This past summer, I was being a good twenty-something and flossing my teeth with one of those tiny flosser-thingies with the handle on them when the floss caught itself in a little gap between one of my molars and the well-worn filling that lived there. I tried wiggling the floss out all nice and gentle, but it wasn’t budging, so I did the sensible thing and started vigorously yanking the little floss stick up towards the roof of my mouth. In a matter of seconds, the floss had been successfully dislodged and was so generous as to take the filling and the back half of my tooth with it. Like any self-respecting young man with a decent pain tolerance and no dental insurance, I proceeded to act as if nothing had happened. Cut to roughly a month later, and I’m a sleepless, nervous wreck who is popping ibuprofen like a proper junky and pouring clove oil into the place where my tooth used to be to cut the pain.
Eventually, I decided to bite the bullet and go in to get the tooth taken care of. I didn’t have a regular dentist, so I decided to head to this place on the outskirts of town that was open on Sundays and advertised crowns for $599. The dentist’s office—ingeniously located next door to a sweets shop—was remarkably modern, with all sorts of automated x-rays and rotating do-dads to examine your teeth and was staffed by a very pleasant group of dental assistants and receptionists and the like. After filling out all of the requisite paperwork about my medical history and (lack of) insurance, I was brought back into a little kiosk with a dentist’s chair, an assortment of menacing dental equipment and a flatscreen TV that had been equipped with Netflix and was playing an episode of That 70s Show. This was undoubtedly the second coolest dentist’s office I’d ever been in, falling behind the pediatric dentist I saw in my youth who had stand up arcade game versions of Donkey Kong and Popeye to play in the waiting room.
A few minutes later, the dentist came by to introduce himself to me and to go over the rather limited options I had if I wanted to save my tooth. The dentist, a 1st generation immigrant from Turkey in his early fifties, was exceedingly nice and also seemingly desperate to convey his familiarity with American culture to his younger patients, if him addressing me as “my bro” and “my brother from another mother” are any indication. However, despite this unorthodox and borderline inappropriate bedside manner, the man came off as genuine so I didn’t think much of it. Going over my paperwork, the dentist nodded and muttered to himself, not seeing anything he deemed out of the ordinary until he got to the section where I had listed what medications I was taking, at which point he wrinkled his brow and a wave of confusion came over his face.
“Fluoxetine…buproprion…lithium…” he said, tapping the paper with his pen in time with his recitation of the medications. “Why are you on these?”
I was taken aback. A non-psychiatric medical professional had never asked me why I took the drugs I took before, especially not a dentist. What the hell did it matter to him why I took them?
“Ummm…I’ve been diagnosed with bipolar disorder, panic attacks and generalized anxiety disorder.” I told him.
“How long have you been taking these?” the dentist asked me.
“Wow…uh, the Lithium I’ve been taking since I was 17, so, a decade now. And the other two I started back in 2009.”
“A decade?” he said. “Shouldn’t you be better by now?”
Shouldn’t I be better by now? Had this guy lost his damn mind? At first I wanted to jump out of my chair and go on a 3 minute-long tirade about this man’s complete and utter lack of professionalism and his troglodytic understanding of mental illness, but something stopped me. This guy wasn’t being purposefully insensitive…he was just ignorant. After all, it’s not like he got much of a primer on mental health when he was in dental school. Better to just let it go.
“I am better now,” I told the dentist. “But if I want to stay better, I have to keep taking the medicine.”
“So, you’re not going to come in and shoot the place up or anything?” he said, with the impish grin of a 9-year old who said a very funny, naughty thing.
“No,” I told him. “I think you’ll be alright.”
I wish I could tell you that this sort of an exchange wasn’t commonplace—that most of the people I encounter in my life have a better grasp on mental illness than my woefully misinformed dentist—but I can’t. Granted, the majority of people I come across aren’t as overt in the profession of their ignorance as Dr. Hackenbush, DDS was, but a good number of them hold the same dangerously ignorant preconceptions about mental illness as he does. By and large, Americans have a very difficult time talking about mental health issues—whether in public or in the privacy of their own homes. The only times that we engage in anything approaching a national dialogue on mental illness are after the suicide of a celebrity, as was the case in the wake of Robin Williams’s death, or after a high-profile shooting like those in Newtown and Aurora. In both cases, the discussions are usually short and without much consequence, but with the mass shootings, pundits, policy makers and politicians all too frequently take the bully pulpit in order to castigate the mentally ill shooters for their actions and to deflect justified criticism of lax gun regulations onto a mental healthcare system that they have little desire to overhaul.
The only times that mental health issues are given a pass in these sorts of shootings are when another political football proves to be more enticing option for those in power to focus on, as has been the case in the murder of New York Police Department Officers Rafael Ramos and Wenjian Liu by Ismaaiyl Brinsley. A 28-year old black man with a documented history of mental health issues and domestic violence charges, Brinsley broke into his ex-girlfriend’s house in the early morning hours of December 20th and put a gun to his head, threatening to kill himself. His ex-girlfriend, Shaneka Thompson, talked Brinsley out of committing suicide and was rewarded with a bullet to the stomach which nearly killed her. However, in light of his virulent, anti-government Instagram rants promising to put “wings on pigs” and dropping the names of victims of police violence like Eric Garner and Michael Brown, the narrative has focused predominantly on racial issues, with politicians like Rudy Giuliani and police union president Patrick Lynch taking the opportunity to erroneously blame a massive, international protest movement for the actions of one, mentally unstable individual.
It would be unreasonable to expect any sort of meaningful action on mental illness in America from these NYPD shootings. It has been more than 2 years since 20 children and 6 adults were shot to death in Newtown and there has yet to be any legislation passed by Congress to address the severe underfunding and poor implementation of mental healthcare in this country. Since the tragedy at Newtown there have been 21 fatal school shootings along with many more mass murders at businesses, military bases and private residences, and our collective sense of urgency to implement mental health and gun reform has actually waned. That dialogue we were all supposed to have about mental health never really happened and we are still frightfully ignorant as a society concerning how to treat the mentally ill in general, and the severely and persistently mentally ill in particular. 10 times as many mentally ill Americans are languishing in prisons than in mental hospitals and more than half of the 350 to 500 Americans killed by police each year have mental health issues. These facts should be alarming us into action, but most of us go through our lives blissfully unaware of the plight of the millions of Americans who have untreated mental illness. On a certain level, I suppose I should be grateful just to have diagnoses and medications prescribed to me for said diagnoses that my dentist can make inappropriate jokes about. A lot of folks aren’t even that lucky.