resorted to needy mode. He suddenly became useless, fiddling with his seatbelt and complaining his shoes hurt. Up front the mother crunched through the gears and the traffic. The girl undid her own seatbelt to loosen her brother´s shoelaces and make sure his belt was secure. “Your father won´t be collecting you after school today”, the mother declared as she huffed before another red light, “I will”.

Distracted and tapping the steering wheel, “You know every night when we brush our teeth. Well today, you´re going to visit the man who makes sure your teeth are okay. He´s called the dentist” she hissed the final syllable, a screech of tyres ending all discussion.

Her girlfriends shared their dentist stories during break. Most were positive so she felt better when her mother returned at home time. Her brother was already in the car with his tired, hungry face. They parked up and the little boy was deposited roughly in his buggy. The mother was oblivious to the tears that streamed down his hot cheeks so the girl grabbed his hand and squeezed, wishing she too was somewhere else.

In the waiting room, they waited their turn. The mother tore sweaty fingers through countless magazines, reading none of them. When a smiling lady opened the door and called the girl´s name, she jumped up from the sofa, tripping over herself with excitement, and fell hard on her knee. The mother rushed to her rescue. “You´re okay, darling. Don´t worry it´s only a scratch, it´s fine”, she reassured rubbing the fresh bruise.

The mother looked up at the nurse and her caring expression evaporated. She shrank back; returning to the magazines where the toddler recorded everything through half closed eyes. Despite the storm of confusion brimming in her brain, the girl took the nurse´s hand and left her mother, her brother and the waiting room. She repeated the nurse´s words over in her head, “such a brave girl”, “such a brave girl”.

“What´s your name?” asked the dentist giving her a big smile as she jumped up on the chair. “It´s your first time with us but where are your parents?” “They´re scared of the dentist”, she replied in that honest way kids only know. “They had a row this morning because my dad didn´t want to bring us. My mam is too nervous to come in and my younger brother´s pretending to be asleep…But I´m not scared, I´m here for my check-up”. And she opened her nearly four-year-old mouth as wide as she could.

The thin veneer

Published Meath Chronicle 26/06/2013

After all these years, the receptionist watched the dentist finally sign the papers. She whisked them up, packed them into an oversized envelope and presented it back to him. He threw her a tight-lipped smile and headed for the post. As the glass shuddered after him, she recalled those signs from her college days in London, grubby signs hung in hotels and guest house windows, often hand scribbled yet still carved in her heart.

Heavy clouds hovered overhead, the air was saturated. A few hardy types well insulated against the elements led the way. Mid-morning breaks never used to be a reality but since the bubble burst he had time on his hands, too much time. Scurrying past the shopping centre he clutched the envelope as if his future depended on it. At least the older clients hadn´t abandoned him. Yet he still felt a little embarrassed when they enquired about business. He didn´t enjoy lying to them, nor to his family for that matter, however the signs were there – flaking paint on the exterior, the patched-up equipment and same-day appointments always available. Most knew his prices hadn´t budged in years; those that complained weren´t sent reminders. After all, he was an experienced dentist and deserved every penny he could wring out of them.

The queue at the post office was moving well until the waves of doubt rolled in again. Suddenly, he felt like an old cloth, once useful but now scrunched up and discarded to dry and wither in some window where one day, if someone should find and try and open him up, he would simply crumble to dust. “Was this envelope the answer to his troubles?” The question still hung on the line when a retired colleague interrupted his thought convention. This good old boy was in great form, having sold up before the crisis, he praised his friend for holding out.  Heads turned as the old-timer worked himself into a lather of criticism against other dentists in town who had dropped their prices, practically foaming at the mouth on the subject of websites and patients shopping around.  “That never happened in our day, eh? If they didn´t like it they went up North, now the Northerners are down here!”

Distracted by the commotion, he didn´t realise he was now hiding the envelope behind his back. Until the old boy spotted it, “What have you got there?” The other retreated, his face reddening with every step towards the door. “Hey, where are you going…and why aren´t you working this morning?” the sentiment squeezed him into the street. He ran for it. 

The receptionist saw him coming. Her heart sank at the sight of the envelope containing the application forms. Those signs from her youth came flooding back – "No Blacks, no Dogs, no Irish". She trembled as she touched her own envelope deep in her tunic´s pocket. Resignation or overreaction, thoughts of family kept it hidden.  The dentist stormed in, refusing to look her in the eye, he casually straightened his sign in the window, it read – NO MEDICAL CARDS.

Dr. Don Mac Auley.

Fear of the dentist.

Published Meath Chronicle 19th February 2013.

An invisible cap tightened its grip around her head as the first rays climbed the curtains and painted the walls. She was blind with sleep. The whole night twisting and turning, she huffed and puffed then cursed the day ahead.  Handfuls of water failed to restore her distorted image in the mirror and squinting against the naked light she plastered those wrinkles she could no longer ignore.

Downstairs, the cats eyed her with concern. She was unable to speak; they knew it and kept their distance. Fighting with her belt, she stamped in frustration sending them scurrying for the safety of the sofa´s shadows. And there they stayed, secretly conceding that today they weren´t coming out until she was gone. The woman stormed down the coffee, burning her throat but when the caffeine kicked in, she felt a little better. However, she couldn´t relax as the dread came again in waves.

Five minutes of frantic bag searching later, she was in the hallway. Outside the air rippled with cold. The spring sunshine distracted her from where she was going and she sparked up a cigarette.  Climbing the hill to town, she puffed deeply. Her heels echoed ahead drawing admiring looks from workmen busying in the opposite direction. Despite the attention, her ego dwindled as the destination loomed. Maybe they´d discover her vice, she agonised and flung the lit butt to the ground, breathing in and out furiously to get rid of the tobacco smell.

When the woman arrived, she was gasping and doubled over. She caught her hunched silhouette in the reflection of the door and set about straightening her clothing.  She thought, “I don´t have to go in, I can leave now and cancel by phone”. But her finger resisted, pressed the buzzer and when the video intercom crackled into life it was clear there was no going back.

Like the condemned to a gallows, she climbed the stairs. The receptionists had seen it all before and greeted her with a smile and much encouragement. While their smiles seemed genuine the disinfectant smell tweaked her bladder, she fled for the toilet. Safely inside, she bolted the door and rallied the troops. “This is stupid, it´s not as if you haven´t done it before, come on now!” Pulling herself together, she put on a brave face in the mirror and washed her hands,  “Stop fretting, everything´s going to be fine!”

Outside her name rang up and down the corridor. She took a deep breath and walked directly to the room at the end, her head swimming with possibilities. It was too late for further hesitation; she went in and sat down. There was a knock at the door, a man entered and she recognised the same brave face. He was her first patient of the day.

The Beautiful Game.

Published in Meath Chronicle 27/11/2012

Recently, a dentist who´d worked with Navan Dental for several years handed in his notice by leaving a message on my answer machine. At least, he didn´t tweet it or post a message on Facebook. When asked later why he had decided to leave, he answered, “this is simply business, it´s nothing personal”. The same person could not understand why staff members were so upset when they found out the news.

The reality is that business and work are personal. If you work an eight-hour day you physically spend more waking time with your work colleagues than your partner. A busy dental practice is like a football match but each half lasts four hours instead of 45 minutes. The dentists may be strikers however without the defenders and goalie they´d never see the ball. As social creatures we rely on the help and friendship of others. From our family nests we soon spread our wings and learn to fly with others of our own age: helping, trusting and sharing the challenges and fun of life.  Growing up we develop the social skills to become team players.

The reaction of the dentist in question reminds me of my childhood days when a new kid showed up on the block to play football with us. We welcomed him into the gang but it became obvious he hadn´t much experience of playing in a team. He wanted to hold the ball and dribble a bit but there was little time for such carry-on in a tight five-a-side game where one-touch and pass not only honed your skills, it also saved your ankles. When he showed up again the following day he brought with him a shiny-new, leather football. Our mouths hung open at its perfect roundness, up until then we had been playing with what can best be described as a semi-inflated naan bread which required pumping every ten minutes.

We took turns setting up free-kicks, bending the ball around a wall of eager youngsters and it worked; it was just like Match of the Day. Next, the newcomer showed his prowess at keepy-uppies but we were so fired up to get on with the game we paid him little attention. Bouncy and unpredictable, the pace of the game was electric and having less time on the ball, the competition grew intense and exciting. Verbal communication dwindled, it became unnecessary, we knew our weaknesses and strengths, we knew what we could do and we knew each other. Except our new mate whose impatience knew better, he snatched up the ball and roared, “it´s nothing personal, but this isn´t football”. He took his ball and stormed off home. Meanwhile, we re-inflated our naan ball and started the game again. Later we clubbed together our pocket-money and bought a new ball. Today, we still remain dedicated to a great team; in my opinion, the best.

Dr. Don Mac Auley  -  navandental.ie