The saltwater aquarium in my new dentist’s office is its best feature. My favorite fish is a red fish with big eyes and a black stripe along its back. He has a generally grumpy demeanor, and I cannot help but feel a friendship form between us. I take photos of him and sometimes post them to Instagram. (“This red fish is my favorite fish, he is a total weirdo.”) He is popular among my friends.
I am aware, though it has not been my experience, that aquariums are common features in dentist offices. (One of my childhood dentists had an arcade machine. My sister and I would race monster trucks before our appointments.) I imagine this is due to the anxiety many people feel about dental procedures. (I once had a full-blown panic attack before my wisdom tooth extraction, even though I had been given Valium to take beforehand. “I can’t do anything if you don’t stop crying,” my dentist snapped.) Aquariums aren’t cheap to maintain, but dentists or their office administrators must feel they have some beneficial or tangible impact. (In the Google reviews for my new dentist office, I find one from four years ago that reads: “Excellent service. But I went because of Dr. K—’s military service and understanding of PTSD.”) Watching fish swim lazily through a fifty-gallon tank surely has some small but significant calming effect.
The red fish doesn’t really swim. He darts from hiding place to hiding place to resting bowl, and then he crawls along with grasping, tensile fins.
My parents didn’t teach my sister and me how to care for our teeth. I have a vague memory of my father squeezing toothpaste onto his index finger and rubbing it across his gums, but for us there were no nightly brushings, no flossing. Only yearly appointments to repair the damage we’d caused, and it was our grandmother, my father’s mother, who took us to those. My parents were alcoholics, and there was an acceptable standard of neglect.
My earliest fillings were dental amalgam, or silver fillings, a mixture of mercury, silver, tin, and copper. They are cheaper and more durable than resin composite (fillings that can be matched to the color of your teeth, pearl white or yellowing). “Cheaper” is the key word here. The dentists we visited belonged to lower-income networks, and cost was always the first consideration. Though mercury is mixed into this amalgam, “silver” fillings are considered safe because the mercury is bound in the metal alloy — the minute amount of mercury vapor released when chewing food is considered an acceptable risk. Governments and health organizations around the world place their confidence in dental amalgam, and no studies have definitively shown that it is causing harm or illness in human populations.
I find other evidence that dentist offices are (or were, at least) significant contributors to mercury pollution in our waterways, where the neurotoxin methylmercury accumulates in the fat and muscle of fish and shellfish, in the feathers of birds. I can’t help but think about the red fish, my friend. A Flame Hawkfish: I identify him by his colors on the web. I find it difficult to uncover easy information about the conservation status of Flame Hawkfish or the health of their natural environments because all of the top search results are about their lives in aquariums. (You can purchase one from Tahiti for $64.99 USD. Care level: Easy. Temperament: Semi-aggressive. “They are a very personable fish,” according to liveacquaria.com, “and are great for reef aquariums as long as there are no small shrimp…”) I can’t say what happened to my silvered baby teeth when I lost them, but I imagine they went into the trash. I can’t say if the mercury was safely trapped, or if the mercury has entered the water or the air. My worries about mercury may be unfounded, may reflect more my overactive mind.
One of my grandmother’s old tenants went crazy because of his teeth, but not because of mercury poisoning. His teeth were rotting, and the infection traveled into his brain. He dragged everything in his apartment — all the furniture, his clothes, even the fridge — into the yard, and my grandmother found him raving, insensible, outside. (“He could have died,” she would say when she told the story, her voice rising as if this information was titillating.) For as long as I can remember, my father’s teeth were like this. In Boston, where he lived with me for a few months, I found him spitting pieces of his teeth into the garbage can. (“It’s fine. I’m fine,” he would tell me. “Stop worrying about it.”) I enrolled him in the state’s healthcare and tried to convince him to pursue dentures where they might be paid for, but he has always been too stubborn, too resistant to pain.
My grandmother told me once, when I was little, that she always asked her dentist to skip the Novocaine. (Canadians call this anesthetic “freezing,” though this is strange, foreign to me.) She preferred the pain of a filling to the temporary numbness that followed the drug. As a child, I tried to follow her example and asked my dentist to forgo the shot. Strangely, he complied, but not seconds into the procedure I changed my mind and made him halt the drilling and the probing until my mouth was comfortably numb. (It is difficult for me to understand why he would have humored me, what point he might have been trying to make.) At the end of the appointment, I told my grandmother I skipped the Novocaine, and she seemed so proud.
I am relatively lucky. I still have most of my teeth. Most of my adult fillings are resin composite, off-white. I am only missing one tooth, molar 17, which was pulled after I let an infection fester five years too long. My father’s tolerance, his belligerence, I harbor these inside my body. (It’s fine. I’m fine.) Before a dentist pulled my molar, it had already become loose in its socket due to shrinking gum and bone.
My father — years after he lives with me in Boston, then Tucson, then hops on a train to San Jose, where he sets up residence in a homeless encampment — finally has all his teeth pulled. He is fitted for dentures, and he sends me a message about how excited he is to eat a steak for the first time in years. I find out later that he has his new teeth for two days only. They end up in a contested storage locker, the contents of which are sold or destroyed. He is not able to afford a new set of dentures, but he tells me it’s okay — that he is used to eating soft food.
Seven years after my first tooth is pulled, I schedule an appointment at my new dentist’s office when one of my back teeth, molar 1, begins to cause me trouble. An old filling in the tooth cracked a year before, but I had no insurance then to treat it, and I was a new immigrant to Canada waiting on my permanent residence card. The tooth has developed an abscess, a swollen, fluid-filled bubble, not on my gum but on the soft tissue at the back of my mouth. Before my appointment, I lance the site of the infection with a fingernail, and my mouth fills with the taste of pus and blood. At first, my dentist does not recognize my abscess as an abscess — he calls it an ulcer, gives me a topical treatment, and tells me to wait. But when the pain persists and the swelling returns, he refers me to an oral surgeon for a biopsy.
There are no fish in the oral surgeon’s office. (I google the question “Why do dentists have aquariums?” even though I suspect an answer. I find companies that market aquariums specifically to dentist’s offices. I find a study conducted by an aquarium and its partners that confirms the psychological benefits of watching fish in aquariums, especially those that replicate diverse natural environments. One forum user suggests the effect is due to smooth pursuit eye movements, one of two ways we shift our gaze.) In the oral surgeon’s office, there are only forceps, scissors, needles, and a man who berates his assistants as he leans over my head.
I am happy when the biopsy confirms my suspicions — that it is an abscess, not an ulcer, not a cancer of any kind. I look forward to returning to my dentist office, to seeing my friend Hawkfish. (I email the office about him, and one of the office admins replies that he is her favorite, too, though he doesn’t yet have a name. She offers to let me name him. I am honored, but unsure. I have only known him for such a short period of time, and what if she sees him differently than I?)
This essay is a glass aquarium. The fish, a smooth-eyed distraction.
My father is dying. Liver cancer, stage 4.
“Tell your sister not to get too excited,” he tells me in a short phone call. By excited, he does not mean thrilled. He means worked up, distraught. We are not supposed to cry about his death.
The morning after that call, I keep my dentist appointment to fill a different tooth, a small cavity. In the time of COVID-19, rescheduling would push the appointment by months, and the tooth has begun to react to hot and cold. A tooth can die quickly, in days, or slowly, over weeks or months or years. Impossible to predict. So I keep my appointment. (It’s fine. I’m fine.) I arrive in a floral mask. I sit as close as I can to the saltwater aquarium, though another patient has left his motorcycle jacket and helmet on the floor between us. Friend Hawkfish peers at me over the edge of a pale coral — his brow serious, his mouth downturned. I follow him with my eyes only. His fins caress the coral’s living body with gentle strokes. I feel my racing heart slow.
When my father dies, there is no memorial service, no funeral. My sister and I send each other a few messages, but there is a _________ between her grief and mine. I struggle to find a metaphor that sufficiently fills that gap: a wall could be climbed, a gulf could be crossed, a world could be obliterated in some cataclysmically astronomic event. In this loss, there is no path we walk together in our current space and time.
I know from the internet that I am striving for “integrated grief,” but that what I am experiencing is “disenfranchised”: a grief that is unseen, hidden away, misunderstood, deviating from societal norms. The people who knew my father — his family — want nothing to do with him or his memory. My husband never met him; my friends are far away. My mind struggles to grasp my new reality. On the surface, nothing changes about my daily life. I snuggle cats with my morning coffee; I procrastinate on emails; I teach creative writing classes and spend my days talking about character and plot and dialogue and description; I play video games with my husband after work. There is even a lens through which my father’s death brings me relief from the current of anxiety buzzing at low but constant levels in my brain: anxiety about my father’s food and housing insecurity, his dysfunctional relationships, his addictions, his mental and physical health. Still, weeks after he dies, I find myself returning to VINELink, a victim notification system, and scanning for his name and birthdate, as if he might not be dead but just held in a cell somewhere, like I could find his inmate number and address and drop a letter in the mail.
My dead tooth is given a root canal, where the infected pulp — the nerves and blood vessels and connective tissue — is removed. I am given a temporary filling until my dentist can fit a crown. When I call to schedule my follow-up appointment, the receptionist reads a note from my file: “I’m supposed to tell you the fish died… I have no idea what that’s about.” I thank her and laugh, but don’t try to explain.
Months later, the grandmother who raised me dies, and our family asks my sister to write a brief memorial note for social media. She is better at articulating warm and heartfelt emotions than I. Inexplicably, the memory she chooses about our grandmother is our shared memory of the dentist — how she would ask him to skip the Novocaine. “Her strength was always something I admired,” my sister writes, but also, “I just couldn’t believe how someone could tolerate that sort of pain.” My sister sends me a draft of the message before she posts it to Facebook, and struck by the coincidence, I send her an early draft of this essay, which I had begun months before. My sister asks, “What do you think it means?”
Though I want to find an answer to her question, I also know a person’s life is not a lesson. A person’s life is its own to live, and yours somewhere alongside it. As a young soul floating out there in the cosmos, I did not choose this life, this network of familial connections, looking for a deeper way of being. There is no greater purpose to suffering or to loss or to pain. This might be why I am bad at memorializing, eulogizing. Why I am bad at integrating grief.
At the dentist, the aquarium remains vibrant. A clownfish hunkers down in a pink anemone, and a speckled blue fish picks at a coral with a hard-looking beak. Life continues, though Friend Hawkfish is gone. After the appointment, after I swipe my credit card, I turn to leave, but then stop. Behind the desk, the office administrator has returned to her computer monitor. “I just wanted to say thank you,” I tell her, “for leaving me the note about the fish.”
Smiling, she looks up at me. “Of course! Ugh, I miss him.”
“He was a great fish,” I say, trying very hard not to cry.
