Tooth

A dumpy-looking low-IQ chick from down the street in Hood Epicenter comes in with what could quite possibly be a real emergency. She hadn't been to our ER before (under that name), had a BP of 210/130, had a 10/10 headache,  no history of severe headaches nor hypertension, and was puking uncontrollably all over the place.  Could this chick have a head bleed, I pondered.

Then I drifted off into another dimension.

As she described her symptom onset, the quality of her pain and all that, I was fixated on the fact that she had a nastyass loose front tooth.  This was a rare moment in my 'hood medical career where I got to see the intermediate step in tooth loss that comes in between when a tooth is stable in the mouth and missing.  Usually either teeth are der or dey ain't.  This chick had like the missing link of missing teeth.  Or some shit.

This tooth was mere hours from falling out for good.   And I had a front row seat.

When she talked, the pyridiumy-orangish-yellow-colored rotten front tooth moved forward and backward with every slither of the tongue.  Back and forth, in and out.  It was positioned next to a toothless hole and another rotten something peeking out from the gingivitis.  The fact that it was near a toothless hole made it so there was nothing to re-distribute the pressure from the tongue (sort of like how people can lie on a bed of nails and not stab themselves---same concept); ergo, the loose tooth took a direct hit with every word and every bit of dinner flying into the emesis bag.

Any moment that motherf'er was going to fall out and it would be a cold day in Hell if I missed that event.  Would she just spit it out like gum?  Swallow it?  Put it in a Kleenex?

I pictured her as a tooth-losing 8-year-old.  Was she pretty?  Was she fugly?  Did her mom and dad take her to the dentist or was she neglected in favor of nights with pulltabs while she fended for herself?  Did anyone ever teach her how to use a toothbrush or did she just not really care to use one?  One always wonders how someone can let their teeth get this bad.

Then, somewhere on the 3rd emesis bag, the patient's sister shows up, looking just about the same, only even more low-functioning with a lisp that caused her tongue to noticeably press on her front teeth as well.  Despite being more slow than her sister, her teeth were in slightly better shape.  As she lisped and rambled on about her own medical problems and tried to put the spotlight on herself as the more ill person in the room, I hypothesized if the pressure from the lispy tongue would---in my presence--cause one or both of the front teeth to loosen enough to make her front tooth match her sister's tooth.  Could she possibly talk enough to loosen the front tooth?  I didn't cut her off during her self-centered ramblings about her IVs and trips to the hospital.  I carefully monitored her front teeth too.  Could this be a two-fer in the world of intermediate-stage tooth loss observational science?  Like finding husband and wife neaderthals in some cave in France or something?

Oh, she didn't have a head bleed.  Reglan and Benadryl worked.