(drilling down deep to discover the root of the problem)

It was a routine dentist appointment, nothing out of the ordinary. A cavity filling on a recessed front tooth and a few cosmetic patches, made possible by recent health care changes. She couldn’t afford it otherwise, but now, why not?

A few small shots of novocaine and she waited a while, relishing the empty time when she could just sit and collect her thoughts, relax and not have to be working.

The procedure began and all was fine. At first. There was an almost imperceptible change, just a little at a time. Her senses registered the chilliness of the examination room, a frigid mid-March New England day at the tail end of one of the coldest and most brutal winters in recent memory. The drilling produced no pain and little sensation, but the sterile instruments felt alien and unfriendly in her mouth, held unnaturally open.

Thinking back much later, she wondered if it was the anxiety of not knowing, of an irreversible change being made, over which she had no control. The cracked tooth was very noticeable, right in the front, but it had been a part of her for so many years, it was as if she had grown accustomed to it being there. It was something uniquely hers, and hers alone; something which distinguished her from all perfect smiles and the reworked faces, the nips and the tucks and the masking and the retouching that went on all around her, without a second thought. As silly as it seemed, she wondered if she was doing the right thing in getting it fixed. But it wasn’t just that.

She saw herself on the dentist’s chair, alone with the Chinese dentist who was busy at work. He was experienced and friendly, but she suddenly felt an alien presence; an aloneness. She was separated from all she knew, in a strange and malevolent world.

From these disjointed sensations of being alone and helpless in an alien universe at the mercy of an unkind presence, came all these unbidden thoughts. There were fragments of half-forgotten news stories — young children with missing limbs in hospitals, hungry, victims of one of a dozen regional conflicts that seemed to be a continuous stream with no beginning and no end. South Sudan, Syria, the Philippines, Central Africa, Pakistan, Afghanistan… she didn’t remember. There were warnings of imminent food shortages, of further social upheaval due to mass migrations of people fleeing the droughts, the floods, the desperate self-purging of a long abused planet. Or was that a movie she had seen trailers for? She couldn’t remember that either. There were perversions of faith, setting into motion twisted, misguided actions. There was the continuing reign of tyrants abusing their power, the mass executions, the ethnic cleansings. Fear giving way to prejudices and persecution. Mixed in with the atrocities were pop stars with shiny hair and photoshopped faces, playing sanitized music for mass consumption. Movie stars with botched facelifts, yearning for eternal youth. The rich widening their distance from the poor with ever more vulgar displays of wealth and the building of physical and psychological barriers. She saw the absurd expenditures as a brazen flaunting of social superiority. The luxury sofa she wrote about in her work was like a personal affront to that frightened, starving child in a Dadaab refugee camp. A symbol of this crumbling civilization: a plane filled with innocent people, lost no doubt due to carelessness and indifference. A lost plane, a lost culture, lost faith.

These fragmented thoughts came in and out like faded snapshots while she laid there in the dentist’s chair. An indefinable, shapeless fear rose up, which, if she had to put a name to it, might have been extreme trepidation of the future and the feeling of losing control. It was a situation she had not chosen but to which she was now bound, planetary currents building into a rushing river headed toward a precipice, carrying along the flotsam and jetsam of her mental faculties. It was this that frightened her the most. She feared that a vortex was forming at the center of her skull which would begin to suck everything into it, rational thought by rational thought, limb by limb, until nothing was left but nothingness itself.

She began to shake. It started in her jaw, pried open and tilted back at an awkward angle. The dentist asked if she was ok. Speech was impossible with a mouth full of novacaine and metal instruments. She wasn’t sure anyway, and tried to will whatever it was away. As a cold chill spread downward, she made a feeble attempt at various relaxation techniques hobbled together over years of new age dabblings — meditation, breathing exercises, mantras, affirmations. She idly wondered, as the tremors reached her arms and legs and she began to violently shake, if she might have had a reaction to the novacaine, or to the filling material, or if a latent medical condition had surfaced. Was she going to die? She didn’t know.

The dentist stopped now and told her to rest. They would continue later. He asked his assistant Natasha to sit with her, and went into the next room to attend to another patient.

Struggling to understand her body’s betrayal, she removed the Mexican cowboy boots she had picked up from a secondhand shop in Los Angeles. Those were happier times, so far away now. She covered herself with her winter jacket. She felt so cold, so terribly cold, as if death was stretching his long gnarled fingers out from the abyss to claim her.

In shuddering, breathless speech, she apologized to Natasha for her condition, asking if it could possibly be some reaction to a particular substance they used there. No, it was just fear, a systemic fear that shut out the possibility of anything else. She began to explain her situation, which wasn’t so remarkable or so traumatic when divided into parts, but which, as they both surmised, had a cumulative effect. She had a part time writing job which inexplicably took nearly every available hour to meet deadlines — a fact that was both economically problematic as well as personally humbling. She fancied herself a writer, though all indications had thus far proven her wrong. If she had trouble conjuring a brief paragraph describing in romantic prose the benefits of a gas grill, how then would she write that thought-provoking psychological introspection that would be lauded and celebrated among the world’s best minds?

She was equally perplexed by her sudden inability to navigate the treacherous emotions evoked when dealing with family matters — or in fact, with human interactions of any kind. Nothing significant had changed in several years. Her elderly father, with the help of aides and nurses, cared for her elderly and bed-bound mother who battled not only physical but also mental immobility. The bipolar disorder had been a constant in their lives, though the dementia was more recent. A psychiatrist at McLean’s once told her that she should keep a close eye on herself, as this sort of thing could be hereditary. She did her best to support them while steering clear as much as possible. It was a delicate dance of terror and guilt, but it was nothing new.

As the women spoke, they found common ground despite their differences. A young and personable single mother and voracious reader who worked as a dental assistant and a middle-aged unmarried woman with no children, aloof and precious, chasing whimsical dreams. The same insecurities; the same fears.

After twenty minutes of casual conversation, the shaking subsided, and she realized how long it had been since she’d had a friendly, unhurried conversation with anyone. It wasn’t a quickly placed phone call in between one location and the next, or a polite yet brisk obligation fulfilled in a succinct email. Nor was it a mechanical acknowledgement on some social media platform or a professional who was receiving compensation.

No, this was different. It felt so strange to her, this face-to-face human conversation, like a vaguely remembered social convention from some lost civilization. Natasha was a comforting presence there in the darkness, one she didn’t realize she had needed.

After a little while, the procedure continued, calmer, much calmer this time. After the appointment, she found herself in a Salvation Army store, shell shocked like a person who had just recovered from a terrible fever and not quite ready to drive off as if nothing had happened. She glanced up at the bookshelf and saw two books that seemed to have been waiting for her — an old collection of poetry by Leonard Cohen and a thin hard covered volume by Deepak Chopra about creating affluence. The idea of wealth consciousness was not new to her, and she knew from experience and many years of soul searching that “wealth” was not just about money.

Walking to her car, she wondered what all this had meant, as she often found herself doing when something unusual would happen in her life. Some might have considered it just a random series of events. She thought of it as a message.

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