Excerpt: brain scan

"Dr. Tigani, you don't see a tooth growing or anything in the back of my mouth?" I asked pensively. "Because there's a small sensation on my cheek, and I thought maybe I've got a tooth growing, a wisdom tooth or something." I didn't really know what a wisdom tooth was but I had heard it referred to enough times that I assumed it was a tooth that someone would get as they got older. "I feel just a little tingling sensation on my cheek."

Dr. Tigani, had his usual ever-present smile; not giving any hint as to what he thought about my question and rationale for asking it. He continued smiling as he put his little mirror thing back in my mouth. After declaring that no new teeth appeared to be
poking through my gums, Dr. Tigani asked me to describe the area on my cheek. What does it feel like? How large is the area of the sensation?

"It feels...numb. Maybe about the size of the tip of my finger."

Dr. Tigani adjusted the dentist chair back to an upright position, placed his hand on my shoulder, and stated "I'm sure everything is fine, Paul. Just for a second look, I'm going to send you to see Dr. Philip Lundy. Dr. Lundy is an oral surgeon...just a precaution...can't hurt. Sarah will see you back here in six months. Take care Paul." Dr. Tigani was still smiling. His eyes belied his smile though; it was as if there was a dimmer switch for the ever-present glint in Dr. Tigani's eyes and it had been turned down a bit.

*****

Dr. Lundy completed his examination and shared the x-rays with me. "Your x-rays are unremarkable, and there is no evidence of gum disease or nerve damage. I do not know why there is tingling or numbness in your cheek. Good luck with your tennis game."

*****

Dr. Steven Farris is a neurologist that Dr. Lundy referred me to. When Dr. Tigani sent me to an oral surgeon, I assumed it was to see if I was growing a wisdom tooth. When Dr. Lundy sent me to a neurologist, I had no idea why. In fact, I really didn't know exactly what a neurologist does. Frankly, I was too intimidated by Dr. Lundy to ask him why he was sending me to a neurologist. So, during the two weeks that I waited for my appointment with Dr. Farris, I speculated. Consequently, my imagination ran wild.

The first thought that came to mind when I heard neurologist was that it was related to neurotic. That word resonated with me. I had heard it quite often ten years earlier during my time in the Army where I was an enlisted man, “enlisted swine” we referred to ourselves, working in a mental health clinic at Ft. Benning, Georgia. My job in the Army, my military occupation specialty, as the Army referred to it, was a behavioral science specialist. Sounds impressive, but essentially I was a glorified receptionist, at least initially. With a high school diploma, high Army entrance exam scores, and several months of training, I was assigned to document case histories and perform an initial screen before a soldier was allowed to see one of the psychiatrists, psychologists, social worker or other commissioned officer mental health professionals in the clinic.

In time I became very proficient at my job. Most of the visitors to the clinic, perhaps as much as two thirds, were soldiers faking mental illness in an attempt to be discharged from the military. Few of them progressed beyond my screening interview, and the more experienced I became, the more adept I got at ferreting out the bullshitters from those who genuinely were in need of further evaluation by one of the clinic professionals. The other third or so consisted mainly of those soldiers (or their dependents) who demonstrated indication of some form of psychosis, neurosis, or personality disorder and was referred on to one of the clinic professionals by me for some kind of intervention, and ultimately either ongoing therapy, medication, hospitalization, discharge from the Army or some combination thereof. Or, they were military prisoners from the Ft. Benning stockade who were escorted to the clinic by armed guards for legal competency exams (including Lieutenant Joseph Calley of My Lai massacre fame.)

So I recalled a little about the term “neurotic”; but nothing in my training and almost three years experience working at the clinic helped me understand the relevance of neurosis and numbness in my cheek. Did Dr. Lundy think there was some neurotic basis for me sensing the numb spot on my cheek? Or for my sorry tennis game? He did seem to take a great deal of interest in my travails on the tennis court. What did the sensation on my cheek and tennis have to do with each other? What the hell did a
neurologist do anyway? We didn't have one in the clinic— psychiatrists, psychologists, psychiatric nurse clinicians, and social workers—but no neurologist. So, I looked it up:

Neurologist: a physician specializing in the science of the nerves and the nervous system, especially of the diseases affecting them.

"Oh shit." I thought