Be Nice, Clear Your Ice ….

by Peter Birek, DDS, MSc., Dip. Perio

Said the late, British born and very Canadian cartoonist Ben Wicks. Although he called for a specific civil task, to me it meant much more. This self-effacing but charming Member of the Order of Canada wished to remind fellow Canadians of our duty to be nice to each other, a simple code of civility — I will call it “Ben Wicks test.” Or perhaps he proposed the notion that we should do nice things even when laws and regulations don’t oblige us. A call for non-mandated, well though out acts of niceness? Yet, more frequently than before, I see examples to the contrary. Here are some:

The cover of the August 6th 2007 issue of Maclean’s Magazine, ( MACL-0001&ns=zno) read in bold letters: “Lawyers are Rats” with pictures of discredited members of the profession who were found guilty of various professional misconduct.

It is one thing to publish an interview of an apparently well-qualified retired lawyer about his less-than-rosy views of the legal profession, as described in his newly printed book and another one to commit libel on front page of a national magazine and in poor taste for that. Certainly, the editor’s decision would not pass the “Ben Wicks test” for “niceness.”

Quite surprisingly, the very next issue of the same magazine (August 13, 2007) showed another example of a “negative Ben Wicks test.” On the last page, I read a very sad and sensitive essay about a young Canadian who died in a ghastly bear attack in our beautiful Rocky Mountains, following a detour she took on a biking trail, just 15 minutes away from her family cottage. This tragic event has a special resonance for those of us who cherish the Canadian outdoors and spend a lot of time in its environs.

To my horror, on the very next page, the back cover page of the issue, I noted a full-page advertisement of a well-know car company showing one of its prized models in the foreground. Looking closer I noted a woman in the passenger seat putting on her makeup. In the background, on a trail behind the car, a man is running towards the car chased by an oversized grizzly bear. In his hand, holding it up for all to notice was undoubtedly the car key. The caption: “remote keyless entry” suggesting that this gizmo can save the running driver from the bear attack. Now, to place this ad next to the article reflects a rather poor judgment of those who lay out this magazine — indeed it is insensitive to the extreme. Another “negative Ben Wicks test.”

Things are not much better within our profession either. Not long ago, in an editorial of a reputed dental publication, an oral surgeon detailed a post-extractional complication: a colleague (a periodontist) extracted an upper molar and fractured the tuberosity in the process leading to complications.

The author of the editorial, an oral surgeon, did fix the problem but lamented, in a very un-collegial manner (“failed Ben Wicks test!”), that the offending periodontist and his kin should not do extractions that is, as all should know, the bread and butter of Oral and Maxillofacial Surgeons and undoubtedly do it better than most.

I am unwilling to be drawn into this controversy, and this is not a response to the said editorial (which deserves no reply, by the way) except that I would like to draw attention to the never-fading and ever-recurring issue of “who does what” in dentistry.

At a time in our profession when most dentists, once called general dentist, navigate towards a narrower scope of practice within 5-10 years after graduation, the issue of “specialization” is rather prevalent. The tendency to “specialize” is a natural phenomenon and it is based on individual dentist’s interests, ability and willingness to have additional training. More often it reflects the needs of the community they happen to serve. There is nothing wrong with that, after all, we can’t expect all dentists to possess and perform the full repertoire of today’s complex dentistry. Apparently, over half of the dentists specialize some time after graduation. Bona fide specialists also “encroach” on each other’s territory with increasing frequency. The best example of “undefined borders” is the realm of dental implants.

Undoubtedly, there will be more “overlaps” between “accepted” and “not-formally accepted” specialties (for the life of me I can’t understand why dental anesthesia is a recognized specialty only in Ontario and not across Canada). To raise the ante you can throw in a number of self-appointed “academies” that “sell” (sorry I just failed the “Ben Wicks test” myself) or rather “grant” fellowships of all sorts creating more confusion to the patients we serve. Hence specialization, real or perceived, will increase in dentistry as a predictable consequence of the ever-widening sophistication of dental procedures and treatment modalities.

Naturally, the issue of “who can do what” will resurface again and again establishing new territories, real or imagined. Perhaps this is a current phenomenon of our times, of even greater magnitude, as the lineup for claiming the northern navigational channel gets crowded (I fear that the Russian government may decide to enter the dental specialty game following the successful planting of a flag on the bottom of the contended continental Arctic Ocean shelf; “oy vey” if the Danes get serious and set up a specialty office on Hans Island!).

Are we dentists all going to ask, “whose territory is it anyway” while inflicting insults on each other? I hope and wish that our reactions to territorial meandering by dentists, imagined or real, would pass the “Ben Wicks test” of civility and congeniality.

This oral surgeon could have gone home and said: “Honey, I had a good day. I fixed a complication that occurred while a colleague did an extraction. I did treat the problem, getting the patient comfortable leading to full recovery. I then called my periodontist colleague to reassure him that our patient will be fine (“passed Ben Wicks test!”). I also gave him some points for preventing this to happen in the future and respectfully reminded him of criteria he can use when deciding when to refer a case, offering my services for the future). Now this would have passed the “Ben Wicks test” and would uphold his legacy.

By the way, this winter, don’t forget to be nice and clear your ice! After all, it takes a single letter to make the difference: (n)ice.