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A Winter’s Tale – A Seasonal Dental Anaesthet
So it was going to be a White Christmas after all. Snow had started to fall through the dwindling twilight of that crisp afternoon in late December, covering the rooftops and pavements with a light powdery dusting. Wrapped up well against the chill in my duffel coat, woolly hat and gloves, I trudged on in silence leaving a trail of footprints in the freshly fallen snow. “Perhaps we could make a snowman in the garden?” said my mother. I nodded. My mother kept up a flow of jolly and distracting conversation as she led me through a maze of broad streets lined with once-imposing Victorian terraces. Finally we turned off the road and into the driveway of a brightly-lit house. Beside the front door was a brass plate bearing the inscription `J.C. Williams BDS’. We had arrived at our destination. It was almost Christmas, and like all nine year old boys I was eagerly anticipating the start of the festivities.
But that year, the approach of the Christmas holiday had been overshadowed by an intractable problem. I had managed to break one of my few remaining milk teeth. The stump was not only painful but bled constantly. An urgent visit to the dentist was clearly in order, but for me that posed a major difficulty. The very thought of going anywhere remotely near a dentist’s surgery, yet alone having any treatment filled me with extreme dread. My big problem with dentists had started when I was about five years old, I had undergone two very traumatic Gas anaesthetics at our local `Health Clinic’ for extraction of some decayed milk teeth. The experience of being held down in the chair and smothered with a stinking black rubber mask had haunted me ever since. Such was my dread of dentists that I had concealed my broken tooth from my parents for several days. Then my gum around the tooth had started to swell. When my mother noticed my problem her immediate reaction was to `ring the clinic’ (i.e. the health clinic where I had previously been gassed), but my profound panic at that suggestion gave her pause for thought. After a few minutes debate about what was to be done about my tooth, and the problem of getting a dental appointment close to the Christmas break, she said that she knew of a dentist in the north of our town. He was apparently very good with c***dren. Perhaps I would prefer to see him? I was still terrified at the prospect however, and so she said that she would first telephone and make sure the dentist would see me as a new patient, and she would also tell him how I felt about having treatment so that he would be very kind to me.
The following morning my mother was up and about rather earlier than usual. She made several telephone calls, and then immediately after breakfast walked down to our family doctors practice. She returned clutching a small brown bottle marked with my name and the legend of the local pharmacy, and labelled `Valium 2mg’. I looked curiously at the bottle which contained six small yellow tablets. She explained that our family doctor had prescribed these so I would not worry about seeing the dentist. I should take one tablet right away, another in the afternoon and one more before bedtime. Tomorrow, I would have one following breakfast, and then take the last two together in the afternoon, about an hour before my appointment with my new dentist Mr Williams. Her last statement had made my blood run cold. I could still visualize the ginger-haired dentist at `the clinic’ advancing toward me with the black rubber anaesthetic mask in his hand. Maybe it would be better this time? My mother poured me a glass of water, and I reluctantly swallowed the first of the tablets. The only discernable effect the tablet had on me was to make me feel rather drowsy.
Everything seemed fairly normal when I was moving around, but when sitting quietly or watching TV I found myself either daydreaming or drifting off to sleep. That night I went to bed earlier than usual, and having taken another tablet slept soundly until late the following morning. I awoke to find breakfast already underway, and scrambled downstairs for orange juice and toast, and yet another pill. Then I was told I could have nothing more to eat or drink until after my dental appointment. Nothing that is apart from two more pills and a sip of water as we left our house that afternoon for the dentists. My mother pushed open the big front door of the dentist’s house and guided me inside. The entrance lobby smelt of floor polish and disinfectant, and at its end there was a receptionist’s window where my mother went to announce our arrival. There was a brief conversation about the time of my last meal, a consent form to be signed, and then it was into the waiting room.
Apart from my mother and myself, the room was deserted. There were comfortable padded chairs and a table covered with faded magazines and comics. Normally, I might have taken an interest in the latter, but the two Valium tablets that I had swallowed in liu of lunch were exerting their full effect. Nothing seemed to worry me much anymore, but at the same time everything seemed too great an effort. I recall standing looking out of the waiting room window at the snowflakes settling into the front lawn. How much snow did it take to build a snowman? I wondered. “John – We Are Ready For You Now”. A womens voice startled my out of my Valium-induced reverie. I looked up to see a nurse standing in the open doorway. I was immediately struck by the brown rubber bib apron she was wearing over her white uniform. It was just like those I had worn during my previous gas appointments at the dental clinic. [Rubber aprons were also kept in the classroom at my school for art and craft lessons. Since my earlier dental experiences I had often worn one in class, even when it wasn’t strictly necessary. Strangely, I had found that I liked the snug sensation of the bib hugging my chest, and the feel of the cool rubber on my bare knees and forearms. That and the soft rubbery smell, which always brought back memories of my gas experiences].
The nurse explained to my mother that I was going to be a `Big Brave Boy’ and see the dentist all by myself, and with that she led me out of the waiting room and up a flight of stairs. The surgery was located on the first floor, and I climbed the stairs guided the nurse. When we got to the landing she helped me to take off my duffel coat, tucked my woolly hat and gloves into its pockets and then showed me into the toilet to `see if I could go’. When I came out of the toilet the nurse was waiting outside the door, and she led me into what looked like a big cloakroom. There was a plastic-covered couch, a small sink, and just inside the door was a wooden hat-stand on which my duffel coat was now hanging. In the corner of the room next to the couch was a tall round object covered with a cloth that I could not identify. There was also an assortment of rubber aprons and bibs in various colours and sizes dangling from a row of pegs on the wall. The nurse selected a brown rubber apron for me to put on. Wearing a rubber apron was of course something that (secretly) I didn’t mind at all. I pulled the loop of the apron over my head and the then nurse had me turn around so that she could do the ties up tightly around my waist. That done, she ushered me through a door at the end of the room with the cold rubber of the apron flapping against my bare knees. I walked through the doorway and found myself in a modern and well equipped dental surgery. In the centre of the room was a blue and chrome dental chair which looked quite different from the black sinister-looking monstrosity that I remembered from my visits to `the clinic’.
However, positioned behind the chair was what could only be a modern-looking anaesthetic machine. I had expected to see a gas trolley somewhere in the dentist’s surgery, but the sight of the machine evidently prepared for my appointment still came as a big shock. I stood transfixed, and despite the effects of the Valium, felt a hollow pit opening up in my stomach. I was still staring at the gas cylinders, the loops of corrugated tubing, the breathing bag and the black rubber face mask, when I heard footsteps behind me and Mr Williams walked into the surgery. The dentist was a man in his mid-fifties, with kindly eyes and a warm and genuine smile. He introduced himself, guided me towards the chair, and asked me about my `little problem’. A detailed inspection of my teeth followed. I was a new patient and a set of dental records had to be generated from scratch, Finally, after what seemed like an age, the dentist completed his poking and scrabbling around in my mouth with his assortment of instruments, gathered up my notes, and went off to see my mother in the waiting room. When Mr Williams returned, he explained that the stump of my broken tooth had become infected, and that meant an extraction. A local anaesthetic injection would be very painful, and because of the inflamation it would also not work very well in numbing my mouth. He had discussed this with my mother, and she had agreed that I needed to have `a whiff of gas’ to have the tooth taken out.
Everything was ready for me, and all that I needed to do was just lie back in the chair and take some deep breaths from a mask. Then I would fall asleep and when I woke up my bad tooth would be gone. Seeing my evident distress at this prospect, and having no doubt been warned of my aversion to dentistry by my mother, he explained that having gas needn’t be unpleasant with the modern techniques and equipment that he used in his practice. And with that, he rolled the gas machine around to the side of the chair so that I could get a better look at it. It looked very new and shiny. He pointed out various parts of the machine including the black rubber bag from which I would breathe in the gas. Finally he picked up the mask from the hook at the front of the trolley and let me hold it. It was jet black and shiny and marked “Anti-Static Size 3”, and connected to the gas machine via a length of black corrugated rubber tubing. Between the tubing and the mask there was a thing like a big flat metal screw that the dentist said was a special valve through which I would breathe out. Mr Williams stood beside the chair holding the mask in his hand and I sensed that my gas experience was about to begin.
He explained that would give me some oxygen to begin with, and that when I had got used to breathing from the mask he would gradually introduce some `laughing gas’ a little at a time, and I would gradually become drowsier and drowsier. This, he said, would be a bit like like falling asleep in my own bed. Then when I was very drowsy and not really aware of what was happening, he would give me a new gas called `halothane’ that his practice had just started using. That would send me deeply asleep so he could take out the stump of my broken tooth without hurting me. He adjusted the oxygen flowmeter on the anaesthetic machine, and I saw the bobbin rise in the tube and spin in response to the oxygen flow. A steady hissing sound emerged from the mask. “This Is Just Oxygen” he said, pointing the black rubber mask towards me. “Are You Ready?”. I had little choice but to nod. Slowly, the softly hissing mask loomed up before my face, and I felt the cold breeze blowing up the corrugated tubing from the machine. But unlike my previous gassing experiences there was no horrid smell – just a rubbery aroma like that coming from my apron. Closer and closer the mask came, covering my nose and mouth gently and then snuggling down to make an airtight seal with my face. “Breathe Deeply” said the dentist after a pause, and pointing at the breathing bag “Watch The Balloon Here”.
I took a cautious sniff, then a shallow breath from the mask, and smelled only rubber. Then I looked out at the gas trolley over the cuff of the mask as I breathed out. The black rubber breathing bag bulged and as I finished exhaling the mask pop-off valve hissed softly making a distinctive `pssst’ sound. I continued to breath quietly, taking deep breaths of rubberized oxygen from the mask. The gas trolley kept up its steady sibilent hiss, and the breathing bag rhythmically bulged and contracted. All this time Mr Williams talked to me in his gentle reassuring voice, reminding me that it was only oxygen that I was breathing, that I needn’t worry, that I should just sit quietly, breathe deeply and relax. I sat quietly in the chair, looking up at the dentist and breathing steadily into the black rubber mask he held over my nose and mouth.
The inflating spigot on the mask was right between my eyes, and the wide corrugated tube ran across the bib of my rubber apron and on towards the breathing bag hanging on the front of the gas machine. It was all so very much like my first gassing, and yet at the same time it felt so different. I am sure the Valium played its part, but no one held me down, there was no use of force and no sense of urgency or haste. I felt that my consent was being sought for everything that was happening to me. Whereas I might normally have shuddered at the thought of sitting in a dentist’s chair, wearing a brown rubber apron and having a black rubber anaesthetic mask on my face, now that it was all really happening it didn’t bother me – at least not too much. Only the immediate prospect of breathing the gas bothered me. I remembered all too clearly the roller-coaster ride of my senses that it would take me on as I headed towards gassy oblivion
“Time For A Little Gas” said Mr Williams, echoing my thoughts, He patted my shoulder reassuringly, and then turned the blue rotameter tap on the trolley sending the bobbin soaring into the top of the tube. The smell inside the mask changed to a distinct sweetness. Mr Williams continued to talk quietly to me, looking down on me in the chair, watching my reaction to the gas, guiding my breathing. I sat quietly in the chair, with my hands now being held gently in my lap by the nurse, taking slow, deep breaths of the gas like I was being told to, and watching the black rubber breathing bag on the gas trolley rhythmically bulging and then contracting. The bib of my brown rubber apron hugged my chest as I breathed deeply in, and the mask valve made its sibilent `pssst’ each time I breathed out. I watched as the dentist began to adjust the flowmeter settings every few breaths, and as he did so the gas mixture that I was breathing gradually become stronger and stronger. At first I began to taste as well as smell the sweetness of the gas. Then, after a few more deep breaths, my hands and feet started to gently tingle and my ears began to buzz. I looked out over the cuff of the mask, watching the dentist and nurse smiling down on me, seeing the breathing bag on the gas trolley rhythmically pulsating away. Still I breathed the gas, the sweet stupifying gas, deeply and steadily. I felt the tingling sensation spread slowly up my limbs until it reached my chest, and then as it swept onwards up my neck the buzzing in my ears rose to a crescendo. Still there was no panic, no sense of being suffocated. I knew and understood what was happening to me. “Breathe . . .” Above the all consuming tingling buzz of the gas, the dentists voice reverberated gently in my ears. I felt acutely aware of everything around me. The sickly-sweet taste and smell of the gas filled my mouth and nostrils. I could hear the steady hiss of the gas trolley, the sound of my deep rhythmic breathing and the mask valve venting towards the end of each breath. My limbs felt as heavy as lead. I stared fixedly straight ahead at the clock on the wall opposite, trying to see how long it would take for the gas to subdue me. The clock hands appeared to be jumping and dancing around the clockface at random, pausing just long enough for me to almost tell the time before jumping to a new position. All this time my eyelids were slowly getting heavier and heavier. “B r e a t h e . . .” Still I heard the dentist’s voice echoing through the deepening fuzz. My lungs pumped away at the gas but they no longer seemed to be under my control. My eyes slowly drifted shut.
Then came a different smell, thick and cloying, flooding my nostrils and filling my lungs. I felt my body take a big deep breath, and then all the external noises and sensations faded completely away. My mind became a red and yellow wall of buzzing stars and I was lost in a void where none of my senses functioned. Then I heard a distant voice calling my name from far away. Then it came nearer and nearer but still I couldn’t understand what else it was saying. I realised I was lying on my back, tried to get up and felt the ground somersault like a funfair ride. I tumbled, and then I was lying down again looking up at a ceiling not knowing where I was or what was happening.
The face of the nurse appeared standing over me. I remembered being at the dentist, having the mask on my face, being gassed. But the mask was off. I was waking up. I lay in the chair feeling very woozy and probing the hole in my gum where my tooth had been with my tongue. It felt huge, and my mouth was very sore and full of a salty taste. The dentist kept appearing in my field of view, making reassuring noises about my tooth being out, and it being all over. I was still to groggy to really respond. After a little while I recovered a bit and could start to sit up and look around. The gas machine was no longer beside the chair, and in its place was a wheelchair. The dentist and nurse gently lifted me into it, and I was pushed into the room that was adjacent to the surgery and lifted onto the black plastic couch. What I had imagined was a cloakroom was in fact the recovery room for the dental practice. My mother was there looking somewhat anxious, and I was very glad to see her.
The nurse removed the d****s from the tall object next to the couch to reveal an oxygen cylinder. She said that she would give me some oxygen from a mask to help me wake up. The nurse opened a drawstring bag that hung from the top of the cylinder and took out a black rubber face mask, different from the one that I had just been gassed with. There was no corrugated rubber tube. Instead it had a smaller version of the black rubber breathing bag attached to it by a wide metal tube with holes, and there was a rubber strap that fitted into little studs at each side. From the bottom of the bag a thin black rubber tube ran to the cylinder. The nurse turned a valve on the cylinder and the mask started to hiss softly. Then she fitted it gently over my nose and mouth, and secured it by stretching the rubber strap over the top of my head. The little black breathing bag emptied into the mask making a `Flub’ noise as I breathed in, and then a valve in front of the mask hissed softly as I breathed out. I sat on the recovery room couch supported by my mother’s arm, still wearing my brown rubber apron, and too groggy to do much more than keep my eyes open. I remember the gentle hiss the cylinder made, and the rhythmic Flub , , , Hiss . . . Flub . , , Hiss’ sound the oxygen mask on my face made as I breathed in and out. Gradually my head began to clear, and then I could sit up unaided. Shortly thereafter, the nurse returned with a beaker of pink mouthwash and took off the oxygen mask. Then I remember standing at the sink rinsing what seemed a lot of blood from my mouth. The nurse helped out of my rubber apron, which like my previous gas experiences had become damp with my perspiration on the inside surface, and then after a final check that I could walk unaided it was finally time to leave the surgery. My mother helped me into my outdoor clothes.
Then we went downstairs, said Merry Christmas to the receptionist sitting behind her little window and stepped through the front door of the dentist’s house into the dark twilight of a cold Winters evening. Mingling with the crowds of late-night commuters and last-minute Christmas shoppers we made our way towards the bus stop at the end of the road. We were on our way home, and tomorrow it would be Christmas Day! I felt warm and snug in my duffel coat, woollen gloves and hat, and the realisation that the dreaded ordeal of a gas extraction was over had just begun to sink in. Perhaps it was that realisation, combined with the effects of the Valium and residual halothane that made me feel so happy and content. Or maybe it was simply my anticipation of the eagerly awaited Christmas holiday. Whatever it was, I remember looking around at the houses decorated with traditional holly wreathes and twinkling Christmas lights and feeling positively euphoric. And it was still snowing . . .
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