Upstream
A stitched panorama of (I think) about nine photos from my 50mm lens.
A stitched panorama of (I think) about nine photos from my 50mm lens.
There wasn’t yet any natural snow on the ground up in Lutsen, but they were working on the snow machines, so the sidewalks had a nice coating of faux snow.
We were watching the odometer get closer and closer to the six digit milestone. I came home from work, and there was just over a mile left, so I waited for Mykala to get home… and yep, we drove aimlessly for a few minutes and made it.
Now, I have to get all the problems fixed on the car.
With my head in the sand of school, the world turned around me, and I kept my horizons narrow and focus tight. What I failed to realize was, well, mortality. You’re young and learning and the last thing you think of is your body—it does what you ask it to do, and it doesn’t sideline your plans with pain, inflexibility, or hospital stays.
My father is fighting cancer. My aunt died. My German teacher died. So, when Mykala and I drove back from Lutsen a few days ago, I looked a the gray sky a little differently. What would it be like if this winter was your last? What if this blizzard is the one you have to remember, and all others will just be walks you take in your mind? What if this Christmas marks the last time you set up the tree? What if, sometime soon, you’ll have to conjure the scent of balsam in your memory, hoping it will mask the acrid detergents and ethanol hand cleansers?
I want to understand the preciousness of my life, but I haven’t been able to do it consistently. Just one look at the bank statement or the loan consolidation, and I’m pulled right back into the everyday concerns of life. Out of the experiential and into the narrative. Yet I hope to avoid the amazing hypocrisy of both Ben Franklin and Samuel Pepys in my personal writing—they always seemed to espouse the virtues of qualities they did not have.
Anyhow, I’m listening to Bon Iver’s Re: Stacks, and Mykala is on her way home. This, too, is precious.
Unaccustomed as I am to air travel (“Oh my god I’m flying! I’m in a chair in the sky!”), much less business travel, it was a mostly new experience to go out to Boston this past Sunday and come back a little over 24 hours later. The purpose of my trip was to learn more about the Bicon implant system, and I was actually comfortable accepting a trip, hotel stay, and continuing education credits from a company for whom I do not work. Why? Isn’t that some type of conflict of interest? It could be, but I had already, during my last year of school, done the research and decided that this system offered the best dental implants for most situations.
Leaning heavily on the experience of professors I trusted, I made the Bicon choice, and I’ve decided to relentlessly pursue this thing—not to stop until I get to a job where I can work with these implants regularly. I’m happy doing dentistry, but sometimes I get, frankly, pissed off and kind of offended with the profession; I keep seeing teeth break off, get fillings, break off further, need root canals, get covered with crowns, break off again, need another root canal and a post and a crown, with each time period between major dental interventions shortening. It is, in my opinion, absolute insanity that insurance will pay for some of the bat-shit crazy treatments people get to save their “natural” teeth, when an implant will serve their needs (chewing, not hurting) for far longer, and cheaper over that time period.
So, the implant treatments I want to see patients get, the ones that last, the ones that are a good investment and represent the best our profession has to offer, are not covered by insurance. I don’t know how to fix that problem, and this isn’t the time, but I do know it’s time for me to learn everything I can about implants.
So, let’s see, where was I? “Charting the right course,” that’s it. I ended my last post with that seemingly-dull platitude, but I realized I hadn’t fully articulated that idea. Here we go.
The more I work building tiny things in a very forbidding environment, the more I value planning and preparation. Bah, here we go into platitude country again. Let me try again: you can’t do good work on a bad foundation. That’s better. Yeah, let’s run with that analogy.
Let’s say you’re a general contractor, and you know your materials and your workers. You know how to get a roof put on exactly right, how to find the best workers to pour (or, assemble from precast concrete) a crack-free foundation. You know where to put conduits so the house can be modified in the future. You who to call to get drywall finished to level 5 awesomeness. So, you get called in at the beginning of a job. “Build a house here,” they say. “But I can’t! That’s a, well it’s a swamp.” “I told the property owner we could do it, so do it.” “Umm.”
Doesn’t matter how nice you make that foundation, or the great things you build on top—if conditions were poorly chosen for the task (building a house), all of your hard work will be wasted. You’ll blow huge amounts of effort and time trying to make it work. The thing was doomed from the start.
On a smaller scale, it’s like asking the area’s best tile layer to redo your shower even though your studs are rotting behind it. The work won’t last! You’ll be disappointed, he’ll be irate. Plan it first!
So, when I say “charting the right course”—this is what I mean. I’m so confident this idea applies to all areas of life, I’ll put it in a blockquote:
Plan twice as much as you work.
Otherwise, you’ll lose confidence, and waste everyone’s time.
Instead of wildly speculating, thoughtfully considering, or analogically writing about life as a dentist, I’ve actually been doing it for the past few weeks. Such a disconnect between writing and experience is precisely the reason I’ve tried to make it so easy to post things in this space and exactly why I am troubled when I do not. That is to say: I don’t want to look back and forget what life was like, so I seek to write it out here. And yet, when I seem to be living the most life, I’m not writing… I’m out living. Like coming back with no pictures of your great tour of Europe, because it was too exciting to stop for photos. I guess I’m someone who isn’t confident that memories in one’s head are good enough souvenirs of a life well-lived.
Immediately after getting married, I wrote little. When I did, it was nothing proportional to the magnitude of life changes I was experiencing. Yet, I remember that period with great fondness — moving in with Mykala for the first time, learning how our lives were going to look together, returning from our honeymoon to a house that was only half moved-in to, yet on its way to becoming a home. My memories of that time are rich, but I wish my writings were equally so.
Now, I am slowly going from being a student to being a not-student. I enter the dental operatory with my mask already on 99% of the time, which has helped to avoid the blatant questioning of my experience or the impossible-to-hide disappoint on some patient’s faces: Oh crap, I got the new guy. Spending all of my work-week in mouths has made me become surer in my actions, which seems to calm down those who may be wondering if they should reschedule with someone else. The other day, I was demonstrating something to Mykala and she told me I was “touching her face like a dentist,” which was actually kind of nice — like, hey, I’m learning some of those subtle things you do when you gain experience!
So, what else would I like to capture about this time; what feeling (that I might remember as a vague sense of this time) do I want to pin down and articulate, sharpening my understanding of “now” for future Alex? Well, I’ve started to get better at handling composite (tooth colored filling material), to the point where I’m actually satisfied with my work. It’s not that it wasn’t OK before, I’m just… insanely picky about my work. Really, really picky. Little stuff, stuff I know patients can’t see, bugs me. I want things to be not just OK, not just long-lasting, but awesome. So I guess I’ve also realized that I am really really perfectionistic, and this drives me from tooth to tooth to refine refine refine. This is excellent news for my career, because I’ve many years of doing the same thing—and that excites me. Most of all, the exposure of going from mouth to mouth, person to person, is helping to hone my instinct for what is normal and what is pathological. Being able to place your patients in a context, put them on a continuum, helps you make better decisions.
And really, I think this is true of any pursuit of excellence: you need to know how what you are doing fits into the tapestry of your profession, only then can you chart the right course.
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