Dafydd’s story

A short story for our times:

Vodka had never been is tipple but it was doing the job now. A beer man by habit and taste. His father had given him the advice early in life “let your stomach control your intake”. Dad’s favourite became brandy as he aged. To Dafydd the modern phenomenon of shots had never appealed, leading as it did to falling over drunkenness. He had grown up believing that the measure of a drinker was how well they held their booze not how drunk they got.

The vodka was hot but light and was doing the job.

Dafydd smiled as he thought about TLAs and their role in his life. Those TLAs or Three Letter Acronyms started with BDS – the light at the end of the 5 year university tunnel.

He had always thought that a university education would something wonderful; discussions about the meaning of life, time to think and debate and the opportunity to expand one’s intellect. Instead dentistry was a sausage machine with elements of confrontation and humiliation which left him feeling that he was never quite good enough.

The five years introduced more TLAs – DSA, MOD, RCT, PJC, BJC, TMJ, FGC & IDB the list seemed to go on forever.

The BDS led to being accepted by the GDC, the shadowy “big brother” that must always be obeyed even if its actions and behaviours in recent years made it lack credibility. More money for less  accountability and even less representation, more bureaucracy more interference. But they wouldn’t be getting their £576 next year.

First had come hospital jobs, the one as an SHO at KGH the best, happy years treating trauma from RTAs and alleged assaults whilst living in the artificiality of the hospital residence. But then came the FDS and he had exhausted his patience with exams so there wasn’t the devotion that would lead to fellowship of the RCS.

General practice beckoned; not a bad direction, 90% of dentists become a GDP, why not you Daf? So came the PCT and SHA, getting approval from the DEB for a PGT. From day one he was uncomfortable ensuring the available treatment fitted the patient. In order to earn money in the NHS one had to know “the system” and make it work for you. If you’re giving an IDB then better to do two MODs he was told. Ensure you don’t just do a S&P, do a PGT if you can. Don’t do anything that might make the DPB /DEB suspicious. Suspicious of what? He was hoping that he was treating every patient, every time on their merits.

He soon realised that people were frightened of him and what he did but not how he did it. His hospital years had left him pretty slick with needles for IV sedations so he saw the “phobics”. Tourniquet, open  & close your fist, butterfly into the AC fossa and off you go. Some of the early days were pretty hairy with cocktails of drugs but Hypnovel sorted that out.

Hypnovel, good old Midazolam what a lovely drug, profound amnesia, oblivion. Finding his own AC fossa had been easier than he would have thought.

Eventually he had started his own practice, doing things his way, his patients liked him and his earnings were good but there was still something that gnawed away inside him, the gremlin on the shoulder whispering “you’re not good enough” in his ear. He had worked hard as he had been taught, was always available for patients preferring to do his own on call. For many years a week was as long a holiday as he allowed himself blaming cash flow but really not wanting to let anyone else have to see “his” patients.

It had been another of those TLAs that had been the last straw. The Care Quality Commission or CQC, really was the bogeyman. It arrived untested and uninvited to hammer General Dental Practice into the pattern and shape that it decreed.

Dafydd had spent hours going through protocols and procedures, night after night at the practice. His wife suspected him of having an affair, “chance would be a fine thing” he said, and he had forgotten what his kids bath and story time was like. Some of his mates had bought one of the off the peg solutions but Dafydd was a perfectionist, he had to know what was in his practice manual, he had to have his mark on his practice’s policies.

His eyelids were heavier now, the peak flow from the Quantiflex machine adding to the feeling of beautiful relaxation.

The inspector had rung yesterday to give the polite 48 hours notice. His receptionist had come and told him about the call and seemed to think it funny about his panic, none of them seemed to realise how important this was. His nurse had admitted to him that she had stopped flushing the chair water lines a month ago and couldn’t see the point of keeping the autoclave records. “How can you expect me to be cleaning instruments, bagging them, dating the bags in one room and chaperoning you at the same time in another, Dafydd?”

She was right of course, it couldn’t be done and reach his UDA targets too. He was doing the wrong job, everyone else had coped with the changes, he was obviously a failure.

Before reaching for the bottle’s blue screw top, he had laid out all the protocols one by one on the reception desk. He had telephoned his first patients for the next morning and apologised for having to postpone their appointments.

Lying back comfortably in the memory foam of his dental chair 70ml of 90 deg proof vodka coupled with 30mg of Midazolam and Nubain running through his veins all topped up with Nitrous Oxide; he felt no more pain.

No frustration at the BDA for not protecting the small guy.

No anger at Barry Cockcroft over the new contract.

No resentment for the PCT that had allowed the 8-chair corporate to open across the road from him.

No fear of the CQC.

Dafydd felt nothing at all.

The next thing he knew was John Humphreys’ voice. Humphreys the Cardiff High School boy. Yet another who had made it from Splott – like Terry Nation the man who invented the Dalek. It was 6.50 am, he had the school bus run to do before heading for the practice. The practice! He often wondered how long he went between clock radio alarm and thoughts of the practice – sometimes (especially if Humphreys was grilling an NHS representative) the thoughts were there before his eyes opened.

It hit him, today was CQC day. Showtime Folks! Not a bad hair day today. Time to shine; time to show that his was a pride of practices. Sod the CQC, stuff the PCT & *****ks to the GDC. He had finally bitten the bullet two days earlier, he was holding a beauty contest with the three top plan providers over the next fortnight. His days of deference to the NHS apparatchiks were behind him. A late cancellation on Tipton’s restorative course had cemented the deal with himself; he had the second half of his career to consider and it wouldn’t be chasing UDAs.

But there was something troubling him, a disquieting image at the back of his mind that he couldn’t quite recapture.

Sod it! No time to worry about dreams.

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