y wife and I visited Berlin this summer – a long desired but much delayed visit … the Reichstag, Unter then Linden, Brandenburg Tor, Checkpoint Charlie, the Jüdische Museum, Topography of Horror, Tiergarten, and the Holocaust Memorial, to name a few visited sites. These places all stood witness to a painful and shameful past and the unimaginable destruction that followed, and then became examples of the determination to rebuild and renew. Although I felt the global aftershocks of it at the time, it was with great consternation that I realized that the wall came down a full two decades ago – in fact 21 years ago to be precise. To use the analogy of the moon cycles, it seems that the past is fast waning while the future is menacingly waxing.
What I saw was the Germans confronting their past with courage after they were hesitant to do so for decades. The signs of the plan to rebuild the former East Berlin, and East Germany for that matter, neighborhood-by-neighborhood, building-by-building, inch-by-inch, were clearly visible; while a few of the relics of the past were left in place on purpose so that we shall never forget. Bold architectural designs all around Berlin are a reflection of the spirit in which the rebuilding is progressing. Murals painted by a selected number of artists from all around the world on the few panes of the Berlin Wall left to stand are akin to a collective global psychoanalysis. By the time the rebuilding process will be finished, perhaps in a decade or so, the initial frictions between the West-Germans and the East-Germans will disappear – either by rapprochement, attrition, or both. The lessons of the painful past and the ideological tunnel vision of the Cold War have shaped the present and will continue to influence the future. Berlin teaches a lesson to all who care to listen. Undoubtedly the Germans took a very courageous approach in planning the future while keeping a worrisome eye into the oversized rear-view mirror. Their investment in intellectual effort, Deutche Marks and Euros of recent is paying off handsomely. Rushing out to the “Brandenburg Tor” on the night of a German soccer team win, I could witness an expression of a newly found, yet still somewhat timid patriotism so much subdued since 1945.
So what does the “Spirit of Berlin” have to do with dentistry in our neighborhood, so to speak? It is true that dentistry does not have a shameful past – on the contrary. It is also true that dentistry does not have to rebuild – accomplishments have been stellar. It is the boldness of looking into the future and planning for it that makes me invoke the renewal efforts in Germany. If we merged the essence of the tale of Berlin with the tenacity of Atul Gawade’s implementation (a must read for all health care providers: “Checklist manifesto: how to get things right. Metropolitan Books, December 2009, ISBN: 978-0-8050-9174-8, ISBN10: 0-8050-9174-2) we could go far. Undoubtedly, will face many crossroads in dentistry’s future as issues of importance come to fore. Although we managed well over the years, some of our decisions seem to have addressed individual issues in a myopic and perhaps paternalistic manner. For example, we did cross all the “t”s and dot all the “i”s very well on the issue of confidentiality by developing specific rules and regulations as to how to guard the privacy of our patients and their records. Looking back at it though, it seems that we over did it losing ourselves in micromanagement (“screen savers to be installed so that nobody could glean any confidential information as they pass by the front desk”; perhaps the suggestions also meant to prevent passengers on low-flying airplanes to find out what happened to the distal cusp of 1.6 as they are looking though the window of our offices). Have we imposed on ourselves a lot more than our medical colleagues and various health institutions, including hospitals?
A more serious issue, based on legal precedent (http://www3.quicklaw.com/cgi-bin/LNC-prod/lnetdoc.pl?DOCNO=288) and clearly beyond the scope of this editorial or my understanding for that matter, is that we dentist lost our rights to treat our spouses or significant others without risking an automatic loss of our right to practice/make a living. What is more disturbing is that, if for example, a third party cares to lodge a complaint at an expense of a Canada Post stamp (52 cents), our plight for defense is without recourse. Those smart lawyers can sure figure out a way to sustain the well founded and fully supported by the profession zero tolerance of sexual abuse without being draconic about it. Somebody has to challenge this mess under the unwritten law of “common sense” – but I’ll leave this to the same lawyers and judges to clean up who created it in the first place.
The emergence of self-proclaimed “learning” institutions, inflated fellowships of all sorts that confuse the public to no end, what do we teach our undergraduate dental students and what is it that we leave out of their curricula, whether to return to our medical roots and continue to be true health care providers or become tradespersons peddling cosmetic services (Botox® for example) are just a few of the great issues of importance shaping dentistry’s future. Those who have the privilege of steering our profession should be bold in planning and meticulously determined to make it happen. Let the “Spirit of Berlin” guide us.
If you did not understand this editorial, it is time to book a trip to Berlin. oh
