Wiser for being at Wise?

I know, that’s a lame attempt at a title.  I struggle for something meaningful.

I am exhausted, drained, dehydrated, and sunburned.  And exhilarated, satisfied that today I did some things good.

I arrived at the site a 5:30 AM.  Some of the volunteers had already been there for more than an hour.  We began seeing people in triage at 6 AM.  We were still finishing up near 7 PM.  

I will try to give a sense of the day, although I fear that as I could not find words for the title, my command of language is insufficient to fully explain.  And I chose not to take pictures.

Please join me as I describe our first full day at the 2010 Remote Area Medical – Mission of Mercy free health and dental mission in Wise VA.

The day began with fog before the sun arose.  Some of the dentists who staying further away, say in Big Stone Gap, began their days driving through fog and darkness on unfamiliar mountain roads.  My ride from the hotel was an easy 10 minute trip.  When I arrived the volunteer parking area was already half full, and the space for those seeking care was almost overflowing.

I know that today in the late afternoon we were seeing people in triage for whom the dentist was the first medical person to be with them except for nurses and medical students who took their vitals and medical history, and some of them had been waiting since the very early morning on Thursday.  

We added a new form for dental this year.  We needed to check the information on their intake forms then attach this form.  In many cases either no medical history had been recorded or it had not been transcribed on the form for dental.  Instead of scribing for the triage dentists I took over responsibility for this paperwork.  Until I got help from a medical student and person who works at the dental program at VCU as a secretary, I was examining the paperwork of all of the people waiting for triage, perhaps several hundred  I really lost track.

I began seeing some patterns that were disturbing.  The number of people with medicines for anxiety disorders and depression was startling.  Then one looked closer and the person was disabled, or unemployed or caring for someone in the family who fit one of those categories.  Imagine taking 5 or more – sometimes many more – specific medications.   They are able to get those meds through Medicaid, but it means they are having symptoms addressed, their conditions are being stabilized, but the underlying problems continue.

I am 64.  I am older that most of the dentists, but there are a few around my age and a good number in their mid 50s or a bit older.  It was interesting to see some of them go largely non-stop for 3-4 hours at a time.

We did have some slowdowns in triage.  We had screened over 200 people yesterday so that those doing treatment –  extractions, reconstructions and fillings, cleanings – would be able to start treating people promptly at 6 AM.  This year we actually began the morning in triage with a full complement of dentists, at times having 6 or seven chairs with patients being screened.  That meant eventually we had to hold off because the backlog in the treatment lines was so great.  And by around 3 PM we were already setting people for treatment tomorrow, and by 4:00 we could not even do further x-rays beyond the people already in line.  

We had at least 4 panorex machines going, and perhaps 3 PAs.  Still, we could not keep up with the demand, because no one was going to get an extraction without an x-ray.  And we had many, many people who needed extractions.

The day was hot and muggy.  At times the temperature was clearly in the mid 90s, with a strong sun.  I had not expected to be dealing with people in the line waiting for triage, did not have a hat, and even with an SPF 45 sunblock got a mild sunburn on my cheeks and the back of my neck.

We tried hard to stay hydrated.  I remember one of the key dentists remarking that he had consumed several gallons of liquid but had not had occasion to go to the rest room –  we were all like that, sweating it out of us.

We thought we had enough water and drinks on hand for the weekend.  We did not.  We were getting very low by evening, with the sun still strong.  At 7:15 as I drove back to the hotel the temperature was still 87.

I do not know where the time went.  There were periods where we were working on-stop,then checked the time to see that another two hours had flown by.  

Wiser for being at Wise?  My title today is in the form of a question. I think the answer is in the affirmative.

In some of the down moments, and at the end of the day, when the local community and some local businesses prepared a nice picnic for us, and there was a greatly appreciated beer truck, I got to learn more about some of the people who have been doing this for many years.  Some work as salesmen in the dental business, yet find time to do four or five or more of these events per year, and having being doing so for the better part of a decade.

The women dentist who has a member of her family dying – she came and worked hard in triage from about 6:30 until noon, and then left.

Another dentist, a former head of the Virginia Dental Association, will not arrive tomorrow.  One of his patients just passed, she had requested he be a pallbearer, and the funeral was today in Blacksburg.  He will be with us tomorrow.

I was surrounded by hundreds upon hundreds of volunteers.  Some like me are lay people.  Dentist, doctors, nurses, dental assistants, students in medicine, dentistry, and in medical support fields. . .  Some would tell you they are doing nothing spectacular.  Others don’t have time to talk about themselves because they want to help more patients.

Yes, people catch up with old friendships.  That includes some of the patients we have seen in previous years.  They remember the dentists.  The dentists often remember them as well.  We have time to find out about one another.

Some bring their children with them –  one dentist in triage is here for the first time, with his daughter handling the paperwork for him.

One of the people I trained for the new paperwork is a medical student in TN, although he lives near Grundy.  He is having his medical school paid for by his local hospital, to which he will return and work.  His wife is already at the pharmacy school there.  

People waiting patiently for hours, in order to get vision checked, or teeth checked.  While they wait perhaps they can have a class in recognizing symptoms of certain medical conditions common to the area.  

We have clothes for the poor, dolls and toys for the young people.

I remember a mother, 24 years old, who was there to ensure her three-year-old daughter got her teeth cleaned.  She did not want her daughter to face what she does –  she is going to lose a significant number of teeth, at 24.  

Today the sun was bright, and hot.  Today there was sunlight of a different kind, the kind that brings hope, and relief, to some who spend too much time without either.

I am told 1500 people were passed through the registration process today.  I do not know if that include the approximately 250 or so processed yesterday.  In either case, it gives you a sense of the scale.

One dentist with whom I worked a lot in triage after I had trained others for the paperwork for the new form had not been here for five years.  He remarked several times on how much the event has grown in scope.  He was dealing with patients here while simultaneously addressing some dental emergencies back home via cell phone.

I am bone tired.  I will probably take a soak in the tub – only wish I had some bath salts.  

How am I wiser?  I am no longer as shocked or surprised.  I do not have time to be such.  My time on site has to be for others, to maximize the time and skill of the dentists, so that the greatest number of people get the most help possible.  

I can make mental notes during the day, to which i can return when I debrief – for that is what this posting is, a bit of a debrief from the day.

I know the need is not going away.  I have already made my room reservation for next year.  I will come in Wednesday night to be able to help setting up first thing Thursday morning.  It will less than $60 to the cost of my trip, and I can be of that much more service.

In the past I wondered if I mattered, if what I did in life made a difference.  I have been very insecure, as perhaps has from time to time been clear in my writing.  

There is a famous tale in Dostoevski’s Brothers Karamazov   Alyosha uses it to  teach a woman.  It is about a woman who had been very bad in most of her life.  When she died her guardian angel looked for some justification to lift her up from hell. He found she had once given an onion to a beggar.  With that onion he began to pull her up.  Only as others grabbed onto her legs, she demanded they let go, because it was her onion.  It then broke, and she fell back into the fiery nether regions.  

I would hope my service here is at least worth one onion.  

And I do not mind if others grab my legs, because really, it is not that I am doing that much.

And that is the point.  It is NOT that much.  And yet it means so much, because of how infrequently we take the time to do not so much.  It should be an ordinary part of our lives.  This may seem like a big gesture.  It is rather small.  But by small things done consistently by many, many more can be lifted up, healed or if you prefer saved.  

I am at Wise. Am I wiser as a result?  Perhaps that is to claim too much.  Perhaps it is only that I am a bit less selfish, centered, self-contained.  That by itself makes for a very big onion, does it not?

Peace.