-this afternoon my thoughts were that i am not cut out for surgery. i already knew that. the feeling that my arm was gonna fall off this afternoon just confirmed it again. amusingly, i got a pamphlet in the mail today about penn's omfs department and program. ha.

-felicita passed away on friday night. m, j and t, have had to miss a lot of work during her 2 month time in hospice. ehc is somewhat of a family business. there are pros and cons. it's a blessing to support one another. but it puts a strain on everyone when we are short-staffed. anyway, my prayer is for peace in their family. felicita's legacy is that she lived a life of faith, prayer, praise and worship, in spite of a hundred novellas' worth of hardship. i asked t if she thinks that her grandmother was fighting for life because she was waiting for someone to see her or some reconciliation to happen. t responded with 'she wants to see all her grand-children saved.' perhaps the faith to believe that would happen was granted and she was able to finally go home.
this experience has led to a lot of reflection on family, bereavement, cultural expectations of caring for the elderly and duty. also thinking about emotional management in the context of daily life management.
and of course, whenever a grandparent passes away, i remember my own grandparents (biological and anyone else i called 'ahmah/ahgohng') and their passing, and how my parents responded, and how they expected me to respond, and how our expectations differed.

-i've sorta come to terms with why people can't stop calling me chinese, even though they say that they understand when i tell them i'm taiwanese. and that they relate because they are from islands like puerto rico, and the dominican republic. and they get upset when people call them mexican. so that last part is key. some people just can't stop calling them mexican. like how some people can't stop calling native americans indians. as if 'chinese', 'mexican' and 'indian' were races. or thinking that "africa" is a country. or asking indians if they speak "indian", rather than hindi. or that time when i was in preschool and someone asked me, "are you chinese or are you english?" and i went home and told my mom about my confusion because, as a 4 year old, it didn't make sense to me why someone would ask such an illogical question. (i guess in canada, there are a lot more british immigrants. but, i only had one childhood friend with a british mom.) kinda like how i was confused in kindergarten why my classmate would confess, "i didn't do nothing!" because it wasn't a good way to plead innocence, because if he didn't do nothing, then he must have done something.

i had to dig deep on this one.

-what would i do without weekends?

-thankful for a snow day last thursday

-tom came to check out the clinic on friday. makes me wonder what it will be like to have 20 years of knowledge and learning from successes/mistakes. and also makes me thankful that i've been able to learn kingdom values at a young age. not that it's any grounds to be proud. but i'd rather live for christ now and not have to think about the woulda/shoulda/coulda later.
doesn't mean that living for christ entails all the external things. because God is trying to tell me that it's really about His dwelling in hearts. (went to two churches this morning. got in touch with my black side at epiphany. then got in touch with my white side at liberti. then realized that i need to let go of whatever residue of guilt i might feel with going to other churches, as if cheating on my church where i have membership, or something. and both messages, expressed very differently, were about Jesus being on the throne of our hearts.)

-patient S returned last week. she's the one who talked about how school was 'corny' and she goes to school 'with criminals'. i have a series of questions that i always ask, it's kind of robotic now. sometimes the patients forget what i ask them (if it's every 6 months). but more often than not, people expect me to remember everything that we talk about. which i understand, since i can remember my convos with my dentist. honestly, though, having 10-20 people to talk to... it's hard to keep track of it all in my aging adult brain. so i spewed out my usual, "did you get any homework today?" and she responds with, "i tooold you! i don't get any homework!!!" so i quickly fire, "did anything interesting happen at school today?"
s: "no. i toooold you, school is boring."
me: "but i thought you went to school with criminals!" (1 point for me, remembering what she had mentioned in previous convo)
s: "ooh. you mean THAT kind of interesting. it's no longer interesting to me if i see it every day."
good point there, s.
s: "one girl was getting jumped by a bunch of people. everyone ran upstairs to see what was going on. so i ran upstairs to see too."
a-ha! you must have been interested enough to run up and check out the hoopla.
s continues: "her face got messed up."
sad. but interesting, i suppose.
still not sure what is the best way to respond to these stories. so i just let S know that i'm glad she is staying out of trouble.
but she really needs to take better care of her teeth.

-O came by very anxious because he needs 2 teeth out (was assaulted by 3 coworkers at work a couple years ago, broke his two front teeth). i felt so bad because i was explaining the treatment plans and costs, and he started sweating.

-E came back after a long hiatus. her dad reports she's been crying in her bed because of tooth pain. her mom told him to take E to the dentist once he had some time off. it's been difficult because he's been plowing snow for the city for the last 72 hours, not much of a break and not much sleep. (the quality of philadelphia snow plowing does not compare to michigan. i never felt like i needed to carry a shovel in my car in michigan because plowing is neater and more efficient. more practice, i guess. but in philly, i'm considering getting one to store in the trunk. i dunno if the state of the roads are exacerbated by the fact that it's a little warmer here, so the snow does tend to be in the slush state longer. but i think i will need a new bumper sooner than later.) back to E. she came wearing her hello kitty jacket. monin made a comment about, "ooh! i like your hello kitty jacket." E looks at me and blurts, "remember you told me about hello kitty in china?!"
i don't think i told her about hello kitty in china. i probably mentioned that hello kitty has a boyfriend, named dear daniel. and that helly kitty has an empire in japan (hk airplane, hk land theme park, hk kitchen appliances, hk computers... etc).
i remember telling a little girl sometime last winter that i would bring her a stuffed hello kitty doll, that was sitting in my drawer in ann arbor. i couldn't remember who it was. so i asked if it was her. she said "yes", hesitatingly. and her dad confirmed it. which leads me to believe that it wasn't her. because there was definitely not a dad around during that first visit.
anyway, she needed to come back to get some fillings. and when people don't come back right away, things start to hurt. she was in so much pain. so i gave it to her anyway. it's kind of a limited edition hello kitty, only sold in hokkaido. i told E that. and her dad was super impressed that he took it from her.
so, dad's snow plowing friends are going to make fun of him for being a grown man with a hello kitty plush doll on his keychain.

-i love it when kids speak like adults. it's so unexpected! even if it's like the adults who don't speak proper english.

-was talking to margaret at lunch. she's got a clinical supervisor and is trying to make the most of this mandatory mentoring relationship. one of her questions for her supervisor was "how to reconcile dual relationships? like in a counseling situation, where do we draw lines/how do we draw lines/is it necessary to draw lines when our friends become patients, or when our friends are patients of our colleagues?" the answer given was to the put the ball in the patients' court. ask them if they're comfortable seeing a friend. and if they are, then that's fine. if they're not, then they can see someone else, no hard/awkward feelings needed.
okay.
i've seen a lot of friends as patients. i've seen my mom. i've worked on a few coworkers. we're generally recommended not to do that due to possible conflicts of interest, or weird emotional things that can be going on.
i guess it depends on what kinds of procedures. and i do try to put the ball in the patients' court. but what about the times when i don't really feel comfortable even if they are completely trusting and comfortable?
in general i love seeing friends. coworkers feel a little different because whenever i see them at work i feel like they think that i'm judging their diets/hygiene habits/teeth. anyway. of course i'm judging! but not without judging myself too. i eat a lot of candy. and it's not like people's health habits change my affections (or in the extremely rare lack thereof) toward anyone.

so calvin just took this class on motivational interviewing and he's been on a motivational interviewing rampage with our patients.
motivational interviewing is a technique to probe patients' wants and desires, assess them, educate them about oral health, and basically get them to want (and thus be motivated to pursue) the appropriate treatment that they need. it's kind of a huge mountain to scale, with the majority of the population being afraid of dentists and all, and especially in this population where
1. people are afraid of the dentist
2. people have a different paradigm as to what is an appointment ("maybe i'll come if i don't have anything better to do! it's gonna be a surprise!" as opposed to, "oh, thank you for setting up an appointment time, which means that i will show up, and if i can't make it i will let you know ahead of time, otherwise i will feel ashamed.")
3. people might not think it's important to go to the dentist until something hurts, and then they finally come while they're already in excruciating pain, so of course it's not that pleasant of an experience, and then finally we're back at #1.

anyway, in dental school all of my classmates hated our motivational interviewing class. it was the bane of many's existence. in school i tried to lay low. i kept quiet. got my work done. didn't say anything within the radar. i've blocked a lot of memories out, but it kind of amuses me how much disdain there was for our behavioural science and treatment planning or communication-enhancing type classes. hahaha.

so it's been amusing (and helpful) seeing calvin so enthusiastic about asking patients why they came to the dentist and trying to empower them to take care of their oral health.

meanwhile, while we're working on patients, we are in constant dialogue. so we analyze this motivational interviewing thing. and he goes, "amy, you're good at asking people what's going on in their lives and listening to them."

i'm an affirmation monger. so that feels good. it's something i appreciate about working at esperanza, that i have time to get to know the patients and learn about their lives. christ's ministry goes beyond physical healing and christ really addresses heart issues. i strive for that.

my secret confession is that

i think deep down there's a part of me that lives to entertain and for entertainment. so there is this residue of motive for me to ask "what happened?" if a patient hasn't shown up for a long time, or is not having a good day because i just find their stories soooo interesting, being worlds apart, and it gives me something to think/talk/blog about.

of course i care about my patients' lives. but i guess the interesting stories are a good incentive to take the time and get to know them.

-i probably can't sustain 5-6 hobbies if i'm going to work full-time. i can probably just pick 1 or 2.
-if i want to get more done, i should probably talk less, blog less, do more. then maybe later i can write a book about it.
-7 yr old girl offered to pay me the money she would get from the tooth fairy if i let her take home her tooth. so cute!

on septa there is this ad that says something like "save $600 by getting a train pass. get 20 more manicures this year."

i guess they kinda know who's riding septa and whom to cater their marketing.

today B came for a denture checkup. usually i comment on my patients' nails. "oh, that's a pretty colour!" or "i really like that design!"
i dunno if B was sad that i didn't say anything right away this time. coz she kept looking at me, then looking at her nails, then looking at me, then at her nails. so finally i caved and said, "ooh! you just did your nails again! nice summer colours to brighten a cold winter day!"
actually i didn't really say that, coz i spoke in spanish. whatever i said probably translated to, "how pretty are your nails! colours for summer. not winter."
i need to work on spanish and linguistic nuances.
jajaja.

the other ad that makes me laugh on septa is for this sam bernstein type lawyer named justin bieber. expect it's justin m. bieber. i wonder how many pre-teen girls call the number on the poster.

snow and ice today, but we had some metaphorical sunshine and rainbows in kensington today because the kensington strangler (serial rapist/killer) has been arrested. they gotta confirm DNA tests but the reports say that he's already come up with a confession.

the kid's only 22. which is kinda amazing that it took so long for him to be caught. he'll probably end up with a life sentence for being a career criminal/menace to society.

i'm trying to think of what i was doing at 22. (finished college, backpacking in europe, mission trip to micronesia, starting dental school, living with parents...)

i'm reminded of a patient, T, who used to be a career criminal. he was the one who explained to me that a career criminal is someone who commits at least 3 felonies. now, in his 60s, he is following Jesus and trying to live for God. it's hard to believe how people can change, especially in thinking about the hurt that victims/victims' families have to endure. but there's hope, somewhere out there.

---------
van came today coz i'm making her some retainers in exchange for a box of contact lenses. she's my new canadian optometry school friend in philly. anyway, her first snapshot of kensington is sitting in the waiting room next to my patient, Q, who came in with her hair full of rollers.
when i saw Q in the chair, i asked if she had a snow day today. she answered that she did not have a snow day. i then asked if she went to school. she did not go to school, but the school called her house to ask why she was absent. i wonder if she told them that she was absent because she had rollers in her hair. anyway, she told me that she's had them in for a few days but was too lazy to take them out.
okay.
van was tempted to take a cell phone camera shot of her, but refrained.
i assured her that Q was the first patient i've seen that has come with rollers.

H came in today and taught me that 'endo' refers to percocet. i looked this up and endocet has the same composition as percocet. prior to knowing this i was told by a coworker that endo usually refers to marijuana, in reference to a snoop dog song. just cross checked this on urbandictionary and endo is specifically marijuana that is grown indoors. H also wrote down 'zanac' and told me he only takes that to get high. me: "are you taking zantac or xanax?"
H: "xanax. sorry, i probably spelled it wrong."
me: "are you taking zantac too? do you have allergies?"
H: "no. just xanax."

went to police athletic league with 8 of my coworkers this morning for martin luther king junior day of service. it was a pretty cool center - lots of gyms, computer room, dance room, game room, homework room. it's free for all kids 6-18 and it's helping keep the philadelphia youth off the streets and out of trouble. we didn't do too much, just helped clean some windows, mopped the floors and tables. but, it was a good break from clinic. and we were able to meet some other folks from the community (volunteers from a local law firm) and then the staff at PAL.

after we had a potluck w/ esperanza and afternoon retreat. our speaker talked about the "whole gospel", meaning integrating service/social justice/mercy/compassion with evangelism (as compassion on souls). the gospel needs to be expressed with our hands, feet, as well as proclaimed with our mouths. he went to the 2010 lausanne convention in south africa and saw, not through the amazing speakers at the convention, that missions, essentially, is loving God and loving neighbour - portrayed when he visited one of the impoverished townships and saw that people were caring for one another.

he read from luke 10, which starts with a busy massive commissioning of disciples, sent out to preach. then goes to very basic principles of "how to inherit eternal life?" - by loving God and loving neighbour, like the 'good samaritan'. then finally wrapping up with loving God starts w/ Mary spending time w/ the Lord, perhaps as a prerequisite to loving neighbour.

met ben today. he moved out to philly from indiana to do missions. he started out w/ frank vega's ministry in kensington to the drug dealers and prostitutes. i told him that hmcc used to send missions teams to kensington. and that pastor frank spoke at one of the hmcc revivals... back in the day when there used to be revivals. so, he's married to p. frank's daughter and said that he remembers travelling to ann arbor and also facilitating some of the hmcc teams. small world! anyway, ben's current ministry was planted by ihop and they're training up inner city youth to use art and prayer into worship.

so every day at work it's been a frequent routine to ask "why am i doing this?!"... B was very encouraging and shared (unsolicited) "it's great that you are here because a lot of us missionaries don't have extravagant health insurance. it's wonderful to see the body helping the body."

good exhortation to finish the week. phew!

-met A today and she is 30. but she is pregnant with her 10th child. my initial reaction in my brain was, "WTH?!" but anyone who i expecting that i see i always start by saying, "congratulations!"
of course i tried to get the story. she had her first baby at 14. the youngest one currently is age 1. her parents have been very supportive. the baby daddy, however, is a different story. he 'finally' agreed to get married after getting out of jail. but it perhaps made things worse for her. she thought/wanted him to change but he didn't. he still comes and goes when he pleases and cheats on her. she's not sure what she's going to do with him next but she kinda wants out. she has 6 boys and 3 girls. the next one coming is another boy. she seems content.
the first delivery was the most frightening. but the 3rd delivery was the hardest/biggest baby/toughest labour.
she sometimes wishes she could take a vacation.
really?!!! i wonder why! hehehe.
anyway, i love having moms enumerate the names of their children. i think it's beautiful, like poetry. kinda like listing off the tribes of israel. or the twelve disciples. or the 7 von trapp children. or the 10 provinces of canada. in order. i like order!
A listed off her children's names with a slow start, but once she got going the names just flowed. i didn't have time to ask her to list off all their birthdays. she needs half her teeth out.

-C came today and reports that she is extremely afraid of health care providers because of a failed toe surgery. perhaps the doctor placed too many steroids while correcting a hammer toe. now the bone is necrosing and she will likely need an implant of some sort. she shared and shed some tears. we prayed for her. and then she went on her way.
this tends to happen a lot.

-helen came back w/ A and N from dawn's place. it's been challenging. but these ladies are so spunky despite who knows what kinds of crazy hardships they've endured in the so-called brothels of harrisburg.

-blanked out on suturing for the first time in a long time. took me 10 seconds to recall how to properly tie a knot. perhaps need to practice.

-i love sewing! that's the worst reason to become a surgeon. if someone wants to become a surgeon they should love surgery. kinda how people get rejected from engineering school if the only reason they write on their personal statement for applying is that they love playing with legos. anyway, i'm gonna stick w/ sewing fabrics.

-why i wash my hair every day:
when doing some suturing earlier this week i leaned my head in and calvin, who is like a foot taller than me, accidentally ran the bloody suction tip into my head's field of movement. one day perhaps i shall invest in a hair net. his look of remorse was quite amusing. but we both quickly get over these types of things.

-yesterday i could hear some patients who had kinda given me grief in the past, but we still love and respect each other. they were talking to one of the nurses in the hallway. there was a time in my life when i was completely conditioned to be an extrovert because i thought it was the christian thing to do - to be super outgoing and friendly and whatever. anyway, after college i've been gradually resorting back to my natural "I"dentity. instead of going out to say 'hi' despite having a lot of free time at the moment, i hid in the corner behind the computer, out of sight, and read a slew of brady hoke articles.

-saw N today. she came with a translator for bahasa indonesia this time. it's great the esperanza sent me to learn spanish. because it's so much more draining to do this job via translators.
anyway, it was cool coz her translator, H, is a nurse by training. but she feels gypped that she's been without a nursing job for several months, because it seems like all nursing schools and advocates promise a huge shortage of nurses resulting in a plethora of jobs from which to choose.

-at home mtg tonight (small group) one of the women was telling me how she also feels gypped by the nursing school for these unfulfilled promises of job location/specialty choice. two isolated comments in one day!

-was reiterating monday's shooting with calvin and talking about how S had to identify the shooters in front of their faces. unfortunately the system of witness protection in the hood is not very there. "snitches get stitches!" i laughed when i heard that mantra. but it's really not funny.

-6 inches of snow and philadelphia public schools call a snow day. wusses!

-i haven't cleaned this much snow off my car since michigan (since i parked in a covered garage last winter). it was kinda nice and made me thankful that i grew up with this type of weather. it's somehow made me tougher (the cold and ice). even though i'm a wuss in the extreme heat.

oh tuesday.

-ty had 2 red bulls and 1 xl coffee from dunkin' this afternoon. she threw up midway. not a good idea! even if you're falling asleep at work.

-"A" came back after a brief hiatus from the dentist. she shared the reason why she wasn't able to come for a year was because her oldest daughter, R, was shot in the neck. she was in the passenger seat of a drive-by, the shooters were after the driver. her english is practically native, but in talking about it, stirred up emotions where she could only express that "fue un milagro!" in her native tongue. one bullet grazed and another was lodged in her neck, just missing the nerve that would have caused her to be a vegetable. meanwhile the second daughter, M, whom i saw right after, was locked up for a brief time. she's only 16. anyway, it must be stressful feeling like she has no control over her children. the thing that someone from my world would not understand is that everyone knows who shot R. but no one can say anything. because worse consequences could ensue.

-had a really good lunch today. marinating things longer always helps.

-Z and K were back. they're inseparable. if i had a normal tolerance for awkward situations, then i'd be uncomfortable. but since my career is based on putting my hands in people's mouths, and people's heads are in my lap all day, my tolerance for awkward is pretty high.

-tried soup dumplings (shiao long bao) at dim sum garden today with K. sure it's a grimy joint. service was... humourous. the dumplings were all right.

today's devotion, susan asked us to think about "why is God amazing?"
it took me a long time.
because i'm not a morning person.
and i wasn't thrilled about monday mornings.

finally, 3.5 hours later at lunch i walked to dunkin' donuts and had to pass through the crowd that waits for the bus on the corner.

God is amazing because there are so many people in this small land area, and everyone is so different. very amazing to me.

more amazing is that God actually cares.

i wonder why. and that's what amazes me.

anyway, had a good renewed realization that my work is work, but really it's not 'work'. some of my most joyful moments were on the field. God reminded me that i'm still on the field. in this country that is not my country of birth.

shooting at K&A today at 1 p.m. wowee!

we heard gunshots around 1 p.m., there were about 10-15 shots fired, and very quickly. so at first i was wondering if there were firecrackers...
but alas, i am still a tourist here.

ada and i, the small town midwestern girls that we are, gawked out the window for the next 20 minutes. (so exciting!) meanwhile our north philly native coworkers decided they had seen enough of this stuff growing up, so they went back to work.

during the time, our coworker, s, comes on the scene and speaks to one of the cops that pulled up in a cop car. it looked like a silent movie coz we saw him pointing and telling a quick story and his mouth was moving, then i guess the cop asked him to get in the car, they made a uey, then went in the direction to where one of the shooters ran.

more cops came, firetruck, helicopter, then ambulance came and picked up two older men who had fallen to the ground, then they taped off the scene.

later i talked to S. he said he had seen the entire episode from his office window, so then he ran out to tell the cops what the shooters were wearing. they apprehended two (of three) of them (chased them down the street into a house). so S had to stand in front of them and tell the cops which ones were the guys. awkward! those two guys were brothers, one of whom was shot in the back. he apparently was well enough to run to the house, but looking up on the news, it says he's currently in critical condition. S said he saw him sitting down on the floor with blood dripping onto the floor. apparently there was a 3rd guy who was shooting back at them and he ran in the other direction. eeks. hopefully they caught up with him.

saturday we had our staff 'three kings holiday party'.

it's cool learning about puerto rican traditions.

thankfully i'm trying to eat more salt these days, trying to raise my super low blood pressure. because 'spanish' food was uber salty.

i learned what is a BOMBA! everyone goes around reciting clever couplet rhymes interlaced with the 'bomba!' chorus. i love the drums, shakers and loud celebratory nature of the culture.

i've never felt actually threatened in north philly before. but after parking my car on a side street and seeing a tall man with his hood over his face walking toward me, i started skipping down the block over to the church where the party was being held.
i never realized i'd be skipping during times of fear. i imagine most people just run.

in retrospect, though, maybe i should have just said, "HI!" to promote some neighbourly friendliness.

kudos too all the brave folks who live in the 19133!

i asked S how her day was at school. she replied "corny".
i asked why and she answered, "because i go to school with criminals".
she's 16 and sees the direness of the school she attends. "my school was on the news yesterday because it's so bad." thankfully she doesn't allow herself to be influenced by it. and maybe doesn't feel the power to do anything against it. or more likely, doesn't want to do anything against it.

lately i've been thinking about social change on smaller scales. my mom sent me to a preschool where i was intended to be a 'good' influence on my classmates who had some behaviour issues. i had to interview with a psychologist, who would evaluate and see if i would be fit for the program. of course my 4 year-old self was unaware of this at the time, and for the next 20 years thereafter. i remember being in the room with the psychologist, but he was having me do more cognitive and creative tests (reading, math, drawing pictures). i remember some kids getting in trouble more than i did (jimmy and nathan). but i still did get in trouble at least once (for not listening to the teacher's instructions during kiddie pool day, resulting in the teacher telling me to change from my swimsuit back into my clothes, but she handed me the wrong clothes, and i went home wearing some other girl's shorts).
anyway, i wonder if the program worked. not that it seems measurable since there are so many variables here w/ child behaviour.

so, it really does take a village to raise a child. and for S and her schoolmates, it's going to take the whole village and an act of God to turn the school around.

fake snow day

everyone on the east coast was going mad about wishing for a snow day today. the weather predicted 1-4 inches of snow in philly. where i am from... that's not cause to close school/delay school start time or to miss work. but, in philly, anything could happen.
this morning i called the work hotline for inclement weather and the message told me that we would open clinic at 10:30 a.m.
i assumed that the road were perhaps pretty icy.
but just to make sure i wasn't dreaming, i called the number again to double check that i could come into work late.
elated, i went back to sleep thinking i could rest another hour or so.
at 9 a.m. coworkers called me to see where i was. that there was a mistake on the hotline - the wrong message was posted. and that there was only an inch of snow.
oops.
the worst way to wake up! (when coworkers call to say, "WHERE ARE YOU?!!!".... reminds me of church meetings on a saturday morning...)
anyway. made it to work finally and everyone had a good laugh about it (at my expense), except for the patients who were a little puzzled why they had to wait so long to get their teeth worked on.
lesson learned that i should look out the window before going back to sleep.

sometimes i think of going overseas. not that i want to. but i've lived overseas a lot.
today i see that the foreigners are indeed coming here to philly. two more indonesian ladies came in today, also from dawn's place, so i got to practice french w/ sister M again. it's so interesting to learn that all these women were sent to philly to this safe house all the way from harrisburg. i don't know anything about harrisburg and assumed it kinda had a suburban feel, but moreso coz the name sounds suburban. but like any state capital, i guess there's the good and the bad. and i could only imagine some brothel in the city with indonesian women, who are deprived of their identities and then forced to work. anyway, i don't really know. but i can only speculate at this point. today the two were both wearing hijabs (can i pluralize this?), and their demeanor was much lighter than N from 2 days ago. incidentally, their teeth, while still completely broken, wasn't as gnarled as N's. body reflects mental/spiritual/emotional states!

speaking of which...
J came in today, another new friend from one of the local men's rehab homes. we're the same age. but he just looks so much older. i guess that's what drugs do. well, those kinds of drugs.

he was kinda entertaining. and very intrigued because he had never seen a chinese person speaking spanish, ever in his life. i told him three times that i wasn't chinese. and then after a 10 minute discussion, calvin chimed in coz he realized that J was using 'chinese' as an antiquated term for race. like, even though he understood that taiwan is kinda like puerto rico, and we had a good bonding moment over that, this new understanding still could not compute to change the language he grew up speaking.

then he told me (unsolicited by me, i swear!) that he has a muchacha that recently has been giving him heart problems, and as a result he's been crying every day. my spanish comprehension is still lacking, so my follow-up questions were, "oh, so you have a girlfriend?" and then he was like, "no, i don't call her my girlfriend. she's married to a dominican. we've had a relationship for 8 months. but she just dropped me. and i have so much pain in my heart."
me: "why do you like her?"
J: "i like her body. and she means a lot to me. but it's over now. and this year i will have a fresh start."
i dunno if i broke professional rules by asking personal questions, or broke rules of counseling by asking poorly worded or poorly sequenced questions. but hey, i'm getting some good spanish convo practice.

on a different note, this week i've learned that there is some animosity between domincans and puerto ricans. maybe there's some animosity between any group. but apparently puerto ricans consider dominican men as being extra flirtatious and promiscuous and abusive.
and my follow-up question was, "so puerto rican men aren't flirtatious?"
the answer was, "heh. yes, but not as bad."

interesting.

calvin told me to check out this link. it's an enlightening exposee on the philadelphian accent. maybe he sent it coz i have trouble understand what folks are saying around here. haha.
hope i don't start talking like this anytime soon.

http://www.youtube.com/watch?v=l3lZFiyd_-0&feature=related

welcome 2011

he seemed to be the typically same ole' same ole' panhandler at the septa station this evening.

initially i thought he was asking for "change". so i gave a sympathetic look and apologized that i couldn't give him anything.

then he kept mumbling similar syllables until finally it dawned on me...

DID HE JUST CHING-CHANG-CHONG ME?!

i think he did.
should i be surprised?
maybe i shouldn't be.
shock and shrug.

super slow day today. God knows when i need a break!

met sister M from dawn's place, which is a safe house for women victims of domestic/sexual abuse. she brought in one of her clients, N, who is originally from indonesia. she's been in the states for about 10 years but doesn't know much english. she has no identification, no visas, no papers, no money. it seems like she was basically in a slavery situation, traffiked to the states and working for whatever she could get. sister M worked in the middle east for 30 years. so she speaks to N in arabic. sister M told me that N learned arabic while working for an arabic-speaking family. i suspect that maybe a lot of indonesians pick up arabic also from the large muslim population in indonesia. not that muslims = arabs, but there is a belief that to really know the koran is to know it in arabic.

then ensues an onslaught of discussion amongst the coworkers about belief systems, the continuum of fundamentalism to non-fundamentalism (?), and faith around the world. i love talking with my coworkers. hehe.

anyway, it made my day that sister M is french, from bretagne/brittany. and my french speaking came back, miraculously. it just sorta flowed, but then there were some points when i wasn't exactly conscious of what language was coming out of my mouth. dental french is a different story, and i think i should just look up all the vocab so i can communicate in my field better.

N will essentially need all her teeth out and finally some dentures. i still feel very much like a novice with these types of complicated cases. but, maybe something different that i can offer is prayer for my patients and their caregivers. :/

later i was telling taina that N probably speaks bahasa indonesia. and she got really excited, the smartphone addict that she is, and looked up youtube videos to hear what the language sounds like. and because she is goofy, she was thinking in retrospect, "omg! we totally should have played these videos for her!"
my initial reaction was that would have scared the patient away. on second thought, maybe it would have been nice for her to hear her mother tongue, because she probably doesn't encounter it frequently anymore.

i, of course, love to hear taiwanese. recent discovery in december was that the owner of ray's cafe down the street is taiwanese and her name is grace and they close on sundays.

my goal this week is to tie up all the loose ends from 2010 at work (and life, i guess) and leave them behind as i enter 2011.

that was my goal 2 weeks ago, but then it was a really crazy december. loved it! (so many visitors: jon, antoine, aurelie, cece, crystal, jess!) but then i tend to get burned and then crash, as opposed to crashing and burning. lots of activities going on and some farewells, then escape to the midwest and to the middle of nowhere in wisconsin... all resulting in a bad month for blogging.

i realize writing takes discipline. and as i'm trying to read more, i see that lots of 'novel' ideas are perhaps quite commonplace, but the difference that makes is a writer is the ability/motivation/drive to sit down and just jot it down. esp in a culture of 'doers'... it's hard to be still for a moment. anyway, here's my attempt for the purpose of reflection, moving forward, and GOOD RIDDANCE!

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quick snapshots of patients that i wanted to remember via writing down, so that sometime in the future i might look back and says 'whoa'.

-woman on 5th and indiana who does not go out of the house. reports there was a shooting out side her home halloween weekend.

-D, who, maybe subconsciously thought that local anesthesia was supposed to make her act loopy. so she was totally loopy, and totally entertaining while taking out her tooth.

-C, who was so disgusted that his previous dentist did not use gloves. i would be disgusted too. it's hard to imagine 30 years ago when gloves were not the standard of care. your mouth is not that clean. and my hands are prolly not that clean either. yuck.

-C came back today. he's horrified of needles. we took our time. as a result he thinks we're awesome. a little respect goes a long way. which is hard to execute sometimes in the rush rush of each day.

-R, who brought her sister in for moral support as we removed some teeth. her sister was so excited and reports that she loves blood'n guts. it was standard sibling banter. it was awesome. and if i didn't have to act 'professionally', i woulda chimed in a lot more. i always sympathize w/ little sibling who is getting beat. but deep down inside i find it amusing, but more intriguing when big sibling is finding so much joy in being the oppressor. waah. anyway, R's older sister was taking photos of the bloody tooth fragments and texting them to all 10 siblings and the whole fam. or something ridiculous like that. anyway, taina and i had a great time listening to them go back and forth. R's older sister is currently being pursued by this man they refer to as "troll", whom they met on the internet, because he is apparently so ugly that his behind is more attractive than his face. oh dear! R, on the other hand, has been married 26 years, which is impressive in our community. she can't let go of anything/anyone, including her teeth. it was kind of a struggle to get 'em all out. anyway, the last one was particularly difficult, and when it came out the root was especially long. R wanted to see the culprit, so i showed it to her. she wailed and said, "ooooh! you yanked that out of my soul! you took my mojo! my mojo is gone!"

-M, who made pasteles (puerto rican version of mexican tamales), which is corn meal and veggies beat down, then wrapped in banana leaves for steaming. except monin bought a dozen pasteles from her for 20$ and everyone said she got hustled. M is this tiny little woman who bore 11 children (she named them all for me, and it took 90 seconds coz their names were so spanish and long. i love testing the recall ability of the elderly!)

-D, who is adopted and attends hp christian academy. her mom is soooo intimidating. anything sounds like scolding. kinda like a CW (term for chinese woman, as coined by the uiuc taiwanese american students club, once designated for me/marcia/carolyn when i took over umich tasa). anyway, i was kinda scared. D saw me chewing gum, then she asked, "whatcha eatin'?" instantly mom snaps and yells, "THAT IS NONE OF YO' BIDNESS! MY CHILD IS SO NOSY!" except that she pronounced it 'noozy'. heehee. noozy.
anyway, we saw D a few times. the first time she was dolled up in her school uniform. she sat in the chair and her mom yells, "CLOSE YER LEGS!" D quickly put her legs and feet together. in attempt to break the silence and add a little cushion to the aftershocks of mom's voice, i commented, "yep, honey, that's a good idea, especially if you're wearing a skirt." then her mom goes, "she's got shorts under there. but she needs to sit properly."
okee dokee. i see love in this picture. but it's not the smooth lovey dovey kind. perhaps, though, D is not bothered by harsh tones of voice and perhaps tunes it out or muffles it before the words enter her heart?

-the couple weeks before christmas were especially emotional and i think people just had a lot of holiday depression. i prayed for more patients than any other weeks.

-one woman broke down as she was explaining that when she was young her mother consented to have her front teeth removed and now she's stuck with dealing w/ dentures. of course that is a traumatic experience, but that is the tip of the iceberg in terms of resentment.

-another woman broke down because the holidays are the anniversary of her father's death and her broken tooth was a reminder of that. eeks.

-D broke down after sharing that his cousin was shot in his home the night before. 38 year old man, who had just bought a 2010 cadillac escalade with brand new rims and tvs inside. survived by wife and three kids aged 15, 13 and 10 (around there). someone came into the house, shot and killed him in front of his family then drove off with his truck. i checked the news, coz D said it was already in the news. there was a short bit about, "man shot and killed in north philadelphia", but "motive is undetermined". then a lot of the internet trolls making comments like, "so there goes another one in north philly". lots of stigma against north philly! but for a reason, i suppose, coz the stats speak. it's kinda hard to think of this incident as a 'statistic' though, because now i'm connected, that this is my patient's first cousin we're talking about. which is the same as one in the 2 million displaced in sudan, everyone is someone's daughter/son/mother/father/cousin. i digress... because my thoughts digress all the time. anyway, D was distraught, but still did not want to reschedule his appt. i supposed life needs to go on. and so does dental care. so we did 'something easy', like a simple filling, opting out of his root canal for the day. maybe we can do the root canal in 2011, when there is a fresh start. when hopefully there will be some sort of comforting justice for his cousin's death. when hopefully there will be some sore of relief for his mother who had a past stroke and a recent heart attack, who is now staying w/ D.
not many people can afford a new cadillac in this area. i asked if cousin was into things where he might have enemies. D got my drift and said his cousin earned his money through working in construction (as opposed to dealing drugs). someone apparently just saw the truck, coveted, and killed. sadly, this person didn't realize that a simple stickup or holdup would have probably gotten him the truck. my screaming thoughts were, "if you're going to steal someone's truck, at least wait until AFTER christmas. what a low blow. and if you're going to kill someone, DON'T F****** KILL PEOPLE!!!!!!!! WTF!!!! WHY ARE YOU SO MESSED UP IN THE HEAD?"
of course D was devastated. he reported going to see the family that morning, seeing the blood on the floor and bullet holes in the walls. he felt sick to his stomach.
i can't say that i can relate. it must be weird seeing a previously living substance (blood) staining someone's home, when he is no longer.
i never prayed for someone going through something like this. a lot of things are new to me here in the inner city.
i don't know why God allows these things. i know that God is not please with the idols of our hearts and of our lives. that sometimes he will take extreme measures to chase after us, to remove these idols. but it of course conflicts with his good character. so like in Job, it's Satan inflicting evil upon us, but God is still sovereign and the One who allows it, while in the end we will see his glory.
just understood "hope of glory" just now, as i type.

[pause for moment of silence and awe and wonder]

-L came in shortly before the holidays to report that she needed an estimate of her dental care for the city of philadelphia. story goes that she was in a paddywagon, the vehicle had an accident, she suffered some trauma to the face and reports had 4 teeth knocked out. trauma also killed the nerves in two other front teeth and she'll need root canals or those teeth removed. so we went over her options and then i printed a copy of her treatment plan for her and another for her lawyer.
i didn't know what a paddywagon was, so i asked her. L said it's, like, a police vehicle. she was on her way to court.
i like to deliberate these situations to my coworkers. coz i tend to give wide-eyed, sunshine and rainbows versions of everything my patients tell me - "and then she said THIS! this is so cool!"
and then my coworkers, who have been in the 'hood way longer than i have will give me a more cynical breakdown of what the patients *really* were sayin', "what she really meant was THIS."
me: "oooooh."
so, a paddy wagon typically is a van of some sort, there are no seats in the back, prolly some benches. usually it's to transport people from jail to court.
me: "and then she said that the city of philadelphia is going to pay for all her treatment!!!"
coworkers: "good luck with that."
me: "well, she said she wanted me to quote her the BEST treatment options. i told her to go to a fancy private office and have implants done. she said that she wanted to stay with us at esperanza."
coworkers: "good luck with that."
a few days later, i got a call from L's lawyer, asking for a more detailed explanation of her treatment plan, and also that i could only report treatment that is needed as a result of the accident.
i called L and asked if she had any previous dental records. coz how the herrr am i supposed to know if those teeth were knocked out after a certain date? or, who knows if the cavities in her mouth resulted in some kind of post-traumatic pain, which led to her not being able to brush her teeth? or some saliva gland trauma that led to tooth decay? or some psychological pain leading to fear of the dentist, leading to deterioration of the dentition. maybe i shoulda gone to law school. j/k.
i talked to L's lawyer again and said i would write a narrative of what i think, according to the best of my ability, was the result of a trauma, as opposed to long-standing unattended dental care/poor dental habits/home care. L's lawyer told me that the city is not even acknowledging that L's paddy wagon was in an accident.
okay, i think i get it now. so, the goal is to perhaps be as objective as possible, although i would still like to advocate for my patient's dental health and overall health. very tricky in such a litigious society.
anyway, i still need to write this narrative for her lawyer. and it's been the bane of my existence all throughout my winter holiday break. it's like school again, and like writing essays at the last minute. except it's not for a grade, just for my own reputation and professional responsibility.
Jesus, grant me your grace.

-today M shared that she lost all her teeth in a traffic accident when she was in her mid-20s. her former husband was/is an alcoholic and had frequent episodes of madness. so one day he picked her up from church, was pretty plastered and declared, "today we will die", then purposely crashed the car into something (a wall or another car).

-3 or 4 grown men today who are just hysterically afraid of injections, despite tattoos on their face/neck. my man, I, who has his forehead tattoo that he got while doing time.

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failures:
-my plan is to privately write down all my failures in clinical dentistry, in order to strive for excellence and prevent those from happening again.
-maybe one day i can publish these, if i ever attain 20 years of dentistry under my belt.

-lord jesus, come.
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-today, starting to be overwhelmed by the paperwork and by the lingering 2010 undone to-do list tasks. despite the clear skies, the clinic seemed a little gloomy today. God's 2011 'promise' for me, to be taken to a place where i am utterly dependent on Him, is already taking place.

[exhale]