I mp res s ion s
Cecelia
by Dr. Stephen T. Radack III, Editor
Shortly after I purchased my practice back
in 1986, I met the Klan sisters, Ann, Mary,
Helen and Cecelia. It was not that it was
unusual to see four adult sisters in their
50s and 60s who were all still patients in
the same practice, but it was the complete
dedication of the older three sisters to take
care of the youngest, Cecelia, who had both mental and physical
disabilities. The sisters told me that Cecelia was never supposed
to live past her 30s, but here she was almost 55 and I was about
to see her in the office for the first time.
That doesn’t seem that unusual by itself, as we are always meeting
and treating new patients every day, but this would very different.
Cecelia hated noise, including being talked to. Each time she had
an appointment with the dentist I had bought my practice from
they would not schedule anyone else near that time slot. When
the car pulled up with her inside, the radio would be shut off.
Her sisters would help get her in the chair due to the challenges
of walking with the braces on her legs. Once she was seated and
ready to go, I would walk in the room and give her a “hello” wave
and begin examining her teeth, and then do her scaling and
prophy. After we had finished her appointment, I would talk to
her sisters and let them know my findings, all in a whisper voice.
I have to say that I was quite anxious leading up to her
appointment. I did not feel adequately trained to treat a patient
with Cecelia’s disabilities. Adding in the noise issue and not being
able to introduce myself and talk to the patient about her teeth
and oral hygiene was very unsettling. I remember thinking how
glad I was that we had all made it through the appointment
without incident. She was due to return in four months for a recall
so we didn’t have to be anxious again for a while.
These routine recalls went on for many years with no issues, that
is until the UPS delivery man stopped by while the sisters were
bringing Cecelia in the office. He was being polite and not only
spoke to them, but held the doors for the girls. As you can imagine
Cecelia did not take it well. She vocalized her displeasure in a loud
guttural angry rant at her sisters. She eventually calmed down,
but was still talking when I entered the room and started working
on her. I always felt bad I could not understand what she was
saying, and even worse that I could not respond back.
After several years of these visits every four months, the sisters
were no longer able to bring Cecelia into the office for her recalls
due to the increasing weakness in her legs. Helen asked me
if I would be willing to make a house call to continue to provide
Cecelia regular recall appointments. I had only made a couple of
house calls to that point and they were to deliver a denture to a
patient who had become house bound. I was able to find a
battery operated prophy handpiece and with that and my
“doctor” bag of instruments, napkin, prophy paste and my new
handpiece, I was off. The sisters were still living in the house they
had grown up in, but the once proud middle class neighborhood
had changed through the years. The middle class had fled to
the suburbs and urban blight had started to claim many of the
nearby houses. I have to admit it was a bit unsettling that first visit
as I did not know what expect.
The sisters had my patient siting in her wheelchair in the living
room with a tray table next to it for my instruments. With my
trusty headlight and loops ready to go, I gave Cecelia my routine
“hello” wave and she opened her mouth for me to start. I was able
to scale and prophy her teeth almost as well as in the office,
except for the lack of suction. We continued this routine every
4 months for over 10 years. Always on a Monday and always at
1:00 p.m. Cecelia always had her appointment card sitting near
her to let me know she knew today was the day! When I saw her
name on my schedule, it always seemed like going for a workout.
The thought of it was never one of enthusiasm, maybe because
I had to drive to a sketchy part of town or maybe because I had
to go outside my office to see my patient, and that I knew I
could do better if she was in my chair. But also like the workout,
I always felt good once it was over. She seemed happy that I had
come and her sisters were grateful that Cecelia was still getting
her teeth cleaned after all these years of being homebound.
The last house call I made was on May 18, 2008. Cecelia had just
celebrated her 76 th birthday earlier that month. She died later that
evening.
I am sure we all have a Cecelia or two that we have treated in our
practices. I can tell you that nothing in my dental school training
prepared me to treat patients with special needs. I encourage
your to read the fascinating articles in this issue about treating
special needs patients and some of the unique practice settings
our colleagues practice in. If you are interested in learning more
about treating your special needs patients, I encourage you to
attend one of the many continuing education courses that are
available. I attended my first one last September and it was
fascinating and very educational.
One final note. You may have already read that PDA has a new
executive director, Mr. Ward Blackwell. As you receive this issue of
the PDJ, Mr. Blackwell will soon be settling in to his new job at
PDA. Let’s be sure to welcome him to our dental family.
— STR3
MARCH/AP RIL 2020 | P EN N SYLVAN IA DEN TAL JOURNAL
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