We found Iris’s home between a cornfield and a lime green house—a little white trailer with no address. As our cars crunched onto the gravel driveway, Iris and her puppy, Osito, froze to examine us before resuming their game of tag. The nurse practitioner, the Spanish interpreter, and I, the medical student, unfolded ourselves and the plastic chairs of our makeshift clinic from the hot cars. I saw Iris’s mother, her skin dark and wrinkled like a used coffee filter, edge out of the trailer’s shadow. A childhood spent growing coffee in Mexico and eight years of picking corn and oranges up and down the Eastern Seaboard made her look far too old to be the mother of a five-year-old. Reserved and stoic, she usually waited until we approached her, but today she marched right up to us. There were tears in her eyes.
“Can you please look at Iris’s rotten tooth?” she asked. “Her face swells when she’s in pain, and it hurts me to see her crying.” She told us that a dentist in Florida had given them pain medicine and offered to pull the tooth, but they moved camps before he had the opportunity. Plus, they’d had no hot water, gas for cooking, or bathrooms for a month. Iris cried each night because she was afraid to pee in the dark fields. Their family had been too busy trying to survive to find and pay for a dentist.
After dunking Osito in a giant tub of water, Iris bounced over, full of five-year-old resilience. “Open your mouth, Iris!” the nurse practitioner commanded cheerfully. We could see the cavity without a light or a mirror: a huge, caramelized mass of brown and gray festering in the back left corner of her mouth. Iris needed to get it removed as soon as possible, the nurse practitioner explained, which meant one of her parents would have to stop working long enough to take a car service to the pediatric clinic an hour away—a significant sacrifice for someone earning $7.25 an hour. We gave them money for transportation and made an appointment, but it was all we could do. We didn’t even know what address to give the car service.
The next week after our rounds at other migrant camps, we returned to check on Iris. Again, it was open wide, Iris, and again, the smell of decay. Her mother had forfeited several hours of work to go to the clinic, but the dentist said that he couldn’t operate until the infection in her mouth cleared. He gave her antibiotics and another appointment. And now, we discovered a new problem: Iris’s mother couldn’t read, and had misinterpreted the instructions for Iris’s medicine, giving her only half the appropriate dose. We corrected the mistake, called for another appointment, gave more money for the car, and crossed our fingers.
Later that week, I happened to have a checkup scheduled with my dentist, who specializes in treating children who were afraid of the dentist. Obsessive about dental hygiene ever since traumatic childhood experiences with orthodontics, I was my dentist’s darling. He always complimented me on my brushing and flossing, and told me that I was one of few patients who had perfect wisdom teeth. But when I arrived at the office, I discovered to my dismay that I was too old to see my friendly, hands-off pediatric dentist. The heartless adult dentist who took his place promptly informed me that I needed to get my wisdom teeth pulled. Disbelieving, I paid $200 for a second opinion from a dentist in an even fancier downtown office. He only confirmed my fears. The teeth had to come out, or else I’d face future infection and decay.
Driving home, I cried. I was afraid of the anesthesia, afraid of possible nerve damage, and above all, afraid of pain. But Iris’s tooth floated in the back of my mind, scaring me into compliance. When I tearfully confessed my fate to my mother, she promised to cancel her plans so she could take care of me after the procedure. An Internet search directed me to a five-star oral surgeon whose patients described their experiences getting teeth pulled as “enjoyable” and “pleasant.” The day approached, my dread growing steadily.
On the Monday before my surgery, I went back out to the migrant camps. When we arrived at Iris’s trailer, we found her mother wringing her hands with frustration. They’d missed Iris’s appointment, she told us, because no one told them when it was. And when she tried to go to the rescheduled appointment, the transportation service wouldn’t drive them because it was too last minute. We apologized for the ‘miscommunications’ and called the dental clinic. The receptionist told us that Iris had missed too many appointments and couldn’t be fit in for months. Her only chance was to show up and ask for an emergency appointment, which could take hours and wasn’t guaranteed. By this time, Iris had been having trouble eating and sleeping for nearly two months, and her face was swollen yet again.
Only a few days later, it was my turn for the dentist’s chair. I signed waivers on a fancy computer tablet acknowledging that I could suffer nerve damage or die during the procedure. The receptionist informed us they didn’t take insurance, and asked us how we would like to pay. My mother handed over her credit card, and several thousands of dollars were charged onto it. Later, our insurance company would reimburse my family for 80% of the cost. The nurse took me back to the operating room and slipped an IV into the crook of my arm. Open wide, Joanna.
When I woke up, I had a mouth full of cotton. A nurse walked me to the car, and my mother bought me a coconut-flavored snow cone. I took Vicodin just in case I had any pain and swallowed massive doses of penicillin to ward off infection. Much to my little sister’s disappointment, I hardly swelled up at all.
After a few days of ice cream and smoothies, I traveled back to the migrant camp. The more I’d lain on the couch convalescing, the guiltier I felt. Why hadn’t I driven Iris to the clinic myself? “You should have!” my sister cried when I confessed my remorse to her. “Imagine what it’s like for her!” I vowed that if Iris wasn’t better the next time I saw her, I would take her.
When I knocked on the trailer’s aluminum door, Iris answered with a big, holey smile. Her two front teeth were gone. Her mother told me that the dentist pulled several of Iris’s other teeth, but not the infected one, because she hadn’t taken the right antibiotic. He promised that he would call and schedule yet another appointment at an adult clinic closer to the migrant camp. So far, they hadn’t heard anything.
“Look, they pulled my teeth!” Iris told me with a grin. I grinned back.
“Did the tooth fairy come?” I asked. She gave me a puzzled look.
“They pulled my teeth out last week, too,” I said to cover up my mistake. She wrapped her arms around me.
“Did it hurt?” I asked. She nodded, smile gone. I didn’t tell her that mine hadn’t hurt at all.