Tuesday, January 31, 2012

Letters

Dear Dr. Schnell (holder of the Remo
sign-out and credit approval),
Thanks for letting me know that 
I officially have much less work
than I had previously anticipated
in order to graduate.
I'm pretty stoked about it and 
heaved a huge sigh of relief,
as well as have been bragging
to high heavens about how well
off I now am in regards to 
graduation requirements.
Its only slightly a bit much.

Dear Requirements,
Thank for giving me such
a sense of accomplishment
as I check off every little one
of you. I love it. I really do.

Dear Katie Thornton,
Thanks for listening to my rants
about how guy/girl friendships 
don't work and how I don't get why
people think they're awesome. And
feeding me delicious supper and
making chocolate peanut butter
no bake cookies. I'm too lucky. 
And was reaaaally hungry.

Dear Boston LDS singles
(aka my future dental licensure
exam patients)
I'm excited you guys are all pumped
for some nice free dental screenings.
Makes me feel a little less stressed
about being able to pull off this little
thing called DENTAL BOARD 
EXAMS. I really hope a few of you
work out
*Crossing my fingers you have bad
teeth (but not too bad)*

Dear Life,
Today you are 
acceptable.
Of course I haven't 
tried studying yet...

Monday, January 30, 2012

We made the school news!

And I was even quoted! HA. 


Three fourth-year dental students: Melissa Lowry, Dee Gulis, and Lucinda Barry recently returned from a trip to Poptun, Guatemala with LIGA International. The trip took place from January 12 to 23. While in Guatemala the students, along with alum Kevin Acone DMD 07, and trip organizer Dr. Fred Kalinoff, spent five days treating patients of various ages in the Dental Clinic at the Poptun Hospital.
(l-r) Dan Barry, Melissa Lowry DMD 12,
Dee Gulis DMD 12, Dr. Fred Kalinoff,
Lucinda Barry DMD 12, Kevin Acone DMD 07,
and Tricia Kalinoff
Ordinarily there is one local dentist who sees patients at the Poptun Hospital in the mornings, but his schedule is a bit unpredictable. So when the GSDM volunteers arrived at the Poptun Hospital the local residents turned out in force for a chance to be treated.
Said Lowry, “We worked five days at the hospital, working from eight to ten hours per day. We rotated patients between the three of us and performed a combination of extractions and restorations. We had to work with limited instruments and supplies and it was difficult treating at times because people had such a great need and there was not enough time to fix everything.”
The students estimated that they treated between 150 and 200 patients. They performed most of the treatment, but Drs. Acone and Kalinoff were always on hand to oversee and assist if necessary. Many of the patients presented with cases the students had never seen before.
Dr. Kalinoff explained one such case, “Every year we see a couple of very unusual cases, and this year was no exception. We were asked by the emergency room staff to see a patient with an abscessed tooth. We agreed and a few minutes later a wheelchair arrived with a lady of about 40 who looked more dead than alive.” Dr. Kalinoff continued, “She had a draining abscess from the angle of her right mandible that had created a hole about three centimeters by two centimeters with copious amounts of drainage. The right side of her face was swollen from above the ear down into her neck and the swelling was rock hard. She had a fever of about 102, with considerable lassitude, and was verbally unresponsive. Our main concern was that the swelling in her neck would soon cause her to suffocate.”
For this patient Dr. Acone cleaned the wound and then worked with the Emergency Room staff to arrange for IV antibiotic treatment, which the patient was kept on for the entire five days that the group worked at the hospital. Dr. Kalinoff said, “By the time we left 90% of the swelling was gone and there was talk of sending her down to Guatemala City to eventually close the wound.”
Needless to say, this trip was a learning experience for the students. Lowry said, “It was great having the freedom to operate as a dentist but the accessibility of help if it was needed. We saw so many different cases that we haven’t seen before.“
Added Gulis, “Dr. Acone was amazing to work with and a great person to lead a trip like this.”
Also on the trip were Dr. Kalinoff’s wife, Tricia, and Barry’s husband, Dan, who the group affectionately nicknamed “Dycal Dan”. Dycal Dan acted as dental assistant, photographer, and took care of the instruments. Barry said the trip exceeded both of their expectations and the others agreed. They all hope to get involved with this trip again and to be able to play a role in expanding the outreach efforts so that the residents of Poptun see a marked improvement in their overall oral health.
Said Dr. Kalinoff, “I cannot say enough about these students. Dee, Melissa, and Lucida were all tremendously hard and willing workers. They showed very good knowledge of their chosen field and will be leaders in the dental industry in the future.”

Sunday, January 29, 2012

Poptun Clinic

Every morning, Dr. Fred, Trisha, Dan, Lucinda, Dee, Kevin, myself (and possibly a translator from the Finca Ixobel where we stayed) would travel in two really old cars, that were functioning as taxis to go to the clinic on the outskirts of Poptun.
I'm not sure what I expected the dental work would be like in Guatemala. I know that what it was wasn't what I expected though. I guess because the trip had been a long standing trip (having happened every year for the last six years), I thought it would be better organized. Turns out I'm a little OCD and like things to be planned out. Mostly I don't like feeling like I don't know what I'm doing. I hate feeling out of sorts. So getting to Poptun and discovering that no one knew we were coming (Hospital and patients alike) was kind of disheartening. 
But we went Monday morning - talked with the director of the Hospital and asked if we could use one of their rooms and thanked him for his hospitality and we set up. Monday was a slow day, since no one knew we were coming. They have a dentist in Poptun that comes and works every morning in the Hospital in a room. We used that room. It had two chairs. We had a portable hand piece unit so we could do fillings that we hooked up to one of the chairs. We organized as best we could.
We used bottled water for the hand pieces and to give patients to take any ibuprofen we prescribed.



Lucinda's husband, Dan, had zero dental background, but you would have never known it.
He honestly was amazing. He disinfected instruments, assisted, organized, took pictures. You name it, and Dan had it under control. He was awesome.





The End of Day One at the Clinic







Working in Guatemala was very different from working in America. For starters, we didn't have access to some pretty crucial instruments (like a dental explorer - yup, we used a probe which is not the same at all in case you don't know) and did a lot of back street dentistry where we just had to get by with what we had. Our burs were dull, we didn't have a ton of oral surgery equipment. We didn't have suction. And a lot of the materials we were working with were old. But I think we got it working pretty smoothly. Lucinda, Dee and I rotated off taking patients at first. And we'd all help assist if we didn't have a patient. Lucinda's husband Dan was Dycal Dan and pretty much a rockstar. He helped us clean instruments, took our pictures as we worked on cases, assisted while we worked. He did everything pretty much. 
It was really different not speaking the language hardly at all. Everyone laughed at the very little amount of spanish I knew. Because turns out, even simple small phrases took me awhile to get my mouth to work the right way. But we were very lucky. We had several people from the community and from Finca Ixobel (where we stayed), that came and gave us entire days to help translate for us. They organized the mass of patients and would help us find out what was wrong with people. We were very lucky (and grateful!) to have their help and support. And the little bit of Spanish I knew allowed me to get by in a pinch. I often wished I knew more words so that I could explain something or just ease the fears of an uneasy patient. Learning Spanish is definitely on my list of post-dental school activities.
We started with two chairs - one for fillings and one for extractions. But we ended up jerry rigging the second chair so it could also do fillings and adding a plastic chair that we did extractions out of so we could try to get more patients through. 



The people were amazing though. Most of them (once they figured out we were there and it became busy), would wait in the waiting room. Some people waited for hours only to have us tell them to come back. And they did it cheerfully. They came in and often thought they needed a filling, when really they needed an extraction. And they didn't question, they just got right on board. It was heart breaking some of it. They were grateful for every little thing we could give them. Some of the dental need was crazy. So many people just had all this decay in their mouth. And I couldn't help but wonder how it could get so bad. But a lot of people didn't even have the basic knowledge of how to take care of their teeth. I felt the worst when young people would come in with horribly decayed front teeth, and I'd have to tell them that in all likelihood they would lose those teeth. Or the beautiful children (and some of those kids were probably the most beautiful kids I've ever seen), that would come in and we'd need to extract so many of their teeth because they've been drinking coffee everyday with tons of sugar and all their teeth were bad.

The appointments themselves were a little ghetto. I will never undervalue suctions or assistants again. Because we would work on people, give them a little paper cup and anytime their mouths filled up with spit or water, I would have to stop to let them spit. The spit cups were probably the grossest thing I've ever seen.
Most of the patient were amazing though.
One lady came in and I extracted all her upper teeth one day and the next day I extracted all her lower teeth, and then I extracted a couple teeth on her son. And she gave me multiple hugs and even though I didn't understand her words, I could feel her gratitude. She was so sweet. It was patients like that that made me feel really great about this trip.
Its hard coming on a trip like this, because I felt how entitled I can be sometimes and how selfish. And how I can complain when things aren't ideal for me. I kept having to take a good hard look at myself, and found that I didn't love the person I saw. And I realized that the self-absorbed, arrogant, pompous, twenty-something with the bright future isn't really who I want to be. I want to not try to buy my happiness. And be happy with my circumstances because I have so much to be grateful for. I still think, that while I may not struggle with poverty, I still have valid challenges - because Third World problems aren't the only important problems in the world - But I think I could use a little Third World gratitude and patience. Thats what impressed me the most. We worked till 7pm on a couple days, and some people waited all day for us to see them, and then we had to send them away and they didn't bat an eye. They just said they'd be back tomorrow. 

Working-wise, what I struggled the most with was treating children. Children are irrational. Some of them cry. Lots of them scream. They jerk their heads around. They don't understand what you're trying to do. Anyone who knows me knows that I'm not exactly comfortable with children. I love my nieces and nephew, but the second children cry, they are going back to their parents. I do much better with older kids who understand reason and who I don't need to force to do things. Forcing people to do things makes me physically uncomfortable. 
So when people in SoAB suggest I become a pediatric dentist I want to laugh in their faces. 
That is the last thing I would ever want to do.
One of the days in the clinic it felt like all I saw were kids. They had huge infections around teeth that needed to come out. Infection means my anesthetic isn't going to work as well. That means that I'm going to have to give more than one shot and that it might not be the most comfortable experience ever. And truthfully, the pressure from extracting a tooth is often uncomfortable and often mistaken for pain.
Pretty much every child who came my way screamed.
This little girl is probably the prettiest little girl I've ever seen and the niece of one of our translators - and I made her cry two days in a row because she had teeth that were infected and needed to be extracted :(
I felt awful. Some of them cried so much. And sometimes I just had to keep going because the tooth was almost out. But I felt terrible. Its terribly disheartening to have children crying at your touch. Even if you're trying to help them. Dee, Lucinda and Kevin kept telling me to not take it so personally. And that they don't know how I'm gonna make it in the dental field if I take things so personally. Sometimes kids cry. And while I can understand that, I also felt a small nagging that maybe it was me. Maybe I'm a bad dentist.


Not every kid was that way. There were a few that were so wonderful I sighed in relief. 

This little stud walked right in, smiling the most darling smile and told one of our translators this:
"Those three girls should come to my house after and teach my brother and I English"
Even as a five year old he was terribly charismatic. And I wished we could go teach him and his brother English. The entire time I worked on him he had his arm lounged behind his head. 

He was adorable and one of my very favorite patients. 
Plus, who can resist that head tilt and his arm around my shoulders?


I got to do and see so much on this trip. 
Kevin (Dr. Acone, who graduated five years ago from BU and was our legit saving grace so many times on this trip) walked me through doing my very first sutures on a patient.
I extracted so many teeth.
I did pulp caps and fillings.
And in so many ways, I got a glimpse of post-dental school life and felt how nice it is to feel like a competent dentist.
(A feeling that is often lacking from the school).
We worked with poor lighting (often using flashlights or our headlamps) and poor instruments.
But I feel like we did some good. 
It wasn't a lot.
And I wish we could have done more because so much more could have been done.
But it was exhausting.
We left everyday completely drained.
And it was not unusual for us to be in bed, under our mosquito nets by 9:30pm.


On our last day it was crazy to see the waiting room go from insanely packed to completely empty.

BEGINNING OF THE DAY

END OF THE DAY

I was so happy to have had the opportunity to go with Lucinda and Dee.
I honestly couldn't have picked two better people to go with.

And I told Kevin several times over the week how grateful I was that he came.
He let us have free reign, but as soon as we needed help he was there.
I felt like he, as an educator, was perfect. He would instruct us, but wasn't overbearing and would teach us things so that we could do learn how to do it by ourselves. 
Plus, Dr. Acone was hilarious.

A few of my favorite sayings of his from the trip:
I was told that there would BE no math.
Boremonism (aka a boring mormon)
You know what they say here in Guatemala - Safety Fifth!
Sassachusettes
Got Guat?
Its called Melanin Melissa, Get some.
Casa de estrogen.
Grumplestiltskin.
Guat blow out.
Rookasaurus Rex.
Whormonism.
The only rule in the Guat: There are no rules.
[Kevin: Do any of you know how to suture bullet holes?
Dee, Lucinda and I: Um, I guess we probably could do it. Why?
Kevin: Because if I have to listen to Adele much longer I'm going to shoot myself in the face]

I laughed so much with Kevin around. 
I taught everyone how to play Rook while we were in Poptun at the clinic. Which lead to much hilarity.
Kevin was hating on me for an entire clinic day though because of Rook from the night before and me saying that Lucinda was the best partner ever, even though he and I had been partners for like three rounds.
It was fun though. Kevin added such a great dynamic to our trip and I was so glad he was around.

Wednesday, January 25, 2012

Home again

While Guatemala was amazing, I was certainly ready to come home. I was tired and a little sick. Add to that the nagging feeling in the back of my head telling me that I had been foolish to be gone for so long (there is so much to do and consider). We talked a lot over the trip about the future of our lives - about the immediate game plans that would be set in motion to result in our graduation. And Dr. Fred, since he couldn't remember the difference between Dee and I, or what either of us was going to do post-school, asked us over and over what our plans were. 
Dee is under the assumption that since I have no foreseeable plans for after dental school, that it doesn't matter if I don't graduate on time. And it irked me that she prioritizes her desire to finish on time over mine because she HAS to been done before she starts her residency and me, with my lack of plans could technically not worry a lick about being trapped in the school. I may not have post-dental school plans, but one thing is sure, I'm ready to be out of this place. And staying late is not something I have any interest in doing.
I had a couple days in Guatemala where I was starting to fall apart a bit. Once in the clinic - I just got so tired and all these children kept crying and screaming. And it wasn't really my fault, and I was trying to help them, but its hard to not feel like a bad dentist when someone is screaming bloody murder at you. I could never be a pediatric dentist, because I take things too personally. Even still, I know I need to separate my ego from the dental care I provide. Its not something I'm good at. So long days and screaming children were wearing me down. 
And the last day. I felt sick and was starting to feel all the pressure I was returning to.
The airport saying became Travel 5: Melissa 0 for how my day was going.
I couldn't find my student visa (having tucked it away in a "secure" location) and had to rummage and pull all my stuff out of my bags right before we checked our luggage (luckily I remembered before we checked our luggage)
I dropped my guatemalan customs paperwork all over - twice.
I had a small moment where I misplaced my passport.
I got pulled over by the guatemalan security over a random pair of tweezers that made it into my bag.
And as we looked at the last bit of souvenirs we could bring back to America, I began to feel ill again and had to go sit down.
Mostly I laughed at these things - once I had procured all the necessary paperwork and any real danger of not being allowed back into the US was over. But I was out of sorts leaving Guatemala.



I'm glad to be back at school - despite the anxiety and fears. We arrived into Boston at 12:15am yesterday and by the time I got home it was 1am. I prepared my bag for the next day (since I had to take my mock boards at 7am). And it was a busy busy day. But while the work in front of me is overwhelming at best, there is a certain comfort in the busyness. And I do love checking requirements off my graduation list.

Distraction

I'm not sure if its my own foolishness or your previous constancy that has allowed so many of my thoughts to turn to you. I know in my head that it is wise to let you go. But my heart is stubborn. Oh I'll pretend that I'm making progress but only because I know no one wants to hear about it. But you still bring a tear to my eye and sharp pain to my chest. Its foolish. But I've been foolish before and undoubtably will be foolish again.
Is it weird that part of me feels like I might run into you again? (And not in the 'you and your crew pretending I'm invisible' way, which has already happened and I didn't particularly care for.)
I keep thinking about travelling to France and serendipitously running into you. Which is highly unlikely; Even in my imagination.
I guess its just me not wanting to be done. Despite the rightness of that decision.
It was right, wasn't it?
Its funny because so often I just want to tell you things; Silly, little things of no consequence. Things I know you would understand or appreciate. But whereas I was brave once before, I can no longer be brave. That time has passed. But I have typed out the words and been on the precipice of sending them when reason came flooding back in. I deleted your number to prevent such weakness.
I know wishing is a waste of time. But I honestly wish things could have been different. Which is probably more a selfish wish than one with your best interest at heart. Because I am worn down and tired.
I was thinking about the number of times that I've been broken hearted. Sure I've been hurt far more times than that small number. I tend to take any form of rejection hard. But it takes more than just a break up to count as a heart break for me. It takes my future hope. And not just anyone can elicit that from me.
I know that you will find someone else. And they'll probably be perfect for you in a hundred different ways that I was not. And even though this fact doesn't make me sad per say, I'm not sure I'll ever really get rid of the unconscious sigh your name brings. At least I haven't yet for the others.
In Guatemala, I laid in the muggy air, in a bed that was questionably clean, under a mosquito net I had tucked close to the bed out of fear for the gigantic tarantula seen in a tree house nearby. The days were busy with patients. I was tired and a little grumpy. I felt like a bonafide dentist in moments and an utter wreck in others. But my skills seemed enough and gave me hope to make it out of dental school alive. And despite a certain excitement and contentedness from a trip that could only be called a success, I cried as quietly as I could, while my friend slept across the room. Tired, cold and sad.
Traveling and you are somehow entwined. And you kept popping up at unexpected moments on my trip. I want to hate travelling because you think it makes people better and more complete than those who love their home and their own people. And I want to hate reading. And I want to hate that I value good educations. And I want to shake you. Truly I do. But I'm not sure I'm doing either.
I'm too sentimental. I know this.
And written down on paper, it doesn't look like there is anything to be sentimental of. But somehow my twisted brain has found it.
I feel like a wreck. Like I haven't been sound since you. Which isn't really because of you. There is so much on my plate right now and somehow I managed to ignore that until just recently. I'm frightened of the future, if I were being honest. And I just want to talk to you about the things that are upsetting me. You got me to trust that I could say anything to you, and even with differing opinions it would be ok. But it isn't. And now I'm left missing that openness. Maybe thats what I actually am missing. Not you but the availability of someone with whom I could voice the thoughts I usually do not dare to utter to another person. And like a hypocrite, I try to fill the void you have left, even though I looked down upon you for doing pretty much the same. But I'm too cognizant to feel anything but guilt because I think deep down, I know thats not right either, even though I'm still going to debate it.
Turns out I'm still upset. And the only person I want to talk to about it is you. Turns out everyone telling me to just get over it and how weird you are and how little you matter and how much they disliked you to begin with and how much better off I am now hasn't helped. But the ebb and flow of my emotions allows me to forget about it sometimes. To express it and then to be ok.
You'd think by now I'd realize that tucking my emotions beneath the surface doesn't work anymore. Because my body has physically reached its limit of hiding things away. I think its stress that has done it to me. This lack of control. Or perhaps I really was delusional about how much emotion I had before. When I continue to try my old coping methods, eventually that sassy body of mine shows me who's boss by giving me days where I have no control over the flow of emotions I emit. Its embarrassing and unexplainable at best, because any explanation sounds small and insignificant even to myself.

I read a post that had a few lines that struck me hard today.
It was originally posted on this. These are my favorite parts.

There are some things you can’t understand yet. Your life will be a great and continuous unfolding. It’s good you’ve worked hard to resolve childhood issues while in your twenties, but understand that what you resolve will need to be resolved again. And again. You will come to know things that can only be known with the wisdom of age and the grace of years. Most of those things will have to do with forgiveness.
You cannot convince people to love you. This is an absolute rule. No one will ever give you love because you want him or her to give it. Real love moves freely in both directions. Don’t waste your time on anything else.
Most things will be okay eventually, but not everything will be. Sometimes you’ll put up a good fight and lose. Sometimes you’ll hold on really hard and realize there is no choice but to let go. Acceptance is a small, quiet room.


I have a lot of hard work in front of me. Its daunting. And I feel a slight deja vu to my stress level in second year - which was among my least favorite of times and least favorite version of myself. It truly is daunting this task of living and succeeding. And I'm worried I'm not up to snuff. And I know that you are no more than a distraction for me. Because if I were being truthful, its my inadequacies that are keeping me awake and not your lack of feeling. I know deep down you don't matter anymore. You made your choice. And I am nothing, if not someone who believes in honoring the consequences of our choices. My school is about the only thing that does matter right now. Because I cannot bear the thought of being here any longer than I have to. Or of failing. And so much of what I worry about, has no bearing in the present.

The present is all I have for now. I can't stand the thought of making any plans for the future while I feel so unsettled in my current situation. And that is just the way things are going to be for now.

Friday, January 13, 2012

Hello From the Guat

Just a quick hello. We arrived yesterday in Guatemala City and met up with Dr. Fred, his wife Trisha and Kevin (another dentist). We took a van ride through the city and to Antigua.

So far, I`m pretty much loving:
ONE - Any and all food; from the amazing dinner I had last night, to the freshest pineapple and orange juice with hearty crepes this morning or the amazing nachos I had this afternoon. Yup. I could pretty much get used to eating this lovely south american fare. Cause it is the bomb.
TWO - The ruins. We spent this morning and part of the afternoon touring the ruins that are in Antigua. It is a spectacular sight to see all these massive structures with huge pieces of building in between and random staircases. Plus, I figured out how to take panoramic shots on the camera I brought and they are winning at life.

Its surreal being here in Guatemala. And so far has been a constant sensory overload. It doesnt feel that different from America in some ways, but maybe I just notice and stop to look at more things here.
I already know that coming back to school is going to be a rude awakening. But Kevin has definitely been painting a lovely post-graduation picture for us all. Maybe traveling the world will be my future life. There`s something kind of amazing about seeing other cultures and being somewhere so different in so many aspects from where I`m from. Although I`m really glad to have Dee, Lucinda and Dan with me, as my shy and introverted nature might not be conducive to all the adventures I`m currently totally on board for. Plus, with all of us taking pictures and the promise of sharing said pictures, I`m sure to have some great shots in the mix and even be in a couple.

On tomorrow`s agenda? Just hiking a volcano. NBD.

Thursday, January 12, 2012