By the skin of my teeth

Now in New York City, fighting jet lag….and missing a Nor’easter)

I almost missed the inauguration of the Oral Health Clinic at Pallium India. This clinic will fill an important need for rehabilitation patients, patients who are chronically ill, and the patients who are terminally ill with painful dental problems. Little did I know that I was selected to cut the ribbon!

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Dr. Sreedevi in red sari, as we inaugurate the clinic.

The faculty and staff at the College of Dentistry, specifically Dr Dan Caplan and Marilyn Wessels-Evers were especially generous to gather surgical dental equipment and fluoride that they thought would be helpful. And Dr. Satish Khera donated 20 dozen pediatric toothbrushes and 20 dozen adult toothbrushes. TEAM IOWA-a group of 15 health science students- collaborated by packing all the instruments, the fluoride packets and the toothbrushes in their luggage for their 3 week course at Pallium India. Luckily we did not get stopped at customs. (We had a story all ready about compulsive Iowa toothbrushers.)

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Sr. Sandhya instructs young patients on the use of the donated toothbrushes.

We wish Dr. Sreedevi and Dr. Amirtha great success for the clinic! It will be great to have this resource for Pallium patients.

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Dr. Sreedevi and Dr. Amirtha checking out the dental hygiene on a patient

Oral health is one area that is not covered well in the medical school curriculum. (I have felt grossly deficient in wound management as well). In my practice in an academic center in Iowa,  I frequently “outsource” medical care to other specialties.  I refer all wounds to the wound nurses, all oncology to oncologists, all oral health concerns to dentists, and rehab concerns to physiatrists.

Outsourcing medical care is not always an option in a low resource country. Referrals to specialists may be logistically or financially impossible in a system where patients pay cash for care, and live at a distance from specialty care.   While I am grateful for the new Oral Health Clinic, it reminds me how much I want to ramp up my knowledge base in wound care, mouth pathology and basic oncologic care.

Perhaps, in my return to a high resource country, I can simply ask the question: What would I do if I did not have a specialist to ask?
I am a general internist after all.

And now for the moment of beauty: (I thought I worked for a living until I saw these fisherman pull in the nets at Samudra Beach).

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