from WAITING IN THE DENTAL LINE
It is April, the month of many names - Eliot's month of Ash Wednesday, the tax man's month, and the month when spring returns to winter over and over on the Comstock. It is the morning of daffodils lying flat, their yellow flowers pinched to the andesite terrace. I think they will never arrive. This is the third day of their falling to freezing temperature. How can anything live in this climate? How, indeed?
I drive down Six Mile Canyon, east into the clouds and snow of morning. An ordinary dawn except the desert peach has started to bloom and then I know, that despite the cold and unrelenting wind, spring will return. Spring will come back just as it has a hundred times before. More signs of life: there are horses at the road edge, and further east, a lone horse tries to find grass in the sage. Highway 50 spreads to the horizon and in the distance some shimmer of water at Lake Lahontan. There are new buildings here - schools in Silver Springs, the places of promise and hope in any community. Much like churches, they are the signal towers for what is right or wrong in a small community. Today, hundreds of people will come to this high school and hope to be seen for their medical and dental concerns. Today, an equal number of volunteers will try to serve them. The irony is that so few will hear this conversation. In our political climate, few will branch out to disappear among those who need more than trivial conversation to assuage their pain. Few will recognise this face in line that has but one thing to hold: the hope of being treated.
Two women sit at the dental table with me. They have volunteered most of their adult lives. They have stood in these lines. Their own teeth need dental work. They have children, some of whom are now adults and are also in these lines. They have made a pact with the future: if I give of my time, perhaps their world will have what mine did not. It is the second day of listening to stories: I am asked to translate what any boy could translate with hand signals: my mouth hurts, my tooth is broken, my face is swollen. I ask repeatedly, what is it you need - fillings, extractions, cleaning? Some cannot reply, some only want to be in the line, to be anonymous without a name or rule or a reason. They fear what lies inside. They fear I will judge them and yet, those who accompany them ask us to look, to verify, to string the loss of dignity to the next chair where they will wait to be seen. What I cannot say is that one-fifth will not find the magic hands of a dentist. What I cannot say is that you will be turned away.
Another volunteer has come to the table both days. She has a tooth that is loose and is about to fall out. She has just taken a job as a receptionist. She is worried that she will lose the job if she cannot smile. She has no one to ask for help. This is the anomaly we call health care. My dear friend and activist, Christy McGill, organized this event ...
… One state legislator, one Congressional representative, and two county commissioners are here. They will return with something of the day on their hands. They will sit before dais after dais and try to explain the conundrum of poverty. They will work for an economy that will permit more than piecemeal legislation. They will return to their constituents with some reminder of living outside the community. They will not, however, stand by what remains, the people in this line because it is hardest to be without recourse. I tried to imagine any one of the individuals standing before me in a relationship, loving someone, caring for others, waking to a mirror that would not intercede on their behalf, going to work, hiding in a cubicle, dressing for out of doors year-round so that their faces could be covered.
This is the first year of the Medical Outreach Event (MORE). Christy and her team have been here since dawn. There are lines to each station - glasses, medical, dental, mental health, and other resources. We are in a high school gymnasium. Every volunteer has a purpose and they try, in their own way, to render assistance. By mid-morning, it becomes clear that many people in the dental line will not get seen. They go home much as they came - with the pain of tooth decay.
Around the corner, in the library, the volunteers offer blood pressure checks and basic physical health screenings. Off the hallway, colleagues provide counselling, which today, might mean counseling on how to cope with the lack of health care. I get up from my station and walk back to the waiting line for the dental van: have there been any changes, is there space for one more person to be seen?
The van is a long mobile home that has been outfitted for portable dental care. Inside, a dentist and three hygienists quickly assess what is required for each patient: fillings, extractions, sealants and more. Miraculously, they keep their sense of humour about them and most of the children exit the van with smiles. Some adults have as many as four extractions. Their mouths are swollen but they, too, are grateful.
At the other end of the gymnasium are the yellow jackets of the Lion's Club. They are distributing glasses to the people at their station. There are literally dozens of volunteers from the local clubs.
In the bleachers, families wait with the children. The kids try and play on the wooden seats. It is too cold to go outside and yet the smokers cough in the wind.
Christy's assistant, Freida, runs from station to station with a walky-talky in her hand. She is in charge of seeing that every patient stop is adequately staffed and they have the resources they need.
Beyond the gym, the volunteers huddle over sandwiches and coffee in the student cafeteria. The morning has the feel of a highly organised Red Cross outpost except that there is no perceived emergency here. That is the paradox: except for the 500-plus people who have come for services, the need for medical and dental treatment is unknown. And were it not for their faces, it would remain so. But Christy and her team have seen these faces too often and they resolved to do something about it.
In two years she will bring the group of medical volunteers, Remote Area Medical, or RAM, to coordinate the event. It will have grown to be staged in Reno and Las Vegas. In the interim, she lobbied the legislature to enable volunteer medical and dental personnel to come from other states to provide services in Nevada. In a word, she could not forget their faces. RAM has coordinated events like these all over the world and so, after months of planning and preparation, when they arrive in Nevada, the treatment is highly coordinated and effective. It runs as efficiently as an assembly line.
Still, I want to follow people out the door, into the wind of Silver Springs. I want to know the person they left behind today, what they cannot tell us on their medical intake sheets. I want to know who it is that told them this is all these is, and how it became the truth.
In an irony I couldn't make up, I returned to the high school to teach poetry in the gifted and talented class last fall. I had a great morning with eight juniors and seniors. Their teacher was one of the most exciting English teachers I had met. I thought this is what school should be for all kids. When I walked to my car I remembered that Freida and her volunteers - many who were at the MORE event - were distributing food one hundred yards from the high school. I looked at the line: old women with oxygen tanks, infants in the arms of young people and everyone in between. Some of the young people were just a year out of high school and yet, this was their future - a line to something almost free in the cold wind and dust of the desert. How is it the brightest and the hungriest can be separated by a hundred yards? What perverse angel led them to these places? Some part of me did not want to know. And I slipped away, just like them, before I could find out.
Of course I did not know any of this would come to pass when I drove to Silver Springs for the first MORE event. Back at the dental table, I grabbed a coffee and resumed taking names. A young girl asked me if her stuffed animal, a cat, could get a new tooth. It was almost funny, almost like relief. But what surrounded her - the stigma of being poor - also waited in the dental line. It was alone, off to the edge of the line, and occasionally it moved closer to the table. It moved closer to us. We could not see it, could not find its name or number in the lottery. We drew tickets from the five pound coffee can and hoped it would not come forward, hoped it would stay in the background, hoped it would be calm in the unrelenting queue. But each hour it made itself known: "Show him your teeth, show him," and she could not until finally in desperation, as if to exhale, she let go. I stared across the gyn floor and wished for some kind of miracle of transformation, some induction scene that would replace what we could not. This is the irony that also waited in line: in a minute, these people could be treated. In an emergency, these people would be treated. In almost any other situation, there would an expectation of common sense response. If you cannot eat, smile, or kiss without pain, how can you work, attend school, and participate in the normal affairs of family, peers, and community?
