American dentists: an Englishwoman's perspective

We knew before we arrived that American dentists are among the best in the world. You only have to look at the shiny straight white teeth in the average American's mouth to know that American dentistry is a great thing. Of course, the shiny straight white teeth come at a price and if one can't afford to pay that price, one is more likely to have a crooked assortment of yellowing and blackened teeth. Crooked rotten teeth are a major indicator of American social class or English nationality.

My children love watching Phineas and Ferb, a children's cartoon in which there is always a back story from the bad guy. For this blog to truly make sense, I feel that I need to engage in a little back story at this point... So, indulge me for a moment as we leave New England behind and return to an Olde England in which dental care was freely provided by the NHS. In those halycon days, my relationships with dentists were complicated; although, as with any complicated relationship, I now realize that blame and responsibility should have been acknowledged by both parties. 

1. My first dentist retired shortly after I bit him. I don't think the two incidents were related.

2. A new dentist replaced the bitten dentist. He didn't have any great belief in anesthesia or personal hygiene. After being coughed on and spending pain-filled moments staring at his yellow-headed acne, I decided that dental care was unnecessary. 

3. In Sheffield, I had a glimpse into an alternative world where dentists could be gentle and kind and talk uninterrupted for three hours while carefully addressing a root canal infection in my mouth. The dentist fiddled and poked and explained in minute detail how I should clean my teeth. He promised to explain flossing in our next appointment, but I never returned. I was too young to be able to appreciate his advice. 

4. Six years later, a dentist called Mr. Yapp followed me out of his surgery after I fled at the sound of his pressurized water jet. If it had been a film, beautiful soul-filled music would have led up to the moment when he stopped following me. I ran out into the East London traffic and he must have known in his heart that I had left him forever. It was a sad day for us both. 

5. By the time that I was in my thirties, the dead tooth at the front of my mouth (the one that the Sheffield dentist had saved) was almost black and badly chipped. I had been appointed to my dream job, but should have realized that things weren't going to go well when my new employer told me that one of the first things that she had noticed about me was my dead tooth. Not my brilliant mind, charm or wit, excellent contacts, or outstanding work ethic... but my dead tooth. Friends convinced me to take advantage of the free dentistry that was available to me as a new mother. By this point in English history, a new era had commenced in which the NHS had decided to take a separate course, leaving dentists to work out their own businesses and to charge patients what they wanted needed to. A South African locum had great fun carving out my front tooth and fixing it up with a new crown. He did a good job and even managed to make the tooth look fairly straight, although I was shaking. 

6. The English dentists who are most successful nowadays are the ones who follow the American model. I have been relentlessly determined that my children should have good teeth. In Penrith, we found a dentist who believed in charging lots of money to be nice to children. We paid him lots of money, even when we lived in Newcastle and had to drive for several hours to see him, and it seemed to work. My children like going to the dentist and that has paved the way for our American experiences...

Now we live in a world where there is no concept that dentistry should be funded by the state. Dentists are well paid professionals. For the past thirty years or so, they have been able to invest extensively in professional development and equipment. Over the past thirty years in England, dentists have seen their state funding steadily cut to a minimum and then, in most cases, scrapped completely. A friend of mine works as a dentist in England; he tells me that it is only in the past decade that English dentists have had the freedom (provided by the new corporate structure) to invest in state-of-the-art technology and professional development. In America, dental patients are customers who are paying for a service. If the dentist hurts his or her patients' teeth, then they are unlikely to return to that dentist. It's a fairly simple business model. American dentists like happy patients (which probably explains the widespread use of laughing gas). My experiences with English dentists suggests that they care less about what the person sitting in the chair thinks: it's not as though the patient can audibly complain anyway. 

My girls' attend a pediatric dental practice filled with toys, funky equipment and very beautiful dentists. The girls hold mirrors to watch what the dentist is doing in their mouths. There is lots of upbeat praise about how well they are doing. They get stickers and toys and rewards for attending. My children have never bitten a dentist and I am very proud of them. 

I'm a recovering dentaphobe (given that there is a word for this, I'm sure that I could find a support group if I looked closely enough). The crown which was fitted seven years ago has reached the end of its life span and this has motivated me to attend a local dentist. The receptionist treats me as though I am a recent convert to her faith. She telephones me to discuss my feelings and encourages me to make appointments that are convenient to me. She hasn't had any stickers to give me, but she gives me lots of brightly colored appointment cards and big reassuring smiles which showcase her impeccable American teeth. The dental hygienist was very excited when she found out that I hadn't had my teeth cleaned for five years. We had a great time together. She wanted to prove that teeth cleaning doesn't have to hurt (it doesn't) and I learnt all about her childhood in Brazil. My dentist is a South African man with enormous hands. He is very gentle but doesn't talk much. We like the same music. He sings fragments of lyrics, and I hum occasionally with my mouth wide open. His nurse is from El Salvador. We all got on like a house on fire. I have a brand new shining white tooth and I haven't bitten any of them. I'm very proud of myself. 

I need to remind myself to mention all this on our green card application: we can't go home. The dentists might hurt us.  

Car(e)free in Cambridge

Just to recap...

We moved to America - land of the automobile. We were raised on a diet of Springsteen ("I've got a '69 Chevy with a 396"), Simon and Garfunkel ("Counting the cars on the New Jersey Turnpike"), Tom Waits ("Crying 'Fill her up and check that oil,/ You know it could be the distributor and it could be the coil"); and the Eagles ("don't let the sound of your own wheels drive you crazy"). And growing up, we watched endless road trip movies - Smokey and the Bandit, Easy Rider, Thelma and Louise, Midnight Run... It seems fairly inconceivable to live in America without a car, but we've done just that for 15 months.

We've compromised with endless local zipcars (and, by doing so, we have become 'zipsters' and part of the 'zipsterhood of Cambridge' and the puns have deteriorated with the selling of the company to someone big and corporate) and we've also made use of the wonderful Sam at our local car hire company. But dogs aren't allowed in hire cars or zip cars, the snow isn't conducive to hauling around groceries by bike, and we realized that the time had come that we needed to buy a car. We thought that, in the Land of the Automobile, this would be fairly easy.

Our first outing took us to Volvo Bob who keeps several acres filled with Volvos near a major junction of the local interstate. He used to sell racehorses, but times have changed. He doesn't really like selling cars. He had maybe forty XC90s and asked us which color we would like to test drive. I asked about the history of the vehicles: had they been in accidents? What kind of mileage had they done? Volvo Bob gave me a very long slow look, as though I was something unpleasant that he needed to feed to his horses, and said that a car is a car is a car.

Volvo Bob isn't the only local Volvo dealer. Volvo Dave knows a lot more about Volvos than Volvo Bob. He has a lot of statistics. He doesn't have any race horse stories but he tells a very good story about his colleague who was in a horrific car accident in New Hampshire. The other cars were right-offs, but his colleague's Volvo wrapped about his colleague like a mother's arms and had even applied band-aids after the event... Well, maybe I exaggerate, but it was a very good story. Volvo Dave likes selling cars and he is very good at it. He nearly persuaded us to buy a brand-new Volvo. This seemed to be a better bet than buying a used car from Volvo Bob because the car didn't have a history. It's a bit like buying a prospective partner at birth so that there aren't any dark secrets hiding in their past by the time you consummate your relationship.

Unfortunately, Volvo Dave forgot to talk about credit ratings. As English people, Nathan and I assumed that having good credit meant having few debts and a record of responsible saving, but that's not how it works in the US. To attain a credit score, one needs to have a history of borrowing money. We tried to tell Volvo Dave that we didn't have a credit history in the US, but he was talking about side airbags. We should have used louder voices.  Poor Volvo Dave had our vehicle sitting in the forecourt, all brand-new and shining and ready to (safely) go, when he realized that we had no credit history. Having no credit history is worse than being sub-prime. Being sub-prime means that you have borrowed money that you haven't been able to pay back. Sub-prime bankrupts have a credit rating of around 300. Having not borrowed money means that our credit rating was zero.  Volvo buyers normally have a credit rating of 700 or above. Volvo Dave shouted at us and we don't want to buy a Volvo anymore.

Perhaps, we thought, we ought to buy American. A Ford. What could be more American than a Ford? We booked a test-drive of a Ford Fusion on Presidents' Day weekend. By then we'd opened a few credit cards and our credit rating was looking perky. The car showroom was very busy and filled with large helium balloons. We watched an elderly woman touch-park her Chevy in the forecourt (literally bashing against the SUV which was parked behind her until she had room for her vehicle), and then push into the queue before us to ask for a red car. She had a card in her purse with the exact color red she wanted. The salesman was keen to help her. I asked a few questions about fuel economy and safety features and our salesman got a bit sweaty. He went to put some gas into the test-drive car and didn't come back. I hope that the old lady found her red car. After half an hour, we went home.

Luckily our homewards route took us past the Toyota garage. A very charming Eastern European man called I-something introduced us to the new Prius. He was an lovely polite young man and the car was equally lovely and polite. It always checked twice that you wanted to accelerate and moved very slowly and carefully around bends. It was a good car to drive if you didn't have anywhere that you wanted to go. The young salesman was absolutely delightful and explained that he, personally, preferred driving Mazdas. We chatted a while about Jeremy Clarkson and he gave us the telephone number for the Mazda garage where he had bought his car.

As responsible parents of two growing children, the Mazda CX-5 seems to be a good choice: it's not quite as safe as a Volvo, not quite as fuel efficient as a Prius, not quite as big as a typical SUV, not quite as small as - well, as a smaller car. Mazda Mike was very happy to take us for a test drive. He knew a lot about car engines and there was even a My Little Pony set in the showroom that Iola was allowed to play with. It's probably a good option for us.

... But, in the showroom next door there was a Ford Mustang Bullitt. It wouldn't make any sense: it's too small on the inside and too big on the outside, it's fuel hungry and lacks both safety features and space for the dog. But there is something utterly American about it - Springsteen's dream of the open road, Waits' freedom of the full tank of gas on a Saturday night, the Eagles' hitch-hikers' paradise of 1970s' desert roads...

I'm fairly sure that, now that we're grown-ups, we'll take the safe option. I am sure that the Volvo Bob's and Albanian Idris's and Mazda Mike's will applaud our decision. It's just that it isn't quite the same as the things we dreamed about when we were growing up.

Snowing alone...

Robert Putnam wrote about the loss of community in American society in the book Bowling Alone. He argues that Americans are increasingly disconnected and isolated from one another. People are less likely now than in the past to be part of social organizations; they are less likely to be involved in communal activities; they are less likely to know their neighbors and local community. People spend more time alone in their own houses - watching tv, playing computer games - and travel alone in their cars to workplaces where they are less likely to participate in trade unions. Children don't play out together. I've read the book a couple of times and, to be honest, I have never really appreciated the full significance of his message because English society is as atomized and isolated as the America he describes. Living in New England, however, has allowed me to better understand the significance of the book's message. It's not the society which he describes now which is the book's real focus, it's the nostalgia for a way of being which Putnam feels has been lost.

America conforms to an 'American' way of doing things in a way that is almost impossible to imagine happening in England. For example, at Thanksgiving everyone eats turkey. In the lead-up to Christmas, English magazines are filled with alternatives to turkey. The focus is upon doing things differently, being individual. For American Thanksgiving there is no such diversity or suggestion that you might want to improvise. It's Thanksgiving - you eat turkey. At my writing group last week, the women spent half an hour discussing the advertisements which were broadcast during the Superbowl. When I explained that this seemed a bit weird to me as an Englishwoman, they talked about how great it was that a person living in Texas would have seen the same advertisements (which were focused upon a particularly normative way of American life) as someone living in New England. It is a moment of convergence; a way of navigating the size of America; a way of creating tradition within a relatively new country formed from a diversity of ethnic immigrant traditions; a way of averting one's eyes from some of the horrors of this country's history.

And one of the reasons why Americans get so excited about big weather events is because they provide an opportunity for convergence, in the same kind of way to Thanksgiving, a big league football game, or a rousing rendition of the National Anthem.

1. Anticipation
The storm was anticipated for nearly a week before it arrived. Weather forecasting is taken extremely seriously in New England. I realize, when writing this, that I have three separate forecasts stored as bookmarks on my web screen. This is not remotely excessive. Most New Englanders access forecasts from several news channels, websites, radio programs and then triangulate them with friends, families and complete strangers in supermarkets. Conversations about the weather tend, therefore, to be quite lengthy and extremely well informed. The weather is something that affects everyone - Republican or Democrat, Christian or Jew, 99% or aspiring 1% - it's a safe area for discussion and it's an area where one has the sense that 'we're all in this together'.

2. Preparation
In the days leading up to the forecast storm, you spend several hours queuing in a supermarket buying food that you wouldn't otherwise have needed and may well never eat. You drive around the shopping mall car park for a very long time trying to get close to the hardware store where you buy batteries and candles to add to the collection you established, and didn't use, for the last storm. Bakhtin thought that 'carnival' served a crucial role in social life through providing a counterbalance to all the social norms by which we have to live for the remainder of the year. On those carnival days, social norms can be broken and people can engage in behaviors which are normally forbidden. Shopping in the lead-up to a 'major weather event' (or Thanksgiving, or a superbowl game) serves the same purpose as Bakhtin's carnival. You can be rude, offensive, and downright vicious with your shopping trolley... this is the only time that you are not expected to conform to the exquisite social manners of the average New Englander. As a sociologist, the supermarket is fascinating at these times. If you need a pint of milk, it's hell.

3. Arrival
Once the storm arrives, you are socially obliged to do what you are told - which is to go into your house and not come out until the news channel tells you that it is ok to leave. New Englanders tend to be fairly obedient on these occasions. For example, the Governor of Massachusetts advised New Englanders to hunker down  and stay inside for Nemo and the roads were empty from lunchtime on Friday. The Governor then got cold feet (sorry) and decided to be more assertive. During the snowstorm, anyone who drove their car (except for emergency workers) was liable to a $500 fine and up to a year in prison. On Saturday, people listened to their radios and watched the news channel, waiting for permission to get back into their cars. Typically, New Englanders feel that the English government is overly regulated... I can't imagine anyone making this kind of ruling in England, even though it was clearly beneficial in enabling the snow plows to do their work.

4. Clean-up
The clean-up to a storm is everyone's responsibility. After the catharsis of behaving selfishly in the supermarket, people become hyper-social following the storm. This is the vision that Putnam has of the America of the past. When you've cleaned your own patch of sidewalk of snow, you help out your neighbors. You make coffee for the guys who are driving the snow plows - they  aren't employed by a council, they are self-employed and they work extremely hard. You watch out for one another's kids. You put out seed for the birds and salt to stop the old ladies slipping on the sidewalk. And there is something truly idyllic about the way that people momentarily come together. In relation to Nemo, this was enhanced by the fact that no-one was allowed to drive. There were no cars on the road. And the sky was blue and the sun was shining... After cleaning up, it seemed that the entire Cambridge community took their children sledding on a nearby hill.

 5. And then happily ever after...
And then you dig out your car and everything returns to normal. The roads are clogged, people leave chairs at the side of the road so that no-one uses their carefully dug-out car parking space, front doors are closed against the street. After Nemo, it even started raining - just to add to the general disappointment (and the officials who define such things decided that it hadn't been a blizzard anyway).

I think that at some level people miss the communality that a big storm creates. That's maybe one of the reasons why we watch the weather forecasts so closely. We want our moments of carnival, our moments of feeling like we belong to a community, before we return to the isolated lives that Putnam describes.

Lady Gaga, full frontal snogging, and gay rights on the yellow school bus

As I understand it, the conversation on the school bus went a little like this...

"What are you reading at the moment, Maya?" asked Kammai.
"I've just finished 'Angus, thongs, and full frontal snogging'," replied Maya.
"Any good?"
"Quite. There's some funny rashing, but it's only really about boys fancying girls and girls fancying boys. At one point they tease the teacher about being lesbian."
"Oh." Kammai looked out of the window as the driver took a wrong turning. "It's the same in 'Know your body' at school. We learn all this stuff about sex, but it assumes that it's only between a girl and a boy."
There was a pause while the bus tried to squeeze into a space smaller than itself so that it could get past the garbage truck.
"I want to teach people that being gay is ok," stated Maya.
"Okay or normal?" said Kammai. Kammai is eleven. She has a more sophisticated understanding of this entire debate than most members of congress.
"What's the difference?"
"Well, if it's okay then people might still be thinking it's weird. Whereas if you teach them it's normal, then they will think it's normal not weird."
Maya thought for a little while. She thought about her wonderfully extended family filled with people who were gay, straight, and bisexual. She hatched a plan.

When she arrived at school, Maya asked her teachers if she could have a lunchtime meeting with them. She proposed writing a PowerPoint presentation to be given in each advisory in Middle School about the fact that being gay was normal. She argued that the curriculum was prejudiced: not just against children who were, or might be, gay but against all children in teaching them that one kind of sexuality was normal and ignoring others. The teachers listened and agreed. Then Maya told her friends and people she knows at school about what she's doing and she's gathered the names of people willing to support her.

Since then, all her spare time has been spent on the internet trying to find quotes and evidence about being gay or from people who were gay - American football players, film directors, pop stars, writers and poets, actors, politicians.... She's gathered facts about the percentage of the population who are gay and worked out the likely ratio of her school population. She's thought about the philosophical importance of recognizing each person's individuality and the problems of using any kind of label. The only major problem she's come up against is that she can't find a quote from Lady Gaga which talks about being gay without using swear words. Maya doesn't think it's right to use swear words in school as some people might find them offensive.

My wish is that both Maya and Iola fall in love with people who love them and who bring them joy. People with whom they can achieve a richer kind of happiness than that which would have been possible alone. It's likely that those imagined future partners might think that my girls are a bit weird for having their mixed-up English/American accents; and it's inevitable that Nathan and I will think that these partners are weird for their taste in music and fashion.That's what parents do, right? Everything else is just normal.