2024-07-26 09:45:13
– You treat patients with severe disabilities. How did it all begin?
– I have been working at the Žalgiris clinic since 1992, when there was still a branch of the Red Cross hospital here. Now everything has changed so much. I remember that there was a neurology department on the second floor, and inpatient beds appeared on the third floor.
At that time, this office of mine, where I now treat the disabled, had a massage therapist, and there was an acupuncture office behind the wall. That was the beginning. I remember that at that time I was working in a polyclinic, and here, at the Žalgiris clinic, training courses were held. After one such course, I was noticed and invited to work here.
After the birth of my daughter, I returned to work in a hospital where patients are prepared for operations under general anesthesia. I became intensely interested in anesthesia. Professor Irena Balčiūnienė, who 25 years ago was a true pioneer of dental treatment of the disabled with general anesthesia in Lithuania, probably had the greatest influence on this interest of mine.
– What is special about your work?
– Today I am a dentist in general practice, I treat patients under general anesthesia, I have the highest qualification category. I treat people with disabilities, whose most common diagnosis is cerebral palsy, mental retardation, schizophrenia, non-contact. It’s work with people who don’t sit in a chair, they can’t scream, they can’t say, sometimes they run, sometimes they fight, they scream.
Most of the time there are four of us, sometimes we need additional help. The biggest challenge is until you put the mask on, until the sedation kicks in. (Sedation is a desensitization, incomplete intravenous narcosis without the need to intubate the person.)
But this work is not really motivated by money. Disabled patients who come to the Žalgiris clinic usually have very complex, long-standing problems, and very often these are teeth that have not been cleaned for many years.
Such is the specificity of my work that I have to know not only dentistry, but also many related diseases, how they affect the patient’s whole body. For example, Down’s syndrome or cerebral palsy is accompanied by heart, lung, and systemic diseases. Then we have to get the cardiologist’s permission before doing the procedures.
And here, let’s say, schizophrenia, autism have fewer comorbidities, but there is a high sensitivity to the environment.
But there are also cases when we cannot anesthetize the patient. Then we work in a brigade. We invite an anesthesiologist next to us, we play, we talk. The anesthesiologist is always ready. It is necessary to understand that it is not only the healing of a tooth: a disabled patient who comes for teeth may not leave at all. It requires a very special and responsible preparation.
– Why are you attracted to such challenging work?
– This is my work, really mine. That’s my way, my character, and that’s probably why this job suits me so well. I survive because of my patients. I care about them.
Sometimes my colleagues ask me if I’m bored. But this is my niche. Even my nurse has been working with me for 12 years!
– What patient stories stick in your memory the most?
– Oh, there are all kinds of stories. I remember one such girl who has a very severe form of cerebral palsy. Her body weighs maybe 20 kg, although she is over 20 years old, all twisted. With such a diagnosis, patients usually do not chew food and therefore have very long tooth roots. The teeth are still damaged by the plaque, and they cannot be treated, and the movements are not controlled. Her mother brings her, her front teeth are damaged to the core, I understand that they should be pulled. But then I think, what will it look like? Then I tell my mother – I fix the front six teeth, fill them. It’s difficult because you don’t take care of your teeth, you don’t think about beauty, but only to heal, only to not hurt.
In all cases, I tend to protect the teeth, so that at least the facade remains, even if the person himself does not chew.
I remember such cases when I have been treating patients since childhood, and now the patient is an adult man. Previously, his parents brought him, but now he lives in social housing, accompanied by nurses.
I was just treating my patients grandson today! When I was 26, I started treating parents, then their children, now children’s children are coming.
Patients come to us from all over Lithuania. From Kaunas, Klaipėda, Visaginas…
I think about them, I remember.
– What makes your heart ache the most in this job?
– I always think that my disabled patients are also people, they also suffer. Only they don’t always tell. Can’t say. Each of us could and still can be in his place. Sometimes my heart squeezes to the point of tears, as I feel sorry for my parents… I got a little used to disabled people and to anesthesia. But my empathy and support for parents always remain.
– When you look at disabled patients, what do you think about us as a society? Are we making enough effort to make them feel comfortable and dignified?
– I think that some kind of change for the disabled started together with the Independence of Lithuania, with the accession to the European Union. However, as a doctor, I also see gaps.
One of them is mandatory dental check-ups in schools. Now it is only the responsibility of the parents and it seems to me that it is not good. And in the past, people with disabilities were completely isolated, as if they were a shame for their parents. I had such close examples. I had to visit a home for the disabled as a child. It was very painful to see that separation.
Since I have been working with disabled people for a really long time, I have to treat and communicate with the presidents of their communities. You know, those people taught me a lot. First taught what compassion is. In order to restore the dignity of such people, we need more education already in school. I think a lot of things come from childhood, from family, from school.
I myself am indifferent, but in medicine, I think everyone should be, because otherwise – what are you working for? Although I really don’t think that all doctors are cynics. This is not true.
First of all, I taught my daughter and me compassion, to notice others, to care. To have as little “I” as possible, less of that ego. It seems to me that the situation of each patient should be looked at in a broader, more human way, not only technically, that it matches or does not match the numbers and the norm. And the youth, I notice, are quite categorical now. In my opinion, individuality is needed, to look at each specific situation.
– Do you see a vision of the future, how we could treat the disabled? How could the Žalgiris clinic look like in the future?
– It seems to me that this format, as it is now, is really not bad, but everything could be more, so that queues for procedures are shorter, and the human resources of doctors are greater.
The worst is the queues, and everything else is done as best and professionally as possible.
– Why do disabled people wait a year and a half for a dentist or surgeon at the Žalgiris clinic?
– Everything depends on the capabilities of the clinic. If there was a larger anesthesiology service, we could certainly do more procedures. One doctor can accept about 10-14 such patients per month.
And the procedures take quite a long time, there is really a lot of work here. The whole process depends on how many and what kind of co-morbidities the patients have. Often we only have 2 hours for the entire job and can only work on one side of the jaw. After sedation, a gap of 3 months must pass, then we handle the other side of the jaw.
– Do you feel the meaning of such work?
– I love and enjoy my work, even if I haven’t been able to make a fortune from it. Sometimes I get so tired that I say, maybe I could go drive a trolleybus, after all, everything is very simple and clear there.
But I miss my patients. I am good at communicating with them. This is my work, my mission.
2024-07-26 09:45:13