Let's Explore Diabetes with Owls

Dentists Without Borders

One thing that puzzled me during the American health-care debate was all the talk about socialized medicine and how ineffective it's supposed to be. The Canadian plan was likened to genocide, but even worse were the ones in Europe, where patients languished on filthy cots, waiting for aspirin to be invented. I don't know where these people get their ideas, but my experiences in France, where I've lived off and on for the past thirteen years, have all been good. A house call in Paris will run you around fifty dollars. I was tempted to arrange one the last time I had a kidney stone, but waiting even ten minutes seemed out of the question, so instead I took the subway to the nearest hospital. In the center of town, where we're lucky enough to have an apartment, most of my needs are within arm's reach. There's a pharmacy right around the corner, and two blocks farther is the office of my physician, Dr. Médioni.

Twice I've called on a Saturday morning, and, after answering the phone himself, he has told me to come on over. These visits too cost around fifty dollars. The last time I went, I had a red thunderbolt bisecting my left eyeball.

The doctor looked at it for a moment, and then took a seat behind his desk. "I wouldn't worry about it if I were you," he said. "A thing like that, it should be gone in a day or two."

"Well, where did it come from?" I asked. "How did I get it?"

"How do we get most things?" he answered.

"We buy them?"

The time before that, I was lying in bed and found a lump on my right side, just below my rib cage. It was like a deviled egg tucked beneath my skin. Cancer, I thought. A phone call and twenty minutes later, I was stretched out on the examining table with my shirt raised.

"Oh, that's nothing," the doctor said. "A little fatty tumor. Dogs get them all the time."

I thought of other things dogs have that I don't want: Dewclaws, for example. Hookworms. "Can I have it removed?"

"I guess you could, but why would you want to?"

He made me feel vain and frivolous for even thinking about it. "You're right," I told him. "I'll just pull my bathing suit up a little higher."

When I asked if the tumor would get any bigger, the doctor gave it a gentle squeeze. "Bigger? Sure, probably."

"Will it get a lot bigger?"

"No."

"Why not?" I asked.

And he said, sounding suddenly weary, "I don't know. Why don't trees touch the sky?"

Médioni works from an apartment on the third floor of a handsome nineteenth-century building, and, on leaving, I always think, Wait a minute. Did I see a diploma on his wall? Could "Doctor" possibly be the man's first name? He's not indifferent. It's just that I expect a little something more than "It'll go away." The thunderbolt cleared up, just as he said it would, and I've since met dozens of people who have fatty tumors and get along just fine. Maybe, being American, I want bigger names for things. I also expect a bit more gravity. "I've run some tests," I'd like to hear, "and discovered that what you have is called a bilateral ganglial abasement, or, in layman's terms, a cartoidal rupture of the venal septrumus. Dogs get these all the time, and most often they die. That's why I'd like us to proceed with the utmost caution."

For my fifty dollars, I want to leave the doctor's office in tears, but instead I walk out feeling like a hypochondriac, which is one of the few things I'm actually not. If my French physician is a little disappointing, my French periodontist more than makes up for it. I have nothing but good things to say about Dr. Guig, who, gum-wise, has really brought me back from the abyss. Twice in the course of our decade-long relationship, he's performed surgical interventions. Then, last year, he removed four of my lower incisors, drilled down into my jawbone, and cemented in place two posts. First, though, he sat me down and explained the procedure, using lots of big words that allowed me to feel tragic and important. "I'm going to perform the surgery at nine o'clock on Tuesday morning, and it should take, at most, three hours," he said — all of this, as usual, in French. "At six that evening, you'll go to the dentist for your temporary implants, but still I'd like you to block out that entire day."

I asked my boyfriend, Hugh, when I got home, "Where did he think I was going to go with four missing teeth?"

I see Dr. Guig for surgery and consultations, but the regular, twice-a year deep cleanings are performed by his associate, a woman named Dr. Barras. What she does in my mouth is unspeakable, and because it causes me to sweat, I've taken to bringing a second set of clothes and changing in the bathroom before I leave for home. "Oh, Monsieur Sedaris," she chuckles. "You are such a child."

A year ago, I arrived and announced that, since my previous visit, I'd been flossing every night. I thought this might elicit some praise — "How dedicated you are, how disciplined!" — but instead she said, "Oh, there's no need."

It was the same when I complained about all the gaps between my teeth. "I had braces when I was young, but maybe I need them again," I told her. An American dentist would have referred me to an orthodontist, but, to Dr. Barras, I was just being hysterical. "You have what we in France call 'good time teeth,'" she said. "Why on earth would you want to change them?"

"Um, because I can floss with the sash to my bathrobe?"

"Hey," she said, "enough with the flossing. You have better ways to spend your evenings."

I guess that's where the good times come in.

Dr. Barras has a sick mother and a long-haired cat named Andy. As I lie there sweating with my trap wide open, she runs her electric hook under my gum line, and catches me up on her life since my last visit. I always leave with a mouthful of blood, yet I always look forward to my next appointment. She and Dr. Guig are my people, completely independent of Hugh, and though it's a stretch to label them friends, I think they'd miss me if I died of a fatty tumor.

Something similar is happening with my dentist, Dr. Granat. He didn't fabricate my implants — that was the work of a prosthodontist — but he took the molds and made certain that the teeth fit. This was done during five visits in the winter of 2011. Once a week, I'd show up at the office and climb into his reclining chair. Then I'd sink back with my mouth open. "Ça va?" he'd ask every five minutes or so, meaning, "All right?" And I'd release a little tone. Like a doorbell. "E-um."

Implants come in two stages. The first teeth that get screwed in, the temporaries, are blocky, and the color is off. The second ones are more refined and are somehow dyed or painted to match their neighbors. My four false incisors are connected to form a single unit and were secured into place with an actual screwdriver. Because the teeth affect one's bite, the positioning has to be exact, so my dentist would put them in and then remove them to make minor adjustments. Put them in, take them out. Over and over. All the pain was behind me by this point, so I just lay there, trying to be a good patient.

Dr. Granat keeps a small muted television mounted near the ceiling, and each time I come it is tuned to the French travel channel — Voyage, it's called. Once, I watched a group of mountain people decorate a yak. They didn't string lights on it, but everything else seemed fair game: ribbons, bells, silver sheaths for the tips of its horns.

"Ça va?"

"E-um."

Another week we were somewhere in Africa, where a family of five dug into the ground and unearthed what looked to be a burrow full of mice. Dr. Granat's assistant came into the room to ask a question, and when I looked back at the screen the mice had been skinned and placed, kebablike, on sharp sticks. Then came another distraction, and when I looked up again the family in Africa were grilling the mice over a campfire, and eating them with their fingers.

"Ça va?" Dr. Granat asked, and I raised my hand, international dental sign language for "There is something vital I need to communicate." He removed his screwdriver from my mouth, and I pointed to the screen. "Ils ont mangé des souris en brochette," I told him, meaning, "They have eaten some mice on skewers."

He looked up at the little TV. "Ah, oui?"

A regular viewer of the travel channel, Dr. Granat is surprised by nothing. He's seen it all and is quite the traveler himself. As is Dr. Guig. Dr. Barras hasn't gone anywhere exciting lately, but what with her mother, how can she? With all these dental professionals in my life, you'd think I'd look less like a jack-o'-lantern. You'd think I could bite into an ear of corn, or at least tear meat from a chicken bone, but that won't happen for another few years, not until we tackle my two front teeth and the wobbly second incisors that flank them. "But after that's done I'll still need to come regularly, won't I?" I said to Dr. Guig, almost panicked. "My gum disease isn't cured, is it?"

I've gone from avoiding dentists and periodontists to practically stalking them, not in some quest for a Hollywood smile but because I enjoy their company. I'm happy in their waiting rooms, the coffee tables heaped with Gala and Madame Figaro. I like their mumbled French, spoken from behind Tyvek masks. None of them ever call me David, no matter how often I invite them to. Rather, I'm Monsieur Sedaris, not my father but the smaller, Continental model. Monsieur Sedaris with the four lower implants. Monsieur Sedaris with the good-time teeth, sweating so fiercely he leaves the office two kilos lighter. That's me, pointing to the bathroom and asking the receptionist if I may use the sandbox, me traipsing down the stairs in a fresh set of clothes, my smile bittersweet and drearied with blood, counting the days until I can come back and return myself to this curious, socialized care.