The Hero
""Maybe your work is meaningless for the patient and for you. But you do it. "

"Truth is an illusion without which a certain species of humans can not survive" Friedrich Nietzsche.

 

Condemned as we are to an inborne need for the intrinsic solution, we like to fill our minds with certainty and to cling to the illusion that an explanation, just any explanation, be possible. This invests us with a sense of control and mastery and makes things bearable.

I love the prizes. The medals. The colored ribbons. The honors. I worship illusions. But above all, I love Heroes. I'm human.

Ernest Becker in "The Denial of Death" is right. We are the only animal who is aware to rank nothing in the cosmic universe. You are given birth, you live and eventually you die. No matter if you rich or poor. If you have done something out of a life or not. The world will go on the same. May you be Alexander the Great, Caesar or Steve Jobs you'll get a few lines in the news and in history books.

But of the average Joe no one will give a penny. The noble mediocre - like me - do not want to admit the compulsion to value themselfes. To add up something to this world. Once upon a time there was religion. The priest told you that each one of us is part of a divine project. Wich one I honestly never understood. Even though I spent my youth amid Benedictine and Jesuits fathers and Capuchin friars.

Alfred Adler – an Austrian world class psychoanalyst - was right. What matters the most to human is self esteem. Whether we struggle for personal success or for an humanitarian cause, the target is always to reinforce our ego. To make sense of our lives.

To get the colored ribbon.

From family, society, your country, Science, from a dental academy. Even from a group on Facebook.

I'm a dentist. I want the ribbon. I want to be the prize-winner.

I want my little place on the hill.

I love the privilege of being a hero.

 

The most scary stuff in dentistry is patient bleeding.

Surgery as a whole.

And here we are. The brave-hearthed-dentist unconsciously neglecting the thought of death, the absence of meaning in existence, engaging in a challenging surgery. The lower jaw wisdom tooth. The nerve lulling over to him, giving sense to the over-sized, money-wasting CBCT of a hero-office. Whose mortgage will last until death. The nurse is supposed to reschedule all the patients. God knows how long it will take. We are in the realm of chance and luck. Or of divine mercy. For 300 euros or maybe less. That he could easy make with 3-4 dental cleaning. Where you switch on just 1 neuron. But you don't do it for the bucks. Patient wants me to do it, you whimpering. Though the tooth looks scary you are confident. She trusts only me, you say. I'm not gonna give up. Die hard. No pain no gain. And shit like this is throbbing in your skull.

Liar. You're a fucking liar.

You want to be The Hero !

You want go back home in the evening, gather wife and child (of course they don't give a damn but deep inside they think let's give the poor man little satisfaction who kills himself to keep us well fed that is we soon leave to the sea while he stays here in a hell of hotness working brave because he is so blessed that he has no other interests, me, I will never succeed in being the same crazy ...) to sing the praises of Weapons and Heroes of the surgical crusade (Eneide - Virgil).

He grabs his I-Phone hastily posting on Facebook doggedly looking for the vital nourishment to his ego. Likes and shares and copy-and-paste comments echoing "top", "like-a-boss", "master", "hats off" "OMG". From his own virtual ass-licker-parterre engineered through years of an ostentatious loyal vassalage to any association, academy or facebook group or kind of sheep-monkey-corporative-social-pack.

Yes you feel a hero, bro... maybe a little one but definitely a hero.

 

Everybody loves heroes. Me too.

Our self-confidence is conditioned through environment. Hinges on other people's mood and judgment. If they do not like us on facebook or they do not call us to lecture, if they do not recognize us, the voidness of our life smashes open underneath the feeth.

"I want to find a way into this life even if this life does not make sense at all" sings Vasco Rossi the new Messiah in Italy. Gathering 200.000 people in one concert and God knows how much money. Nonetheless he is not that happy. He is a vino and a stoner. Fighting depression.

 

I'm almost 57 years old. Patients ask about my health. Kidding if I will be back to work after vacation. My job scores the highest level of stress. 25 years of activity – american shrinks say - is the maximum before to burn-out.

I cut back on staff. One man team.

Down-shifting after 50 years in my opinion is mandatory. A famous anthropologist - Marshall Sahlins - wrote: the best business model to pursue the well-being of a person is to want as little as possible.

He got there after 50 years of investigation. Buddha already 2500 years ago.

I chose to work alone, with an assistant and a secretary. I do everything.

 

Dental cleaning too.

Long days passing by cleaning teeth. She the assistant sleeps. Annoying to death. Unwillingly helping me in a job not matching with an heroic device like Pentero and not fitting to my heroic CV. She is desperating about some tricky case, possibly a "bloody one". To force the hero on stage.

I'm listening to the creeping ultrasonic scaler.

Thinking.

An inglorious surrending of a profi-loser?

Don't think so. It was a blink. After 15 years of an improbable self-observation. A desperate journey in the abyss of my unconscious. Or - as psychologists found out after 100 years of Freudian religion - it was just a little sparkling of conscious mind.

Everything started on June 24 in year 2000.

After 3 days of coma I woke up. Nothing matters as before.

I had 30 years of positivism absolutely sure you can plan, schedule and measure everything. Living amid german-kartoffeln until my 20ies, I was very fond of the Anglo-German righteousness.

I was a firm supporter of the free-market philosophy ("the invisible hand" of Adam Smith) and of American liberismus missing the real meaning. An ingloriuos example of miseducation.

Science and Technology were my religion.

My hero was Rocky.

 

I believed everything I was taught: caries should be immediately treated or you lose the tooth, composite fillings with dental dam are eternal, dentinal adhesion is a fact, root canal is a certainty, crowns if you make a beautiful shoulder or chamfer under the microscope and you have a good technician fit close to zero microns, an implant is forever, bone regeneration is routine, you just use autologous bone, orthodontics heals malocclusion ... And if you behave good you will get a place booked to paradise.

 

I do dental-cleaning. I discover a different reality.

 

If you brush, decay do not progress. Especially in adult patients. The poor has no money for the dentist so she brushes and keeps what she has ad infinitum.

Composite fillings infiltrate and abrade in a short time.

Old crowns with macroscopic marginal unfit last more than 20 years. Crazy refined shoulders do not stand leakage even if you apply the holy adhesive protocol. After a few years you get receding gums anyway. Crowns prepared vertical with no finishing line behave the same or even better in the long term.

Ceramic veneers are yellowing because of underneath composite.

60% of implants have perimplantitis. When you remove implant's abutment after a couple of years it smells like a cesspit.

All the struggling for excellence may be useless. Or maybe not. No one knows.

 

It sounds weird. Dentists around the world are on facebook. The chat in real time. A new truth is surfacing. The situation is embarrassing for dental corporates, for the academias, the universities and ... for the miserable itinerant door-to-door-vendor of scientific illusions, the odontology-opinion-leader.

The shepherd of sick souls of institutional heroism.

 

Let me re-read the literature with a more attentive eye. Because informations do exist. Well hidden. Maybe at the end of a 500 pages thick tome of a famous prosthodontics book (Precision Fixed Prosthodontics Clinical and Laboratory Aspect - M. Martignoni, A. Schönenberger 1987). Autors warn about elevation of all crowns after cementation. Because cement has an in vitro minimal physical thickness of 20 microns. In vivo: who knows how much it will become. Tons of scientific papers certify an average crown elevation of 200 microns and an average gap of 120 microns. Of those working accurate. Of the bad guys, I don't know. Dental technicians are hilarious but silent, otherwise they lose their dreaming customers. The smart dentist is silently bulking his bank account. The naive one, mostly inexperienced, dreams of the perfect fit at zero micron.

Bone regeneration is not that much a miracle how I got to believe in 25 years ago. Same age surgeons as me have seen follow-ups beyond the 10-year boundary: they do not do it anymore. Emdogain is a huge hoax. Prosthetic components for implants are far from being precise. Leakage causes perimplantitis.

Composite fillings do not last like amalgam. That was criminalized on behalf of a well-fed literature. Mercury in people's bones and brains comes from the nutritionist's dogma no-meat-just-fish for an everlasting life.

 

What is in the backstage ?

The money.

Companies sell their products.

The pitch-odontology-man sells his courses.

The average dentist sells capsules, plastic fillings and implants and illusions like DSD.

Above all is ego.

We want to play heroes. To increase our self-esteem. To give our life sense. To overcome the damn fear of the death.

Becker explains the perverse mechanism why the hero-character tickles phantasy of people so much. Especially women.

Women love heroes.

Coporate's shrinks, they know it.

If you buy our useless tool ... we make you famous. They promise you.

Wanna publish? Just write what you want but you say our stuff works nice. Do not care about the scientific committee, we will. Wanna be lecturer? Wanna be famous? Don't worry we organize you the very best world tour.

You'll become a hero of Odontology !

Of course not everyone can be that hero thing. So we have different categories of heroes :α,β, γ, δ ... ε (Aldous Huxley 1932).

The epsilon-rank in the Hero's Status Recognition Scale is the so-called Premium-Follower of a group on Facebook.

The one who has posted with the most diligent obsequiousness is the lucky prize-winner: a for-free dreamy journey to the Patron of the group. Recognition and congrats to the poor innocent dumbass are the pay-back for all the evenings, all the weekends he wasted cheering and posting online 24 hours a day.

But he feels a hero.

He will take up the cudgels on behalf of his Master who occasionally throws some "crumps" to those beggars helping him to increase the number of members of his facebook-retaliation-group. Facebook is just mirroring politics. Definitely more efficient in poisoning brain and soul.

 

The show must go on.

Craziness rocketing. You can't get off. Because your wife wants a bigger house. Your children want to master in the USA. Family absolutely sucks. And everyone else on this goddamn place is like, happy. Throwing Frisbees to goddamn golden retrievers. Jogging in the park. Doing everybody the same. And posting on Facebook.

You boring as hell. You want to scream. There is no way out.

Your self-esteem is plummeting. You scared to die.

There's nothing left as to play the hero-game.

 

Because YOU deserve to be a hero.

Frenzyness goes on. My biased brain takes everything for real. I'm unconscious most of the time. Living in an imaginary world proud of my illusion of scoring in the universe more than my dog.

Because I'm doing the perfect 15-x-under-the-microscope and zero-micron-fitting crown.

Because I'm doing a nice regeneration with bio-oss and membrane on the jaw.

Ah ... I forgot.

Because I'm using The Microscope.

Then I go to courses or congresses where there are other heroes, consciousness-deprived zombies like me, and the illusion becomes an indisputable scientific truth.

Because is Shared.

That's Science.

At least until a new truth will be given birth.

(The Medical Mind - Antonio Imbasciati 2008 - Ordinary Professor of Clinical Psychology, Faculty of Medicine, University of Brescia)

 

Meanwhile the conditioner is humming in the sultry darkness. I hope it will not get stroked. Otherwise I will too. I don't get stoned. I can't. I'm forced to the brutal soberness. Right now. I have no TV. I don't drink. My wife posted on facebook she and her friends on the beach in Sardinia. My son made a selfie at Ibiza in the discoteque with his girlfriends ... But he still deserves it.

He got successful in that expensive private school where his mama wanted him to go because her girlfriends say they take care of the boys and they do not bother him, unless I forget to pay.

I remember at his age I was working during my off time as a waiter and all the money I gave to my father to pay for the college.

Tomorrow I have a tough day. Better I get some sleep.

I need an explanation. Any explanation. I need illusion to last.

 

One day I quit.

It was Saturday. On June 24, 2000. I woke up after the coma. Motorbike accident. Cranial trauma with cerebral hemorrhage. Thoracic trauma with internal bleeding, 5 fractured ribs. On the highway to the see. It was fucking hot. Car drivers were hopelessly stuffed in an endless summer queue. I was the hero on motorbike. Just in case. 560 kilometers to reach family on the beach. A total madness of 1120 km.

After 3 days I woke up. They call it a miracle.

Light switched on right over there. I didn't understand. It took me another 15 years to get clear mind. To cancel illusions.

 

I make dental cleaning.

Sort of dental-hygiene coaching. Not one of those showing you on the plastic model how to brush. Despite lecturing the fairy tale of periodontal disease they bribe you with a holy foo-foo offer - you pay right now for 9 and you get 10 cleanings and I will also gift you the office-branded toilette-bag!

I put you to the sink to brush your teeth until you got it. And if you do not, if you just do not want to understand, I'll kick you out of my office. You're not a patient, you're a waste of time. Whatever I do to you in that dirty faulty mouth, it will be a mess.

And then you blame me. You sue me.

Because you can not take responsibility for brushing teeth seriously. Like a child.

Get out of my way!

 

I do vertical prepping. I do as less implants as I can. I often avoid composite fillings. I do veneering only if there is a real indication - that is, never. I do not do bone regeneration anymore. Orthodontics I let to colleagues who still want to play Rambo.

The not-doing, waiting, postponing, delaying - I discovered late - is often the best treatment choice (Nassim Taleb - Antifragile).

For the patient and for us.

I do care of my people. I do not sell any more illusions. I no longer need to collect pieces of heroism for pics to post on facebook or for a course. I no longer want to play the hero-character to make sense of my life.

I would not buy anything that isn't strictly necessary. I do not sell anything.

Despite smaller figures, profits increased.

Teeth cleaning is at no expences.

Dental Companies weeping.

Patient says thank you to me.

I have no more cravings.

I'm not saying to be a hero is always as bad an experience.

It depends.

 

m.m.

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