Until I was about 10 or 11, it seems every hemorrhage I had was either my knee, usually the left, or something to do with my face. During one trip to the doctor, after I used my nose and mouth to break a particularly hard fall, he asked me, “Have you got something against your face, son?” When I was a toddler, all my pictures for about an 18-month period show a large, bruised lump in the middle of my forehead.
Cutting teeth always seems to be a very worrisome time for the parents of guys with hemophilia. In my family, and for many others I’ve talked to, it has always been almost disappointingly uneventful. My younger brother and I seeped a tiny bit around a couple teeth for a couple days and that was about it. At last report, my grandson did the same.
This is strictly a layman’s opinion, has absolutely no scientific basis, and is based on purely anecdotal observations of a few incidents (which of course means it is as well-thought-out as most miracle diets and bowel cleansers are), but I think the baby’s gums are programmed to open and slide around the tooth, which is why they don’t bleed as much as you might expect. The next kid I meet will probably blow that out of the water, but until then, that’s my theory and I’m sticking to it.
Let's Yank That Tooth
The real fun started when you began to lose your baby teeth to make way for the big boys. I seemed to have started later than some, and when I was about 10, I had a couple of back molars that refused to come out. I would worry it with my tongue until Mom caught me and then start up again as soon she turned around. My parents tested the tooth’s hold and decided it was more firmly attached than they felt they could comfortably pull. The local dentist agreed.
At some point it was decided that I should go to the hospital and have it pulled. My assertions that it really didn’t bother me didn’t seem to have any impact on the decision. So, I was admitted to the hospital, my arm was taped down to an arm board, an IV was started, and I was given some AHG. I would continue to get AHG every few hours for the next week or so. After dinner, which seemed to be heavy on the broth and Jell-O, and fairly light on things like meat and potatoes, they hung the NPO sign over my bed, and I was officially condemned to a night of starvation.
I didn’t even get an evening snack, and I can’t tell you the importance of the 8 p.m. glass of grapefruit juice and the two graham crackers. Not only did the flavor clash between the juice and the crackers usually make the muscles on the left side of my jaw lock up; searching for the larger cracker crumbs could take up half the night. At midnight one of the nurse’s aides took my water pitcher away and made veiled threats against my immortal soul if I even looked in the direction of food or drink until after my surgery.
“Yeah, you’re scheduled for surgery at 11:30.”
“But I can’t have surgery! I’m a bleeder!” This was awful. Worse.
This was around 1957 or 1958. I had had one good case of tonsillitis awhile back, and in a couple years I’d have a real bang-up case of appendicitis with the chief of general surgery and my hematologist checking me, in person, every hour. In both cases they gave me large, frequent injections of antibiotics and were hoping for the best.
At that time, if you had hemophilia, the only time you went into surgery was if it was certain you would die anyway. When they were trying to decide if my appendix had to come out, I was given the ever-so-encouraging pep talk: “Don’t worry, Guy, Dr. Fry is our oldest, most experienced surgeon. He might not be the fastest anymore, but he is the most accurate. He’ll probably be able to go in there and get that thing out through a ¾-inch incision.” I still have what’s left of my tonsils and didn’t give up that appendix until well into middle age.
Waiting for Surgery
Around 10:30 that night, an intern came in to do what he was supposed to do that afternoon but forgot. He explained that my tooth would be removed by an oral surgeon in one of the oral surgery operating rooms. It all had to do with, as Douglas Adams called them, clearly marked lines of demarcation. This was the removal of a tooth, which meant the oral surgery department had to do it. Since it was their job, it would be done on their turf. I felt much better. This was hospital politics as I had come to know them.
The next day I went down to oral surgery to have my tooth pulled. That morning they put me in one of those hospital gowns instead of the usual jeans, T-shirt and socks, which meant I had to be very careful if I wanted to read lying on my stomach. I read comic books while the other kids ate breakfast. Of course, it was my favorite hospital breakfast of scrambled eggs and bacon.
Now, I wouldn’t have been able to have my favorite breakfast anyway, because when my mouth was bleeding I was always put on a light, clear diet. It was just the principle of the thing. For those who might not have had the pleasure, a clear diet was exactly that. Everything they gave you was see-through. It consisted of various arrangements of tea, coffee, 7-Up, consommé, broth (the distinction between those two was rather fine) and lots and lots of Jell-O, usually red.
Somewhere around 10 a.m., the nurse came in and gave me a fresh piece of the gauze I had to bite down on all the time. Whenever I came in with busted lips, a badly bitten tongue or bleeding teeth, they would pack my mouth with gauze that tasted like highly medicinal crap, but crap none the same. On a normal day it would serve to clean your mouth of the taste of the consommé.
At 12:30 I got to watch the other kids chow down on what was my all-time favorite meal in the hospital: bean soup. Now, contrary to popular belief, the hospital made a number of truly excellent dishes. Their custards were wonderful, and the cream puffs beyond belief. They also made things that were not so good. The swordfish steak just looked completely wrong, and you only ordered a hamburger if you needed a weapon. But their soups were the best, if you didn’t count the consommé and the broth. And bean soup was the absolute best. Even the guys in the Senate Dining Room in Washington didn’t get soup that good, and when I could have it, I always got three bowls.
Time for Surgery
After a couple more delays, two transporters came to get me at about 2 o’clock. They put me on a stretcher and put a blanket over me, and once again I began to feel this was going to be a much bigger deal than they were telling me. Leaving the ward, we went down the main corridor to a corridor that crossed it at its center point. We turned left and, after 50 feet or so, stopped at an elevator. This elevator was strictly for taking patients to places they very often didn’t want to go. You could go down to Physical Therapy, or X-ray, or to the fourth floor and the surgical suites. As it turned out, we went past the fourth floor down to, I think, one of the basements.
Once I was in the right place, a nurse had me change into an even cleaner gown, and she tied one of those surgical caps on my head so it came down over my ears. Then they wheeled me into the surgery. In it was the largest dentist’s chair I have ever seen, and from the chips and bangs to its enamel it didn’t look like it had had a very peaceful existence. There was the usual pillar next to it with what appeared to be an extensive collection of drills, lights, trays and other things I wasn’t real comfortable looking at.
On the trays next to the chair were several pairs of pliers of various sizes and more sharp, pointy things than I ever really wanted to see, along with enough very large syringes to numb an angry elephant and have enough left to subdue any rhinos that happen by. And there, alongside some pliers with jaws designed to get a death grip on just about any number of items, none of them body parts, were some saws. Saws, for Hector’s sake. They had brought in saws to take out a baby tooth that was hanging on to a bit of flesh the size of an obese rice grain.
A nurse done up in full surgical kit of scrubs, gown, hat, mask and gloves was fussing with the placement of the sharp, pointy things. After a few minutes, the surgeon came in, and another nurse put his gloves on him, just like on Medic with Richard Boone. He also had the whole costume on. He was very serious, and said something to the nurse guarding the sharp, pointy things, and then he sat down on a stool and said, “OK, young man, let’s see what we’re up against here.”
By that time I was in the same mental state as a deer in headlights. I knew something was coming, but I didn’t know what, and I really didn’t want it to happen, but I couldn’t stop it.
He looked in my mouth for a bit, wiggled the tooth with his finger and sighed. The nurse with the sharp pointy things was holding a syringe the size of my forearm in one hand. I swear the needle was at least 10 inches long. In her other hand she had chosen one of the medium-sized pliers, which to my eyes meant it was perfect for dealing with a hippo’s tusk. “Oh, brother,” I thought, “this is going to be bad.” When doctors sighed like that it always meant they didn’t like what they were going to do and it was going to hurt. The reason doctors didn’t like doing those things wasn’t because they were going to hurt, but because it meant the patient was going to be less than cooperative.
Then he completely confused me. He leaned back for a second and then took his cap off and pulled the mask down. He winked at me and said, “I think I can handle this.” And before I could even wince, I felt a sting when he pulled the tooth out with his fingers. He looked at the tooth, looked in my mouth, put more of that bad tasting gauze where the tooth had been, said, “Take care of yourself, champ,” and left.
A few minutes later some transporters (two guys, not the Star Trek kind) took me back to 6-West. I think the nurse was angry because she didn’t get to hand the surgeon any sharp, pointy things.
Read more Guy Boss at the Missing Factor.