Sunday Morning : putting our problems into perspective

Everyday I hear plights. Not only my own but also those of my peers and patients. I cannot control which thoughts enter my head nor those that may come my way, but I can filter and control the manner in which I interpret them and choose to act upon them.

I think of this past week, I had a patient who has a very difficult cosmetic problem. It's two maxillary central incisors (two upper front mid-most teeth). Like architecture we need to satisfy both aesthetics and function, it must be both beautiful and strong. Just like architecture often times it is easier to renovate the entire space; in dentistry this would often mean re-doing the entire smile. When we renovate the entire space we have more control both aesthetically and functionally. However, full renovation just like in architecture is often too expensive and not practical for our client or patient. Therefore, in this situation as in many I am forced to try to fit what seems like an ill-fitting puzzle piece into this puzzle without anyone noticing that this actually isn't quite the right piece.


1. Previous trauma case with shorted root structure (foundation)

2. Very deep marginal seal due to need to capture ferrule past fracture patient presented with.

3. Covering up Gray metal Cast posts from previous dentist (screw posts as well).

4. Closing diastema patient had her entire life.

5. Closing space that is actually too large for just two central incisors.

6. Closing black triangle space (similar to diastema challenge)

7. Ensuring structure stability with limited VDO (apparent attrition throughout maxillary arch, flattened canines)

8. Meeting aesthetic demands

The try-in appointment was very difficult. The patient was not happy at all with the outcome returned from the lab. I do empathize with the patients situation, this is indeed a big deal it is her two front teeth.

But then I dwell upon this in terms of all of the problems we face, both in perspectives of my own life, her life, my wife's life, and from a worldly view, a grand-scheme perspective.

1. In my own life. I know that this challenge, this problem will soon too pass. Whether the next try-in goes right or not, somehow I will get past this. The path may not be easy but I should find comfort in that I have overcome much more arduous, seemingly un-fixable challenges in the past with great success. There should be no reason I cannot overcome this one. In my own life this is just a bump in the road, but I know I will continue down my road towards life's fulfillment and this is just one event. This is just one experience that is meant to happen to help shape me for life's journey. I should trust that this is meant to be and the only thing I can control is that I myself give this challenge my best.

2. In terms of the patient's perspective. She has a big exam coming up, she is stressed by that. She did not expect another stressor given that the first set of temps went well and smooth with no hiccups. Secondly she has a wedding coming up and is now concerned she will not have her smile for that wedding. I should understand that in the world that she lives in this is monumental and it is not my job at all to open her eyes to any body else problems.

3. In terms of my wife's perspective. I just had a car ride with my wife. It was one day after a very hard week where she was pitted between the egos of two attendees Dr. C and Dr. B. They were very different in style and the connector or the whipping post was my wife given that you cannot blame the patient, so the next closest one is my wife. These lives, the welfare of her patient's, was very much in my wife's hands. She tries her best to advocate for her patient's best interest. Patient's die on her weekly, some who have lived long fulfilling lives and some who have seemingly been dealt an unlucky card too early in their lives. Tied down by bureaucracy, protocols, egos, and the constraint of time, in the end, she works herself to a breaking point, emotionally and physically. I myself cannot do anything to change her situation, but I can be a supportive husband. I can do myself to support and recharge her inner self and outer well being.

4. From a grand-scheme, 100 mile up perspective, both my worries and the patient's worries really don't matter. Refugees are dying every day. Bombs are dropping. People are starving. Ice caps are melting. A moron is the US president.

In some sense we all succumb to a victim mentality. We think that life happens to us in some unfair way that we are undeserving of. I refuse to succumb to this. It is important that I realize that it is how I filter and then express, or as my brother would put it, that rather than react I respond what life throws at me. How beautiful would it be that every horrible situation that comes my way I spin and convert to a beneficial one for those involved and those around me. What greater thing can I do then to change one person, one situation, one at a time. It's all about incremental gains rather than big faith of leaps. I will take this time to remember that.

ps: I forgot to write that this case turned out to be successful! I am sorry I got all caught up in the philosophy of it.

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