Monday, July 9, 2018

Daredevil Dentistry

drawing by Suzanne Dunaway
If I had felt like it, when I opened my medical office for business on Rome’s Via Scialoja in 1980 I could have set up a double-duty exam table that tilted thisaway for me to take your Pap smear and thataway for me to fill your cavities. True, most dental drills in Italy even back then were wielded by guys who had gone through all the paces: first a regular medical degree, then a book-based specialization in teeth, finally a practical apprenticeship with a dentist father or family friend to actually learn the job. But a good chunk of the Dentista offices were run by . . . General Practitioners, who rounded out their income with improvised odontoiatric skills. Until 1984 anyone who had graduated from medical school could legally set up shop as a dentist in Italy, without having done a specialization and without any hand-in-mouth training whatsoever. It must have taken nerves of steel. By now, thankfully, that cohort of medical moonlighters are almost all retired.
In Italy the default for doctors and hospitals is public, but the default for dentists is private. For one thing the waiting list for dental work on the public health system can be two years long, and for another NHS dentists are notoriously "cavadenti" who yank teeth instead of fixing them. So whereas private medicine in Italy is largely for the well-to-do, private dentists cater to the masses. But – paradox – they charge twice what they do in the States. The circle is squared by a semi-clandestine horde of cut-rate imposters – as per one of my first blog posts.
(There are phony physicians too, of course. One Roman pseudo-doctor, unmasked after 15 years of practice, rode off into the sunset on his bicycle. Two months later a clochard died of exposure on the steps of a noble Palazzo: it was him. But, then, in 2003 Florida alone convicted 101 fake physicians, so we can confidently guess that right this moment thousands of charlatans are practicing medicine without a license in the US.)
Nino Campanelli, my own dentist for my first 30 years in Rome, had a delicate touch and was a whiz with the Xylocaine. Once, though, I had an emergency while Nino was out of town, and when his substitute leaned on my shoulder for leverage it came close to dislocating. The day they gave a lesson on how to handle flesh gently he must have played hooky. I told my beloved Nino he’d handed me over to a backup who was oblivious to patient comfort. He answered with a sigh: “Yes, I know, he’s a little rough. He knows his stuff, but until now he’s been working in the National Health Service. He still needs to learn how to behave with private patients.” That’s all I know from personal experience about public dentistry, and all I need to know.
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