My experience began with the fabulous dinner we were served by our backpacker guests, who have not yet adapted to the very different liability environment here in Ecuador, which can be summed up by the Latin phrase inscribed above the entry to the country's highest court: "cum fortuna," which means, "Good luck with that." So our guests didn't think of looking over the couscous for foreign objects. In hindsight we might have chewed more gingerly anyway, given the label on the couscous that proclaimed that it was "processed in a facility with rocks."
My rock was about half the size of my tooth before it actually met my tooth. Shortly after the meeting it was a pretty even match. Well, really my filling took one for the team and threw itself in front of the attacking rock, but I was left thereafter exposed to whatever might have been processed along with the steak.
Were I at home in North America, I'm sure I'd have been compelled by law or a billboard* to sue. Here, however, I'd probably face a prosecutor (himself missing two front teeth from a similar fate) and a judge (a first cousin of the couscous manufacturer) both unsympathetic to my complaints.
(* Actual billboard I once saw in denver: white background with a few drops of blood splattered on it and two typeface lines that said, "They made you bleed. Now return the favor." And then the name and phone number of a highly ethical and reputable law firm.)So I got a chance to experience first hand for you, dear reader, this emerging Ecuadorian dental market. I went to a dentist recommended by another gringo, but I've yet to hear a bad dentist story, so I will tell you whom I visited but not presume she's an exception in the field.
I showed up yesterday morning at Dr. Rosalia Moscoso's office (approximately here) but had to make an appointment for 10a.m. the next day. The friend who referred me had said he walked right in and got treated. And from the looks of the appointment book it was pretty fair odds you could do that. But no problem. I came back the next day and was given a stack of paperwork and...heh! just kidding, there was no paperwork. The only time I gave any information whatsoever was the day I set my appointment and gave my name.
She directed me to an already inclined chair which she never readjusted for my sake or for hers (saving some money on electricity). There are two dentists in the office and one assistant who was both secretary and…what, hygienist? So the doctor did most of the work. There was no opening of the hand, calling for tools. Due to the often unwelcome mirror on the ceiling, I could see this lady managing with one hand the tools she had to work with.
But don't let "what she had to work with" mislead you. I had presumed that medicine down here could be inexpensive because labor is so damn cheap and they don't have the uber-expensive equipment we have in the States. Cheap labor, sure. But they've got all the technology here, too. The only thing different here is that you don't get your own private room to keep you from feeling like an idiot laying in a recliner for an hour with your mouth wide open and drool flowing down into your collar. Other than that, totally modern facility.
More than once someone came in to have a conversation with the doctor or the receptionist-slash-hygienest (RSH). And twice the dentist had a phone conversation with both hands in my mouth and the RSH holding the phone to her ear. And though phone etiquette in Ecuador alone is worth another post, I must say I was impressed with the RSH's ability to assist on my mouth at critical times while simultaneously texting. No kidding.
So anyway, I mentioned the unwelcome mirror on the ceiling which, besides making me feel cheap for some reason, also seemed to echo my discomfort back to me. When I paid the bill upon leaving I surmised also that part of the savings comes in anesthetic. I had had a filling replaced at home—oh, within a year prior to leaving for Ecuador—and it was essentially the same as getting a new filling. There was topical anesthetic before the needle for the local anesthetic, drilling, and filling. Here we saved time and money and went straight to the drilling.
Now that may sound bad, and for the sake of a good story, I'll tell it that way by highlighting my coping strategies for the ten minutes that took. As I've said, you're already familiar with the implements. The high speed drill without anesthetic is like a physical manifestation of fingernails on a chalkboard to the nerve that usually lies buried under an exceptionally hard surface but is now dangling like a wet noodle in the wind. Not painful, but enough to make every nerve in my body vibrate like sheet metal cut by a hacksaw. So for the ten minutes it took I kept my eyes closed so I could better envision my happy place. And with eyes open I'd be staring at myself in the mirror on the ceiling and could watch every movement of the drill and anticipate it zinging my tooth, thereby adding the stress of anticipation. So, eyes closed. Deep, regular breathing...
Still, the chalkboard effect echoed through every nerve of my body to create the greatest piloerection I have ever experienced, such that I could sense the inside of my clothes the way a mole feels its surroundings in the dark. And my cold sweats actually produced a thin layer of ice on my skin that I had to quickly and surreptitiously shake off when she turned her head to change instruments. C'mon, ol' boy, Ecuadorian children can do this. You can, too.
Have I made it sound bad? Well, it was uncomfortable, but I will tell you that having experienced that ten minutes of discomfort (not pain), I would gladly choose it again over the time it takes for a general anesthetic swab to accommodate a still tear-jerking shot in the mouth, followed by half a day with Play-Doh face. At home when I leave the dentist after anesthesia I'm just certain I'm drooling like a savant and will terrify small children I pass on the street. I already get stares all day here, without feeling like a frothing circus freak.
As it was, after one hour in the chair, the doctor (not the RSH) escorts me three steps back to the reception desk, says something I don't understand, and writes "23...?" on a pad of paper and pushes it across the desk to me. As I am clearly baffled by this, she says, "veintitrés dolares." Twenty-three dollars. No receipt. No forms. No need to know who I am. I feel guilty pulling out the $300 I had in my pocket to be sure I had enough, whatever the eventuality, and try to hide it as I peel off a twenty and a five.
She gives me two dollar coins, says gracias, smiles, and stares, waiting for me to leave. I feel so cheap. Not even "call you later," or "I had a really good time."
So I hope I didn't "over tell" the drilling part. If I wasn't clear, it was a fantastic experience, as much as that can be said about any trip to the dentist. And when did you ever come back from the dentist, have your spouse look at your filling and say, "Wow! It looks really good"? And even if you ever did, you still would have spit all over her saying, "Phanksh! Ish dahr a ho en ma cheeck?"
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