My undergraduate days of final year dentistry were a reality check. Like every dentist says it definitely is a roller coaster ride. There were eight different departments, where we get to apply whatever we learned in books and practice what we did on dental mannequins, on real patients. We had rotational postings in all departments and the Pediatric dentistry was the last one for me. After successfully performing different dental procedures on patients on previous department postings, I was under the assumption that I’m going to ace the pedo posting too. The beginner me never knew that these tiny humans are going to humble me with reality.
Before going for the posting, I read all of the behaviour management techniques in books and spoke with my seniors and learnt few things from them.
On the first day of my pedo posting, I was given a case of simple tooth extraction. Before starting the procedure, I spoke to the kid and explained everything in a way the kid could understand and successfully performed the procedure. I slowly got hold of few techniques to convince the kids for dental procedures which for me was a monstrous peak to scale, considering how challenging it is to get the kids to sit on the dental chair, leave alone performing dental procedures without them crying or being scared. After completing the month long posting successfully and learning a few things, I was overconfident that I’m good at this, and will ace pediatric dentistry someday. I liked the pediatric dentistry posting more than anything else, the sole reason being, the kids were really wonderful to work with. The kids whom I met for procedures were always excited to see me whenever they come for a dental visit. The false sense of achieving something got me under a clout.
The reality check came in the form of the university practical exam in pedo department. We always used to screen and select patients for the exam beforehand and that’s when I came across this fantabulous kid, who was around 9 years old. He was the patient that I have to perform the procedure on for my final exam. He was a very intelligent kid who even learnt to identify who has root stumps or cavity in their teeth just by observing the previous patients by tagging along with us.
On the day of exam, when I was about to do the extraction, I explained the kid what is going to be done and he was quite confident and brave. I was about to give him a local infiltration LA injection and explained that it is going to be so simple and won’t hurt even a tiny bit. The kid was fine and calm when I first sprayed the LA on the inj site. But the moment he saw the injection in my hands; he shouted at the top of his voice and wreaked havoc so much so that every single person in that room turned towards us. I immediately put the injection away and spoke to him for few minutes again on how it is going to be so easy and will never hurt. The kid seemed fine again and even laughed at few jokes I cracked with him. I geared up for a second time hoping this would go through smoothly. This time I took out the injection without him noticing, at least that’s what I thought. To my surprise he outsmarted me this time too and noticed the injection before I could realise that he did notice it already. The same loud shouts followed and this time it became infectious. The other kids nearby started crying after seeing him. My heartbeat was racing, thinking of the conditions we had for our university exams. My pedo professor had one rule, any kid going through any kind of procedure in the hall should neither cry nor shout. Every time the kid shouted, the professor’s rule echoed in my ears constantly. Just like I imagined, my professor was standing next to me in the next few seconds and reminded me that, if the kid shouts again, I will be sent out.
All the confidence I had built up leading to the exams has been shattered and I was in dire straits to build some confidence before I could pick up the forceps again. I calmed myself and spoke to him again for almost half an hour. Not just about the procedure but a lot of different other things. A soccer coach encouraging their players will be proud the way I was talking and building confidence in this kid.
Just when I thought everything was fine and good to go, I took out the injection again. The third time lucky didn’t work. The same old story of shouting repeated. My Patience ceased to exist and my hands trembling. I started speaking in a harsh, threatening voice to make the kid understand and fall in line. Nothing seemed to work with him. He shouted and cried endlessly. Just like in the worst of my dreams, my professor came and asked me to leave the department. I was so angry, I removed my gloves so fast and barged out without looking back.
Surprisingly one of my seniors did perform the same procedure on that kid successfully without a single squeak.
That kid did humble me and taught me a very valuable lesson which I will hold to me till the time I practice dentistry. Every patient, every human is different. There is no hard coded trick that would work for everyone. Experience is all that matters and you can never learn it all in a short span of time.
Even after a few years of practice now I still have got a long way to go, a lot to learn and explore. As they say a doctor is the one who is always practicing.
Please share if you too had similar experiences in any of your practical exams.
MBH/PS