A young man named Dr Semwal had recently joined the organization we worked with in India. He had a basic degree in Ayurvedic medicine, but it was soon clear to both Pradeep and me that his knowledge of any form of medicine was minimal. He was brimming with enthusiasm and told us he was ready to take on any challenge. I recognized him as one of those dubious doctors whose confidence exceeds their competence.
However, I had to admit that he was keen to learn. He followed Pradeep like a shadow, learning a practical approach to medical conditions in Garhwal. When a dentist came to conduct a dental camp near Pauri, she offered to teach us how to extract teeth. She went over the basic principles of extraction and showed us how to use some simple dental instruments. Then she taught us how to freeze the mouth prior to extraction. She explained that the most difficult teeth to freeze are the back molars, because there is a small branch of the facial nerve that curves over the jawbone that must be properly located. She showed us how to identify the landmarks in the mouth and how to angle the syringe in order to hit the precise point.
This medical camp in Ghat would be our first opportunity to try out our skills. Dental care is very hard to obtain in these remote areas of Garhwal, and at previous camps we’d often wished we had some basic dental skills. We did well with our first few cases, mostly easy extractions of teeth that were already loose. But then a young man consulted us, complaining of persistent pain in a back molar. Dr Semwal and I both had a look and it was clear that the molar was badly decayed.
“Do not worry!” said Dr Semwal enthusiastically, patting the man on his shoulder. “We’ll have that out for you in just a minute.” He drew up the local anesthetic into a dental syringe, and leaned forward to administer the dose. Only a few moments later, he lifted the dental extraction tool out of the sterilizing tray and reached into the man’s mouth. As he began to pull, the man let out an agonized bellow.
“Dr Semwal - you haven’t properly frozen that man’s mouth,” I said urgently.
“Do not be bothered, Madam,” replied Dr Semwal confidently. “He’s not really in pain. I have frozen him. This must be psychological pain only.”
Before I could intervene, he gave another tremendous yank on the tooth. The man once again roared in pain. But Dr Semwal had the tooth in his pliers, and he waved it happily before the patient’s eyes.
Many years later, I visited a remote area of Garhwal where we had once worked. I was chatting with the nurses at the centre, when I heard a familiar voice. It was Dr Semwal, smiling broadly and giving me an enthusiastic greeting. He had set up shop as a dentist in this area, and he told me proudly that he’d now extracted more than 2000 teeth! I hoped that by this time he’d developed more skill in dental anesthesia!