January 31, 2018
by Michael Carabash, BA, LLB, JD, MBA, CDPM
Do you recall the best 10 days of 2017? I do. Mine go something like this:
The Best Ten Days of Twenty-Seventeen
Started With Strangers, Anxious And Keen
To Go To A Country Some Hadn’t Seen
To Pull or Save Teeth With a Fill or a Clean
Or To Educate Children About Oral Hygiene
And Yes We Sweat Buckets and Felt Like Sardine
In Clinics Whose Equipment Failed On Routine
While Hundreds of People Without Any Means
Stood In the Sun for Hours To Dream
Of Relief from the Pain or to Gain Back Esteem
That Comes With Having a Smile That Gleams
Despite Problems and Pressures, Patients Got Seen
And Our Day Stories Fueled Our Nightly Scene
Where We Dined on Cuisine and Drank In-Between
Pool and Beach At a Place So Palatial Pristine
It Could’ve Jumped Straight Out of a Magazine
And Though We Started As Strangers, Anxious and Keen
We Finished as Friends, Part of a Team
Full of Laughs, Full of Love – For That Which Has Been
And I Hope You Will Come Down for Twenty-Eighteen!
That sums up our most recent (and dare I say best ever?) Jamaica dental outreach trip (September 2-11, 2017). Where we once again teamed up with the Sandals Foundation (which graciously donates transportation, accommodation, meals, entertainment, facilities, etc.) and Great Shape! Inc. (a U.S.-based not-for-profit organization, which helps administers the program and organizes the clinics for us) to provide free dental care and education to hundreds of impoverished Jamaicans. Our team of Canadian dentists, hygienists, dental students and support staff was joined by a group of Oregon Institute of Technology (“OIT”) dental hygiene students and faculty. It was a very complimentary and dynamic group.
This year – our third year of going down – was perhaps our most challenging from a logistics point of view. Some volunteers were forced to cancel at the last minute, leaving one clinic understaffed. A personal tragedy among Great Shape! Inc. staff left a temporary void in organizational support. Hurricane Irma, which had been looming in the distance, had some people on edge. Our U Tech (Jamaica) dental student volunteers weren’t available to volunteer (and we were counting on them). Half of the supplies we shipped were nowhere to be seen when we got there. And cavitrons, compressors and sterilizers kept breaking down while we struggled to find the supplies we needed to keep providing care.
Despite all that was stacked against us, we persevered. We changed schedules around to accommodate clinics. We ended up getting foreign trained dental students from Germany to help out. Hurricane Irma avoided us entirely. Our supplies eventually arrived. And we fixed or made due with the equipment we had.
Through it all, we adopted of a number of rules and sayings that helped make everything OK. Rules like: NO DRAMA, TRIPLE P!!! (PUNCTUAL, POSITIVE, PARTY), TAKE A MOMENT TO HAVE A MOMENT, and (one of my personal favourites) JIMMY…. JUST F* IT JIMMY! Importantly, by the end of our mission trip, our team of volunteers had successfully treated over 900 patients – that’s 440 cleanings, 524 extractions, and 200 fillings. Quite an accomplishment given all the setbacks!
But there’s more to it than that. There were so many moments. Moments where we laughed, cried, took a deep breath, reflected, and smiled. Where we loved and were loved back. Cherished memories. A new perspective on life. And I’d like to share some of the funniest, saddest, and reflective stories that came out of this trip…
Dental hygiene student Chanelle “M3” Koster with her 7-year-old patient.
HEY LITTLE BUDDY!
“In North America, ‘Buddy’ means ‘Friend’. But in Jamaica, ‘Buddy’ means penis, so don’t say it in your clinic when talking to a patient”, Papa Joe (Great Shape! Inc. executive director) said during clinic orientation on the second day of our trip.
The very next day, at our clinic, I escorted one of our first patients, a young anxious boy who needed an extraction, to a dental chair and said, “Get up there, LITTLE BUDDY!” with a smile. Then Ron Fung (private equity investor who was assisting) said: “You’re in good hands, LITTLE BUDDY!” And to top it off, Dr. Arsalan Poorsina (multiple practice, Ontario) added “Hey LIL BUDDY, what’s going on?” with his hand extended, signalling for a high five.
Then it immediately dawned upon all three of us. In disbelief, we had just called this nervous patient a little penis no less than three times in a matter of seconds. We slowly turned to look at the young man, hoping for the best. But he wasn’t anxious anymore; he had a somewhat confused look, coupled with a big grin.
A big sigh of relief! Shaking our heads, we all let out a big laugh. We forgot we were in Jamaica doing free dental work in challenging conditions for a group of impoverished people who desperately needed it; we felt like we were at Second City in Toronto doing improv. And for a moment, everyone forgot about the extraction. And so went the week… working hard, laughing harder.
Team Whitehouse outside their clinic in Jamaica.
Team Savanna-la-Mar outside their clinic in Jamaica.
OSCAR THE GOAT
I laughed so hard that I cried. Honestly. That’s what happened when Ron Fung told everyone in the pool (where we typically met up after clinic) on day THREE about his interpretation of the patient intake form.
You see, one part of the form asks: “PET NAME”. Now reasonable people would interpret this as “ALIAS” or “NICK NAME”. But not Ron.
He actually asked patients for THREE DAYS if they had a PET and, if so, what was their NAME. One such memorable patient responded, “I have a goat”. “Great!”, said Ron, filling out the form for them, “and what’s their name?” Confused, the patient said, “Oscar”, referring to themselves (unbeknownst to Ron). “Oscar the Goat? OK” replied Ron, writing it down on the intake form as the patient looked on, confused.
And this happened for THREE days! Oh, how I would have loved to tabulate the intake forms, to determine how many goats, dogs, cats, and fish people had and what the most popular names were.
Dr. Arsalan Poorsina (multiple practices, Ontario) with happy patients.
Dental Hygiene Instructor Sharon Crawford (left) and Dr. Samir Barsoum (Downsview) (right) with a happy patient at Savanna-la- Mar clinic.
Dental Hygiene Instructor Sharon Crawford (left) with Michael Carabash posing at Whitehouse clinic.
While Little Buddy and Oscar the Goat were some of the funniest memories, Chanelle Koster’s (dental hygiene student, OIT) story about one little girl she treated was definitely the saddest. I’ll admit it: I still tear up a bit when I think about this one.
Growing up as a teen mom was hard enough for Chanelle and her husband Andrew. But it got even harder when they learned that their 3-year-old daughter Brianna had a cavity. They didn’t have the money to get it filled. They didn’t have jobs with dental benefits. “I felt helpless and guilty”, recalls Chanelle. Fortunately, after a few months of working hard and monitoring that cavity, they could finally afford to get Brianna to the dentist for a filling.
Chanelle experienced that same feeling of helplessness in Jamaica with one particular patient: a 7-year-old girl. When this young girl came to the clinic for her free cleaning, she wasn’t in a school uniform (as is usually the case), and she wasn’t smiling at all. When Chanelle finally got her to open up, she saw the worst of it. This little girl had roots, but no crowns, on three teeth. All of her baby molars had large cavities. Three teeth needed to be extracted immediately, one of which had an abscess. Infection was rampant. Only seven teeth were viable. No wonder she wasn’t smiling.
It was heartbreaking. Memories of Brianna flooded in. Chanelle, a fighter and now proud and successful mother of three, had gone into dental hygiene to save teeth – to prevent this very thing from happening. But it was the same issue she had experienced years earlier: lack of financial resources. Only this time, it wasn’t a single cavity: it was a tragedy. This young girl’s family didn’t have enough money to send her to school, let alone ever buy her a toothbrush or toothpaste. And so she was just left on her own, to live with the pain and the embarrassment. Seven years old with her whole life ahead of her.
Chanelle empathized. That feeling of helplessness set in again. She cleaned whatever she could and told the young girl she needed to see a dentist at a later date to have the fillings and extractions done. Whether she could come back to see a dentist to do those things for free was unknown, particularly given the long lines of people waiting to get in. Chanelle then gave her a toothbrush and toothpaste and told her, “Even if you don’t have these things, you can use a washcloth and baking soda to clean your teeth”. Chanelle smiled and waved to the little girl as she left, holding back tears and memories.
Chanelle’s story makes me think about what my parents went through with my two older brothers and I while growing up in Malvern (lower-income part of Toronto, Ontario), and also about my own kids and how good they have it nowadays. I don’t take anything for granted anymore. I wake up every morning with a smile and say to myself:
“Yes! I’ve got one more day! It’s a gift! It’s a bonus! If any of those patients that we saw in Jamaica lived one day in my shoes, they’d think they won the lottery. What would they do today? And what am I going to do to help make the world better?”
Going down to Jamaica sure gives you perspective. A perspective that you know exists deep inside, but which you’re distracted from and unconscious to, until you’re exposed to it. There’s no hiding from it in Jamaica when you’re out in those clinics. That’s why I go down every year: to wake up and know that I’ve already won the lottery.
Jenna Vander Velden (future dentist?) watching dad, Dr. Jurgen Vander Velden (Peterborough) and his assistant (Tammy Nelson) treat a patient on her birthday at Whitehouse clinic.
Dr. Arsalan Poorsina (multiple practice, Ontario) and Ron Fung (private equity investor) pose with Whitehouse clinic’s favourite patient: 84-year-old Cephas A. Clarke. The volunteers at Whitehouse clinic raised money to get Mr. Clarke dentures. He thanked us (including literally singing our praises) for coming down and helping his people.
IT ENDED AS IT STARTED
Dr. James Vassallo (Mississauga) remembers his very first patient at U of T’s dental school as if it were yesterday: a little Greek lady named Mrs. Papadopoulos. James picked her because she needed a simple filling for a tiny cavity (1.3 distal) and he wanted to impress his instructor. He soon realized, however, that his dream patient had turned into a nightmare…
James gave her anaesthetic and asked if her tooth felt numb. “Oh yes!” she replied, adding with a smile, “and so is the bottom and whole side of my head”. Not a good start, James thought. After that, things started to really go downhill. The cavity turned into a 3 mm subgingival monstrosity! James struggled with the case while feeling the pressure of his instructor looming over him.
When he finally finished, he braced for the worst of it. Instead, his instructor looked him in the eye and said, “If you can do that one, you can do anything. Congrats!”And that’s how his illustrious dental career started.
Twenty-seven years later, James sold his practice and stopped associating in March 2017. But he only officially stopped practicing dentistry on the afternoon of Friday, September 8, 2017 at the Whitehouse Dental Clinic in Jamaica. After a gruelling week of providing free dental care in harsh conditions, “Jimmy” (as he came to be known) finished the day and his dental career the same way he had started: with a simple filling.
This time, he was prepared for anything. But ironically, it actually was just a tiny cavity on the lower mesial bicuspid. “It was the easiest thing I’ve done in a while”, said Jimmy. “Kind of ironic that I finished that way.”
When I pressed him about how it felt to finally put down the drill, knowing that he’ll never need to pick it up again, he responded:
“It was a weird feeling. Bittersweet. I thought it would be like ‘I’m so glad it’s over’. But then I was like, ‘oh sh**, this is going to be the last time I’m going to be working on someone’. It made me think of back home. I missed my patients and my team. I definitely had mixed feelings, but I have no regrets. I’m happy how it all ended. But I’d definitely come back next year as someone’s assistant!”
Dr. James Vassallo (retired, Mississauga) with a patient and Ann Bengert (TD Bank) assisting.
Our 2017 volunteers left the comfort of their homes, waded into unfamiliar territory, and selflessly gave back. They were all warned about the challenges they faced at their clinics – the humidity, the poor lighting, the crude instruments and equipment, and the long lines of people desperately vying to see a dentist or hygienist.
But when the volunteers finally went down, they didn’t expect to laugh, cry, or reflect on their own lives to the extent that they all did. And if you too need to wake up to your reality, to see how you’ve already won the lottery, then come down to Jamaica this year (September 1-9, 2018). Trust me: you’ll get more than what you give.
Michael Carabash is the managing partner of DMC LLP, Canada’s largest dental law firm. The firm’s websites include www.DentistLawyers.ca (get educated), www.DentistLegalForms.com (get protected with legal forms), and www.DentalPlace.ca (make/save money when you sell your practice). Michael is currently recruiting volunteers for the 2018 Jamaica dental outreach trip (September 1-9, 2018). You can reach him at 647.680.9530 or firstname.lastname@example.org.
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