Franchot Nuedelman

Franchot Nuedelman was in the other day. He’s a little guy, wispy white hair, wouldn’t top 110 soaking wet. You remember, I told you about Nuedelman, the old party who always comes in with a newspaper folded several times so that the crossword puzzle he has under construction will be readily available in case there’s a lapse in the conversation. This is not likely since he and I claim the same generation and any treatment he receives must be prefaced by a 20-minute litany of bodily malfunctions we have in common. He and his wife, Hyacinth, have been patients of mine for years, the two of them constituting a walking museum of just about everything dentistry has to offer.

We engage in the obligatory retrospective of our past and current geriatric woes, during which my 23-year-old assistant slumps on her stool, eyes rolling. She’s heard all this before.

"What can I do for you today, Franny?" I offer finally.

"Another one of your fillings fell out," he sighs, like this was a weekly occurrence. "What’s an 11-letter word for ‘lacking the qualities for effective action’?"

"Incompetent?" I suggest.

"Right!" he chuckles.

I like older patients as a rule. They are direct, if not downright blunt, know what they want and are usually a little less critical of my work than I am. Nuedelman hasn’t had a carious tooth for years. For one thing, he smokes a pipe whose by-products of combustion are a more potent antibacterial agent than anything developed by the entire pharmaceutical community in the past 75 years. For another, everything that’s likely to decay has already done so and been restored with whatever was in vogue at the time.

He carefully rummages through his pockets to retrieve a small packet made of folded Kleenex wrapped in Scotch tape. "This it?" I ask as he carefully passes it to me like it was the Hope diamond.

"Yep. Saved it so you could paste it back in."

It is the entire buccal of No. 14, fractured off about a half millimeter below the gingival. I poke the intraoral camera in his mouth and fix the image of the upper left first molar up on the screen. The MOD amalgam is still there, clinging precariously to the lingual walls. "See, Franny, your filling is still there; you’ve lost a big chunk of your tooth." Hard to keep the triumph out of my voice. He pushes his trifocals up from the tip of his nose and peers at the monitor with wooden incomprehension.

"Not your filling?"

"No, your tooth." I need to establish whose what is whose. "It’s gonna need a crown to save it."

"Suppose that’ll run, what, a couple hunnert bucks?"

"More like $600."

"Doc, I’m 82 already. Pull it out. I won’t be around long enough to pay for it."

It doesn’t rank among the dizzier flights of the human imagination to appreciate Nuedelman’s position. This is the downside of treating old people. Many of them recognize that, actuarially speaking, the numbers are not going to keep accumulating indefinitely, and their logic is irrefutable. No sense mentioning No. 14 might also need a root canal treatment at another $800 or so. Forget the whole implant option, the zillion dollars worth of equipment and supplies to accomplish the miracles of modern dentistry. I might as well try to sell him on the concept of goat gland extracts at some rejuvenation clinic in Switzerland. A tsunami of internal marketing would wash over Nuedelman with negative results. In the absence of infection, I make peace with my conscience.

"Fran, does this tooth hurt?"

"No, but I’m fixin’ to wear my tongue out on the edge of it."

"How about if I try building up the missing part with some stuff that kind of bonds to the tooth and old filling? Might last a couple years."

"Stuff" and "bond" share a common understanding in our mature lexicons.

"Long enough," he agrees.

The job is done, I show him the tooth on the monitor. It looks good, the prognosis doubtful. I explain. "What do you think?"

"About what?" He’s anxious to get back to his crossword.

"Your tooth, the thing we just did, remember?"

He cranes his neck at the screen. "Better’n I could do," he ventures after a moment, returning to his puzzle. "What’s German for ‘thanks’ -- five letters?"

"Danke."

"You’re welcome," he smiles, wets the tip of his pencil and painstakingly blocks in the letters.

Takes him 10 minutes to gain the front door with his walker.

"Senior discount?" he says to Mary.

"The usual," she affirms.

He turns to me as he passes out the door. "Doc, you’re the best!"

"I know, Franny, so are you. Lose the pipe, OK?"

"Sure, Doc. See you when another one of your fillings falls out."

"I’ll be here," I promise. And I hope I am. I hope we both are.