The good receptionist.

We had a patient who was extremely hard of hearing, and she refused to wear a hearing aid. In order to care for her teeth it was necessary for us to engage in some form of communication so that she could participate in her treatment decisions. This meant that if we needed to say something of importance we would sit directly in front of her, lower our face masks and speak at three times normal volume, practically screaming whatever we needed to say. At that point she would nod, and say that she understood, and that whatever we had to do was fine by her. She always dressed in a flowered sort of dress with a hat, and was so sweet to everyone; she was a confection. Yet this scenario was so disruptive that we got into the habit of scheduling her at the end of the day, after our other patients had left. The receptionist had known her for years, and had grown quite fond of her.

One day she came in with a sore tooth, and after taking the requisite X-ray it was plain that the tooth needed to be removed. On this occasion I wanted to be particularly careful that this darling lady understand what was about to happen to her, and that she give her full approval. We had a loud discussion. I had written a basic consent agreement in the chart, and asked her to read and sign it so that we could proceed. She seemed accepting of her plight, and attached her signature to the file. I proceeded to give her an injection of local anesthetic, and, leaving her in the company of my chairside assistant, walked back to my private office to return the phone messages that were sitting on my desk.

Not five minutes later the lady began shouting, "Waitress! Waitress!" The assistant attempted to calm her down, but the patient became quite agitated. At that point the receptionist ran into the treatment room and asked, "Do you want me to get Lola?" "What would I want with Coca Cola at a time like this?" she answered so loudly that I cut my phone call short and beat it back into the operatory.

Seeing me seemed to settle her down somewhat, and we proceeded with what we in the profession call the "sunshine and cold steel" remedy for dealing with infected teeth. Our patient was remarkably cooperative throughout, and we released her to the care of her daughter, who was pacing outside the office. The patient left with the usual instructions for postoperative pain and bleeding, and carried away her little packet of sterile gauze in her purse. It was now six o'clock, and the dental team was a bit worn out. We began our usual cleanup and shutting down when the phone rang.

It was our patient's daughter, asking if her mother's denture was in the office. They had driven home without it, apparently. My sheepish assistant found it in the wadded-up surgical toweling. "Yes," the receptionist said, "we had the denture." "Will you be there for another few minutes if I dash over there?" the daughter inquired, and we said, "Sure." Another few minutes passed while we finished up. Then the phone rang again.

"My car won't start, and I have no way to get over there, and my mother will be so upset if she doesn't have her teeth! What do we do?"

"No problem," the receptionist said. "I live near you and can drop it off to you on my way home; don't worry about it." She hung up after checking the address. One minute later the phone rang again.

"There's nothing in the house to eat. Do you think you could pick us up a pizza at Bruno's market on your way over here? I don't have anything for dinner."

Good soul that she was, our front desk saint said that she would. I told her that this kind of service was beyond reasonable, but she assured me that she didn't mind, and we all finally locked up the office, set the alarm, and went home.

I dragged into my kitchen about 6:45 and began dinner preparations with my husband. Our two children were wailing about hunger, so we worked fast. Between chopping and frying I told him about this last episode at the office. He said nothing, but stopped what he was doing, looked straight at me, shook his head, and said, "Give me the phone."

He dialed the receptionist at her home. "Hey," he said, "it's Tony. Have you seen my wife anywhere? I've been paging her and she doesn't answer, and nobody's at the office, do you know where she is?"

"Well," she said, "I just got home myself, still have my coat on, as a matter of fact. I thought she was going straight home."

"I have a problem," he said. "I've missed the last bus out of the city, and the ferries aren't running anymore, do you think you could pick me up? I know it's late, but I'm stuck and really need your help." He gave her detailed directions into downtown San Francisco with special attention to one-way streets, and when he was about to hang up, added one more thing.

"Oh, and by the way, could you pick me up a pizza?"

The next morning the assistant greeted me with a wry look on her face, and said, "No good deed goes unpunished!"

Lola Giusti, DDS, is Assistant Professor of Removable Prosthodontics at University of the Pacific, A. Dugoni School of Dentistry.