first time for everything, right?

so this week was full of firsts - first paycheck (however meager it may be, i won't make any real money until the insurance checks roll in, but still nice), first ever red velvet cake (a culinary success, pics to follow shortly!), and, most importantly, the first time i've ever had to dismiss a patient from my practice.

now, about a week ago, a gentleman came into the office with some discomfort on two large fillings. he had had a crown on the opposite side that was started by my colleague several months ago (she now refuses to treat him). after all her hard work, he had ripped off the temporary and made himself an ill-fitting gold crown, with the help of his jeweler and in his basement, and then subsequently developed an endodontic infection. i refered him to the endodontic surgeon, telling him that surgery and antibiotics would be the only way to treat the infection. i then replaced the large silver fillings on the other side with sedative fillings with the intent of starting crowns on those teeth in the next few weeks, on the condition that there would be no more shenanigans in his basement. he agreed and we were cool, so when i saw him in my schedule today, i was ecstatic. i felt like i really got through to him and thought he had a modicum of respect for me and took our conversation to heart, because even though i thought this guy was a little wacky, i still humored him a bit. he is a person, after all. so he came in today, and when i asked him how things were going and feeling, he replies with a "well, the hole i drilled in my tooth is not doing so hot, you better take a look at it, it may be infected." um, excuse me???? you drilled a hole in your tooth? how the hell did you do that? wait, i don't even want to know....

he saw the endodontist last week, who basically told him exactly what i told him about surgery being necessary, and he wasn't happy with the diagnosis. surgery is invasive, antibiotics exacerbate my chronic state of candida, yada yada yada. so he attempted to treat the infection himself by drilling a hole in the tooth and filling it with iodine and zinc oxide (?). he almost perforated the tooth, it's a miracle that the thing is even remotely salvagable. i just didn't know what to do with the damn thing at this point - me further treating that tooth would be a total liability, plus he won't comply with the recommended treatment and anything i did now would be futile. the endodontist doesn't even want to see him, either. i was so angry with this person, it was like, why the hell do you waste your time and money, and my time as well, and ask me for my opinion when you're just going to treat the problem yourself how you see fit anyway? i said, you don't respect my opinion or my clinical judgement, you've obviously have things figured out for yourself and you are a professional liability to me at this point, kindly take your business elsewhere. i will send a formal letter of dismissal along with a list of providers in the area, and will treat him on a limited emergency basis for a period of 30 days, as within the guidelines of the royal college of dental surgeons of ontario. but i wash my hands of this. i feel bad, he's a nice guy with lots issues, but i just can't waste my time on crap like this.

on a happier note, nana and grandpa are coming to visit tomorrow!!! yay!

cookie's off the wall today, i'd better go out her to bed. as usual, more drama to follow...